The paper introduces the user demands and the concept of health management,proposes the design idea of the health management system,and develops a comprehensive health management service platform integrating functions of health registration,medical examination,health assessment,exercise and physiotherapy,and regular follow-up.It mainly describes the system architecture and major functional modules.

It has been widely accepted that Faecalibacterium prausnitzii (Fp) induces the differentiation of Treg cells.Lymphocyte function-associated antigen-1 (LFA-1) is also involved in the differentiation of Treg cells.Aims: To investigate the effect of Fp on Treg cells and cytokines in colitis mice with LFA-1 knockout (LFA-1-/-).Methods: Twenty wild type mice and twenty LFA-1-/-mice with same genetic background were randomly divided into wild type control group, wild type treatment group, LFA-1-/-control group and LFA-1-/-treatment group.Colitis model was induced by drinking DSS solution.Mice in the two treatment groups were intragastrically administrated with Fp.General status and histopathological score were assessed.Percentages of Treg cells in spleen and mesenteric lymph nodes were measured by flow cytometry.Serum levels of IL-10 and TGF-β1 were measured by ELISA.mRNA expressions of IL-10 and TGF-β1 in colonic tissue were detected by real time PCR.Results: Compared with corresponding control groups, histopathological score was significantly decreased in wild type treatment group (P<0.05);percentages of Treg cells in spleen and mesenteric lymph nodes were significantly increased (P<0.05), serum levels of IL-10 and TGF-β1 were significantly increased (P<0.01), expression of TGF-β1 mRNA was significantly increased in wild type treatment group and LFA-1-/-treatment group (P<0.05);expression of IL-10 mRNA was significantly decreased in LFA-1-/-treatment group (P<0.01).Compared with wild type treatment group, serum level of TGF-β1 was significantly decreased (P<0.05), and mRNA expressions of IL-10 and TGF-β1 were significantly decreased in LFA-1-/-treatment group (P<0.05).Conclusions: Fp can up-regulate the percentages of Treg cells and enhance the secretion of anti-inflammatory cytokines IL-10 and TGF-β1 in LFA-1-/-mice.The therapeutic efficacy for colitis in wild type mice is superior to that in LFA-1-/-mice, which may be related to the inhibition of function of Treg cells and secretion of cytokines due to LFA-1 knockout.

Objective To investigate the short and longterm effect of the treatment on acute coronary syndrome(ACS) with percutaneous coronary angioplasty and stenting.Methods 65 patients suffering from ACS were treated with angiography to illuminate the features of lesions and proceeded with percutaneous coronary angioplasty and stenting when the angina was not completed controlled with internal medicine.All patients were treated with a new anti-thrombotic regimen,including aspirin,ticlopidine or clopidogrel, and low-molecular-weight heparin.Results The rates of success for patients and lesions were 96.9% and 82.7% respectively.One patient died without myocardial infarction or emergency bypass surgery.56 patients had no symptom of angina after procedure,and 5 patients had non-typical chest pain which disappeared within 2~3 days.During the 3~54 month follow-up,one patient died,one patient developed myocardial infarction and 4 patients underwent target vessel revascularization(repeated angioplasty 2 and bypass surgery 2).Conclusions With the widespread use of aspirin-ticlopidine-low molecular heparin regimen,ACS patients can undergo PTCA and stenting with high success rate,excellent immediate efficacy and long-term efficacy.

The national examination of doctors' qualification is the examination which assesses the medical students' knowledge and skills for doctors' work. This paper introduced autorities concerned, implementing agencies, examination forms and procedures, examination contents and keypoints, pass-ing criteria and matters needing attention of national examination of doctors's qualification be tween Canada and Australia expecting to provide references for the revolution of Chinese Examination of Doctors' Qualification.

OBJECTIVETo investigate the main factors that influence measles morbidity and the genotype of measles virus, so as to provide evidence for scientific decision making to further control the prevalence of measles.

