Objective:To explore a scheduling method of rehabilitation medical resource for smart traditional Chinese medicine(TCM) for dysphagia because of cerebral apoplexy in order to save diagnosis time for patient and reasonably arrange treatment process for medical personnel.Methods: We designed the framework of smart TCM rehabilitation system, and proposed the medical resource scheduling model including acupuncture, massage and rehabilitation training. In addition, the genetic algorithm was employed to establish the scheduling method under the optimal objective towards the scheduling time.Results: (1) The treatment time of five dysphagia patients by using rehabilitation resource scheduling in Beijing Zhongguancun Hospital were saved 42.5% from the total treatment time compared to without scheduling; (2)The rehabilitation process of twenty virtual dysphagia patients were treated by the simulation scheduling, and 71% of total treatment time was saved. The efficiency of diagnosis and treatment was improved obviously .Conclusion: Smart TCM rehabilitation resource scheduling method can be used in an assisted rehabilitation therapy for dysphagia because of cerebral apoplexy, and it can improve the efficiency of diagnosis and treatment for patient and save a lot of medical resources.

Objective To study the effectiveness of electroacupuncture plus bloodletting in treating deglutition disorder after cerebral stroke.Method Eighty-four patients were randomized into a treatment group and a control group, 42 cases in each group. The treatment group was intervened by electroacupuncture plus bloodletting and rehabilitation training, while the control group was intervened by rehabilitation training. After 2 treatment courses and 6 months after the treatment, Kubota's water drinking test and clinical bedside assessment were evaluated to measure the short-term and long-term therapeutic efficacies. By observing the change of clinical bedside assessment score, the effect of electroacupuncture plus bloodletting on certain symptoms of deglutition disorder was analyzed.Result The total effective rate was 90.5% in the treatment group versus54.8% in the control group, and the between-group difference was statistically significant (P<0.01).Respectively after 2 treatment courses and 6 months after the intervention, the drinking water test scores in the treatment group were superior to those in the control group (P<0.05). The bedside assessment scores in the treatment group were better than those in the control group respectively after 2 treatment courses and 6 months after the intervention (P<0.05). Post-treatment water drinking and bedside assessment scores were significantly better than pre-treatment scores in both groups (P<0.05). According to the observation of short-term and long-term change of bedside assessment, electroacupuncture plus bloodletting significantly improved both short-term and long-term scores of throat function, pharynx reflex, involuntary cough, throat movement, and swallowing cough (P<0.05).Conclusion Clinical observation showed that electroacupuncture plus bloodletting can produce significant short-term and long-term therapeutic efficacies in treating deglutition disorder after cerebral stroke. Electroacupuncture plus bloodletting can produce satisfactory effects in improving mouth-phase and pharynx-phase symptoms and signs in treating deglutition disorder after cerebral stroke.

Objective: To analyze and estimate the risks of failure modes in a pharmaceutical Co.Ltd.in Nanjing producing solid preparations by collinear production, and come up with measurements to improve the quality level accordingly.Methods: The quality risk level evaluation table for the failure modes in the various steps of collinear production was obtained through the failure mode and effects analysis (FMEA).The risk control measurements were put forward in order to control and improve different failure modes with various unacceptable risk levels.Results: The risks of solid preparations by collinear production were greatly reduced through FMEA.Conclusion: The FMEA method is an effective way to improve the quality level of collinear products.Meanwhile, there are limitations of FMEA, and other risk management methods should be combined to control the overall risk of drug production.Moreover, the failure modes at the same risk level with different properties should be analyzed and controlled accordingly.The above methods can improve the risk management level of a company and reduce the risks of cross-contamination, mistakes and air-transferring in order to enhance the efficiency of quality management system and produce safe and effective drugs.

Glomerulonephritis, IGA ; classification ; pathology ; Humans ; Kidney ; pathology

Adrenal Cortex Diseases ; etiology ; Child ; Humans ; Sepsis ; complications ; physiopathology ; Shock, Septic ; complications ; physiopathology

Background Free-flap Epi-LASIK surgery show a fast epithelial healing and mild trauma responses.Its mechanism is notable. Objective The aim of this study was to compare the corneal epithelial healing response following photorefractive keratectomy(PRK)and flap-free Epi-LASIK surgery. Methods Twelve experimental rabbits were randomly assigned to high cutting group(-10.00 D)and low cutting group(-3.00 D),and 2 normal matched rabbits were used as controls.PRK was performed in lateral eyes and flap-free epipolis laser in situkeratomileusis(Epi-LASIK)surgery was curried out in the fellow eyes.The corneal wound healing response in early stage of post-operation was examined under the slim lamp,and the inflammatory cells infiltration in cornea,basic fibroblast growth factor(bFGF)and nuclear transcription factor(NF-KB)expressions in corneal stroma were detected by hematine-eosin staining and immunohistochemstry in the seventh day after operation. Results The inflammatory reaction was milder in the eyes with Epi-LASIK than ones of PRK under the slim lamp.No significant difierences were found in numbers of inflammatory cells in cornea.expressions of bFGF and NF-κB in corneal stroma between two types of surgeries in low cutting group(P＞0.05).In high cutting group,the numbers of inflammatory cells were(12.25±1.22)/400 field in PRK eyes,and those of free-flap Epi-LASIK eyes were(6.67±0.31)/400 field,showing obvious difference between them(t=-8.87,P＜0.01).Expressions of NF-κB(A value)in cornea were 6.11±1.36 and 41.82±8.7 1 in PRK eyes of low cutting group and high cutting group.and those in free-flap Epi-LASIK were 3.01±0.81 and 11.59±4.55.indicating a drastically increase in PRK eyes(P＜0.05).The expressions of bFGF(A value)in corneal stroma were 33.59±6.98 and 123.68±18.81 in PRK eyes and those in free-flap Epi-LASIK eyes were 69.20±8.85 and 123.68±1 8.81 in low cutting group and high cutting group,presenting a considerably decrease in PRK eyes (P＜0.05).The corneal epithelial healing was faster in free-flap Epi-LASIK eyes than that in PRK eyes.and deeper cutting slowed the healing procedure. Conclusion In low cutting group,healing time of corneal epithelium is close between PRK and flap-free Epi-LASIK.But in high cutting group,epithelial healing is faster and inflammatory reaction is lighter in flap-free Epi-LASIK compared with PRK.

