The paper gives a systematic account of the basic concepts, genealogical classification, chief research contents and application scope of computer supported cooperative working (CSCW). It expounds the modes of CSCW when applied to telemedicine. These include the asynchronous, non real time mode of medical consultations via e mails in telemedicine activities, the real time interactive mode of long distance, real time consultations and operation guiding activities via video conference systems, and the mode of client computer/server in telemedicine education activities.

Adolescent ; Adult ; Age Determination by Skeleton ; methods ; Child ; Child, Preschool ; China ; Diagnosis, Computer-Assisted ; methods ; Female ; Humans ; Male

Objective To explore the application value of endoscopy in the diagnosis and treatment of patients with gastrointestinal bleeding.Methods The clinical data of 74 patients with digestive tract hemorrhage underwent gastroscopy and treatment were retrospectively analyzed.The effect of gastroscopy was compared at different time and different treatment methods.Results Endoscopic examination showed 23 cases of duodenal ulcer disease (31.08％),including 15 cases of gastric ulcer(20.27％),10 cases of acute gastric mucosal lesion (13.51％),8 cases of gastric cancer(10.81％),gastrointestinal complex ulcer in 7 cases (9.46％),4 cases of gastritis (5.41％),anastomotic ulcer or erosion in 4 cases (5.41％),no lesions in 3 cases (4.05 ％).71 cases were clearly diagnosed by gastroscopy,the detection rate was 95.95％,the hemorrhage in 48h positive rate was 100.00％,which was significantly higher than 87.50％ of the hemorrhage 48h detection rate (x2 =13.33,P ＜ 0.05).71 patients received endoscopic treatment,67 patients were successful,the success rate was 94.37％,the injection of hemostatic success in 16 cases (94.12％),spraying hemostasis successfully in 51 cases (94.44％),there was no significant difference (x2 =-0.01,P ＞ 0.05).Conclusion In the patients with gastrointestinal bleeding,gastroscopy has advantages of high diagnostic accuracy,accurate curative effect,can shorten the bleeding time,improve the success rate of hemostasis,improve the prognosis,with high clinical value.

Treatment of hormonal refractory prostate cancer (HRPC) is nowadays a challenge in the clinic. Although different types of treatment such as chemotherapy, radiotherapy, biotherapy, and radioisotope treatment have been used, their effects on patients' survival is uncertain. Docetaxel plus prednisone has been confirmed to be the first line regimen, which can effectively increase patients' survival. Zoladronic acid has been demonstrated to be efficacious in reducing bone related events, and has been widely applied in bone metastasis of prostate cancer. Targeted therapy is currently under intensive investigation for HRPC treatment, and many early clinical studies have shown their effective results, and further studies with larger samples may prove their efficacy. This review will cover different topics in terms of the treatment of hormonal refractory prostate cancer and update the progresses in recent clinical trials.

Objective To determine the 50%effective dose (ED 50) of dexmedetomidine for sedation in the brachial plexus block, so as to provide reference for clinical. Methods Twenty-three patients underwent the brachial plexus block using an ultrasound guided technique. After blocked for 30 min, the dexmedetomidine was infused by a intravenous continuous pump,and an observer' s assessment of alertness/sedation score (OAA/S) and auditory evoked potential index (AEPI) were used for monitoring the depth of sedation. The dexmedetomidine was adjusted according to the response of the previous patient using a up-and-down sequential method until the sequential response curve appeared seven fold points. The initial dexmedetomidine of the first patient was 1μg/kg. Each time the dosage increased/decreased by 0.1μg/kg. The OAA/S score of no more than 3 was defined an effective sedation. Results The ED50 of dexmedetomidine for sedation was 0.78μg/kg (95%CI 0.66-0.86μg/kg). The AAI was positively correlated to the OAA/S score, and linear regression equation was Y=-1.43+0.109 X, R2=0.919. Conclusion The ED50 of dexmedetomidine for sedation in the brachial plexus block is 0.78μg/kg (95%CI 0.66-0.86μg/kg).