METHODA retrospective analysis included 182 children in Children's Hospital of Fudan University, diagnosed with measles from January 1, 2012 to December 31. The clinical and epidemiological characteristics, including the gender, age, the incidence of seasonal trends, measles vaccine vaccination history, contact history and other clinical manifestations, laboratory test results, and so on were analyzed. And the reverse transcription PCR (RT-PCR) was adopted to detect sputum specimens from suspected patients with measles,who were selected randomly,the sequence of the part of the PCR products was analyzed.

RESULT(1) Clinical and epidemiological data: Totally were 182 children with measles (125 males, 57 females) were enrolled into this study. The age of the patients ranged from 3 months to 89 months, 127 cases were younger than 9 months (69. 8%). The prevalence season was from April to August, while the peak month was April and May (22. 5%, 23. 1%). Among 182 hospitalized children, only 11 cases underwent measles vaccination (6. 0%), and among them 5 cases were within 2 weeks before disease onset. A total of 167 cases (91. 8%) had not been vaccinated, most of whom were immigrants, and the measles vaccination history of the remaining 4 cases were unknown. There was a positive correlation between the measles vaccination ratio in children of the floating population (8. 45%, 6/71) and the settled children (29.4%, 5/17, χ =8. 11 P =0. 004). In total, 24 cases (13. 2%) had definite measles exposure history, with 153 cases (84. 1%) of unknown origin,5 cases (2.7%) without any history of contact. (2) Clinical manifestations: All the 182 patients had fever (100%) and obvious rashes (100%), among them 145 cases had body temperature higher than 39 °C (79. 7%). The fever period ranged from 2 to 38 days. Among 182 hospitalized children,165 cases (90. 7%) had typical measles,17 cases had atypical measles. Among the 17 cases, two had severe measles, one had heterotypic measles. (3) The common complica tions: 96 cases had pneumonia (52. 8%), 80 had laryngitis (44. 0%), 38 had bronchitis (20. 9%),15 had hepatic dysfunction (8. 2%), 11 had myocardial damage (6. 0%), 3 had febrile seizures (1. 6%), and no patient had encephalitis. Of the 96 cases with pneumonia, 92 received sputum test; 38 were sputum culture positive (41%). The dominant pathogens were Streptococcus pneumoniae(11/38,29%), Haemophilus influenzae (6/ 38,16%), Moraxella catarrhalis (4/38, 11%), Escherichia coli (4/38, 11%), Candida albicans (4/38, 11%), Mycoplasma pneumoniae (4/38, 11%) and Staphylococcus aureus (3/38, 8%). (4) The H1a genotype was the only one genotype in the detected sequence of 54 measles virus strains.

CONCLUSIONMeasles was more often seen in the children under the age of 9 months from the floating population. The morbidity peak month was from April to May in Shanghai. The H1a genotype was the only one genotype. We should try to improve vaccination coverage rate in the children who are at the age for vaccination, so as to prevent measles outbreak.

Child ; Child, Hospitalized ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Female ; Genotype ; Humans ; Infant ; Male ; Measles ; epidemiology ; Measles Vaccine ; administration & dosage ; Measles virus ; classification ; Retrospective Studies ; Vaccination ; statistics & numerical data

Objective:To observe the clinical efficacy of treating somatoform pain disorder(SPD)with electroacupuncture(EA)at the Governor and Conception Vessel points plus duloxetine.Methods:Eighty-two SPD patients were randomly allocated to an observation group and a control group,with 41 cases in each group.The control group was intervened by oral administration of duloxetine hydrochloride enteric capsules at a dose of 60 mg per time once a day;based on the medication,the observation group received additional EA treatment by selecting points from the Governor and Conception Vessels.Clinical efficacy was evaluated after 8 weeks of treatments;changes in the scores of the short-form McGill pain questionnaire(SF-MPQ),self-report symptom inventory,symptom check list-90(SCL-90),Pittsburgh sleep quality index(PSQI),and generic quality of life inventory-74(GQOLI-74)were also compared.Results:After the intervention,the observation group surpassed the control group in comparing the total effective rate(P＜0.05).The SF-MPQ score,SCL-90 somatization score,and PSQI score dropped notably in both groups after treatment,and the intra-group differences were statistically significant(P＜0.05);the three scores were significantly lower in the observation group than in the control group(P＜0.05).The GQOLI-74 score got an increase in each dimension in both groups after treatment,and the intra-group differences were also statistically significant(P＜0.05);the GQOLI-74 dimension scores were all significantly higher in the observation group than in the control group(P＜0.05).Conclusion:For patients with SPD,combining EA at the Governor and Conception Vessel points and duloxetine hydrochloride enteric capsules can markedly improve their clinical symptoms and quality of life.

