An introduction to the telemedicine service of the hospital in its web-based hospitalprogram which covers theweb-based healthcare center,and thehealthcare cabin to interact with the center remotely.The center operates on the telehealth management platform based on cloud computing, offering remote monitoring,health assessment,health management,follow-up,online consultation,pre-registration and mobile payment.Theweb-based hospitalcan simplify the medical service flow,alleviate the complaints incurred by concentrated quality medical resources,influx of patients and limited physical space of tertiary hospitals,and the tense doctor-patient relationship as well.

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) with scissors knife in difficult cases.Methods A total of 36 sessions of ESD in 34 patients were performed from May 2010 to May 2012 with application of new scissors knife.The complications and followup outcomes were recorded.Results All lesions were removed successfully with an en bloc resection rate at 91.7％.Delayed bleeding occurred in 2 patients (5.6％),and both of them were cured sucessfully with endoscopy.No perforation happened and the average hospitalization time was 5 days.Follow-up endoscopy performed 6 or 12 months after ESD in 6 patients revealed no recurrence or residual lesions.Other patients are under follow-up now.Conclusion The scissors knife is easy to manipulate,which can ensure the safety and efficiency of ESD.

An organic solvent tolerant isolate A213 originating from soil samples were successfully isolated via direct plating method using 10g/L of toluene as the sole carbon source and transparent cycle plate assay method.It was identified as Yarrowia based on its characteris- tics.The results in shake flask cultivation showed that the suitable tipase producing media were(g/L):yeast extract 40,vegetable oil 10, MgSO_4?7H_2O1,KH_2PO_4 5.Under optimal culture conditions (27℃and pH 6.5 ),the maximal lipase activity could reach 67.8 IU/ mL The optimal pH and temperature for the hydrolysis of p-nitrophenyl acetate by crude lipase were pH6.5 and 40℃The enzyme was sta- ble under 70℃and pH 5.5～8.5.Then isolate A213 was found to produce the lipase which can synthesize L-ascorbyl palmitate in tert-amyl alcohol validated by the thin-layer chromatography.

Objective To determine the effect of nanochemotherapy drug on Survivin and p53 ex-pressed by human biliary traet carcinoma cell line QBC939.Methods Culturing the human biliary tract carcinoma cell line QBC939 in vitro and it was divided into five groups including saline,nanochemotherapy drug,nanopartiele withoul nanochemotherapy drug,5-FU and gemcitabine.Using the methods of MTT and flow cytometry to observe the growth of QBC939 which was dealt with different drugs.In addition,RT-PCR and Western blot were used to delect the expression of mRNA and protein by Survivin or p53.Results The expression of mRNA and protein by Survivin decreased in the following set:saline,nanoparlicle withoul nanochemotherapy drug,5-FU,gemcitabine and nanochemotherapy drug,respeclively.However,the ex-pression of mRNA and protein by p53 were in reverse order.The inhibiting action to QBC939 was obvious in nanochenmtherapy drng and the apoplotic rate was higher than others except for gemcitabine(P＜0.05). Conclusion Nanochemotherapy drug has significant effect on treatment cholangiocarcinoma in vilro,which may attribute to the down regulation of Survivin and up regulation of p53.

Objective To evaluate renal hemodynamic changes in hydronephrosis children with no image on intravenous urography by color doppler flow image(CDFI). Methods The resistance indexes(RIs)in main renal arteries(MRAs),interlobar renal arteries(IRAs)and arcuate renal arteries(ARAs)were measured in 48 children with hydronephrosis with no image on intravenous urography.The thickness and area were also measured in hydronephrotic kidneys.Resistive index ration(RIR=hydronephrotic kidneys RI/contralateral RI)was calculated. And pathological changes of kidneys were graded in these cases.Spearman's correlation test was used to compare RIR and pathological grades in these kidneys. Results In healthy and hydronephrotic kidneys,the relevant parameters were as fol1.13±0.14,1.14±0.09,respectively in MRAs,IRAs,ARAs in hydronephrotic kidneys(P＞ness,area of hydronephrotic kidneys(P＜0.05),also between RIR and thickness,araa(P＜0.05),MRAs,IRAs,ARAs and pathologic grades(P＜0.05),especially in IRP(s(r=0.795,P＜0.01).Conclusions RIR of IRA could be an ideal parameter of renal hemodynamics to evaluate renal damage in children with congenital hydronephrosis with no image on intravenous urography.

OBJECTIVETo study changes of plasma ADMA levels of patients with non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI) and to explore the effect of Salvia Miltiorrhiza (SM) on them.

METHODSTotally 52 patients with confirmed NSTEMI undergoing PCI were randomly assigned to the SM treated group and the control group, 26 in each group. Patients in the SM treated group received the conventional therapy plus SM (1 g each time, three times per day till one month after PCI). Those in the control group only received the conventional therapy. Plasma ADMA levels were measured before PCI, and at day 1 and 30 after PCI.

RESULTSPlasma ADMA levels in both group obviously decreased at day 30 after PCI with statistical difference (P < 0.01). The decrement was more obviously seen in the SM treated group, with statistical difference when compared with the control group (P < 0.01).

