Objective: To study the determinants that affect patient satisfaction to rural doctors. Methods:Based on survey data of Liupanshui City, Guizhou Province, structural equation modeling analysis was adopted, and the study was mainly from the following four aspects:the image of rural doctors, service quality, quality of diagnosis and treatment, and harmonious doctor-patient relationships. Results: The study found that the quality of diagnosis and treatment had the greatest direct impact on rural patient satisfaction, followed by service quality, the image of ru-ral doctors and harmonious doctor-patient relationships;rural patient satisfaction has a significant impact on rural pa-tient loyalty. Conclusion:Rural patient satisfaction and loyalty to rural doctors is mainly based on kinship and geopo-litical relations;given the state of medical technology, the medical environment, medical equipment, service aware-ness and other restrictions, rural doctors cannot fulfill the “gatekeeper” role, and consequently, the primary health-care system has been severely affected.

TCM believes that apoplexia is a disease of deficiency in origin and asthenia in superficiality. The deficiency is mainly the Qi deficiency and the superficiality is turbid phlegm retention and blood stasis due to Qi deficiency. Therefore, the therapeutic method should treat the origin of apoplexy as well as its superficiality. Based on the pathogenesis of apoplexy of Qi deficiency and phlegm-blood stasis, Naomaitai Capsule was formulated with the functions of supplying Qi to consolidate the origin, activating blood flow, dissipating phlegm, dredging collaterals, and stopping endogenous wind.

Objective To observe the clinical effects of treating petptic ulcer with Complex Tianqi Weitong Capulse.Methods 163 cases of petptic ulcer were randomly divided into a treatment group with 80 cases and a control group with 83 cases.The treatment group was given Complex Tianqi Weitong Capulse,and the control group Was treated with Famotidine and Metronidazole.Results After treatment,the total effective rate in the treatment group was obviously better than that in the control group (P＜0.05);the extinctive time of some clinical symptoms and physical signs in the treatment group were shorter than that in the conutrol group(P＜0.01 or P＜0.05).Conclusion Complex Tianqi Weitong Capulse is effective in treating peptic ulcer.

As a non-invasive examination method, anterior segment optical coherence tomography (AS-OCT) has huge potential in detecting neoplastic epithelial lesion.With AS-OCT, detection and differentiation of ocular surface squamous neoplasia (OSSN) within ocular surface pathologies can be achieved and the diagnosis rate is comparable to that of biopsy.With the development of technology, AS-OCT imaging mode has developed from time-domain OCT to spectral-domain OCT with higher penetrance and resolution, the high-quality images of which are helpful to distinguish the benign and malignant OSSN, enhance the detection rate of OSSN, improve the differentiation of ocular surface tumors, and thus improve the diagnostic accuracy of OSSN.In addition, AS-OCT can help optimize the treatment regimen and effectively monitor the outcome of the disease in the clinical management stage, such as monitoring the recurrence of OSSN and evaluating chemotherapy.In this article, the morphological features of OSSN, the advantages and disadvantages of OSSN auxiliary examinations, the development of AS-OCT, the specific manifestation of OSSN on AS-OCT, the application of OCT in atypical OSSN, as well as the value and limitation of AS-OCT in the diagnosis and management of OSSN were reviewed.

Many cardiac sympathetic changes occur before clinical symptoms being found in heart disease.PET/CT imaging can sensitively detect abnormal cardiac sympathetic nerve function.The recent development of several 11 C and 18F labeled cardiac sympathetic imaging agents is reviewed in this paper.11C-meta-hydroxyephedrine (11 C-HED) and 6-18F-fluorodopamine (18F-FDA) have been comprehensively studied already.N-11C-CH3-dopamine (11C-MDA) and N-(3-bromo-4-(3-18F-fluoropropoxy)-benzyl)-guanidine (18F-LMI1195) are novel imaging agents with potential for clinical application.

Rheumatoid arthritis is one of the most critical diseases that impair the quality of patients' life, but its pathogenesis has not yet been fully understood. Osteopontin (OPN) is an extracellular matrix protein containing Arg-Gly-Asp (RGD) sequence and has been recently recognized as a potential inflammatory cytokine. It is discovered that OPN plays an important role in the pathogenesis of rheumatoid arthritis. It is a bridge between bone and the immune system. This paper reviewed the pivotal role that OPN plays in the pathogenesis of rheumatoid arthritis.

