A scientific appointment-driven outpatient service proves vital for the medical quality improvement initiative, and a key part of public hospital reform as well. The authors introduced the approaches taken by Northern Jiangsu People′s Hospital as follows. The hospital-wide appointment-drive service was coordinated in terms of top-level design, appointment items, appointment channels, supporting services, and monitoring regulations. This service could optimize the allocation of medical resources, enrich the connotation of appointment for registration, examination, bed, examination, operation and treatment. These efforts were expected to provide references for the implementation of overall management of the appointment-driven service of the hospital.

The purpose of this study is to investigate the transdermal delivery characteristics of Gentiana macrophylla complex components system through different parts of the skin under micro-needles conditions. Two-chamber diffusion cells were used, different parts of isolated skin and micro-needle pretreated isolated mouse skin were applied separately, high performance liquid chromatography (HPLC) similarity evaluation methods were used to evaluate transdermal delivery characteristics of Gentiana macrophylla complex components system on receiving pool and the permeation rate and penetration amount of Gentiopicroside at different parts of mouse skin. In the 24 h, the similarity between receiving fluid which was on passive transdermal delivery and micro-needle transdermal delivery conditions and original fluid were ranged from 83.0% to 98.9%; By the micro-needle pretreatment with different parts of the mouse skin, the time that Gentiana macrophylla complex components system though abdominal skin to the receiving fluid which reached 90% similarity compared with that of original fluid was 4 h, which was 18 h at back skin and 12 h at neck skin separately. Micro-needles can be used as the ideal ingredients for traditional Chinese medicine complex transdermal delivery; transdermal absorption time delay could be greatly reduced and its bioavailability was improved. The permeation rate and similarity to original liquid of Chinese medicine complex components increased significantly in the abdominal skin relative to the neck and back skin under micro-needle conditions.
Administration, Cutaneous ; Animals ; Biological Availability ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacokinetics ; Gentiana ; chemistry ; Iridoid Glucosides ; pharmacokinetics ; Mice ; Needles ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Skin Absorption

OBJECTIVETo determine the clinical characteristics and outcomes of redo CABG.

METHODSThe outcomes of 42 consecutive patients who underwent redo CABG from January 2002 to December 2010 was analyzed. There were 29 males and 13 females, aging from 46 to 78 years old with a mean of (61.2 ± 2.1) years. Off-pump CABG was applied for 31 patients and on-pump CABG for 11 patients. There were 1 patient underwent concomitant aortic valve replacement and 1 patient underwent aortic root and right aortic arch replacement respectively.

RESULTSThree patients died of right ventricle rupture, heart failure and multiple system organ failure respectively and the perioperative mortality rate was 4.8%. The post-operatively mechanical ventilation time varied from 9 to 27 h with a mean of (17 ± 7) h. There was no residual angina and perioperative myocardial infarction in the remaining patients who were all discharged uneventfully. Intraoperative 6 patients had accepted intraaortic balloon counterpulsation. During the follow-up from 6 months to 4.5 years for 38 patients, which showed no evidence of recurrent angina and postoperative coronary CT angiography in 12 patients showed the patency of grafts is good.

CONCLUSIONSatisfactory outcome of redo coronary artery bypass grafting can be achieved if proper indication were choose and reasonable management were performed.

Aged ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Restenosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reoperation ; Treatment Outcome

OBJECTIVETo study the application of extraoral distraction devices in correction of various maxillo-mandibular deformities.

METHODSFrom 1997, 11 cases with various maxillo-mandibular deformities were corrected by distraction devices of designed by myself. 7 cases of then were the patients with cleft palate who have severe secondary maxillary hypoplasia. 1 case with micrognathia, 1 case with partial mandibular mentum defect, 1 case with lateral deviation of micrognathia and 1 case with hemimandibular hypertrophy. The mandibles were elongated, from 12 mm to 20 mm, the maxillae were elongated from 7 mm to 22 mm, the vertical mandibular distraction was 15 mm.

RESULTSAll cases were corrected satisfactorily and haven't any complications. In 1 cases the 1 Kischners pin had been pull out by loosen during distration. 4 Kischners pin were curved during vertical mandibular distration. Another case the maxillary hypoplasia appeared edge-to-edge and mild open occlusion after 4 weeks fixation.

CONCLUSIONThe extraoral distration osteogenesis provides a new method with many advantages for those maxillo-mandibular deformities that are difficulty corrected by ordinary orthognathic surgery.

Cleft Palate ; therapy ; Humans ; Jaw Abnormalities ; therapy ; Mandible ; abnormalities ; Maxilla ; abnormalities ; Micrognathism ; therapy ; Osteogenesis, Distraction ; instrumentation ; Treatment Outcome

OBJECTIVETo evaluate the effects of Huafenqinutang combined with vardenafil for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with erectile dysfunction.