Objective To study the changes of serum IFN -gamma,TNF alpha and IL -10 levels in ulcera-tive colitis and its relevance to helicobacter pylori infection.Methods 80 UC patients were selected as the research object,and 50 cases of 80 patients were in the activity stage of UC,30 patients were in remission.In the 50 patients with active UC:14 cases were mild,26 cases were moderate,and 10 cases were severe.30 healthy subjects were set as healthy controls.Detection of serum IFN -gamma,TNF alpha,IL -10 levels and Hp infection were made.Results The serum TNF alpha and IL -10 levels of the activity group were higher than those of the remission group and the control group,the difference was statistically significant[TNF alpha :(54.75 ±5.92)ng/L vs.(23.69 ±4.15)ng/L vs.(20.45 ±4.01)ng/L,F =36.79,P =0.000;IL -10 :(35.16 ±6.72)ng/L vs.(25.12 ±5.37)ng/L vs.(23.96 ± 5.21)ng/L,F =35.68,P =0.000],the serum IFN -gamma level of the activity group was lower than those of the remission group and the control group,the difference were statistically significant[(14.98 ±3.15)ng/L vs.(26.06 ± 4.31)ng/L vs.(27.16 ±4.39)ng/L,F =35.68,P =0.000].As the aggravating of patients with UC in activity stage,TNF alpha and IL -10 levels showed a trend of increase(F =32.81,24.95,all P <0.05),while IFN -gamma showed a trend of reduce(F =22.29,P <0.05).In 50 cases of active UC patients,18 patients with Hp positive, 32 cases were Hp negative.In active UC group Hp positive patients'serum TNF alpha and IL -10 levels higher than the Hp negative patients,the difference was statistically significant(t =4.62,4.35,all P <0.01).Serum levels of IFN-gamma of active UC patients with Hp positive group was lower than the Hp negative patients,the difference was sta-tistically significant(t =5.91,P <0.01).Conclusion In active UC patients expression of TNF alpha and IL -10 are high,and IFN -gamma expression is low.The expression of IFN -gamma,TNF alpha and IL -10 are closely related to Hp infection.

ObjectiveTo establish a method for rapid identification of bloodstain age.MethodsUnder laboratory conditions(20 ℃, 25 ℃and 30 ℃), an integrating sphere ISR-240A was used as a reflection accessory on an UV-2450 UV-vis spectrophotometer, and a standard white board of BaSO4 was used as reference, the reflection spectrums of bloodstain from human ears’venous blood were measured at regu-lar intervals. The reflection radiosR541 andR577 at a specific wavelength were collected and the value of R541/R577 was calculated. The linear fitting and regression analysis were done by SPSS 17.0.ResultsThe results of regression analysis showed thatR2 of the ratios of bloodstain age to UV visible reflectivity in specific wavelengths were larger than 0.8 within 8 hours and under certain circumstances. The regression equation was established. The bloodstain age had significant correlation with the value ofR541/R577.Con-clusionThe method of inspection is simple, rapid and nondestructive with a good reliability, and can be used to identify the bloodstain age within 8 hours elapsed-time standards under laboratory conditions.

[Objective] To understand Chinese scholars in different periods on the different understanding of tongue, for further development of research and provide a theoretical basis. [Method] Access to a large number of ancient books and literature, selection and tongue of related articles, extract and summa-rize the main points. [Result] The ancient understanding of TCM tongue is very knowledgeable, and by the subjective leading generation, does not have the scientific rigour;modern research of Chinese medicine tongue is mainly from the tongue and tongue color, tongue shape and other aspects, the objec-tive diagnosis and analysis system, the research methods of modern TCM tongue with scientific rigor modern Chinese Medicine; from the point of view, different degrees of col aterals and the width of the color purple tongue, sublingual y reflect the progress of the blood stasis degree and disease conditions, different diseases have different characteristics of the tongue. [Conclusion] Research on the development of modern tongue made certain contribution to TCM development.

Abstract?AlM: To study the number of myogenin - positive activated satellite cells in the inferior oblique muscles and the medial muscles of V- pattern exotropia with inferior oblique overaction, to further explore the possible etiological factors of V-pattern exotropia with inferior oblique overaction.? METHODS: The inferior oblique muscles and the medial muscles were cut from V - pattern exotropia patients with inferior oblique overaction during strabismus operation treated as the strabismus group. Cross sections were stained immunohistochemically for the presence of activated satellite cells, as identified by myogenin immunoreactivity. The inferior oblique muscles and the medial muscles were obtained from the corneal transplant donors ( six eyes of six cases) , which treated as the control group.? RESULTS: The frequency of myogenin - positive satellite cells of the inferior oblique muscles was (22. 7± 7.03)% and (4. 2±0. 75)% in the strabismus group and the control group. Significant differences existed in the expression of myogenin in two groups (P<0. 05). Again, the frequency of myogenin-positive satellite cells of the medial muscles was (2. 2±0. 75)% and (4. 5±1. 05)% in the strabismus group and the control group. Significant differences also existed in the expression of myogenin in two groups (P<0. 05).?CONCLUSlON: lt is first report that myogenin-positive satellite cells presents in extraocular muscles of V -pattern exotropia with inferior oblique overaction. The current results suggest that myogenin is one of possible etiological factors of V-pattern exotropia with inferior oblique overaction.