Objective To explore related factors affecting bone mineral density (BMD) and osteoporosis (OP) in patients with type 2 diabetes mellitus (T2DM). Methods Dual-energy X-ray absorptiometry was used to measure BMD of the femoral neck and the lumbar vertebrae in 220 patients with T2DM. All the patients were divided into three groups:normal bone mass group, decreased bone mass group and OP group according to the value of BMD. The clinical data and biochemical indicators were compared and analyzed between these groups, and the influencing factors of T2DM and OP were explored. Results Compared with normal bone mass group and decreased bone mass group, there were more older patients, longer course of T2DM, lower BMI and high density lipoprotein cholesterol (HDL-C), and higher glycated hemoglobin (HbA1c) level in OP group. There were significantly higher age, longer course of T2DM, higher level of HbA1c, and lower levels of BMI, HDL-C in decreased bone mass group than those of normal bone mass group (P＜0.05). There were no significant differences in waist-to-hip ratio, systolic blood pressure (SBP), diastolic blood pressure (DBP), postmenopausal women (PMW) ratio, fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), blood phosphorus, calcium, total cholesterol (TC), three acyl glycerin (TG) and low-density lipoprotein cholesterol (LDL-C) between three groups. The risk factors for T2DM combined with OP were older, female, long duration of T2DM, higher levels of FPG, 2hPG and HbA1c. Conclusion Older and female T2DM patients were high-risk group of OP. The treatment plan should be timely adjusted by regularly monitoring indexes of blood glucose and HbA1c.

〔Abstract〕 Based on the retrieval sources of the official website of Inforway in Canada , Tongfang Knowledge Network and Internet re-sources, by investigating the conformance test of health informatization and health standards conducted by Inforway in Canada , the paper makes a comprehensive analysis of the conformance test of health information standards in Canada from 4 aspects, namely the certification subject, certification object , certification standard , certification process .It aims to provide references for the conformance test of health information standards in China .

Objective To evaluate the clinical efficacy of Qilinxintongshu pill for treatment of critical patients with unstable angina pectoris (UAP) accompanied by upper alimentary tract damage.Methods A prospective randomized controlled trial was conducted. A total of 60 critical outpatients or inpatients with confirmed diagnosis of UAP accompanied by upper alimentary tract damage in Cardiology Department of Hospital of Traditional Chinese Medicine of Qionghai City from November 2011 to January 2015 were enrolled in the study, and they were assigned to a therapy group (30 cases) and a control group (30 cases) by table of random number. The conventional medical basic therapy was given to both groups, in addition, the patients in therapy group took Qilinxintongshu pill (made of notoginseng, dragon's blood, fruit of immature citron, etc.) 5 g once, three times a day, and the patients in control group orally administered clopidogrel 75 mg once a day, the therapeutic course being consecutive 30 days. After treatment, the rates of main cardiovascular events [including death, a newly-happened myocardial infarction (MI), and obstinate ischemia] and events of alimentary damage were compared between the two groups, and adverse effects were observed.Results There was no statistically significant difference in incidence of cardiovascular events between the therapy group and control group [6.7% (2/30) vs. 16.7% (5/30),P > 0.05]. The incidence of massive hemorrhage of gastrointestinal tract was significantly lower in therapy group than that in control group [10.0% (3/30) vs. 36.7% (11/30),P < 0.05]. In the treatment process, there was no significant untoward side effect, and no abnormalities in routine blood and urine tests, liver and renal functions were found.Conclusion Qilinxintongshu pill for treatment of critical patients with UAP accompanied by upper alimentary damage is safe and effective, and does not enhance the incidence of massive hemorrhage of gastrointestinal tract.

Objective To observe the therapeutic effect of Qilin Xintongshu pill for treatment of patients with non-ST segment elevation acute coronary syndromes(NSTE-ACS)accompanied by gastrointestinal bleeding (GIB). Methods A prospective randomized controlled trial was conducted. A total of 67 hospitalized patients in Cardiovascular Department of Qionghai City Hospital of Traditional Chinese Medicine were divided into therapy group(35 cases)and control group(32 cases). Both groups were given conventional medical treatment(except anti-coagulative agent). In the therapy group,the patients received Qilin Xintongshu pill(the ingredients consisting of panax pseudo-ginsen,dragon's blood,immature orange fruit,etc.)oral administration,once 5 mg and 3 times a day,while in the control group,the patients accepted clopidogrel orally,once 75 g and once a day,the therapeutic course in both groups being 30 days. The major cardiovascular events(such as death,a newly-happened myocardial infarction(MI),MI secondary,obstinately ischemia)and incidence of massive hemorrhage of gastrointestinal tract were compared between the two groups,and the adverse events were observed. Results After treatment,the incidence of cardiovascular events and massive hemorrhage of gastrointestinal tract in the therapy group were decreased significantly compared to those in the control group 〔incidence of cardiovascular events:8.57%(3/35)vs. 28.13%(9/32), incidence of massive hemorrhage of gastrointestinal tract:2.86%(1/35)vs. 21.88%(7/32),both P<0.05〕. Adverse events were not observed in both groups,and the examinations of blood,urine,liver and renal functions were of no abnormalities before and after treatment. Conclusion Qilin Xintongshu pill can effectively reduce the incidences of cardiovascular events and massive hemorrhage of gastrointestinal tract in patients with NSTE-ACS accompanied by GIB in the therapeutic course of 30 days,therefore this traditional Chinese herbal medicine is an ideal agent for treatment of such disease.