Objective To explore the feasibility of evaluation of hepatic fibrosis using the tissue dispersion quantitative analysis software based on ultrasonic elastography. Methods Forty-six chronic liver disease patients were examined by tissue dispersion quantitative analysis software. There were 11 characteristic quantities of elastography imaging obtained by the tissue dispersion quantitative analysis software,including average relative strain value,standard deviation of relative strain value,area ratio of low-strain region ( AREA%) , complexity, kurtosis, skewness, contrast, entropy, inverse different moment,angular second moment,correlation. The 11 characteristic quantities were compared with pathological stages of hepatic fibrosis. Results The characteristic quantities had statistically significant differences except kurtosis and correlation in the analysis of variance and correlational study with pathological stages ( P < 0.05). The AREA% had the highest related coefficient ( r = 0.725). The ROC curve was made by AREA% ,the areas under the ROC curve were 0. 865 ,0. 880 and 0. 886. Conclusions The tissue dispersion quantitative analysis software is helpful in the evaluation of stages of hepatic fibrosis. The AREA% has the highest relationship with pathological stages of hepatic fibrosis and good diagnostic value.

Objective To collect and summarize long-term complications of glucocorticoid (GC) in treatment of Diamond-Blackfan anemia (DBA).Methods A total of 17 DBA patients,treated with GC more than 1 year from December 2009 to November 2012 in Being Children's Hospital,Capital Medical University,were retrospectively investigated.The data of general information,drug treatment,treatment response,height and body mass in different therapy periods,and therapy related adverse reaction were collected.The data entry and the statistical analysis were performed using SPSS 16.0 software.Results Seventeen cases which fulfilled the research criteria were enrolled.The 58.8 percent of cases (10/17) began GC therapy from the age younger than 6 months.The 76.4 percent of the cases (14/17) started prednisone therapy with the dosage ≥2 mg/(kg · d),and the median time of maintenance therapy with this dosage was 2 months (1-5 months).The median time of prednisone dosage greater than 0.5 mg/(kg · d) was 6 months (3-48 months).Patients were divided into 2 groups at the beginning of therapy according to whether their age was younger or older than 6 months.The median height of younger age group was-1.0 SD (-3.5-1.0 SD) of corresponded age-sex-standard height at the beginning of prednisone therapy,and was dropped to-3.5 SD (-3.5--2.0SD)afterhalfyeartreatment.For older age group,it was0.0 SD(-1.5-2.0 SD)and-0.5 SD (-1.5-0.5 SD) respectively.During the therapy,there were 1 fracture,2 measles pneumonia,3 pneumonia,3 hirsuitisms,5 thrushes,and 12 central obesity cases.Conclusions GC related adverse reaction might appear when applying prednisone for the treatment of DBA in long term.It was suggested that GC therapy should start after 6 months old if possible,and the duration of 0.5 mg/(kg · d) GC treatment should be reduced as short as possible.

Objective To investigate.the co-stimulatory pathway of gastric cancer patients by examining the expression of co-stimulatory molecules CD28,CTLA.4(CDl 52)and B7 molecules on peripheral blood lymphocytes(PBLC)in patients with gastric cancer,and to discuss the role of costimulatory pathway in the pathogenesis of gastric cancer.Methods The expression of CD28,CD152,CD3,CD4,CD8 and B7 molecules on peripheral blood lymphocytes and T cell subpopulation were measured by flow cytometry in 56 patients with gastric cancer,and the data was compared and analyzed with that in gastric benign tumor group and healthy control group.Results The expression levels of CD3+,CD4+,CD3+ CD28+,B7-1(CD80),B7-2(CD86)and CD41/CD8+on PBLC in patients with gastric cancer was significantly lower than that of benign stomach tumor group and healthy control group.The expression levels of CD3+ CDl52+ and CD8+ on PBLC in patients with gastric cancer were significantly higher than those of gastric benign tumor group and healthy control group.Conclusion Peripheral lymphocytcs in gastric cancer patients express low level of CD28 and B7 molecules and high level of CDI 52 molecules,which results in dysfunction of B7:CD28/CTLA-4 co-stimulation pathway and in turn affects the capacity of T cell to eliminate tumor cells,which makes tumor cells evading the immune surveillance and metastasizing.