Objective To explore the expert survey of the weight and the current common weight of the similarities and differences in the quantitative analysis of the symptoms in syndrome evaluation. Methods Through the expert questionnaire survey, the data of the questionnaire were analyzed by SPSS11.5 software. For the question of whether the weight of each symptom was the same, the frequency of the experts who gave yes and no was calculated. For the weight of the specific number of such openness, the weight given by the experts was listed firstly, and then the weight of frequency of each expert was calculated, and the frequency of the largest weight was selected as the weight of the symptoms to determine the weight of the syndrome quantification assignment in the evaluation of the efficacy of the syndrome, and to compare the obtained weight with the current weight. Results The weight of the two methods is very close in the weight of the primary symptom and the weight of secondary symptom. But as for whether the weight of the primary symptom and secondary symptom is the same, the majority of the experts think that it should be different, and the current usual practice is to give the same weight. Conclusion During the weight determination, not every primary symptom or secondary symptom is the same important. Therefore, the practice of giving the same weight to evry primary symptom and secondary symptom is questionable.

Objective:To explore the effect of enhanced recovery after surgery(ERAS)-based multidisciplinary collaboration model on shortening the time of forbidden eating before receiving surgery, provide the basis for the selection of the preoperative diet prohibition scheme.Methods:From January 2017 to February 2019, a total of 384 patients who received the operation in Qingdao Municipal Hospital were analyzed retrospectively. The patients who under the traditional preoperative diet prohibition scheme were taken as the control group(156 cases) while those who under the multidisciplinary cooperation mode nursing under the concept of eras were taken as the experimental group(228 cases). The experimental group formulated the perioperative diet prohibition process according to the guidelines of eras, and the experimental group carried out the perioperative diet management for the patients according to the procedure. The difference between the two groups in the time of fasting, hunger, thirst incidence, insulin resistance, temporary stop will be observed and compared.Results:The time of fasting was (4.01±1.55) h in the experimental group and (10.12±1.57) h in the control group,there was significant difference between the two groups( t value was -1.65, P < 0.01). The incidences of thirst,hunger were 13.2%(30/228), 11.8%(27/228) in the experimental group and 89.7%(140/156), 87.2%(136/156) in the control group, there were significant differences between the two groups(χ 2 values were 220.20, 215.20, P < 0.01). The levels of insulin resistance on the first and third day after operation were 1.85 ± 0.43,1.52±0.61 in the experimental group and 1.99±0.51, 1.67±0.49 in the control group, the differences were statistically significant ( t values were -2.90, -2.56, P < 0.05).The temporary stop rate was 1.75%(4/228) in the experimental group and 7.69%(12/156) in the control group, the difference was statistically significant( χ2 value was 8.19, P<0.01). Conclusions:The ERAS-based multidisciplinary collaboration model can effectively shorten the preoperative fasting time, reduce the level of insulin resistance, reduce the incidence of hunger and thirst, and improve the rate of temporary stop and adjustment.

OBJECTIVETo evaluate the osteoblastic differentiation and compare the difference in the gene expression of rat bone marrow mesenchymal stem cells (MSCs) affected by a single period of mechanical strain.

METHODSBone marrow MSCs were harvested from the femurs and tibiae of SD rats and cultured in vitro. A four-point bending apparatus were used to perform a single 40-minute period of 2,000 microepsilon mechanical strain on these MSCs. The proliferation of the MSCs was tested by MTT on scheduled date, and the osteoblastic differentiation of the MSCs was measured by testing the expression of osteocalcin and alkaline phosphate (ALP) activity of these cells. In addition, we have investigated the possible mechanisms underlying the action of the single 40-minute period of 2,000 microepsilon mechanical strain on these MSCs, after profile blotted and handled by bioinformation, the gene expressions of these two periods of MSCs were examined.

RESULTSThe MSCs have grown well in vitro. Our experiment showed that mechanical environment did not weaken the proliferation of the MSCs. However, the ALP activity and the expression of osteocalcin were significantly up-regulated by the 2,000 microepsilon mechanical strain. Using the 27 K Rat Genome Array, 416 different expressions were found. The rate of different genes was 2.8%, of which the expressions of 247 genes increased (61 genes remarkably increased) and 169 genes decreased (74 genes remarkably decreased) in these two periods of MSCs.

CONCLUSIONMechanical strain induced the osteoblastic differentiation of the MSCs, which may be attributed to the different gene levels.