OBJECTIVE: To analyze and explore the association between the 1607(1G/2G) single nucleotide polymorphism (SNP) in promoter of matrix metalloproteinase-1 (MMP-1) gene and susceptibility of head and neck cancer (HNC) by Meta-analysis. METHOD: By the end of January 2014, the published literatures were collected for the case-control studies evaluating the relationship between HNC and -1607 SNP of MMP-1 gene from English and Chinese literature databases according to the inclusion and exclusion criteria. Then the meta-analysis, the heterogeneity, bias and sensitivity of the results of the eligible literatures were conducted by Stata 10. 0. RESULT: A total of 9 studies including 2049 patients with HNC and 2158 controls were extracted for systematic review on the association of MMP-1 (-1607) 1G/2G SNP with the risk of HNC. Meta-analysis which based on random effects model showed that MMP-1 (-1607) 1G/2G SNP can significantly increase the risk of HNC[1G2G + 2G2G vs. 1G1G: OR = 1.45, 95% CI 1.25-1.68, P < 0.01; 2G2G vs. 1G1G + 1G2G:OR = 1.77, 95% CI 1.37-2.30, P < 0.01; 2G vs. 1G: OR = 1.52, 95% CI 1.26-1.85, P < 0.01; 2G2G vs. 1G1G: OR = 2.06, 95% CI 1.41-3.01, P < 0.01). CONCLUSION MMP-1 (-1607) 1G/2G SNP has close relationship with HNC susceptibility, people who with 2G2G genotype carriers are susceptible to HNC.
Asia ; Asian Continental Ancestry Group ; Case-Control Studies ; Genotype ; Head and Neck Neoplasms ; enzymology ; ethnology ; genetics ; Humans ; Matrix Metalloproteinase 1 ; genetics ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic

BACKGROUND:Slow growth of peripheral nerve, muscle denervation atrophy and fossilization of motor end plate fol owing sciatic nerve injury cause irreversible limb function disorders. Umbilical cord mesenchymal stem cells have been widely used in multi-disciplinary research, but studies concerning umbilical cord mesenchymal stem cells delaying denervated muscle atrophy in rats fol owing peripheral nerve injury are rarely reported.
OBJECTIVE:To observe the value of human umbilical cord mesenchymal stem cells transplantation to delay denervated muscle atrophy of rats after sciatic nerve injury.
METHODS:Umbilical cord blood was col ected from healthy parturient woman after ful-term delivery. In the experimental group, the rat’s Sunderland IV degree sciatic nerve injury model was established by 5 mm denervation, epineurial repair, and 5 mm smal gap transplantation of umbilical cord mesenchymal stem cells. In the control group, after modeling, the same volume of normal saline was injected into the smal gap. The main outcome measures included the sciatic nerve function index, the wet weight of triceps surae,sciatic nerve latency, action potential conduction velocity and amplitude,and skeletal muscle fiber cross section area maintenance rate.
RESULTS AND CONCLUSION:After 4, 8 and 12 weeks of modeling, the sciatic nerve function index values, the wet weight of triceps surae and skeletal muscle fiber cross section area maintenance rates in the experimental group were significantly higher than those in the control group (P<0.05). After 12 weeks of modeling, electromyography results showed sciatic nerve latency was significantly lower, but action potential conduction velocity and amplitude were dramatical y higher in the experimental group than the control group (P<0.05, P<0.001). Human umbilical cord mesenchymal stem cells transplantation in denervated muscle atrophy rats after sciatic nerve promotes nerve growth, delays denervated muscle atrophy, maintains the denervatied neuromusle’s morphology and function.

This paper defined the main stakeholders of basic medical insurance mobile payment using the stakeholder theory, namely the government ( medical insurance bureaus, human resources and social insurance authorities, and healthcare regulators ), medical insurance agencies, pilot hospitals, medical workers, patients, and third-party social resources ( third-party payment entities, commercial insurers, web-based medical enterprises, and state-own financial institutions). SWOT analysis is used in analysis of stakeholders, to uncover the strength, weakness, opportunity and threats in advancing basic medical insurance mobile payment, thereby proposing how to guarantee the healthy and sustainable development of such mobile payment.

