Objective The paper analyzes the operating patterns of the outpatient process and identifies the links needing reengineering so as to provide scientific basis for the optimal allocation of outpatient resources and process reengineering and prove the rationality and feasibility of using the queuing theory. Methods Using the methods of the queuing theory, the service time and the patients' arrival time at such service links as registration, billing and accounting, internal medicine, and gynecology in the outpatient department of a certain hospital were measured and the operational indexes at various links such as service intensity, average queuing length, average queuing time, average stay, probability of the service desks being idle, and the probability of the patients having to wait were calculated so as to estimate the rational number of service desks and the optimal value of the sum of the cost of waiting and the cost of service. Results Registration, billing and accounting , service intensity in internal medicine, personnel allocation, and queuing time were basically rational in the outpatient department of the hospital surveyed. One more physician should be added to the gynecology department so as to improve efficiency and reduce patients' waiting time and queuing length. There was currently a shortage of medical staff in the hospital. The cost of hospital input was moderate while the cost of waiting was on the high side. Conclusion It is rational and feasible to evaluate the efficiency of the outpatient process with the methods of the queuing theory. The method deserves to be spread.

Objective To investigate the effects of CD4+T cell depletion in BALB/c mice on the immunogenicity and virulence of replication-competent recombinant vaccinia virus. Methods Twelve BALB/c mice were inoculated with recombinant Tiantan vaccinia ( rTV, n=8 ) or vaccinia virus Tiantan strain ( VTT, n=4) by tail scarification after the depletion of CD4+T cells with anti-CD4 monoclonal anti-body( McAb) injected intraperitoneally for three days before virus inoculation.A control group without anti-body treatment was set up accordingly.Several parameters including the body weight, pocks on tail, viral shedding and the percentage of CD4+T cells were monitored.In the fourth week after virus infection, ovaries were collected from mice and viral loads in the tissue were titrated by plaque forming assay on chick embryo fibroblast ( CEF) cells.The specific cellular immune responses against vaccinia virus and HIV induced by inoculation of VTT and rTV respectively were detected by intracellular cytokine staining ( ICS) assay.ELISA was used to detect antibodies against vaccinia virus and HIV-1 gp120.Results All mice with or without CD4 McAb treatment showed typical poxvirus pocks on tails after inoculation of vaccinia viruses, but none of them developed secondary or satellite lesions.It took a longer time for CD4+T cell-depleted mice to heal from lesions, to regain body weights and to release viruses than the mice in control group.No vaccinia virus was detected in the ovaries of CD4+T cell-depleted mice or mice in control group.The mean absorbance( A) values for the detection of HIV-specific and vaccinia virus-specific antibodies in CD4+T cell-depleted mice with ELISA were respectively 0.119 and 0.168, which were significantly lower than those in mice of control group.The titers of neutralizing antibodies against vaccinia virus in McAb/rTV treated mice (1 ∶321) were lower than those in rTV treated mice (1 ∶1286) (P<0.05).The percentages of CD4+T cells secreting IFN-γ(0.654%) in McAb/rTV treated mice were significantly lower than those in rTV treated mice in the fourth week after immunization (P <0.0004).No significant differences with the vaccinia virus-specificCD8+ T cell responses were observed among mice with or without CD4+T cells depletion.Conclusion Thereplication and dissemination of replication-competent recombinant vaccinia virus could be effectively controlledin the mice with CD4+ T cell-depletion.The depletion of CD4+ T cells significantly reduced the humoraland CD4+ T cell responses, but had no effect on CD8+ T cell responses.

Objective To investigate the advantages of BLADE technique in MR T2WI/TSE abdomen scanning. Methods 36 cases, which had obvious motion defects with conventional T2WI/TSE axial abdomen scanning because of psychology or disease, performed T2WI/BLADE/TSE scan with the same regions. Then the image quality was compared, and amendment of motion defects was reviewed. The equipment was SIEMENCE 3.0T scanner and phased-array coil. Results Motion defects of all images with T2WI/BLADE/TSE were attenuated with different degree compared with T2WI/TSE. All images with T2WI/BLADE/TSE satisfied the diagnostic demand. Conclusion The BLADE technique in abdomen scanning solves the difficult problem of impossible MR scan with uneven breath and trembling patients because of psychology or disease, and obtains good diagnostic imaging.

