Objectives To identify the mainstream studies and their development trends in health management research, and enable domestic scholars and institutions in their decision making to select strategic research fields and their discipline development on health management. Methods Co-citation cluster analysis of high-frequency citations, combined with co-word cluster analysis of high-frequency of MeSH terms were used to discover research focuses. This was followed by statistical analysis of the content of each cluster, and demonstration of the research trends through citation and subject strategic diagrams. Results Eight hot sub-fields have been identified both before and after 2002, which include both cross and separate topics. Conclusion With a multi-disciplinary characteristic, health management has not yet developed into a mature and stable research field; Health management involves the whole management process of healthcare services; Mental health management, chronic disease management and its primary health care service are all constant hotspots of studies. Health literacy is an area deserving greater attention in health management; Health management should interact with health insurance,making it part of the medical insurance system.

Adolescent ; Adult ; Child ; Female ; Fistula ; surgery ; Humans ; Male ; Recurrence ; Reoperation ; Retrospective Studies ; Thyroglossal Cyst ; surgery ; Young Adult

Objective To explore the outcomes of kidney transplant recipients who developed urinary and male genital cancers after transplantation. Methods Data of 31 kidney transplant recipients developed de novo urinary and male genital cancer were compared with data of 31 patients in general population with the same age and same tumor stage. Results Compared with the general population, the overall survival was significantly worse in the transplant recipients (P=0. 02) , 5-year survival rates for each group were 50% vs 68%. Multivariate analyses demonstrated cancer stage to be a negative risk factor for survival for transplant recipients with de novo urinary and male genital cancer, and surgery and functioning graft to be the positive survival predictors. Conclusions Transplant recipients experience worse outcomes than the general population from urinary and male genital cancers. Cancers in transplant recipients are more biologically aggressive at the time of diagnosis.

Fermentation condition optimization of P. decumbens Ju-A10 for production of CMCase using three kinds of plant cellulosic wastes as carbon sources was made using RSA method. The result was that CMCase was the highest when the level of carbon source was 9. 77 % , 8. 69 % and 9. 97% , and liquid volume was 64. 7 mL, 54. 2 mL, 40. 8 mL for carbon sources of millet straw, wheat straw and paper sludge, respectively. The value of CMCase was 29. 26IU/mL, 29. 14 IU/mL, 29. 81 IU/mL, respectively, in the above cases. The value of R2 is 0. 9117 , 0. 9246, 0. 8655 , respectively. It could be concluded that the fermentation models were quite reliable. The method can be applied in optimization of fungi fermentation medium.

Objective To study the correlation between the coagulation factor Ⅶ (F Ⅶ) and progressive hemorrhage after brain contusion in mice and provide the experimental evidence for the clinical application of recombinant human FⅦa.Methods Twelve male BALB/c mice were given liposomeencapsulated FⅦsiRNA via tail vein at doses of 1,3,5 and 10 mg/kg with 3 mice per dosage.The other 3 mice received equivalent volume of normal saline as controls.Two days after the injection,mice blood sampling was used to detect FⅦ mRNA expression in liver using real-time PCR,level of plasma FⅦ using ELISA method,and activity of plasma FⅦ using chromogenic substrate assay.The optimal dose at which F Ⅶ expression was inhibited was determined.Thirty BALB/c male mice were assigned to two groups (n =15 per group) according to the random number table:FⅦ-suppressing group,mice were injected with FⅦsiRNA at the optimal dose and control group,mice were injected with same volume of negative control vector.The model of brain contusion was established in both groups.Volume of hemorrhage following brain contusion was measured at 3,24 and 72 h postinjury,and hematoma volume at 24 and 48 h postinjury.Results Liposome-encapsulated siRNA delivery down-regulated FⅦ expression in the mouse liver.Level and activity of plasma FⅦ were also reduced significantly.The optimal siRNA dose was 3 mg/kg.At 3,24 and 72 h postinjury,relative volume of brain hemorrhage in FⅦ-suppressing group was 1.46 ± 0.10,1.82 ± 0.23 and 2.28 ± 0.15 respectively,significantly higher than that in control group (1.00 ± 0.25,1.20 ± 0.31 and 1.20 ± 0.22 respectively) (P ＜ 0.05).At 24 and 48 h postinju-ry,volume of hematoma in FⅦ-suppressing group was (6.7 ± 1.5)mm3 and (9.8 ± 1.0) mm3,significantly higher than that in control group [(5.2 ± 1.2) mm3 and (5.5 ± 1.5) mm3] (P ＜0.01).Conclusions Level of FⅦ in vivo relates closely to the progressive hemorrhage of brain contusion in mice.Administration of FⅦ is effective to reduce the incidence of progressive hemorrhage.

