The design principles of healthcare wearable devices: ambient intelligence, service continuity, and micro-context provide more choice and solutions for the healthcare and social needs, and have the potential to be an integral part of the modern health care system. The use of wearable devices will contribute to the innovation of healthcare data acquisition and healthcare behaviors, the promotion of health consciousness and literacy, it also benefits the patient education, clinical pathway, medical model and health management performance.

Objective To analysis the efficacy and safety of endovascular graft exclusion for patients with Stanford type B aortic dissection.Methods The clinical data of 46 patients with Stanford type B aortic dissection who received endovascular graft exclusion were analyzed retrospectively.The stents were inserted from the femoral artery to exclude the tear of dissection,and all operation were peformed under digital subtraction angiography (DSA).The operative technique,outcome and complications were observed.Results The stents were successfully performed in all patients.The length of stay in hospital time after operation was 5-20 (12.9 ± 3.4) d.Endo-leak occurred in 2 patients and relieved after re-expanding.Followed up for 2 d to 5.1 years,average 36 months,1 patient got lacunar infarction and 1 patient died after leaving hospital 2 d.The others were free from the serious complications such as aortic dissection and paraplegia.Conclusion Endovascular graft exclusion is safe and effective for the treatment of Stanford type B aortic dissection in hospital and mid-term,and can significantly improve the survival rate and quality of life.

Objective To retrospectively investigate the clinical features of localized primary small bowel stromal tumors (SBSTs) and the impacting factors for prognosis.Methods The clinical and pathological data of 89 consecutive SBSTs patients,with pathologically confirmed,who underwent complete resection in Ruijin hospital between January 2003 and September 2007 were collected and analyzed.All patients were followed up for assessment of tumor recurrence and metastasis.The impacts of clinical and pathologic factors on rate of disease free survival (DFS) of the patients was evaluated.Results In total of 89 follow-up patients,15 patients were diagnosed with tumor recurrence and 9 of them died.The tumor size,mitotic index and pathological risk stratification were statistically related with DFS (P=0.000,P=0.006,P=0.000,respectively) by using Kaplan-Meier univaritate analysis.Tumor size and mitotic index were proved to be independent prognostic factors for tumor recurrence by multivariate analysis COX regression model.Conclusions Tumor size and mitotic index are related with tumor recurrence,and can be regarded as independent predictive factors of tumor recurrence.

OBJECTIVE:To develop a method for simultaneous determination of 6 alkaloids in Coptis teeta.METHODS:The determination was performed on XtimateTM C18 with mobile phase consisted of 30 mmol/L ammonium bicarbonate [containing 0.1％ triethylamine and 0.7％ ammonia-acetonitrile (gradient elution)] at the flow rate of 1.0 mL/min.The detection wavelength was set at 270 nm,the column temperature was 30 ℃,and the sample size was 10 μL.RESULTS:The linear ranges of jateorrhizine,columbamine,epiberberine,coptisine,palmatine hydrochloride and berberine hydrochloride were 0.85-16.96 mg/L (r=0.999 9),1.25-24.96 mg/L(r=0.999 8),2.05-40.96 mg/L(r=0.999 9),3.65-72.96 mg/L(r=0.999 9),2.88-57.60 mg/L(r=0.999 9) and 13.25-264.96 mg/L(r=0.999 9),respectively.RSDs of precision,stability and reproducibility tests were all lower than 3.0％.Recoveries were 97.14％-102.14％ (RSD=1.93％,n=6),97.00％-102.00％ (RSD=2.06％,n=6),98.18％-101.82 ％ (RSD=1.79％,n=6),96.15％-101.28％ (RSD=2.06％,n=6),96.88％-101.88％ (RSD=1.87％,n=6),99.31％-103.76％ (RSD=1.89％,n=6),respectively.CONCLUSIONS:The method is simple,accurate,stability and reproducible,and can be used for simultaneous determination of 6 alkaloids in Coptis teeta.

Objective To evaluate the diagnostic significance of blood cells and electrolyte in preoperative diagnosis and surgical treatment of Cushing's disease (CD).Methods 116 csses of CD and 21 cases of adrenocortical adenoma (ACA) patients pathologically proven adrenocorticotropic hormone (ACTH) adenoma from Jan.2003 to Dec.2010 were enrolled into the study.They were given transsphenoidal surgery (TSS) and laparoscopic resection of adrenal adenoma (LRAA).Patients were divided into remission group ( group A),non-remission group (group B) and ACA group (group C) according to the remission criteria of CD.The preoperative and postoperative level of blood cells and electrolyte were determined.Results TSS treatment improved the abnormal level of blood cells and electrolyte in patients with CD.Group A had significant change in preoperative and postoperative level of blood cells and electrolyte,while group B and group C didn't.Conclusions Compared with the endocrine examination items which need huge expense and harsh conditions,the change of blood cells and electrolyte level is more superior in assessing diagnostic and cruative effects on CD patients.

