The medical consulting service, disease inquiry and seeking medical advice functions of 10 commonly available APP software in China for seeking medical advice, such asRapid Asking Doctors,Handholding Doc-tor Selection, andChunyu Handholding Doctors, were compared, which showed that although the functions of APP software in China for seeking medical advice could meet the requirement of people for seeking medical advice, importance should be further attached to their accurate and integrative information and establishment of profit-making model in order to promote the sustainable development of medical APP software.

Objective To investigate the clinical diagnostic significance of detecting T in peripheral blood lymphocyte subsets (CD4+,CD8+ and the ratio of pulmonary tuberculosis with diabetes) and explore drug therapy of the five thymus peptide combined anti-tuberculosis on the diabetes complicated with pulmonary tuberculosis.Methods Eighty cases of pulmonary tuberculosis complicated with diabetes mellitus were selected as our treatment subject,who were treated with anti-tuberculosis drug treatment and five thymus peptide regulating immunity treatment.T lymphocyte subsets (CD4 +,CD8 + and their ratio) were detected.Meanwhile acid-fast bacilli and image detection were performed.Another 80 cases were as our control group that treated with anti-tuberculosis drug.Results Following the thymus peptide five treatment for 1,2,and 6 months,T lymphocyte subsets were (CD4+:(34.34 ± 7.32) ％,(39.23 ± 6.62) ％,(41.06 ± 7.13) ％),(CD8+:(31.42 ±8.91)％,(32.52 ±8.58)％,(32.12 ±8.59)％),(CD4+/CD8+:(1.23 ±0.31),(1.34 ±0.30),(1.36 ± 0.32),higher than that of before treatment (30.26 ± 8.25) ％,(30.36 ± 9.86) ％,(1.13 ± 0.42) CD4 +.Through 2 months treatment,CD4+,CD4+/CD8+ of patient in treatment groups were different with that of control group (P ＜ 0.01 or P ＜ 0.05).80 patients after anti-TB plus application thymopentin regulating immunity for 2 months,normal sputum negative conversion rate of CD4+ was 97.2％ and improvement rate was 98.0％.However cases with high CD4+ T lymphocyte subsets showed 78.6％ negative rate of acid-fast bacilli and 88.0 ％ cured rate,and there was significant difference (x2 =4.764,7.680,respectively,P ＜ 0.05).Conclusion Thymic peptide five might have the ability of improving the cellular immune function in patients with pulmonary tuberculosis and diabetes.The prognosis is better when T lymphocyte subsets CD4+ of patient was back to normal through treatment.

Objective:The present study was designed to explore the role of ER stress in cardiac hypertrophy of adult APPswe /PS1dE9 transgenic mice.Methods:10 adult APPswe/PS1dE9 transgenic mice and 10 C57BL/6 wild type (WT) mice were divided into the transgenic experimental and control group,WT experimental and control group,respectively,with 5 mice in each group.Experimental groups received a low dose ofIsoproterenol (ISO) (2 mg/kg) once a day for 4 weeks to induce cardiac hypertrophy,while control groups received the same volume of normal saline.After 4 weeks,the mice were anesthetized,followed by,electrocardiogram (ECG) recording and the measurement of the heart rate and body weight before being sacrificed.The heart was dissected out,and the masses of heart and the left ventricle were measured,the left ventricule mass index (LVW/BW) and the whole heart weight ratio (HW/BW) were calculated.HE staining was used to observe the pathological and morphological changes of cardiomyocytes,and Western Blot and immunohistochemistry were used to detect the expressions of ER stress relevant proteins-GRP78,JNK,P-JNK and CaMKII.Results:Compared with WT experimental mice,the ventricular wall in the APPswe/PS1dE9 transgenic experimental mice was apparently hypertrophic after the induction by low doses of ISO,and the HW/BW and the LVW/BW were also significantly increased in the APPswe/PS1dE9 transgenic experimental mice than those in the transgenic control mice,WT experimental and control mice (P＜0.05).HE staining showed that compared with the transgenic control mice,WT experimental and WT control mice,in the adult APPswe/PS1dE9 transgenic experimental mice,the cardiomyocyte diameter was obviously increased,cell density was decreased,the capillary density was decreased,the intercellular substance was increased,and the intercellular space was increased.Western blot showed that the expression of GRP78,p-JNK and CaMKII in the experimental group of adult APPswe / PS1dE9 transgenic mice were significantly higher than those in the transgenic control mice and WT mice (P＜0.05,P＜0.01).There were no significant difference among the control group oftransgenic mice and the two groups of WT mice.Immunohistochemistry showed that the positive rates of GRP78 and CaMKII in the cytoplasm of cardiomyocytes of the APPswe/PS1 dE9 transgenic experimental mice were significantly higher than those of experimental WT mice (80％&40 ％)(P＜0.05),and the expressions in the two control groups were negative.The positive rates of p-JNK and JNK in the APPswe/PS1dE9 transgenic experimental mice were 90％ and 40％ respectively,and the expressions were negative in other three groups.Conclusions:The adult APPswe/PSldE9 transgenic mice are more prone to cardiac hypertrophy than WT mice after the induction with a low dose of ISO.ER stress is involved in the formation of cardiac hypertrophy in adult APPswe/PS1dE9 transgenic mice.