Objective To study the clinical significance of the mRNA expression level of a novel gene which encodes a kind of transmembrane prostate protein induced by androgen-PMEPA1, as it may predict the progress of prostate cancer from hormone-dependent to hormone-independent. Methods We used Real-time PCR to detect the mRNA expression of PMEPA1 and GSTP1 in prostate cancer cell lines (LNCaP, PC-3), epithelia cells of benign prostatic hyperplasia and tissues from 33 patients with prostate cancers and 16 cases of prostatic hyperplasia. Results We found the mRNA expression of GSTP1 and PMEPA1 were both down-regulated in prostate cancer cell lines. The mRNA expression of GSTP1 was up-regulated in 6.1% of cases, down-regulated in 81.8%, and showed no difference in 12.1%. While PMEPA1 was highly expressed in 27.3% of cases, lowly expressed in 27.3%, and not differently expressed in 45.4%. Statistical analysis showed that the mRNA expression of GSTP1 was relevant to ages, but had no relationship with PSA, TNM stage, osseous metastasis or tumor differentiation, while the mRNA expression of PMEPA1 was relevant to osseous metastasis and tumor differentiation, but had no relationship with age, PSA or TNM stage. Conclusions PMEPA1 is possibly a useful biomarker, as it can identify patients with unfavourable prognosis, however, this hypothesis needs to be further studied with large samples.

OBJECTIVETo explore the isolation, in vitro culture and chondrogenic differentiation of goat bone marrow mesenchymal stem cells (BMSCs).

METHODSBone marrow was harvested from a 10-month-old Chinese goat for adherent culture of the BMSCs in vitro. Flow cytometry was performed to detect the cell surface markers of the BMSCs of the fourth generation. The induction medium (containing 10% fetal bovine serum, high-glucose DMEM, 6.25 microg/ml insulin, 6.25 microg/ml transferrin, 50 microg/ml vitamin C, 100 nmol/L DXM and 10 ng/ml transforming growth factor-beta1) was then applied for chondrogenic differentiation. Cytochemical staining, RT-PCR and Western blotting were performed to detect the expressions of type II collagen and aggrecan in the cells at the time points of 0, 1, 2 and 4 weeks.

RESULTSThe goat BMSCs grow well in vitro with a high purity in the fourth generation. The expression of chondrocyte phenotypes were observed at 1, 2 and 4 weeks, which became more obvious as the culture prolonged. The mRNA and protein expression of type II collagen and aggrecan in the BMSCs increased obvious after the induction and had reached a satisfactory level by 2 weeks.

CONCLUSIONGoat BMSCs have the potential to differentiate into chondrocytes in vitro, and the results of this study provide the experimental basis for application of goat BMSCs in bone and cartilage tissue engineering in vivo.

Aggrecans ; genetics ; metabolism ; Animals ; Bone Marrow Cells ; cytology ; Cell Culture Techniques ; Cell Differentiation ; Cell Separation ; Cells, Cultured ; Chondrocytes ; cytology ; Collagen Type II ; genetics ; metabolism ; Goats ; Mesenchymal Stromal Cells ; cytology ; RNA, Messenger ; genetics ; metabolism

OBJECTIVETo investigate the possibility of differentiating prostate cancer (PCa) from benign prostatic disease by total prostate specific antigen (T-PSA) dynamic profiles following transrectal prostate biopsy, and to determine the cutoff value of the T-PSA ratio between pre- and post-biopsy.