Objective To observe the clinical effects of invigorating the spleen promoting blood flow and removing stasis therapy on hypertension .Methods 104 subjects were randomly divided into 2 groups :control group ,including 52 cases ,which was treated by Benalapril and treatment group ,including 52 cases ,which was treated by Benalapril and herbs ,with a course of 4 weeks .The clinical symptom score ,blood rheology were observed .Results The total effective rate was 92 .31% in treatment group ,which was higher than that in control group ,whose effective rate was 76 .92% (P<0 .05);Improvement of the clinical symptoms and blood rheology were better in treatment group than in control group(P<0 .01) .Conclusion This therapy is quite effective for hyperten-sion and can reduce blood lipid and improve blood rheology .

【Objective】 To investigate the control rate of blood glucose and its influencing factors in type 2 diabetes mellitus patients in Yulin area. 【Methods】 We selected the adult type 2 diabetes patients who visited our hospital from May 2020 to December 2021 as the subjects. Then we collected their basic information (gender, age, household income, type of medical insurance payment, education level, and duration of disease), measured their height and weight, calculated their body mass index (BMI), detected HbA1c, and measured their subcutaneous and visceral fat. The Chi-square test and multivariate Logistic regression methods were used to analyze the influencing factors. 【Results】 The total attainment rate of HbA1c (HbA1c<7%) among 877 adults with type 2 diabetes was 13.34%. The Chi-square test showed that statistical differences in the attainment rate of HbA1c among different ages, family annual income, type of medical insurance, and duration of disease. Further unconditional multivariate Logistic regression analysis model results showed that the HbA1c attainment rate in 18-44 years old group was 0.418 times higher than that in ≥60 years old group (95% CI=0.219-0.799, P=0.008). The HbA1c compliance rate of patients with employees’ medical insurance was 1.744 times that those with residents’ medical insurance (95% CI=1.131-2.782, P=0.013). The HbA1c attainment rate of diabetic patients with an annual family income of 30 000 yuan to 100 000 yuan was 1.873 times (95% CI=1.074-3.266, P=0.027), and with an annual family income of more than 100 000 yuan was 2.649 (95% CI=1.299-5.404, P=0.007) times than that of diabetic patients with less than 30 000 yuan. 【Conclusion】 The blood glucose control rate in adults with type 2 diabetes mellitus in Yulin area is lower compared with the level of the nation and other regions. Age, annual household income, and type of medical insurance payment are independent influencing factors.

Objective 5-azacytidine could induce the diffcrentiation of stem cells into cardiomyocytes (CMs). The aim of this study was to screen the optimal condition for 5-azacytidine inducing differentiation of human mesenchumal stem cells (hMSCs) into CMs, and the effect of 5-azacytidine on adherence, cell vigor and chromosome karyotype ofhMSCs. Methods hMSCs were isolated from human bone marrow and cultured in vitro. The phenotypes ofhMSCs were identified by flow cytometric analyses. MTT test was used to investigate the effect of different concentrations of 5-azacytidine on proliferation ofhMSCs. Four weeks after 5-azacytidine induction, semi-quantitative RT-PCR, transmission electron microscopy (TEM), single-cell action potentials, detection ofcardio-cnzyme AST and LDH, cell adherence, cell viability and chromosome karyotype test were performed. Results The typical morphological features of hMSCs were fibroblast-like in shape, hMSCs expressed CD44 and CD105,and did not express CD34, CD45 and CD31. The optimal concentration of 5-azacytidine was 10μmol/L. The shape ofhMSCs treated with 5-Azacytidine changed from fusiform to polygon or astrocyte gradually, and passaged cells were evenly arranged as polarity structure. Induced-hMSCs connected with neighbouring cells, forming myotube-like structures 4 weeks later. It was confirmed that induced hMSCs shaped myotubule-like structure and had some of micro-histologic structures of CMs by TEM. RT-PCR showed that induced hMSCs expressed cardiac specific product BNNP and early cardio-myogenesis specific transcription factor NKX2.5mRNA. Besides, induced-MSCs led to the weak action potential and secreted cardio-enzyme AST and LDH. There was no significant difference in cell adherence and viability before and after induction. Both hMSCs and induced-hNSCs kept stable normal diploid nucleus. Conclusion The optimal condition for inducing effect of 5-azacytidine is 10 μ mol/L and 24-hour incubation; and under this condition, the adherence, vigor and chromosome karyotype ofhMSCs would not be affected.

Combined antiretroviral therapy ( cART) is widely used for infections of human immune deficiency virus ( HIV) .However , some antiviral drugs can not reach the effective concentrations in central nervous system due to the hinder of blood-brain barrier ( BBB) , resulting in the formation of viral reservoir in central nervous system .BBB is formed by human brain microvascular endothelial cells ( HBMVECs ) , which are connected by tight junction and a thick basement membrane , and astrocytic end-feet.This paper reviews possible mechanisms of BBB hindrance and anti-HIV drug efflux by transport proteins , as well as effective methods to deliver antiretroviral drugs into brain , including the application of nano technology .