The progress and application of teletriage,which is one of emerging telemedicine technologies, is introduced with highlighting its advantages and characteristics. Advices are also given on how to explore this technology in China by learning the experience abroad. Teletriage will be one of the most useful e-health technologies for meeting the great need of medical resources in the innovation process of Chinese medical system.

Objective To analyze the antibody titer value of indirect haemagglutination test(IHA)in 135 confirmed acute schistosomiasis patients,so as to provide the evidence for improving the diagnosis and treatment of acute schistosomiasis. Meth-ods A total of 135 acute schistosomiasis inpatients were selected from 2001 to 2006. They all received the IHA antibody titer de-tection,and the correlation among the age,incubation period,and hospitalization days was calculated. Results The antibody titers of IHA were higher than 1:320 in all the cases. The percentages of 1:640,1:1280,1:2560,1:5120 and 1:10240 were 1.48%,28.15%,35.56%,20.00%,and 14.81%respectively. The mean age was(47.70 ± 14.58)years,average incuba-tion period was(38.03 ± 4.59)days and mean hospital stay time was(15.08 ± 3.79)days. The antibody titer value had no corre-lation with the age distribution(r=0.109,P>0.05). There was a negatively correlation between the antibody titer value and in-cubation period,(r=-0.558,P<0.01),there was a positive correlation between the antibody titer value and hospitalization time(r=0.791,P<0.01),and there were significant differences among different groups(F=17.07,64.53,both P<0.01). Conclusions The antibody titer of acute schistosomiasis cases detected by IHA is 1:640 and above. There is no correlation be-tween the antibody titer value and age,but the antibody titer value is higher,the incubation period is shorter and hospitalization time is longer.

ObjectiveTo investigate and analyze the doctor-patient communication skills of medical students and hereby to explore the efficient training system.MethodsUsing the questionnaires and statistic analysis,we focused on the doctor-patient communication skills of the observed 914 medical students in our college,their awareness of doctor-patient communication and the existing problems in the field.Results96.6％ of medical students realized the importance and necessity of doctor-patient communication,while 62.7％ of them lacked such kind of communication skills.Additionally,some other problems are exposed in medical history taking.ConclusionDoctor-patient communication skills might be the most important prerequisite for establishing harmonious relationship between doctors and patients,improving the quality of medical service and reducing the number of medical disputes.Consequentially,it's time to redesign relevant curriculum,to improve the old-fashioned training methods,to enhance the practice of doctor-patient communication training.Furthermore,improvements of teaching quality and a scientific evaluation system are also effective approaches to resolving the issue.

Mesoporous silica nanoparticles as drug carrier have become the new hot point in the field of biomedical application in recent years. This review focuses on the more recent developments and achievements on experimental design aspect of mesoporous silica nanoparticles with cancer diagnosis and therapy. The key advances of functionalization strategies of mesoporous silica nanoparticles with controlled release, tumor targeting and overcoming multidrug resistance are discussed in particular. Mesoporous silica nanoparticles as unique delivery systems have the potential to provide significantly a sound platform for cancer theranostic application.