CONCLUSIONSPatients with NSTEMI undergoing PCI could have plasma ADMA levels decreased. Administration of SM just before PCI might be associated with negative regulating plasma ADMA levels.

Arginine ; analogs & derivatives ; blood ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Myocardial Infarction ; metabolism ; Percutaneous Coronary Intervention ; Salvia miltiorrhiza

Abstrac Objective:To investigate the clinical efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in the treatment of squamous-cell lung cancer patients with EGFR mutations. Methods:We screened out seven patients who were diag-nosed with EGFR mutations and received EGFR-TKIs, such as gifitinib or erlotinib, from 2,317 squamous-cell lung cancer patients treat-ed at the Beijing Chest Hospital from January 2010 to July 2016. Results:After using EGFR-TKIs, the objective response rate was 42.9%, the disease control rate was 100%, and the median progression-free survival was 6.1 months. Conclusion:EGFR-TKIs exert a certain clinical curative effect on patients with EGFR mutations in squamous-cell lung cancer. However, given that only seven cases are pre-sented in this research group, more cases are needed for further research to verify the above conclusion.

Humans ; Hyperplasia ; pathology ; Male ; Melanoma ; pathology ; Middle Aged ; Neoplasm Metastasis ; Palatine Tonsil ; pathology ; Skin Neoplasms ; pathology

Objective To identify changes in the occurrence of endemic fluorosis in order to provide scientific basis for making countermeasures. Methods Five villages from 14 counties of mild, moderate and severe fluorosis affected areas were selected by stratified cluster sampling every year in the whole province during 2006 - 2010. Water and urinary fluorine were determined by ion selective electrode method(GB/T 8538-1995); dental fluorosis of children 8-12 years old was diagnosed with Dean method; skeletal fluorosis was diagnosed according to "clinical indexing standards of endemic skeletal fluorosis "(GB 16396-1996), between 2006 and 2008, and "clinical diagnosis standard of endemic skeletal fluorosis"(WS 192-2008) between 2009 and 2010. Results A total of 25 diseased villages were surveyed, 14 with water sources changed, covered a resident population of 8005 people, beneficiary population 7154, and accounting for 89.37% of the resident population; not changed villages 11. In accordance with the "State drinking water health standards", in the 14 changed villages the fluoride in drinking water was qualified (≤ 1.20 mg/L), there were 3 schools whose water fluorine content exceeded the standard; among the 11 villages that did not change water sources 7 drinking water samples fluorine content exceeded the standard. Of the 8 to 12 years old children in villages with changed water sources, 363 of them were checked and 142 dental fluorosis were found, the detection rate of dental fluorosis was 39.12% (142/363); in villages with water sources not changed, 303 children were checked, the detection rate of dental fluorosis was 43.89%(133/303). Of sixteen and elder adults in water source changed villages, 6424 people were checked and 403 skeletal fluorosis were found, skeletal fluorosis detection rate was 6.27% (403/6424); 3572 people were checked in not changed villages, the detection rate of skeletal fluorosis was 13.89%(496/3572). In water sources changed areas, geometric mean of urinary fluoride was in the normal reference value(WS/T 256-2005, 1.40 mg/L)or less. Conclusions Endemic fluorosis is decreased in water improved areas, but in unimproved areas the disease is still severe, and control of endemic fluorosis is still an arduous task.

Objective To evaluate the surgical modalities and prognosis in elderly patients with gastric cancer.Methods Sixty three gastric cancer patients aged ≥≥ 75 years underwent radical surgery,with D0 + D1 resection in 32 cases and D2 resection in 31 cases,in Beijing Hospital from January 2005 to December 2009.Results More lymph nodes were dissected in D2 group than those in D0 + D1 group (27.42 ± 12.75 vs.14.59 ± 12.11,t =-4.095,P ＜ 0.05).There was no significant difference in postoperative complication rate [25.81％ (8/31) vs.31.25％ (10/32),x2 =0.095,P ＞ 0.05] and perioperative death rate [3.23％ (1/31) vs.6.25％ (2/32),x2 =0.324,P ＞ 0.05] between two groups.The 5-year survival rate was higher in D2 group than that in D0 ± D1 group (47.3％ vs.21.4％,x2 =6.346,P ＜ 0.05).The 5-year survival rate was higher in POSSUM score (PS) ＜ 20 group than that in PS≥20 group (46.3％ vs.11.1％,x2 =5.492,P ＜0.05).In PS≥20 group,postoperative complication rate did not increase after D2 radical resection(1/8 vs.3/10,x2 =0.824,P ＞ 0.05).Univariate analysis showed that PS ＜ 20 was associated with the prognosis of patients (x2 =5.492,P ＜ 0.05).Cox proportional hazards model showed that lymph node metastasis (OR=4.103,95％ CI:1.790-9.405,P ＜ 0.05) and D2 radical gastrectomy(OR =0.313,95％ CI:0.158-0.620,P ＜ 0.05) were the independent factors associated with the prognosis of patients aged ≥ 75 years with gastric cancer (all P ＜ 0.05).Conclusion Standardized D2 lymph node dissection is beneficial for gastric cancer patients aged ≥75 years.PS ＜ 20,lymph node metastasis and D2 radical gastrectomy are associated with the prognosis of patients.