Objective To investigate the clinical effect of Transcather arterial embolization in treatment of acute obstet-rics hemorrhage. Methods From January 2012 to October 2014 in our hospital,selected 91 patients with acute obstet-rics hemorrhage as the research object,were divided into operation group and the conservative group,the conservative group 41 cases were treated with conservative treatment(invalid to uterine resection or ligation treatment),the operation group 50 cases were treated with the catheter arterial embolization. The hemostatic time,hemostatic efficiency,uterine resection rate and the incidence of adverse reactions were compared between two groups. Results The time of hemostasis operation group was (1.43±0.65)h, and the conservative group's bleeding time was (7.48±1.62)h (P<0.01);operation bleeding control rate and hysterectomy rates of operation group were 92.00%,8.00%, was higher than optimal opera-tion group(51.22%, 48.78%)(P<0.01). Conclusion Acute obstetrics hemorrhage more common,conservative treatment ineffective, to transcatheter arterial embolization treatment has exact effect, the hemostatic rate and high safety, can be better to retain the uterus,is worth learning from.

Background:The abundance of Faecalibacterium prausnitzii (Fp) is reduced in patients with inflammatory bowel disease (IBD).Previous studies demonstrated that the supernatant of Fp exerts an obvious anti-inflammatory effect in experimental colitis.Aims:To investigate the effect of Fp supernatant on monocytes/macrophages and colonic inflammation in dextran sulfate sodium (DSS)-induced colitis in mice.Methods:Thirty male C57BL/6J mice were randomly divided into control group,colitis group and Fp treatment group.Acute colitis was induced by drinking 4.5％ DSS in distilled water for seven days in colitis and Fp treatment groups.Mice in Fp treatment group were also given gastric infusion of Fp supernatant during the process of colitis induction.Weight loss,defecation and histopathological damage of colon tissue were observed.The percentages of monocytes and macrophages of different phenotypes in spleen and colonic lamina propria,as well as the serum levels of a series of inflammatory cytokines were detected by flow cytometry.Results:Compared with colitis group,Fp treatment showed an ameliorating effect on weight loss,shortening of colon length and histopathological damage (P ＜ 0.05).The percentages of total amount of monocytes and proinflammatory monocytes in spleen and colonic lamina propria,and the percentage of M1 macrophages in colonic lamina propria in Fp treatment group were significantly lower than those in colitis group;the percentage of M2 macrophages in colonic lamina propria in Fp treatment group was significantly higher than that in colitis group (P all ＜ 0.05).The serum levels of interleukin (IL)-10 and IL-4 in Fp treatment group were significantly higher than those in colitis group,and the levels of IL-6,interferon (IFN)-γ and chemokine CCL2 were significantly lower than those in colitis group (P all ＜ 0.05).Conclusions:Fp supernatant may exert anti-inflammatory effect in experimental colitis in mice via reducing proinflammatory monocytes,inducing M2 polarization of macrophages in inflamed colon,promoting secretion of anti-inflammatory cytokines,and inhibiting secretion of proinflammatory cytokines and chemokines.

