This paper systematically analyzed the concept of patients'trust based on a study of the literatures and compared patients'trust with patients'satisfaction. The conclusion is that patients'trust plays a key role on the quality improvements of medical services.

Female ; Humans ; Leiomyomatosis ; diagnosis ; surgery ; Uterine Neoplasms ; diagnosis ; surgery ; Vascular Neoplasms ; diagnosis ; surgery ; Vascular Surgical Procedures ; methods ; Veins

From the aspects of advantages, barriers, opportunities and challenges, this paper analyzed the environmental factors of Shanghai medical resources serving people in the Pan-Yangtze River Delta. As envisaged by the author, such services will provide medical resources information to patients from outside Shanghai, probe into feasible ways to medical insurance based on experiences drawn from serving such patients, help with the resources integration of medical systems in Shanghai, and probe into the potentials of telemedicine and distant medical e-learning, as well as improve hospital management levels and service functionality.

OBJECTIVETo study the effect of Compound Ezhu Powder (CEP) on serum levels of CA125 and CA19-9, and the expression of cyclin D protein in endometriosis patients, thus providing theoretical evidence for clinical application of CEP.

METHODSTotally 69 all endometriosis patients underwent surgical treatment at Department of Gynecology and Obstetrics, Tianjin Nankai Hospital from January 2011 to January 2013 were randomly assigned to group A (35 cases) and group B (34 cases). Meanwhile, 30 patients with uterine fibroids who prepared for surgical treatment during the same period were recruited as the control group. Patients in group A took EZP 3 months before surgery. No treatment was given to patients in group B and the control group. The serum CA125 level and the expression of cyclin D in the ectopic endometrium and the eutopic endometrium were detected in the 3 groups before surgery.

RESULTSThe expression of cyclin D was higher in group A and group B than in the control group (P < 0.05). The serum levels of CA125 and CA19-9 were significantly lower in group A than in group B (P < 0.05). The expression of cyclin D in the ectopic endometrium was lower in group A than in group B, but with no statistical difference (P > 0.05). The expression of cyclin D in the eutopic endometrium was significantly lower in group A than in group B with statistical difference (P < 0.05). Meanwhile, the serum CA125 level was positively correlated with the serum CA19-9 level (r = 0.45, P < 0.05).

CONCLUSIONSThe expression of cyclin D obviously increased in endometriosis patients, which was associated with the occurrence of endometriosis. CEP could lower serum levels of CA125 and CA19-9, and down-regulate the expression level of cyclin D, indicating its roles in inhibiting the cell cycle.

Adult ; Antigens, Tumor-Associated, Carbohydrate ; blood ; CA-125 Antigen ; blood ; CA-19-9 Antigen ; blood ; Cyclin D1 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Endometriosis ; blood ; drug therapy ; Female ; Humans

Objective　To investigate the relationship of proximal femur geometry and hip fracture in elderly women. 　Methods　 We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. 　Results　 The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9±3.1) mm and (13.2±2.9) mm, and the Singh index below Ⅲ° was 86.05% and 66.67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated.　Conclusions　 Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

The patient-physician relationship can be understood from the two aspects of patients′ trust and patients′ satisfaction.Compared with patients′ satisfaction,dimensions and attributes of patients′ trust indicate to better match with the measuring capacity of patients.Thus,the evaluation of the quality of medical services based on patients′ trust is justified theoretically.The existing literatures assert that the research on patients′ trust could help understand patient-physician relationship and eventually improve the quality of medical services.The conceptual model in this paper entails the concept,dimensions and attributes of patients′ trust.Also,this paper points out its effect on the measurement of the quality of medical services through the comparison of patients′ trust and patients′ satisfaction.

Objective To investigate the relationship of proximal femur geometry and hip fracture in elderly women. Methods We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. Results The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9?3 1) mm and (13 2?2 9) mm, and the Singh index below Ⅲ? was 86 05% and 66 67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated. Conclusions Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

Objective To observe the expression of SGK in decidua in patients with unexplained recurrent spontaneous abortion(URSA) and to investigate its role in the course of apoptosis.Methods The expression of SGK was detected by immunohistochemistry in decidua of URSA(abortion group,n =50) and normal first trimester pregnant women(control group,n =30).The apoptotic index was detected by TUNEL.Results Compared with the control group,the positive expression of SGK decreased significantly in the abortion group,and the difference was statistically significant(x2 =6.78,P ＜ 0.05).The average apoptotic index of the abortion group was (8.19 ± 3.58) ％,which was significantly higher than (2.87 ±1.07)％ of the control group(t =7.94,P＜0.05).Conclusion Intensive apoptosis,the decreasing positive expression rate of SGK in decidua cells may play critical roles in URSA.