At present,the prevention and control of the COVID-19 is still severe,its pathogen SARS-CoV-2 is highly infectious and pathogenic,and the population is generally susceptible.Thus,it requires a higher standard to diagnose and treat patients with acute abdomen.The first step is to carry out procedures to identify whether the patient is infected or not.Those who are not infected can go through the normal treating procedures.For patients diagnosed with COVID-19 or suspected patients,the second step is to achieve classified diagnoses and treatments,and to adopt a treating plan that integrates TCM and western medicine.In order to protect patients and medical staff,the COVID-19 in hospital transmission must be avoided.For patients with COVID-19 who need emergency surgery,we must strictly comply with the hospital 's protection regulations,closely coordinate the relevant departments of surgery,perform the three-level protection,operate in accordance with the principle of damage control in the negative pressure surgery room,and return to the isolation ward according to the prevention and control process after operation.For units without surgical conditions,patients should be transferred to hospital in time on the premise of maximum damage control,and patients must not be delayed for timely diagnosis and treatment due to the epidemic.

Objective:To evaluate the surgical effect of repairing soft tissue defect of hand and foot with medial gastrocnemius fascia flap combined with skin graft.Methods:From January, 2018 to June, 2019, 10 patients were treated with transfers of free medial gastrocnemius fascia flaps combined with skin graft to repair soft tissue defect of hand and foot. The size of free fascial flap was 5.0 cm×8.0 cm-12.0 cm×15.0 cm. After successful transfer on the wound, the skin was grafted onto the fascial flap, and the donor site was sutured directly. The appearance and function of the recipient and donor sites were observed and the effect of the operation was evaluated. Sensory recovery was assessed by the standard set by British Medical Research Council (BMRC) at the last follow-up.Results:All the free medial gastrocnemius fascia flap survived. After 6-10 days of granulation tissue growing, the skin grafts were transferred and all survived. All patients entered follow-up for 3-9 months, with an average of 7.5 months. The tissue at the recipient sites were soft and wear-resistant without swelling or ulceration. According to the self-designed evaluation system of soft tissue defect reconstruction, 10 patients had score from 68 to 92 (average, 75.2) . At the last follow-up, sensory recovery was assessed by BMRC, 7 cases were excellent and 3 cases were good.Conclusion:The repair of hand and foot soft tissue defect by the free medial gastrocnemius fascia flap combined with skin graft has advantages in constancy of vascular anatomy of free fascia tissue, long vascular pedicle and for repair of various types of hand and foot defects. Skin of the recipient area is soft with good appearance without swelling after the reconstruction of fascia flap. It is a method of treatment in repair of soft tissue defect of hand and foot by avoiding the thinning of a flap in the second procedure.

Objective:To screen genetic and epigenetic expression differences associated with pulmonary embolism through integrated bioinformatics analysis.Methods:Four patients with pulmonary embolism and healthy physical examination in the Third Affiliated Hospital of Xinjiang Medical University in 2019 were selected as the research objects, using high-throughput sequencing technologies and methylation chip technology to detect, screening and integrated peripheral blood difference genomes and the epigenome data to identify the pathogenesis of pulmonary embolism caused by methylation of drive and differentially expressed genes, GO and KEGG enrichment analysis were performed.Results:Coexpression analysis of DNA methylation and gene expression data between the pulmonary embolism group and the healthy control group showed that differential methylation in the upstream region of genes was negatively correlated with gene expression. Among them, 8 significantly methylated genes in the upstream region of genes were screened out, and independent sample t-test and Pearson correlation analysis were done. In the pulmonary embolism group, there were 6 significant methylated genes of TSS1500, namely TSPO2, C1QA, AQP1, TNFSF9, MIA and STAB1, and the differential expression multiple log2FC of corresponding genes was 1.298, 1.629, 1.024, 2.746, 2.539, 1.060, respectively. The correlation between gene expression and gene methylation were -0.908, -0.900, -0.824, -0.784, -0.783, -0.779, respectively, and the methylation differences between the two groups were -0.049, -0.053, -0.048, -0.057, -0.050, respectively. -0.053 ( P < 0.05). There were three significantly methylated genes in the TSS200 region, namely TSPO2, SLC9A, and SIGLEC1. The gene expression differential multiple log2FC was 1.298, -2.252, and 1.866, respectively. The correlation between gene expression and gene methylation was -0.860, -0.774, and -0.739, respectively. The methylation difference between the two groups was -0.051, 0.027, -0.048 ( P < 0.05). In the pulmonary embolism group, 7 genes, including TSPO2, C1QA, AQP1, TNFSF9, MIA, STAB1 and SIGLEC1, showed hypomethylation and high expression in the TSS region. SLC9A3 gene showed high methylation and low expression. In the analysis of GO function, significant enrichment was obtained in complement activation, immune response and activation protein cascade. In the KEGG signaling pathway, the immune system, bacterial infection, and signaling molecules and interactions are significantly enriched, thereby regulating the occurrence of pulmonary embolism. Conclusions:Based on the combined analysis of DNA methylation and gene expression, a new idea of the occurrence and development of pulmonary embolism has been found, which can be further studied in the future.