Objective To evaluate the effects of interventional thermotherapy(60℃)via hepatic artery on the vascular permeability of hepatic tumor tissue and normal liver tissue in VX2 tumor-bearing rabbits.Methods Thirty white rabbits were used in this experiment,Thirty VX2 tumor-bearing rabbits models were established by direct injection of VX2 tissue particle into the liver parenchyma and were randomly and equally divided into three groups:(1)non-perfusion group(n=10),used as control group; (2)normal thermal perfusion group(n=10),a perfusion of 30ml saline at 37 4±0.5℃ via hepatic artery in 15 minutes was used;(3)hyper-thermai perfusion group(n=10),a perfusion of 30ml saline at 60±0.5℃via hepatic artery in 15 minutes was used.The vascular permeability of the tumor tissue and the normal liver tissue was estimated with Evan's blue method.Results In all three groups the vascular permeability was significantly incleased in tumor tissue than that in normal liver tissue(P＜0.05).Normal thermal perfusion resulted in a significant increase in the permeability of vasculature(JP＞0.05).Hyper-thermal peffusion resulted in a significant increase in vascular permeability of tumor tissue (P＜0.05),and vascular permeability was increased in tumor tissue mole markedly than that in normal tissue(P＜0.05).Conclusion Hyperthermia hepatic arterial perfusion can increase vascular permeability for both tumor tissue and normal tissue in VX2 tumor-bearing rabbits.

BACKGROUNDRecent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio-opacity using the stents, Guidant of the USA has designed a new type of bare metal stents (BMS)-Multi-link (ML) Vision/ML MiniVision stents. The clinical outcomes of Asian patients with coronary artery disease (CAD) after implanting the Multi-link Vision or MiniVision stent were investigated in this study.

METHODSAn observational, prospective, multi-center, non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS-ML Vision/ML MiniVision stents. The primary end point of the registry was clinical target lesion revascularization (TLR) at a 6-month follow-up. The major secondary end points included the rate of major adverse cardiac events (MACE) and serious adverse events (SAE) in hospital and at 6 months; and the rate of clinical TLR as a function of the type of angina. A total of 429 Asian people with 449 lesions from 14 centers were selected for this study. The average reference diameter of the lesions was (3.0 +/- 0.5) mm, and the mean length was (15.7 +/- 5.0) mm.

RESULTSThe successful rate of the procedure was 99.3%. Twenty-five percent of the lesions were treated by direct stenting without pre-dilation. Eighty-six percent of the lesions were implanted with ML Vision stent. After the 6-month follow-up, the rate of clinical TLR was 1.4%. The MACE, SAE and target vessel revascularization (TVR) were 6.8%, 3.5% and 1.4% respectively.

CONCLUSIONThe current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Chromium Alloys ; Coronary Disease ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Registries ; Stents

BACKGROUNDAs an important determinant of patient satisfaction, waiting time, has gained increasing attention in the field of health care services. The present study aimed to illustrate the distribution characteristics of waiting time in a community hospital and explore the impact of potential measures to reduce outpatient waiting time based on a computer simulation approach.

METHODSDuring a one-month study period in 2006, a cross-sectional study was conducted in a community hospital located in Shanghai, China. Baseline data of outpatient waiting time were calculated according to the records of registration time and payment time. A simulation technique was adopted to investigate the impact of perspective reform methods on reducing waiting time.

RESULTSData from a total of 10,092 patients and 26,816 medical consultations were collected in the study and 19,947 medical consultations were included. The average of the total visit time for outpatients in this hospital was 43.6 minutes in the morning, 19.1 minutes in the afternoon, and 34.3 minutes for the whole day studied period. The simulation results suggested that waiting time for outpatients could be greatly reduced through the introduction of appointment system and flexible demand-orientated doctor scheduling according to the numbers of patients waiting at different time of the workday.

CONCLUSIONAdoption of an appointment system and flexible management of doctor scheduling may be effective way to achieve decreased waiting time.

Adult ; Aged ; Aged, 80 and over ; Appointments and Schedules ; Computer Simulation ; Cross-Sectional Studies ; Female ; Hospitals, Community ; Humans ; Male ; Middle Aged ; Outpatients ; Patient Satisfaction ; Time Factors

The Academy of Medicine (AMS) and Ministry of Health (MOH) have developed the clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level to provide doctors and patients in Singapore with evidence-based treatment for infertility. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the AMS-MOH clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical/2013/cpgmed_infertility.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Evidence-Based Medicine ; Female ; Guidelines as Topic ; Humans ; Infertility ; diagnosis ; therapy ; Male ; Practice Guidelines as Topic ; Primary Health Care ; methods ; standards ; Public Health ; standards ; Singapore

Tumor cells along with a small proportion of cancer stem cells exist in a stromal microenvironment consisting of vasculature, cancer-associated fibroblasts, immune cells and extracellular components. Recent epidemiological and clinical studies strongly support that vitamin D supplementation is associated with reduced cancer risk and favorable prognosis. Experimental results suggest that vitamin D not only suppresses cancer cells, but also regulates tumor microenvironment to facilitate tumor repression. In this review, we have outlined the current knowledge on epidemiological studies and clinical trials of vitamin D. Notably, we summarized and discussed the anticancer action of vitamin D in cancer cells, cancer stem cells and stroma cells in tumor microenvironment, providing a better understanding of the role of vitamin D in cancer. We presently re-propose vitamin D to be a novel and economical anticancer agent.

Long-term primary culture of mammalian cells has been always difficult due to unavoidable senescence. Conventional methods for generating immortalized cell lines usually require manipulation of genome which leads to change of important biological and genetic characteristics. Recently, conditional reprogramming (CR) emerges as a novel next generation tool for long-term culture of primary epithelium cells derived from almost all origins without alteration of genetic background of primary cells. CR co-cultures primary cells with inactivated mouse 3T3-J2 fibroblasts in the presence of RHO-related protein kinase (ROCK) inhibitor Y-27632, enabling primary cells to acquire stem-like characteristics while retain their ability to fully differentiate. With only a few years' development, CR shows broad prospects in applications in varied areas including disease modeling, regenerative medicine, drug evaluation, drug discovery as well as precision medicine. This review is thus to comprehensively summarize and assess current progress in understanding mechanism of CR and its wide applications, highlighting the value of CR in both basic and translational researches and discussing the challenges faced with CR.