Objective To investigate the clinicopathologic characteristics of premalignant and malignant endometrial polyps (EP) in premenopausal and postmenopausal women.Methods A retrospective analysis was conducted in 42 cases of premalignant and malignant EP from 1993 to 2012.Polyps were classified into premenopausal (group A,10 cases) and menopausal (group B,32 cases),including 26 cases of endometrioid adenocarcinoma,4 of clear cell carcinoma,9 of serous adenocarcinoma,and 3 of atypical hyperplasia.Results The prevalence rate of premalignant and malignant EP was 1.42％ (42/2 965),the prevalence rate of malignancy in postmenopausal and postmenopausal women was 0.48％ (10/2 064) and 3.55％ (32/901),respectively.The mean size of EP was (1.6 ± 0.8) cm,abnormal uterine bleeding was positive in 90％ (38/42) of cases.The EP pathological diagnosis showed all were endometrioid adenocarcinoma in group A,while there were 4 of clear cell carcinoma,9 of serous adenocarcinoma in group B.The mean size of EP was (1.1 ± 0.6) and (1.7 ± 0.9) cm in group A and B respectively (P ＜0.05).According to immunohistochemistry,all cases of group A were ER positive,but 41％ (11/27) of group B were ER negative (P =0.059).The PR positive rate was 8/9 and 56％ (15/27) in group A and B,respectively (P =0.169).Conclusions The risk of the EP malignancy rate is higher,while ER,PR positive rate are lower in postmenopausal womcn.Postmenopausal EP,especially accompanied by abnormal uterine bleeding and large polyps should be removed as soon as possible.

Objective To develop a murine model for infection by Cladosporium carrioni. Methods A total of 72 ICR mice were equally divided into 4 groups, group A (healthy mice inoculated by C. Carrioni suspension of 1 × 108 cfu conidia mL-1, group B (immune-suppressed mice inoculated by C. Carrioni sus pension of 1 × 108 cfu conidia mL-1), group C (immune-suppressed mice inoculated by C. Carrioni suspen-sion of 1 × 106 cfu conidia mL-1), group D (healthy mice inoculated by sodium chloride solution). C. Car-rioni suspension or sodium chloride solution was subcutaneously inoculated into foot pads of mice. On day 7, 30 and 60 after inoculation, 6 mice were killed in each group followed by the measurement of thickness of foot pads, pathology and mycology of skin samples taken from foot pads. Results In group A, B and C, there were swelling, blackening, ulceration and crusts at the inoculation site of all mice, with a morbidity of 100%. The thickness of foot pads in group A on day 30 was significantly higher than that on day 7 (2.40 ± 0.45 mm vs 2.85 ± 0.47 mm, P < 0.05), but lower than that on day 60 (1.64 ± 0.13 ram, P < 0.05). In group B, increased thickness of foot pads was observed on day 30 compared with that on day 7 and day 60 (2.19 ± 0.27 mm vs 1.80 ± 0.21 mm and 1.86 + 0.22 mm, respectively, both P < 0.05), which was the case with group C (1.98 ± 0.06 nun vs 1.51 ± 0.11 mm and 1.82 ± 0.09 mm, respectively, both P < 0.05). No significant changes occurred to the thickness of foot pads in group D from day 7 to day 60 (P > 0.05). Pathological changes in group A, B and C included necrosis, abscess and chronic granuloma formation; dark brown sclerotic bodies were observed on HE and PAS staining as well as on direct microscopy; cultures of tissue samples grew Cladosporium carrionii. The mice in group D remained uninfected. Conclusion Mouse model for chromoblastomycosis may be established by subcutaneous inoculation of Cladosporium carrionii suspension into foot pads of healthy or immuno-suppressed mice.