METHODSA total of 36 men at the mean age of 69.89 years with increased serum PSA underwent prostate biopsy guided by transrectal ultrasound, followed by measurement of T-PSA at 10, 30, 60 and 90 min, plotting of T-PSA dynamic profiles and calculation of the pre- and post-biopsy T-PSA ratio at different time points. The patients were divided into a PCa and a non-PCa group according to the pathological results and compared for the difference in T-PSA ratios. The cutoff value of the pre- and post-biopsy T-PSA ratio was determined for the differentiation of PCa from benign prostatic diseases.

RESULTSThe post-biopsy T-PSA ratio was obviously higher in the non-PCa than in the PCa group (P < 0.05). With the ROC curve applied, the cutoff value of the T-PSA ratio was 1.5 and the best time for blood sampling was 30 minutes after the biopsy, with a 75% sensitivity and a 93% specificity.

CONCLUSIONEvaluation of the T-PSA ratio 30 minutes after biopsy might help screen the high-risk PCa population. Biopsy should be repeated for those with a lower T-PSA ratio in spite of initial benign results. The results are to be further supported by more prospective studies.

Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Diseases ; blood ; diagnosis ; pathology ; Prostatic Neoplasms ; blood ; diagnosis ; pathology ; Sensitivity and Specificity

OBJECTIVETo investigate the changes of CD4(+)CD25(+) regulatory T cells (TREG) and TREG-related foxp3 gene expression in the peripheral blood at the onset of chronic allograft nephropathy (CAN) after kidney transplantation.

METHODSTwenty-five patients with initial onset of CAN were examined for CD4(+)CD25(+)high/CD4(+) ratio and the expression of Foxp3 gene in the peripheral blood using the flow cytometry, and the data were compared with those of 30 kidney recipients with normal graft function, 20 patients with chronic renal function (CRF), and 20 normal subjects. All the recipients had no more than 1 HLA mismatch and received the same inductive and maintenance drug treatment.

RESULTSThe recipients with CAN had significantly lower CD4(+)CD25(+)high/CD4(+) ratio and Foxp3 gene expression compared with those with normal graft function (0.71∓0.33 vs 1.17∓0.25 and 62.75∓10.80 vs 70.42∓6.8, respectively, P<0.01). The recipients with normal renal graft function showed no significant difference in CD4(+)CD25(+)high/CD4(+) ratio and Foxp3 gene expression from the normal control subjects.

CONCLUSIONThe peripheral blood CD4(+)CD25(+)high/CD4(+) ratio and Foxp3 expression in the kidney recipients with CAN are significantly lower than those of recipients with normal renal graft function, which does not correlate with elevated creatinine level, suggesting a role of TREG in the occurrence and development of CAN.

Adult ; Case-Control Studies ; Female ; Flow Cytometry ; Forkhead Transcription Factors ; metabolism ; Humans ; Interleukin-2 Receptor alpha Subunit ; metabolism ; Kidney Diseases ; blood ; etiology ; Kidney Transplantation ; adverse effects ; Lymphocyte Count ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; metabolism ; Young Adult

OBJECTIVETo investigate the clinical effect of Devine's technique with free skin grafting in the treatment of concealed penis with prepuce deficit.

METHODSThis study included 7 children with concealed penis, aged 6 - 15 (mean 8.6) years, 6 of them treated by circumcision previously. All the patients underwent Devine's operation to resect the inelasticity sarcolemma and lengthen the penis. The length of prepuce deficit ranged from 2 to 4 cm. Intermediate split thickness skin grafts of the corresponding length were taken from the femoribus internus to wrap up the tunica albuginea penis, followed by the procedures of saturation, encapsulation and fixation.

RESULTSSurgery time ranged from 70 to 120 minutes, averaging 90.5 minutes. The penis was prolonged about 2 - 4 cm after surgery. A 6-month follow-up revealed desirable penile appearance and normal penile erection.

CONCLUSIONDevine's technique with free skin grafting from the femoribus internus is an ideal treatment for concealed penis with prepuce deficit.

Adolescent ; Child ; Foreskin ; abnormalities ; surgery ; Humans ; Male ; Penis ; abnormalities ; surgery ; Skin Transplantation ; Surgery, Plastic ; methods ; Surgical Flaps