Day care is described in the paper in terms of its meaning and management.As to areas deserving attention given the initial success,the authors proposed to priortize medical insurance compensation policy,medical resource deployment,patient safety and follow-up for discharged patients.These efforts may further quality of care and patient satisfaction.

Defibrillation is the most effective method of treating ventricular fibrillation(VF), this paper introduces wearable automatic external defibrillators based on embedded system which includes EGG measurements, bioelectrical impedance measurement, discharge defibrillation module, which can automatic identify VF signal, biphasic exponential waveform defibrillation discharge. After verified by animal tests, the device can realize EGG acquisition and automatic identification. After identifying the ventricular fibrillation signal, it can automatic defibrillate to abort ventricular fibrillation and to realize the cardiac electrical cardioversion.
Animals ; Defibrillators ; Electric Countershock ; Electric Impedance ; Equipment Design ; Heart ; Humans ; Monitoring, Physiologic ; instrumentation ; Ventricular Fibrillation ; therapy

Objective To explore the efficacy,mechanism and safety of silibinin combined with Ruangan pills(a Chinese herbal preparation)in the treatment of schistosomiasis liver fibrosis. Methods A total of 200 patients with schistosomiasis liver fibrosis were randomly divided into a control group and a treatment group,and 100 patients in each group were respectively admin-istered with oral silibinin alone and oral silibinin combined with Ruangan pills,respectively. The curative effects in the two groups were evaluated in 3 months,6 months,9 months and 12 months respectively. Results The common five clinical symptoms of schistosomiasis liver fibrosis patients significantly relieved in the treatment group 12 months after the therapy,and the total effi-ciency reached more than 75%,which were significantly higher than that in the control group. In the treatment group and the con-trol group,there was no improvement in the liver B ultrasonic classification 3 months and 6 months after the therapy(P>0.05);however,in 9 months and 12 months,the liver B ultrasonic classification in the treatment group was better than that in the control group(P<0.05,P<0.01,respectively). For the four serum indexes of liver fibrosis,there was no significant differences between the two groups in 3 months,however,in 6 months,9 months,and 12 months,there was a significant improvement in the treat-ment group compared with the control group. There were no obviously adverse effects in two groups. Conclusion Silibinin com-bined with Ruangan pills has a better curative effect in the treatment of schistosomiasis liver fibrosis.

Objective To investigate the prevalent feature of children with Mycoplasma pneumoniae (MP) infection in Xi'an region from Jan.2015 to Dec.2016.Methods From Jan.2015 to Dec.2016,9 648 cases with acute lower respiratory tract infection in xijing hospital were given serum test of the antibody of Mycoplasma pneumoniae by ELISA.Results A total of 9 648 cases with lower respiratory tract infection in children in xijing hospital received MP antibody detection,the positive cases were 2 971,the total positive rate was 30.79 ％.MP-IgM antibody positive rates between different age groups had significant differences,in which infants' group has the lowest(7.00 ％),and with the age growing,the positive rate increased.The positive rates in different age groups of toddler,preschool age,and school age were 27.29 ％,36.10 ％ and 37.76 ％ respec tively.The positive rates of MP-IgM antibody in different quarter were different.The highest antibody positive rate was found in the first quarter (January-March),followed by the fourth quarter,the third quarter and the second quarter.The difference was statistically significant (P＜0.01).Conclusion There was MP infection prevalence in Xi'an from 2015 to 2016.The positive rate in children increased with the age,the peak of infection was in the first quarter,so the detection and prevention of MP should be strengthened at that time of the year.

After communication with professional course teachers, clinical experts and graduates by investigation, informal discussion and expert interviews, the course and teaching of rehabilitation therapy was reformed to make the students not only meet the skill requirement,but also acquire basic theory and sustainable develop in their career.

OBJECTIVE: VEGF-C,D are known to be capable of inducing proliferation of lymphatic endothelia cell and development of lymphatic vessels, so we investigated the expression of VEGF-C,D in the differentiated thyroid carcinoma tissues microarray in order to understand the significance mechanism of cervix lymphatic metastasis of thyroid cancer. METHOD: A tissue microarray containing 71 specimens was constructed, including normal thyroid tissues, thyroid adenoma, papillary thyroid carcinoma with and without lymphatic metastasis, follicular thyroid carcinoma. VEGF-C, D protein expression was detected with immunohistochemistry. RESULT: The expression of VEGF-C,D were not observed in normal thyroid tissues and adenoma tissues. The expression of VEGF-C,D in papillary thyroid carcinoma was significantly higher than those in follicular thyroid carcinoma (P < 0.05) and adeno ma tissues (P < 0.01). The expression of VEGF-C,D in papillary thyroid carcinoma with lymphatic metastasis was significantly higher than those in papillary thyroid carcinoma without lymphatic metastasis (P < 0.05). CONCLUSION By inducing proliferation of lymphatic endothelia cell and development of lymphatic vessels, VEGF-C,D contributed to lymphatic metastasis of papillary thyroid carcinoma.
Adolescent ; Adult ; Aged ; Carcinoma, Papillary ; metabolism ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Thyroid Neoplasms ; metabolism ; pathology ; Vascular Endothelial Growth Factor C ; metabolism ; Vascular Endothelial Growth Factor D ; biosynthesis ; Young Adult

OBJECTIVETo analyze the impact of platelet count on the prognosis of stage II-III colorectal cancer receiving adjuvant chemotherapy.