Objective To detect the expression of multidrug resistance proteins P-gp, LRP, MRP, and analyze the relationship between them and the clinicopathological factors. Methods The expression of P-gp,LRP, MRP in formalin-fixed paraffin-embedded tissue sections was determined by a labelled StreptavidinPeroxidase (SP) immunohistochemical technique, and the results were analyzed in correlation with clinicopathological data. None of these patients received chemotherapy prior to surgery. Results The positive rates of P-gp, LRP, MRP were 86.4 %, 84.7 % and 27.1%, respectively. The difference between the positive rate of P-gp and MRP was significant statistically, as well as the difference between the expression of MRP and LRP. No significant difference was observed between P-gp and LRP, but the positively correlation between the expression of P-gp and LRP was observed. No significant correlation between the expression of P-gp, LRP, MRP and the grade of differentiation were observed. The expression of P-gp was correlated with clinical stages positively (r=0.742), but the difference with the expression of P-gp in different stages was not significant. Conclusion The expression of P-gp, LRP, MRP in patients with gastric cancer without prior chemotherapy are high and indicates that innate drug resistance may exist in gastric cancer.

Cervical anastomosis by the thoracic approach for the treatment of upper esophageal cancer can simplify surgical steps and reduce incidence of anastomotic leak. This approach has been used for 26 patients with upper esophageal cancer who were admitted to the Jiangsu Cancer Hospital from July 2006 to August 2009. The mean length between lesion and incisor was 23.3 cm. General anesthesia and double-lumen intubation through left posterolateral incision in the fifth intercostal space was adopted. The stomach was dissociated with the technique of "in situ dissociation", and esophagus was dissociated conventionally. Double purse-string suture was adopted to fix the esophageal mucosa onto the supportive base of the stapler, and make purse-string suture to fix stomach on the center pole of the stapler. There was one failure case which has been converted to the manual cervical anastomosis, and the operations for the rest 25 cases were completed successfully, without anastomotic leakage and positive margin. The average blood loss was (352 ±211 )ml, and the average operation time was (3.7 ±0.6 )hours.

Schizophyllum commune has emerged as the most promising model mushroom to study developmental stages (mycelium, primordium), which are two primary processes of fruit body development. Long non-coding RNA (lncRNA) has been proved to participate in fruit development and sex differentiation in fungi. However, potential lncRNAs have not been identified in S. commune from mycelium to primordium developmental stages. In this study, lncRNA-seq was performed in S. commune and 61.56 Gb clean data were generated from mycelium and primordium developmental stages. Furthermore, 191 lncRNAs had been obtained and a total of 49 lncRNAs were classified as differently expressed lncRNAs.Additionally, 26 up-regulated differently expressed lncRNAs and 23 down-regulated between mycelium and primordia libraries were detected. Further, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that differentially expressed lncRNAs target genes from the MAPK pathway, phosphatidylinositol signal, ubiquitin-mediated proteolysis, autophagy, and cell cycle. This study provides a new resource for further research on the relationship between lncRNA and two developmental stages (mycelium, primordium) in S. commune