METHODSOne hundred and thirty-eight cases diagnosed as CP/CPPS with erectile dysfunction were randomized into trial group (70 cases) and control group (68 cases) for treatment with Huafenqinutang for 8 weeks, and in the former group, vardenaffil was added since the fifth weeks. All the cases were evaluated according to NIH-CPSI and IIEF-5 scores at 4 weeks and 8 weeks, respectively.

RESULTSAt the end of the fourth weeks, NIH-CPSI score was 13.1-/+4.7 in the trial group and 13.3-/+4.5 in the control group, which were comparable between the two groups (P>0.05) but significantly decreased compared with the pre-treatment scores in both groups (P<0.01). IIEF-5 score was also similar between the two groups (14.1-/+3.3 vs 14.3-/+5.0, P>0.05) but significantly increased compared with the pre-treatment scores in both groups (P<0.01). At the end of the eighth week, NIH-CPSI score was 7.8-/+2.2 and IIEF-5 score 20.1-/+4.4 in the trial group, which were significantly different from those at the end of the fourth week (P<0.01). In the control group, NIH-CPSI score was 12.7-/+2.3 and IIEF-5 score 14.3-/+4.5 at the eighth week, similar to those at the end of the fourth week (P>0.05). There were significant differences in NIH-CPSI and IIEF-5 scores between the 2 groups (P<0.01), and the change of NIH-CPSI score was negatively correlated with IIEF-5 score in the trial group (r=-0.89, P<0.01).

CONCLUSIONFor patients with CP/CPPS with erectile dysfunction, Huafenqinutang treatment in combination with vardenafil can effectively improve the erectile functions and decrease the NIH-CPSI score to favor the recovery from CP/CPPS.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Imidazoles ; therapeutic use ; Male ; Middle Aged ; Pelvic Pain ; drug therapy ; Phytotherapy ; Piperazines ; therapeutic use ; Prostatitis ; drug therapy ; Sulfones ; therapeutic use ; Triazines ; therapeutic use ; Vardenafil Dihydrochloride

Objective To investigate the brain mechanisms of aging of the visual attention. Methods Through the precue-target visual search paradigm using the event-related potentials technique,16 young and 16 elderly subjects participated the electrophysiological experiment.The background was comprised of three homocentric black circles and eight English capital letters consisted of each circle.The letter “T” was designed as the target stimulus.T was a target only when it located the circle clued to the same size of the precue.For example,when the cue was the “large”,“T” may appear within 3 circles.When the cue was the “median”,“T” may appear within either the median or small circles.When the cue was small,the target “T” may appear only within the small circle. Results The reaction time of the two groups of subjects became quick with the reduction of the cue scale,while the amplitudes of P1 and N1 components of event-related potentials increased with the decrease of the cue scale.Old subjects showed longer response time than did young subjects,and the posterior P1 component was enhanced significantly and N1 component was inhibited obviously.The P2 component was manifested as significantly inhibitory effect not only in the amplitude but also in the abnormal and unstable waveform.Conclusions The cognitive function of elderly subjects declines in the research of target stimuli,which suggests that the age-related changes could lead to deficit in the posterior area of the brain to visual spatial attention (involuntary attention).

Objective To explore application effect of modified postural drainage on treating stubborn pulmonary infection after cardiothoracic surgery.Methods Totals of 88 patients with stubborn pulmonary infection after cardiothoracic surgery were chosen,and randomly divided into the experimental group (n =47)and the control group (n =41).The control group received conventional drug therapy and nutritional support treatment,while the experimental group received modified postural drainage method in addition.Two groups'treating time,rehabilitation conditions,antibiotic use time were compared.Results Fifteen days after modified postural drainage,41 cases in the experimental group and 21 cases in the control group had smaller lesion,and the difference was statistically significant (x2 =32.19,P ＜ 0.01).The score of physical function,physical role,general health condition,vitality,and psychological health in SF-36 scale was respectively (52.22 ±9.27),(56.87 ± 9.22),(58.69 ± 7.54),(49.33 ± 8.25),(53.28 ± 7.89) in the experimental group,and (41.54 ± 10.11),(44.28 ± 10.41),(45.22 ± 8.29),(33.21 ± 9.57),(42.74 ± 8.03) in the control group,and the differences were statistically significant (t =3.45,2.65,4.21,3.54,2.58,respectively;P ＜0.05).There were no obvious adverse reactions in both groups.Conclusions Modified postural drainage,better than simple drug therapy,can promote the recovery of stubborn pulmonary infection after cardiothoracic surgery.

OBJECTIVETo explore the differences of PDGF and EGF expression in the wound healing between fatal and adult.

METHODSWith the established animal model of fetal scarless healing and the adult samples, an immunohistochemical technique was used to evaluate the expression of PDGF and EGF in the normal adult skin, normal fetal skin, and the process of their wound healing.