Objective To explore the application of "disease-characteristics nursing quality improvement" program in the nursing practice of atrial fibrillation patients. Methods On basis of patient-centered and evidence-based nursing, the cardiovascular department of Peking University First Hospital made the "disease-characteristics nursing quality improvement" program. The differences of patients′ satisfaction, the index of work satisfaction of nurses, the index of disease management before (2014)and after(2015)the implementation of "disease-characteristics nursing quality improvement"program were observed and compared. Results Before and after the "disease-characteristics nursing quality improvement" program, the patients′ satisfaction were 90.0%(135/150) and 96.8%(149/154), the rate of well warfarin knowledge were 74.3%(78/105) and 90.2%(101/112), the compliance rate of international standardization ratio were 79.0%(83/105) and 91.1%(102/112), the rate of telephone follow-up as requested were 57.3%(86/150) and 85.7%(132/154), the rate of outpatient follow-up as requested were 72.0%(108/150) and 83.1%(128/154). The differences all above were statistically significant (χ2=5.408-30.171,all P<0.05).Before and after the"disease-characteristics nursing quality improvement"program, the scores of the index of work satisfaction were(135.19±19.17)and(178.37±18.46)points.The difference was statistically significant (t=-13.577, P<0.05). Conclusions The "disease-characteristics nursing quality improvement"program is an effective method to improve the nursing quality of patients with atrial fibrillation.

Objective:To compare the effect of O-arm assisted and free-hand pedicle screw placement in the treatment of AO type C thoracolumbar fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 34 patients with type C thoracolumbar fracture admitted to Henan Provincial People′s Hospital from January 2018 to June 2021, including 23 males and 11 females; aged 42-63 years [(50.4±7.4)years]. The fracture was located at T 11 in 4 patients, T 12 in 10, L 1 in 12, L 2 in 6, T 11~12/L 1 in 1 and T 12/L 1 in 1. Posterior reduction and internal fixation was carried out for all patients, of whom 18 were treated with O-arm assisted pedicle screw placement (navigation group) and 16 with free-hand pedicle screw placement (free-hand group). The operation time, single screw placement time, intraoperative bleeding volume, operation mode and screw placement accuracy were compared between the two groups. The kyphotic Cobb angle, visual analogue score (VAS) and American Spinal Injury Association (ASIA) score were compared between the two groups before operation, at 1 week after operation, at 3 months after operation and at the last follow-up. Postoperative complications were observed. Results:All patients were followed up for 12-29 months [(16.8±6.1)months]. There was no significant difference between the two groups in the operation time, intraoperative bleeding volume and operation mode (all P>0.05). The single screw placement time was (9.4±1.6)minutes in navigation group, but was (10.8±1.5)minutes in free-hand group ( P<0.05). The screw placement accuracy was 97.4% in navigation group, but was 81.5% in free-hand group ( P<0.01). The kyphotic Cobb angle and VAS had no significant differences between the two groups before operation (all P>0.05). The kyphotic Cobb angle in navigation group and free-hand group was (4.3±1.1)° and (5.9±1.1)° at 1 week after operation, (4.4±1.2)° and (5.7±1.3)° at 3 months after operation, and (4.4±1.2)° and (6.8±0.9)° at the last follow-up, decreased significantly from that before operation [(21.8±3.1)°, (22.2±3.2)°] (all P<0.01). The kyphotic Cobb angle in navigation group was significantly lower than that in free-hand group at 1 week, 3 months after operation and at the last follow-up (all P<0.01). The VAS in navigation group and free-hand group was (3.2±0.7)points and (4.1±0.7)points at 1 week after operation, (2.4±0.6)points and (3.0±0.8)points at 3 months after operation, and (1.8±0.9)points and (2.6±0.7)points at the last follow-up, decreased significantly from that before operation [(8.4±0.8)points, (8.3±0.9)points] (all P<0.01). The VAS in navigation group was significantly lower than that in free-hand group at 1 week, 3 months after operation and at the last follow-up (all P<0.01). The ASIA score showed no significant difference within and between the two groups before operation, at 1 week, 3 months after operation and at the last follow-up (all P>0.05). Postoperative incision infection occurred in 1 patient in both groups ( P>0.05). Implant failure such as loosening or displacement was not observed in navigation group, and only occurred in 2 patients in free-hand group ( P>0.05). Conclusion:Compared with free-hand pedicle screw placement, O-arm assisted pedicle screw placement in the treatment of AO type C thoracolumbar fracture has advantages of rapid and accurate screw placement, good reduction and notable pain relief.