Objective To investigate the difference of electrocardiographic(ECG)features between total left main artery(LM)occlusion and subtotal occlusion,and analyze risk factors of in-hospital mortality.Methods A total of 94 patients with left main complete occlusion and 99 patients with subtotal occlusion were included.ECG characteristics,coronary angiography and other clinical data were compared,and factors of hospital death were analyzed.The receiver operating characteristics(ROC)curve was used to analyze the predictive value of ECG characteristics in hospital death risk in patients with LM occlusion.The relationship between ECG characteristics,shock and collateral circulation were analyzed in patients with LM occlusion.Results Compared with the subtotal occlusion group,patients with LM occlusion presented with more ST-segment elevation(STE)in Ⅰ,avL,V2-V5,more STE in avR and avL,more left anterior fascicular block+right bundle branch block,prolonged QRS duration,less STE in avR and less STE in avR+V1.The in-hospital mortality was 46.8%(44/94)in LM occlusion and 14.1%(14/99)in LM subtotal occlusion.STE in avR+avL predicted total LM occlusion with a specificity of 0.97,and left anterior branch+right bundle branch block predicted total LM occlusion with a specificity of 1.00.In patients with total LM occlusion,STE in Ⅰ,avL,V2-V5,prolongation of QRS duration,shock,no collateral circulation,STE in Ⅰ,avL,V2-V5 combined with left anterior fascicular block+right bundle branch block,and STE in Ⅰ,avL,V2-V5 combined with shock predicted in-hospital mortality,with the area under the curve of 0.716,0.619,0.766,0.688,0.572,0.785,respectively.The diagnostic specificity of STE in Ⅰ,avL,V2-V5 combined with shock was 0.82,and the sensitivity was 0.75.STE in Ⅰ,avL,V2-V5 combined with left anterior fascicular block+right bundle branch block predicted in-hospital death in LM occlusion with a specificity of 0.94.The proportion of shock was higher in patients with STE in Ⅰ,avL,V2-V5,left anterior fascicular block+right bundle branch block and collateral flow absence(P＜0.05).In patients with total occlusion,no collateral flow was observed in patients with STE in Ⅰ,avL,V2-V5.In patients with STE in avR(including avR+V1),82.4%of patients presented with right coronary collateral circulation supplying the left anterior descending coronary artery and left circumflex artery territory.In patients with STE in avR+avL,69.2%of patients presented with right coronary collateral circulation supplying left anterior descending coronary artery territory.Conclusion Total LM occlusion presents with different ECG features compared with subtotal occlusion.In LM total occlusion,the ECG features predict in-hospital mortality and are associated with different collateral circulation.

Objective To understand the application effect of early screening scale and behavioral intervention effect in children with autism spectrum disorder (ASD). Methods A total of 348 children with suspected ASD were selected and evaluated using the Modified Checklist for Autism in Toddlers (M-CHAT) and Autism Behavior Checklist (ABC). The evaluation results were compared with those from the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Children enrolled were given Early start Denver model (ESDM) intervention. The evaluation results of Gesell Developmental Scale and Autism Treatment Evaluation Checklist (ATEC) scores were compared before and after intervention. Results The sensitivity, specificity, accuracy and Kappa value of M-CHAT for evaluating ASD in children aged 1-3 years were 89.53%, 90.70%, 89.92% and 0.78. The corresponding values of ABC were 78.49%, 81.40%, 79.46% and 0.56. The sensitivity, specificity, accuracy and Kappa value of M-CHAT for evaluating children aged >3-6 years were 87.30%, 77.78%, 84.44% and 0.64. The corresponding values of ABC were 85.71%, 77.78%, 83.33% and 0.62. The sensitivity and accuracy of M-CHAT were higher than ABC for evaluating ASD in children aged 1-3 years (P<0.05). There were no significant differences in sensitivity, specificity and accuracy between M-CHAT and ABC for evaluating ASD in children aged 3-6 years (P>0.05). After intervention, development quotients (DQ) of personal-social aspects, adaptability, language, gross motor, and fine motor of children with ASD were higher than those before intervention (P<0.05). ATEC scores for language, behavior, sensation, and social contact of children with ASD were lower than those before intervention (P<0.05). Conclusion M-CHAT and ABC both can be used for early screening of ASD in children, especially M-CHAT. Early behavioral intervention can effectively improve the condition and developmental level of children with ASD.