RESULTS1. The expression of the PDGF was not found in the fetal skin, but a mild amount of the PDGF was shown in the epidermis and the upper dermal layer 12 hours and 1 day after the wounding process. In the normal adult skin, expression of PDGF was shown in the dermal fibroblasts, macrophagocytes and blood capillaries, and a strong expression was presented during its wound healing process. 2. In the fetal skin, the expression of the EGF was seen in the epidermis, hair follicles, sebaceous glands and sweat glands, but there were no markedly changes during the wound healing. In the adult skin, a positive stain of the EGF was shown in the basal layer of the epidermis while the mild stain in hair follicles and sweat glands. The level of the expression became gradually decreasing with the time going in the wounded adult skin.

CONCLUSIONThe different expression of growth factors between fetal and adult skin in wound healing may be one of the important reasons that the fetal wound could produce scarless healing.

Adult ; Epidermal Growth Factor ; metabolism ; Epidermis ; metabolism ; Fetus ; Fibroblasts ; metabolism ; Hair Follicle ; metabolism ; Humans ; Platelet-Derived Growth Factor ; metabolism ; Skin ; injuries ; metabolism ; Sweat Glands ; metabolism ; Wound Healing

Objective To investigate the indications and complications of the total thyroidectomy in the management of thyroid cancer. Methods Fifty-one patients with thyroid cancer operated with total thyroidectomy in a period from April 2007 to June 2010, were retrospective analyzed. There were 48 cases of papillary adnocarcinoma, 1 follicular adnocarcinoma, and 2 medullary carcinoma as well, 2 cases with hyperthyroidisms, 3 cases with remote metastasis. There were 17 males and 34 females who in their age ranged from 5 years old to 82 years old with a middle age of 50 years old. Among the 45 cases who were initial surgical management patients, there were 17 T1, 13 T2, 7 T3, 8 T4; and there were 31 NO, 11 N1a,3 N1b, 2 M1. The recurrent laryngeal nerve and the parathyroid gland, and supper laryngeal nerve were exposed routinely. Lymph nodes in Level Ⅵ were dissected in all patients, and Level Ⅱ -Ⅳ dissected in 25patients. 131Ⅰ were administrated in 8 patients. Results Patients were followed up from 1 month to 36months. There were no patients died and lost of follow up. The two years survival rate was 100. 0% ( 15/15 )Pathological examination showed that the multiple focal disease rate was 42. 2% ( 19/45 ), the cervical lymph nodes metastases rate was 51.0% (26/51). There was no permanent paralysis of recurrent laryngeal nerve and outer branch of supper laryngeal nerve. The permanent hypoparathyroidism rate was 3. 9%(2/51). One case with contralateral lymph node metastasis was reoperated and survived without disease.Two cases with remote metastasis were alive with steadied disease. Conclusions Under the skilled hand,total thyroidectomy is a safe procedure in the management of thyroid cancer. Totally exposing the parathyroid gland and laryngeal nerve is the key point to prevent the major complications.

OBJECTIVETo detect HPV 58, a common type of human papillomavirus (HPV), clone and express its E7 gene from biopsy specimens of cervical cancer.

METHODSHPV 58 from 58 biopsy tissues of cervical cancer was detected by GP5+/GP6+ PCR followed by template-directed dye-terminator incorporation assay with fluorescence polarization detection (TDI-FP). HPV 58 E7 gene was amplified from one HPV 58-positive sample, and then cloned into pGEM-T Easy vector. The recombinant plasmid, HPV58E7-pGEM-T was confirmed by sequencing. Subsequently, E7 gene was cloned into prokaryotic expression vector pRSET-A. The constructed pRSET-58E7 plasmids were transfected into BL21(DE3) cells, and induced to express 58 E7 protein by IPTG.

RESULTSAmong the 58 biopsy tissues of cervical cancer, 10 were HPV 58-positive, accounting for 19.2% of 52 HPV-positive cases. HPV 58 E7 gene was amplified from one HPV 58-positive sample. The constructed plasmids were identified containing HPV58 E7 gene by restriction enzyme analysis and sequencing. SDS-PAGE analysis showed that HPV58 E7 His6 fusion protein of M(r) 16 x 10(3) was expressed by pRSET-58E7 after induction by IPTG. The fusion protein accounted for 30% of total bacterial proteins.

CONCLUSIONHPV 58 is not uncommon in Chinese women with cervical cancer in Shaanxi province. Constructed HPV58 E7 recombinant plasmids can be effectively expressed in E.coli, which may provide a tool in diagnosis and vaccine design for HPV of HPV58-associated tumors.

Adult ; Cloning, Molecular ; Escherichia coli ; metabolism ; Female ; Genes, Viral ; Humans ; Middle Aged ; Papillomaviridae ; genetics ; isolation & purification ; Papillomavirus E7 Proteins ; biosynthesis ; genetics ; Papillomavirus Infections ; complications ; genetics ; Plasmids ; Recombinant Proteins ; biosynthesis ; genetics ; Transformation, Genetic ; Uterine Cervical Neoplasms ; genetics ; virology