Alkaline Phosphatase ; Animals ; Bone Marrow Cells ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteocalcin ; Rats ; Rats, Sprague-Dawley ; Transcriptome

Objective To determine factors affecting postoperative survival of elderly patients with hepatocellular carcinoma (HCC). Methods A retrospective analysis of consecutive 54 elderly patients undergoing hepatectomy for hepatocellular carcinoma from Jan 1995 to Dec 2002 was performed. The data were analyzed by Kaplan-Meier method and Cox regression. Results Univariate analysis and Cox regression showed Child Pugh grading, vessel invasion, satellite nodule formation, Edmondson Steiner grading, intrahepatic recurrence and distant metastasis all related to postoperative overall survival or disease-free survival of the elderly with hepatocellular carcinoma (all P

The medical insurance system in the United States has a free -marketing model that focuses on commercial health insurance .The go-vernment performs little intervention in the medical insurance system . Under this situation, the citizens are living under high medical expenses while low health equity and accessibility .The medical insurance system of United Kingdom (UK) provides free medical care for all citizens.The go-vernment plays a leading role in the medical insurance system .Along with better equity and accessibility , UK has achieved a relatively high level of national health at a low cost .Based on the differences of the medical insurance systems between the two countries , there are also certain differences in the working patterns of clinical pharmacists .In this article we summarize the differences and propose references for China's medical insurance reform and the development of clinical pharmacists .

Objective:Clot waveform analysis (CWA) of activated partial thromboplastin time (APTT) was used to rapidly identify patients with hemophilia A (HA) and lupus anticoagulant (LA) positive, and to explore the diagnostic efficacy of APTT-CWA in HA and LA-positive patients.Methods:From July 25, 2022, to December 28, 2023, 145 patients with APTT prolongation were admitted to the First Hospital of Jilin University. This group comprised 106 males and 39 females, with an average age of (29.3±15.8) years, among whom there were 94 clinically confirmed HA cases and 51 LA-positive cases. The retrospective analysis employed the Mann-Whitney U test to compare APTT results and CWA parameters between HA patients and LA-positive individuals.CWA parameters including the first derivative of maximum reaction velocity (|min1|), the second derivative of maximum acceleration (|min2|), and maximum deceleration (|max2|) were investigated. Patients were classified based on the duration of APTT prolongation into mild (33 s53 s) groups. A comparison of APTT seconds and CWA parameters |min1|, |min2|, and |max2| was conducted for HA and LA-positive patients between each group. Furthermore, receiver operating characteristic (ROC) curves and area under the curve (AUC) were utilized to assess the diagnostic efficacy of CWA parameters and determine cut-off values. Results:The APTT results for HA and LA-positive patients were 70.2 s and 41.5 s, respectively, exhibiting a statistically significant difference ( P<0.001). CWA parameters |min1| were 1.459 %/s vs 3.868 %/s, |min2| were 0.124 %/s2 vs 0.502 %/s2, and |max2| were 0.054 %/s2 vs 0.388 %/s2in HA and LA patients, respectively ( P<0.001). In all APTT prolongation groups, the CWA parameters |min1|, |min2|and |max2| for HA were significantly lower than those for LA-positive patients ( P<0.05). CWA graph analysis revealed that the peak heights of |min1|, |min2|, and |max2| in HA were lower compared to LA patients. In the severe extension group, HA displayed significantly decreased peak values and a flatter, incomplete curve. ROC curve analysis indicated AUC values were greater than 0.8 ( P<0.01) for |min1|, |min2|, and |max2| in all APTT prolongation groups. Cut-off values for |min1|, |min2|, and |max2| were established for each prolongation group: mild (3.205 %/s, 0.423 %/s2, and 0.300 %/s2), moderate (2.884 %/s, 0.340 %/s2, 0.231 %/s2), and severe (2.209 %/s, 0.190 %/s2, 0.095 %/s2). Conclusion:When APTT was extended within the same range, there were significant differences in CWA parameters between HA patients and LA patients, ROC curve analysis demonstrated the effectiveness of CWA parameters in distinguishing HA from LA-positive patients,APTT-CWA can serve as a low-cost, efficient, and specific method for the rapid identification of hemophilia and lupus anticoagulant-positive patients.

OBJECTIVETo study the feasibility and validity of multi-modal serial therapy for primary liver cancer in senile patients.

METHODS153 senile primary liver cancer patients (>or= 60 years) were given multi-modal serial therapy from June 1993 to December 2000. Hepatectomy was performed in 37, deep cryosurgery in 32 and non-operative therapy in 84 (intervention as chief therapy in 81, combined local and intervention therapy in 3). The multi-course intervention therapy was given postoperatively in hepatectomy and cryosurgery groups, while bioimmunotherapy and traditional Chinese medicine were used in all groups.

RESULTSThe 1-, 3- and 5-year survival rates in the hepatectomy group were 78.4%, 46.4% and 35.7%, without operative mortality. The 1- and 3- and 5-year year survival rates in the cryosurgery group were 64.5%, 40.9% and 25.0% with mortality of 3.1%. Among patients with non-operative therapy, the 1- and 3- and 5-year year survival rates in intervention group were 47.5%, 23.5% and 4.3%. The operative mortality was 1.2%. The 3 patients who received combined local and intervention therapy have survived for 2.5, 3.8 and 7.1 years.

CONCLUSIONMulti-modal serial therapy with surgical treatment as the chief means, being precise in the effect and good in safety, is feasible and valid for primary liver cancer in senile patients.