Objective To improve the in vivo analgesic activity of acacetin and find leads for the development of new drugs, novel acacetin derivatives containing alkyl amide groups with different length of carbon chain were designed and synthesized according to the molecular structure of the active hit compound found in our previous work. Methods Using apigenin as the initial chemical ma-terial,the acacetin was synthesized through 3 steps,then the target compounds were prepared by conjugating hydroxy group of acace-tin at position 7 with bromoalkyl amides. The analgesic activity of the target compounds was evaluated by acetic acid writhing model of mice. Results and Conclusion Novel acacetin alkyl amide derivatives showed more potent analgesic activities than that of clinical medicine diclofenac,which could be used as leads for further development of new drugs.

ObjectiveTo compare the therapeutic effects of a new surgical endoscopic technique, the transilluminated powered phlebectomy (TriVex System, Smith+Nephew) and pointed phlebectomy in the treatment of varicosis of the great saphenous vein of the lower limbs. Methods Thirty-nine patients (46 limbs) received TriVex operations under spinal, or epidural anesthesia. The powered vein resector and an irrigated illuminator device-a minimally invasive system was used for varicose vein surgery. During the same period, 41 patients (46 limbs) underwent pointed phlebectomy. Results The average postoperative hospital stay was 4.6 days in patients receiving TriVex, and 8.1 days for pointed phlebectomy. Compared with the pointed phlebectomy, the incision of TriVex procedure was shorter and the number less. Conclusion This new surgical device is easy to operate, minimally invasive, efficacious and time saving with satisfactory results.

Objective To evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL), retrograde ureterolithotripsy(URSL) and percutaneous ureterolithotripsy(PCL) in the treatment of proximal ureteral calculi. Methods A total of 397 patients with proximal ureteral calculi treated by ESWL,URSL or PCL ftom September 2001 to December 2005 were retrospectively analyzed. Results Among 397 patients,83 patients with a mean stone size of 1.23 cm were treated by ESW L.Of then.13 patients transferred to URSL or ureterolithotomy and the stone-free rate of ESWL 1 month later was 65.7%(46/70).TWO hundred and thirteen patients with a mean stone size of 1.21 cm were treated by URSL and 101 patients with a mean stone size of 1.50 cm were treated by PCL.The stone-free rate of URSL and PCL 1 month after the treatment was 88.2%(172/195)and 96.9%(95/98),respectively.Eighteen patients in URSL group and 3 patients in PCL group trans-ferred to ureterolithotomy.ESWL had a statistically lower stone-free rate than that of URSL and PCL (P＜0.001),both in patients with stone size≤1 cm and＞1 cm.For patients with stone size＞1 cm,PCL achieved a higher stone-free rate than URSL(P=0.005).PCL also had a higher stone-free rate than URSL in treating patients with stone size≤1 cm but there was no statistical difference between them. Conclusions ESWL can still be used as first-line treatment choice for proximal ureteral stones less than 1cm.For patients with proximal ureteral stones larger than 1cm.URSL and PCL are more proper treatment modalities since they can achieve higher stone-free rate and have acceptable low complications.

Hemangioendothelioma, Epithelioid ; pathology ; Humans

Objective To report the clinical characteristics of prosthetic valve endocarditis (PVE).Methods All 25 cases of definite PVE (Duke criteria) diagnosed at our hospital between January 1992 to December 2008 were retrospectively analyzed. Among them, 7 cases were pathologically confirmed and the others were clinically confirmed with either 2 major criteria or 1 major and ≥3 minor criteria. Their clinical characteristics, underlying heart diseases, previous heart operations, presenting manifestations, causative microbes, echocardiographic findings and prognosis, were studied. Results (1) Although most cases underwent valve transplantations for underlying heart diseases of rheumatic heart diseases and congenital heart diseases, 10 patients were complicated with infectious endocarditis (IE) prior to the operations, 4 of them were PVE. (2) Eleven of them developed PVE within 2 months postoperatively. Fever (100%),major vessel embolism (48%), and anemia (36%) were the most frequently manifestations. Fourteen cases (56%) had positive culture results with 15 causative pathogens, including 5 coagulase-negative Staphylococcus (CNS, 3 were methicillin-resistant coagulase-negative Staphylococcus, MRSCoN), 4 fungi, 2Enterococcus faecalis, 2 Burkholderia cepacia, 1 Stenotrophomonasmal-tophilia, and 1 Streptococcus.(3)Prosthetic valve vegetations, periannular leakage, regurgitation, were the main echocardiographic findings.Transesophageal echocardiography (TEE) revealed 13 PVE who had no positive findings on previous transthoracic echocardiography (TTE). (4) Eighteen PVE (72%) developed peri-annular complications (12 leakage, 3 dehiscence, 2 abscesses, 1 fistula), major vessel embolism, congestive heart failure (16%) were frequently observed, 9 of the 17 patients died in hospital, in spite of intensive managements.Conclusions PVE has a high mortality and is a severe complication for patients who underwent heart surgery. Its causative pathogen spectrum is quite different from that of native valve endocarditis. TTE is not sensitive for some PVE cases.