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.

The presence of hepatitis B virus (HBV) proteins leads to changes in the cellular gene expression. As a consequence, the cellular signaling processes are influenced by the actions of HBV proteins. It has been shown that HBV nucleocapsid protein and the amino-terminal part of polymerase termed as terminal protein (TP) could inhibit interferon signaling. Further, the global gene expression profiles differ in hepatoma cells with and without HBV gene expression and replication. The expression of interferon (IFN) stimulated genes (ISGs) was differently regulated in cells with HBV replication and could be modulated by antiviral treatments. The HBV TP has been found to modulate the ISG expression and enhance the HBV replication. The modulation of the cellular signaling processes by HBV may have significant implications for pathogenesis.

Objective To investigate the clinical efficacy and safety of temperature-controlled radiofrequency ablation(TCRF)for treatment of elderly patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From March 2009 to June 2010,52 elderly patients with OSAHS confirmed by polysomnography(PSG)were treated with TCRF under local anesthesia.PSG monitoring was used preoperatively and 6 months postoperatively to determine the therapeutic effect.Apnea hyponea index (AHI),the lowest blood oxygen saturation(LSaO2),sleep apnea quality of life index(SAQLI)and the Epworth sleepiness scale(ESS)were assessed before and 6 months after operation.Results All these cases were reevaluated with PSG by the end of postoperative period lasted for 6 months.Thirteen cases were cured,18 cases were significantly improved,15 cases were improved,6 cases were not improved,with a total effective rate of 88.5％(46/52).No serious complications occurred.After operation,AHI decreased from (47.8 ± 13.7)times/h to(13.5 ± 7.3)times/h,LSaO2 increased from 0.677 ± 0.095 to 0.808 ± 0.056,SAQLI increased from(3.53 ± 0.43)scores to(5.01 ± 0.22)scores and ESS scores decreased from(14.93 ± 3.13)scores to(5.33 ± 2.52)scores,all above index had significant differences(P＜ 0.01).Conclusions TCRF for elderly patients with OSAHS is effective,and can improve their health-related quality of life.This treatment is convenient,simple,minimally invasive,repeatable,without serious complications,and can be especially suitable for surgical treatment of elderly patients with mild and moderate OSAHS.

Body Mass Index ; Humans ; Male ; Middle Aged ; Obesity, Abdominal

Biopsy, Fine-Needle ; Cytodiagnosis ; Humans ; Parathyroid Glands ; pathology

Objective To study the relationship between the exposure time of puncture needle of infusion bottle stopper and microbial contamination during clinical intravenous transfusion. Methods A total of 600 cases from November 1, 2014 to January 31, 2015 who have received the clinical intravenous transfusion for investigation were selected.When replacing the infusion bottle (bag), inserting the puncture needle slowly across the bottle stopper and making the needle tip be canted to the transfusion bottle mouth (bag) of the rubber plug, gently squeezing the Murphy's tube until solution was not dripping, recording down the exposure time in the air of the needle tip from medicine droplet to the end. To dip the lower part with sterile swabs and culture the swabs in nutrient broth medium. Meanwhile, to replace the next bottle of medicine and get the remaining 2 ml of liquids into the culture broth medium, after 48 h, both of which medium were switched to blood plate culture cultivation for observing the general situation of the bacteria growth. Results Among the 600 cases of clinical transfusion, 24 cases were positive for sterile swabs microorganisms culture, positive rate was 4.0%, among which microorganisms, 15 cases were gram-positive coccus, 3 cases were gram-negative bacillus, 3 cases were gram-positive bacillus and 3 cases were fungi. Correspondingly, 3 cases were positive for liquid broth culture, positive rate was 0.5%as the gram-positive coccus. The exposure time and broth microbial culture result was statistically significant, while the exposure time and medicinal broth microorganisms culture result possesses had no statistical significance. Conclusions Inserting the puncture needle across the bottle stopper could successfully reduce the liquid drug residues in the infusion bottle (bag), however, which might also cause time-dependent microbial contamination during the exposure process in the air.