METHODSClinical and follow-up data of 286 patients with stage II-III colorectal cancer receiving adjuvant FOLFOX chemotherapy from March 2003 to October 2011 were analyzed retrospectively. Associations of baseline blood platelet count before chemotherapy and nadir blood platelet count during chemotherapy with relapse and death after adjuvant chemotherapy were analyzed by ROC curve and the optimal cutoff was selected. The association of the blood platelet count and the prognosis was analyzed by Kaplan-Meier and Cox regression model.

RESULTSROC curve showed the baseline blood platelet count was associated with recurrence (AUC=0.588, P=0.034). The optimal cutoff affecting recurrence was 276×10(9)/L. Kaplan-Meier showed those with baseline platelet count >276×10(9)/L receiving adjuvant chemotherapy had worse disease free survival (DFS) than those with baseline platelet count ≤276×10(9)/L, whose 5-year disease free survival(DFS) was 66% and 80% respectively (P=0.013). Cox regression analysis revealed baseline platelet count >276×10(9)/L was an independent unfavorable factor for DFS of adjuvant chemotherapy in colorectal cancer (HR=1.865, 95% CI: 1.108-3.141, P=0.019).

CONCLUSIONColorectal cancer patients receiving adjuvant chemotherapy with baseline platelet count >276×10(9)/L have worse prognosis.

Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy, Adjuvant ; Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Fluorouracil ; Humans ; Leucovorin ; Neoplasm Staging ; Organoplatinum Compounds ; Platelet Count ; Prognosis ; Recurrence ; Retrospective Studies

Objective Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS)and network pharmacology technology combined with pharmacodynamic experiments were used to analyze the quality markers(Q-markers)in Saorilao Qingfei Zhike Capsules.Methods Using UPLC-Q-TOF-MS technology,the chemical components in different polar extracts of Saorilao Qingfei Zhike Capsules was analyzed.Potential pharmacological components were screened by using antitussive and expectorant models.The"components-targets-diseases"network was constructed and potential Q-markers were screened by network pharmacology technology.Then we conducted pharmacodynamic validation to confirm the Q-markers,which have antitussive and expectorant effects in Saorilao Qingfei Zhike Capsules.Results A total of 120 compounds were obtained from the Saorilao Qingfei Zhike Capsules through qualitative analysis.Among the extracts of different polarity,44 compounds were derived from petroleum ether extract,85 compounds were derived from ethyl acetate extract,79 compounds were derived from n-butanol extract,and 71 compounds were derived from water extract.The results of pharmacological experiments showed that among extracts of different polarity,petroleum ether extract had the best antitussive effect,while n-butanol extract had the best expectorant effect.Three core components for eliminating phlegm and relieving cough were screened through network pharmacology techniques:farcalinol,farcalinediol,and rubimaillin.Pharmacodynamic studies verified that all core components mentioned above have certain antitussive and expectorant effects.Conclusion Based on the above research,farcalinol,farcalindiol,and rubimaillin can be used as Q-markers for the antitussive and expectorant effects of Saorilao Qingfei Zhike Capsules.This paper provides reference for the quality standard of Saorilao Qingfei Zhike Capsules.

Objective:To explore the method and clinical efficacy of Flow-through latissimus dorsi musculocutaneous flap to repair children’s limb wounds.Methods:From January, 2017 to September, 2019, the Flow-through latissimus dorsi myocutaneous flap was used to repair the limb wounds in 9 children, which were 3 cases of upper extremity wounds and 6 cases of lower extremity wounds. The patients were 5-12 years old, with an average age of 9.4 years. The wound debridement was performed in the first stage, and the wound was covered with VSD. The second operation was performed 5-8 days later. Flow-through free latissimus dorsi muscle flap was used to repair the wound, and 6 patients combined with skin grafting. During the operation, both ends of the recipient area artery were trimmed into a downward slant. The proximal end of the recipient area blood vessel was coincided with the subscapular artery, the distal end was coincided with the circumflex scapular artery, and the thoracodorsal vein and the recipient area vein were coincided. One patient had 2 thoracodorsal veins, and 8 patients had 1 thoracodorsal vein. After the operation, the patients were given anti-infection, anticoagulation and antispasmodic treatment. And regular follow-up.Results:In this group, 8 flaps survived completely, and 1 had partial epidermal necrosis, which healed under the scab. Skin grafting survives well. Nine patients were followed-up for 3 to 28 months, 7 of which were followed-up in the outpatient clinic, and 2 by WeChat. CDU showed smooth blood flow in all patients 1 month after operation, in addition of 3 after 1 year. The flap had good blood flow and soft texture. Flap plastic surgery was performed in 3 cases.Conclusion:Using Flow-through latissimus dorsi musculocutaneous flap to repair the wounds of the children’s limbs, the flap survived well after the operation, and the blood circulation of the main vessel in the affected area was smooth, which had no obvious effect on the blood supply to the distal limb of the affected area.

Hierarchical diagnosis and treatment system is an important measure to rationally allocate medical resources and promote the homogenization of basic medical services. The medical alliance is an important service mode and service system of hierarchical diagnosis and treatment, whose role is to perfect the up-down linkage and meet the patient′s medical needs. Informatization construction is an important starting point to promote the services of the medical alliance. In order to solve the problem of connectivity, the medical alliance needs to establish a regional referral platform and realize the integrated service of all medical institutions. Renji Hospital, Shanghai Jiaotong University School of Medicine, has built a blockchain based referral system for hierarchical diagnosis and treatment, incorporating the S2B2C mode concept, and using the traceability, tamper proof and distributed accounting features of blockchain technology, realized independent storage of data in hospitals, realized real-time information sharing and interconnection, and provided a feasible solution for medical alliance management.