BACKGROUND:Stroke is the leading cause of death and long-term disability. This study was undertaken to investigate the factors influencing daily activities of patients with cerebral infarction so as to take interventional measures earlier to improve their daily activities. METHODS:A total of 149 patients with first-episode cerebral infarction were recruited into this prospective study. They were admitted to the Encephalopathy Center, Department of Neurology, the First Affiliated Hospital of Wenzhou Medical College in Zhejiang Province from August 2008 to December 2008. The baseline characteristics of the patients and cerebral infarction risk factors on the first day of admission were recorded. White blood cell (WBC) count, plasma glucose (PG), and many others of laboratory targets were col ected in the next morning. Barthel index (BI) was calculated at 2 weeks and 3 months respectively after onset of the disease at the outpatient clinic or by telephone cal . Lung infection, urinary tract infection and atrial fibrillation if any were recorded on admission. The National Institute of Health Stroke Scale (NIHSS) scores and the GCS scores were recorded within 24 hours on and after admission, at the second week, and at the third month after the onset of cerebral infarction respectively. RESULTS:The factors of BI at 2 weeks and 3 months after onset were the initial PG level, WBC count and initial NIHSS scores. Besides, urinary tract infection on admission was also the factor for BI at 3 months. CONCLUSION:Active measures should be taken to control these factors to improve the daily activities of patients with cerebral infarction.

Objective: To explore the dynamic regulation of histone acetylases p300 and p300/CBP associated factor (PCAF) on cardiac development gene NKX2.5 during cardio-genesis and to provide the new theoretical basis to clarify the regulatory mechanism for cardio-genesis in fetal mice.
Methods: Our research included 4 groups of cardiac tissues: Embryo (EB) 14.5 days group,n=10, EB 16.5 days group, n=10 and Neonatal 0.5 day group,n=5, Neonatal 7 days group,n=3. Immunoprecipitation was performed in myocardial tissues using anti-p300, anti-PCAF and anti-H3K9ac antibodies to retrieve p300, PCAF and H3K9ac binding DNA, the speciifc DNA sequences were ampliifed by real-time PCR to detect and the binding levels of p300, PCAF and the acetylation level of H3K9ac in NKX2.5 promoter sequence. In addition, the mRNA expression of NKX2.5 was examined by RT-PCR.
Results: The binding levels of p300 and PCAF had the timing consequence at different stage of cardio-genesis. The binding level of p300 in EB 16.5 days group (0.063 ± 0.021), Neonatal 0.5 day group (0.019 ± 0.008), Neonatal 7 days group (0.011 ± 0.003) were all lower than that in EB 14.5 days group (0.231 ± 0.033), and in Neonatal 0.5 day group and Neonatal 7 days group were lower than EB 16.5 days group, allP<0.05. The binding level of PCAF in EB 16.5 days group (0.063 ± 0.021), Neonatal 0.5 day group (0.019 ± 0.008), Neonatal 7 days group (0.011 ± 0.003) were all lower than that in EB 14.5 days group (0.185 ± 0.023), allP<0.05. The H3K9ac acetylation level and NKX2.5 mRNA expression level had the timing consequence at different stage of cardio-genesis. H3K9ac acetylation level in EB 16.5 days group (0.098 ± 0.014), Neonatal 0.5 day group (0.074 ± 0.010), Neonatal 7 days group (0.045 ± 0.014) were all lower than that in EB 14.5 days group (0.119 ± 0.020), and in Neonatal 7 days group was lower than EB 16.5 days group, allP<0.05. The NKX2.5 mRNA expression level in EB 16.5 days group (0.701 ± 0.181), Neonatal 0.5 day group (0.502 ± 0.159), Neonatal 7 days group (0.529 ± 0.13) were all lower than that in EB 14.5 days group (1.000 ± 0.130), allP<0.05.
Conclusion: Histone acetylases p300 and PCAF may dynamically regulate H3K9ac acetylation in NKX2.5 promoter sequence, and the mRNA of NKX2.5 was dynamically expressed during cardio-genesis in experimental fetal mice.