Objective This study aimed to investigate the effect of splenic CD11clow CD45RBhigh dendritic cell (DC)derived from endotoxin tolerance (ET)mice on the expression of zinc finger protein A20 in acute liver failure (ALF)and to clarify the possible mechanism.Methods ET mice were modeled. CD11clow CD45RBhigh DC were isolated from spleen by magnetic activated cell sorting (MACS).One hundred and twenty-six healthy male BALB/c mice were randomly divided into four groups:control group (group A,n=6),ALF group (group B,n =40),normal CD11clow CD45RBhigh DC-treated group (group C,n=40),ET-CD11clow CD45RBhigh DC-treated group (group D,n=40).Mice in group B,C and D were injected with D-galactosamine (D-GalN)600 mg/kg and lipopolysaccharides (LPS)10 μg/mouse.Mice in group A were given the same volume of normal saline (NS).Half an hour after the D-GalN/LPS injection,mice in group C were treated with splenic CD11clow CD45RBhigh DC derived from normal mice (1 ×10 6/mouse,0.2 mL/mouse).Mice in group D were treated with splenic CD11clow CD45RBhigh DC derived from ET mice (1 × 10 6/mouse,0.2 mL/mouse).Mice in group A and B were given the same volume of 0.9% NaCl solution (0.2 mL/mouse).Alanine aminotransferase (ALT)and aspartate aminotransferase (AST)levels were measured at each time point.Liver histopathological changes were confirmed by hematoxglin and eosin methods.Expressions of tumor necrosis factor-α (TNF-α),nuclear factor-kappa B (NF-κB),and zinc finger protein A20 were measured by reverse transcriptase polymerase chain reaction(RT-PCR)and Western blot.One-way analysis of variance was used to compare means between groups.Normal distribution and homogeneity of variance were tested.LSD test was conducted in patients accorded with homogeneity of variance.Results ALT and AST levels increased 2 h after modeling in group B and peaked at 24 h,which were significantly higher than groups A (t = 31 .00, 11 .52,both P <0.05).ALT and AST levels also increased after 2 h after modeling and peaked at 24 h in group C and group D,which were both significantly higher than group B (t =14.60,26.43,both P <0.05).The mRNA levels and protein expressions of TNF-αand NF-κB in group B increased gradually and peaked at 12 h after D-GalN/LPS injection.Compared to that of group A,the differences were both statistically significant (t = 427.58,122.42,179.35 ,165 .98,all P < 0.05 ).The mRNA level and protein expression of zinc finger protein A20 in group B decreased gradually and reached the minimum at 12 h after D-GalN/LPS injection,which was statistically different compared to group A (t = 90.80, 160.43,both P <0.05).On the contrary,the levels of zinc finger protein A20 in group C and D increased gradually and peaked at 12 h after D-GalN/LPS injection.The expression level of zinc finger protein A20 in group D was significantly higher than group C (t = 11 .21 ,24.80,both P < 0.05 ).Conclusion Treatment of splenic CD11clow CD45RBhigh DC derived from ET mice contributes to liver protection against D-GalN/LPS-induced ALF.

Objective To study the impact of the thymosin alpha 1 on the toxicity and celluar immune function during neoadjuvant chemotherapy of breast cancer.Methods 83 patients of Ⅱ b-Ⅲ a stage breast cancer were randomly divided into two groups:study group(40 patients,neoadjuvant chemotherapy of CEF combined with thymosin α 11.6mg HQD) and control group(43 cases,neoadjuvant chemotherapy of CEF alone).Results Rates of gastrointestinal reaction and bone marrow depression in study group were significantly lower than those in control group.The levels of CD3,CD4,CD4/CD8 and NK in study group were significantly higher than those in control group after chemotherapy.Conclusion The combination of thymosin alpha 1 and neoadjuvant chemotherapy for breast cancer can reduce the toxicity,improve the tolerance,enhance cellular immune function and improve the quality of breast cancer patient's life.

Objective To evaluate the risk factors of septic shock after mini-percutaneous nephrolithotripsy (mPCNL). Methods Clinical data of 1 590 cases who underwent mPCNL from January 2013 to December 2014 were retrospectively analyzed. The x2 test and logistic regression were used to identify the key risk factors for septic shock after mPCNL. Results Of the 1 590 patients, 18 patients suffered septic shock, including 6 male patients and 12 fe﹣male patients. Their mean age was (45.6 ± 13.5) years (28 ~ 69 years). White cell in urine was 100 percent, the stone diameter ranged from 1.5 to 5.0 cm, unichannel for 15 cases while multichannel for 3 cases, the operation du﹣ration ranged from 45 to 200 min, mean (87.0 ± 56.0) min. 2 in 18 cases died in multiple organ failure, the others recovered till discharged. In x2 test, female gender (P = 0.001), (+++ ~ ++++) white cells in urine (P= 0.042), un-preoperative nephrostomy drainage (P=0.041) had significant association with septic shock after mPCNL. While in multivariate analysis, female gender ( O? = 5.471, 95 % CI: 0.756~21.452, P< 0.05) and un-preoperative nephrostomy drainage (O? =3.106, 95%CI:1.283~7.907, P<0.05) were identified as independent risk factors for septic shock after mPCNL. Conclusions Female gender and un-preoperative nephrostomy drainage are the key risk factors for septic shock after mPCNL.

ObjectiveTo evaluate the methods in treatment of upper urinary calculi in a low-head lithotomy with right or left lateral tilt by an ureteroscopy approach. Methods From September 2009 to May 2015, 110 patients with upper ureteral calculi (after failed ESWL) were underwent holmium laser lithotripsy by a ureteroscopy approach in a low-head lithotomy with right or left lateral tilt. Their clinical data and complications were analyzed retrospectively. Results Surgical effect of patients was satisfied with the success of gravel 91 patients, with a total rate of 82.7 %gravel. Conclusion Low-head lithotomy with right or left lateral tilt is a good body position to perform ureteroscopic lithotripsy for upper ureteral calculi. It is safe and effective.