Objective To evaluate the effect of schistosomiasis control in Gongan County,Hubei Province by longitudinal ob-servations so as to provide the evidence for formulating the schistosomiasis control strategy in lake and marshland regions. Meth-ods The schistosomiasis epidemic data in Gongan County from 2000-2013 were collected by the retrospective research method, and analyzed about the changing tendency of human and cattle infection rates,and Oncomelania hupensis snail situation. Re-sults The tendency of schistosomiasis epidemic situation was descended from 2000 to 2013. The human infection rate declined from 12.62%in 2000 to 0.69%in 2013. The decline scope of human infection rate was 24.1%in the first stage,64.4%in the sec-ond stage,and 73.0%in the third stage. Eight acute schistosomiasis cases were reported in the first stage,15 cases in the second stage,and none in the third stage. The cattle infection rate declined from 6.50%in 2000 to 0.30%in 2013. The rise scope of cattle infection rate was 74.2%in the first stage,but the decline scope was 75.0%in the second stage and 87.6%in the third stage. All the cattle were disposal at the end of 2013. The infection rate of snails,area with infected snails,and average density of living snails in the first stage increased by 18.1%,46.0%and 7.6%,respectively. The 3 indexes above-mentioned in the second stage de-creased by 76.8%,97.8%and 37.9%,respectively. In the third stage,the infection rate of snails and area with infected snails de-creased by both 100%,but the average density of living snails increased by 2.7%. The infected snails were found from 2000 to 2011,but none in 2012 and 2013. The infection rate of snails and area with infected snails dropped yearly,the infection rate of snails declined from 0.0007% in 2000 to 0.0002% in 2011,and the area with infected snails declined from 267.8 hm2 in 2000 to 6.37 hm2 in 2011. Conclusions After the implementation of the integrated schistosomiasis prevention and control strategy with the emphasis on infectious source control,the human and cattle schistosome infection rates decline significantly. Hereafter,it is necessary to prevent the schistosomiasis epidemic outbreak or rebound.

Objective To understand the schistosomiasis endemic situation at a national surveillance site in Gong an Coun-ty Hubei Province. Methods According to The Scheme of Schistosomiasis Surveillance in China the schistosome infection rates of residents and cattle and the Oncomelaniahupensissnail status were investigated yearly in Zhangjiahu Village a nation-al surveillance site in Gong an County from 2004 to 2013. Results From 2004 to 2013 the human schistosome infection rates decreased from 10.66%to 0.58% and the cattle schistosome infection rates from 12.75%to 0. Meanwhile the snail areas and densities reduced and the schistosome infected snails were eliminated. Conclusion The schistosomiasis endemic situa-tion declined dramatically at the surveillance site and schistosomiasis is well-controlled.

Objective To study the efficacy and safety of combined therapy of compound azintamide and domperidone in functional dyspepsia. Methods A randomised, double-blind, placebo-controlled trial.Two hundred and eight patients with functional dyspepsia were randomly grouped into group A (experimental group, 102 cases) and group B (control group, 106 cases). The patients in the group A were given 2 tablets of compound azintamide 3 times a day in addition to domperidone 10 mg 3 times per day for four weeks. The patients in the group B were only given domperidone 10 mg 3 times per day for 4 weeks. The therapeutic efficacy was evaluated by modified Severity of Dyspepsia Assessment (mSODA) and Global Patient Assessment (GPA). Results Subscore in mSODA:the change of bloating/pain intensity score in group A is -12.35±5.48 while group B is -10.52±4.65(P=0.009), the change of non-bloating/pain symptoms score in group A is -5.75±3.31 while group B is - 4. 86 ± 2.65 (P=0.033), and the change of satisfaction score in group A is 7. 09 ± 3. 78 while group B is 5.62 ± 3. 54 (P = 0. 004). The response rate in group A is 89. 2% which is significantly higher than 76.4% in group B (P=0. 015). Other symptoms for response assessment included loss of appetite, early satiety, fullness after meal, diarrhea. No severe side-effect was found in both groups. Conclusions Combined therapy of compound azintamide and domperidone may lead to bigger improvement in overall efficacy and health related quality of life in patients with functional dyspepsia than use of motility medicine alone. Potential mechanisms that may account for the efficacy of compound azintamide in functional dyspepsia include modulation of visceral sensitivity and/or gastrointestinal motility.