Objective To observe the correlation between zinc-a2-glycoprotein (ZAG) in human plasma and the degree of coronary atherosclerosis lesion.Methods A total of 242 research subjects were included.The clinical indexes were perfected and plasma ZAG level was detected.The coronary angiography was performed.The subjects were divided into the coronary atherosclerosis group (CAD group) and control group according to the examination results.The Gensini score was used to assess the degree of coronary artery lesion,different degree subgroups were divided according to the assessment results.The correlation between the ZAG level with the clinical indexes was analyzed by Spearman analysis.The ROC curve was used to evaluate the efficiency of ZAG in the diagnosis of coronary atherosclerosis and its sensitivity and specificity were analyzed.Results The plasma ZAG level in the CAD group was significantly lower than that in control group,the difference was statistically significant [(45.12±5.02)μg/mL vs.(53.93±2.96)μg/mL,P＜0.01].With the increase of Gensini score,plasma ZAG level showed the decreasing trend,the difference among the groups were statistically significant (P＜0.05).The Spearman correlation analysis showed that body mass index (BMI),waist circumference and waist to hip ratio(WHR) were negatively correlated with ZAG (P＜0.05),and positively correlated with high density lipoprotein cholesterol(HDL-C,P＜0.05).The sensitivity of plasma ZAG for evaluating coronary atherosclerosis was 89.8％ and its specificity was 91.2％.Conclusion Plasma ZAG is negatively correlated with the severity of coronary atherosclerosis lesion,and its level detection has a certain value in the screening of coronary atherosclerosis.

BACKGROUND AND OBJECTIVES: The aim of this study was to identify clinical, lesional, and procedural predictors for adverse outcomes of coronary angioplasty and stenting in coronary bypass candidates. SUBJECTS AND METHODS: This cohort study included 107 consecutive candidates for coronary artery bypass surgery who underwent percutaneous coronary intervention with multiple coronary stents between Jan 2004 and Dec 2011. The study endpoint was major adverse cardiovascular events (MACEs) including all-cause mortality, nonfatal myocardial infarction, repeat revascularization, and stent thrombosis. Follow up was from the date of index percutaneous coronary intervention to the date of the first MACE, date of death, or December 31, 2015, whichever came first. RESULTS: In this study (age 62.3±11.2 years, 86% male), 38 patients (36%) had MACE. Among baseline, angiographic, and procedural parameters, there were significant differences in lower left ventricular ejection fraction (LVEF) and worse renal function. In a Cox regression model, LVEF and chronic kidney disease (CKD) were significant predictors for MACE. After a multivariate adjustment, CKD remained a significant predictor of MACEs (hazard ratio: 2.97, 95% confidence interval: 1.50-5.90). CONCLUSIONS: For coronary bypass candidates who were treated with coronary angioplasty and stenting, CKD seems to be the strongest predictor for adverse outcomes compared with other traditional factors.
Angioplasty ; Cohort Studies ; Coronary Artery Bypass ; Coronary Artery Disease ; Follow-Up Studies ; Humans ; Mortality ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Renal Insufficiency, Chronic* ; Stents ; Stroke Volume ; Thrombosis

Electromagnetic Fields ; Magnetic Fields ; Microwaves ; adverse effects ; Television

OBJECTIVE: To determine the relationship between uroflowmetry and age, the course of disease, premicturition volume, transition zone index and proportion of stroma-to-epithelium in benign prostate hyperplasia (BPH) patients. METHODS: Eighty-nine BPH patients in our hospital from 2000 to 2003 were evaluated. With the CMM3 pathology image analysis system, transrectal ultrasound and Dantec 2000 urodynamic instrument, the value of influence factors was determined. A linear regression was applied to analyze all the data by SPSS software. RESULTS: The flow rate was correlated to premicturition volume ( r = 0. 477, P < 0.01) and proportion of stroma-to-epithelium significantly ( r = - 0.437, P < 0.05) , but was not correlated to the age, the course of disease and transition zone index significantly. The parameter of flow rate/premicturition volume had no difference in 3 micturitions in all patients. CONCLUSION The parameter (flow rate/premicturition volume)could be used to evaluate the micturition status of the BPH patients whose bladder volume is less than 200 ml. We should pay more attention to receptor blockers when we treat BPH patients.
Aged ; Circadian Rhythm ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; physiopathology ; Urination ; physiology ; Urodynamics ; physiology

Objective To explore the effects of chitosan flocculation clarification process and alcohol precipitation process on the principal chemical constituents of water extract of Codonopsis Radix. Methods The influence of two purification processes on water extract of Codonopsis Radix was investigated through lobetyolin contents, extract yield, and relative apparent content of each component in HPLC fingerprint as evaluation indexes. Results Chitosan flocculation clarification process showed a significantly higher extract yield of water extract compared with alcohol precipitation process, and it has a markedly better retention effect for strong polarity constituents; alcohol precipitation process exhibit a little better retention effect for lobetyolin and a better retention effect for weak polarity constituents. Conclusion The above two processes have some regularity in the influence on the main chemical constituents in the water extract of Codonopsis Radix, which can provide some guidance for the reasonable choice of the purification process for water extracts of Codonopsis Radix, and other TCM water extracts.