Aged ; Aged, 80 and over ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Hepatocellular ; pathology ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Cryosurgery ; Feasibility Studies ; Female ; Hepatectomy ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Survival Rate

OBJECTIVETo understand pathogen patterns of enteric infectious diseases and its impact on this pattern due to aggregation of a great deal of foreign visitors during Beijing Olympic Games.

METHODSThe diarrheal patient's rectal swabs and stool specimens were collected from Olympic stadium and hospitals of four districts, including Dongcheng, Xicheng, Haidian and Chaoyang. Enteric multiple pathogens were detected from the total 45 specimens. The culture method was used for the enteric bacteria, ELISA and RT-PCR for the enteric viruses. Molecular typing of Salmonella Enteritidis isolation was completed by PFGE.

RESULTSIt was found that 26 out of 45 cases were positive with 57.8 percent for pathogen detection, and 24 were identified as enteric pathogenic bacteria, including Vibrio parahaemolyticus, Salmonella, diarrheagenic Escherichia coli and Campylobacter jejuni, two as norovirus. There were mixed infections of two pathogenic bacteria for three cases. Ten kinds of pathogens were detected from foreign cases, while five kinds from Chinese cases. A total of 5 PFGE patterns were identified in 10 Salmonella Enteritidis isolates from national and foreign diarrheal cases, which were concentrative in some extent.

CONCLUSIONVibrio parahaemolyticus, Salmonella, diarrheagenic Escherichia coli and Campylobacter jejuni were found to be the primary bacterial pathogens during the Olympic Games. Enteric virus infection existed in summer diarrhea.

Adult ; Bacterial Typing Techniques ; Campylobacter jejuni ; classification ; isolation & purification ; China ; Diarrhea ; epidemiology ; etiology ; microbiology ; virology ; Enterobacteriaceae ; classification ; isolation & purification ; Enterovirus ; isolation & purification ; Escherichia coli Infections ; microbiology ; Female ; Humans ; Male ; Salmonella ; classification ; isolation & purification ; Shigella ; classification ; isolation & purification ; Sports ; Vibrio parahaemolyticus ; classification ; isolation & purification

BACKGROUNDObstructive sleep apnea/hypopnea syndrome (OSAHS) and laryngopharyngeal reflux (LPR) disease have a high comorbidity rate, but the potential causal relation between the two diseases remains unclear. Our objectives were to investigate the esophageal functional changes in OSAHS patients and determine whether OSAHS affects LPR by affecting esophageal functions.

METHODSThirty-six OSAHS patients and 10 healthy controls underwent 24-h double-probed combined esophageal multichannel intraluminal impedance and pH monitoring simultaneously with polysomnography. High-resolution impedance manometry was applied to obtain a detailed evaluation of pharyngeal and esophageal motility.

RESULTSThere were 13 OSAHS patients (36.1%) without LPR (OSAHS group) and 23 (63.9%) with both OSAHS and LPR (OSAHS and LPR group). Significant differences were found in the onset velocity of liquid swallows (OVL, P = 0.029) and the percent relaxation of the lower esophageal sphincter (LES) during viscous swallows (P = 0.049) between the OSAHS and control groups. The percent relaxation of LES during viscous swallows was found to be negatively correlated with upright distal acid percent time (P = 0.016, R = -0.507), and OVL was found to be negatively correlated with recumbent distal acid percent time (P = 0.006, R = -0.557) in the OSAHS and LPR group.

CONCLUSIONSOSAHS patients experience esophageal functional changes, and linear correlations were found between the changed esophageal functional parameters and reflux indicators, which might be the reason that LPR showed a high comorbidity with OSAHS and why the severity of the two diseases is correlated.

Adult ; Esophagus ; physiopathology ; Female ; Humans ; Laryngopharyngeal Reflux ; etiology ; Male ; Middle Aged ; Polysomnography ; Sleep Apnea, Obstructive ; complications ; physiopathology

OBJECTIVETo investigate the expression and clinical significance of KiSS- 1 and E- cadherin in gastric cardia carcinoma and the correlation between the two proteins.

METHODSThe expression of KiSS- 1 and E- cadherin in 80 patients with gastric cardia carcinoma and 20 patients with normal gastric cardia epithelium was detected by immunohistochemical technique.

RESULTSThe expression of KiSS- 1 was negatively correlated with lymphatic metastasis and clinical stage (P < 0.05), but not correlated with the cancer differentiation (P < 0.05). The expression of E- cadherin was negatively correlated with lymphatic metastasis, clinical stage, and cancer differentiation (P < 0.05). Spearman test showed a positive correlation between KiSS- 1 and E- cadherin expression (r(s)=0.722, P < 0.05).

CONCLUSIONKiSS- 1 and E- cadherin may play important roles in inhibiting the invasion and metastasis of gastric cardia carcinoma.

Adult ; Aged ; Aged, 80 and over ; Cadherins ; metabolism ; Cardia ; pathology ; Female ; Humans ; Kisspeptins ; Male ; Middle Aged ; Neoplasm Metastasis ; Stomach Neoplasms ; metabolism ; pathology ; Tumor Suppressor Proteins ; metabolism