Objecfive To investigate the effects of treatment for cerebrovascular disorder patients with heparin and low molecular weight heparin(LMWH) on serum PAPP-A concentrations and provide the basis for evaluating the clinical significance of PAPP-A in the following study.Methods Forty cases with cerebrovascular disease from Qilu Hospital from November 2009 to May 2010 were collected in this study.Blood samples were taken before and after drug administration.All cases were divided into four groups according to situation of medication.Group A consisted of 10 patients who received subcutaneous LMWH anticoagulation therapy, and blood samples were collected before LMWH injection, three hours after subcutaneous LMWH anticoagulation therapy in the first day, the second day and the seventh day and 24 hours after the last injection. Group B consisted of 10 patients who did not receive LMWH therapy, and blood samples were collected immediately after admission, the first day, the second day and the seventh day after admission. Group C consisted of 10 patients with percutaneous carotid intervention who received intravenous heparin at the beginning of stenting, and blood samples were collected from the arterial sheath just before angiography and heparin administration, and at 3, 5, 15, 40 and 100 min after heparin administration. Group D consisted of 10 patients who received carotid angiography but LMWH-free therapy,and blood samples were collected from the arterial sheath just before and after angiography. Serum PAPP-A concentrations were analyzed by ELISA to evaluate the differences of intra-groups and differences at different time points of inter-groups. Results In group A, PAPP-A concentrations were time dependent and elevated gradually from 12. 36 (9. 90-14. 32) mIU/L before LMWH injection to 21.80 (23.50-19.73) mIU/L at the seventh day after injection (M=38. 72, P < 0.01 ). In group C, there was a rapid increase of PAPP-A concentration from 12. 86 ( 9. 67-14. 05 ) mIU/L to 51.56 ( 44. 20-66. 00 ) mIU/L within 5 min after intravenous heparin injection (M=46. 06, P <0. 01 ). The PAPP-A concentration of one week after LMWH administration in group A was 21.80 (23.50-19.73) mIU/L, significantly higher than that in group B [11.81 (9. 21-12. 89) mIU/L] (U<0. O01, P<0.01). The PAPP-A concentration at 15 min after heparin administration in group C was 43.70 (37.70-54. 30) mIU/L, significantly higher than that after angiography in group D [14. 18 (11.25-15. 86) mIU/L] ( U<0. 001, P <0. 01 ). The peak level of blood PAPP-A after subcutaneous LMWH injection was significantly lower than that after intravenous heparin injection. The concentrations in group A and C were 21.80 ( 23.50-19. 73 ) and 51.56 (44. 20-66. 00) mIU/L respectively, and had a significant difference ( U=0. 999, P < 0. 01 ) . Conclusions Both intravenous heparin and subcutaneous LMWH administration induce an increase in serum PAPP-A concentration. The effect of drug should be considered when PAPP-A is selected as an evaluation indicator.

Objective To identify and assess whether circumferential electrocautery is useful to improve outcomes after primary total knee replacement.Methods We searched MEDLINE,EMBASE,PubMed,SpringerLink,Web of Knowledge,OVID CINAHL,OVID EBM and Google Scholar,and included articles published through January 2014.This study used the methods of meta-analysis to assess whether circumferential electrocautery could improve anterior knee pain and knee function after total knee replacement,and identified the function of circumferential electrocautery in total knee replacement.Results A total of eight articles met the inclusion criteria.Among the 1 048 cases included in the analysis,526 cases had patellar denervation,and 522 cases were in the control group.The meta-analysis revealed no significant difference in the incidence of anterior knee pain (P =0.18) and visual analogue scale (VAS) (P =0.23) between two groups.However,patellar score (P =0.01),Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score (P ＜ 0.01),and range of motion (ROM) (P ＜ 0.01) indicated that circumpatellar electrocautery improved clinical outcomes compared to non-electrocautery groups.Conclusions The results indicated that circumferential electrocautery of the patellar did not significantly improve anterior knee pain relative to non-electrocautery techniques.However,circumferential electrocautery significantly improved patients' knee function after surgery.Therefore,circumferential electrocautery might be beneficial to the outcome of primary total knee replacement surgery without patella replacement.

To implement the excellent doctor education training plan and construct the training model of practical ability in clinical education,the researchers analyzed the problems existing in the training of clinical practice ability and put forward a new train of thought,and constructed a training method system of personal experience,reading classics,teacher guidance,simulation training,clinical practice and reflection strengthening.In addition,we also established a safeguard mechanism with the characteristics of the organizational corporation of teaching,the expert-oriented teaching team,team-oriented mentoring,pro-ject-oriented ability training,the diversification of evaluation system,the modernization of teaching platform and the realistic training environment,to train the qualified clinical medical talents.