This paper proposed a mobile vital-signs monitoring system based on ZigBee localization and wireless transmission technology for the elderly in nursing home. The system can monitor the vital-signs (pulse, ECG and blood oxygen), localize human body and warn in emergency. The validity and accuracy of this system were testified by the experiments of mobile acquisition and storage of pulse. In these experiments, the measurement of pulse ranged from 50 to 170 time a minute, the mean error of which was less than 3%. The mean error of localizing was less than 4 m. And the data transmission rate was 250 kbps. The system, which effectively conducts the real-time monitoring of the health and safety situation for the elderly, has a great significance for protecting the elderly's life safety.
Aged ; Equipment Design ; Homes for the Aged ; Humans ; Monitoring, Physiologic ; instrumentation ; Nursing Homes

Objective To investigate the surgical strategies for management of unstable fractures of intertrochanteric lateral wall.Methods From July 2012 to June 2014,50 patients with unstable fractures of intertrochanteric lateral wall received osteosynthesis with proximal femoral nail anti-rotation.They were 37 men and 13 women,with an average age of 65.6 years (range,from 42 to 87 years).According to our morphology classification,25 patients belonged to type Ⅰ (comminuted fracture of lateral wall),4 to type Ⅱ (split fracture of lateral wall with loss of medial support),21 to type Ⅲ (comminuted fracture of lateral wall and subtrochanteric part with loss of medial support).The fractures were managed differently according to our classification.Type Ⅰ were treated by intramedullary fixation with compression screws to reconstruct the lateral wall,type Ⅱ by intramedullary fixation after reconstruction of the lateral wall lby cables,and type Ⅲ by intramedullary fixation after optimal reduction of the coronal plane and neck-shaft angle because the lateral wall could not be reconstructed.Results The 50 patients obtained an average follow-up of 17 months (range,from 5 to 24 months).No deep infection or wound dehiscence happened.Deep vein thrombosis occurred in 2 patients.No nonunion,cutout of the sliding screw,or coxa vara occurred.The operation time,blood loss,time of weight loading after operation and time of union increased with our increased classification.One patient died from a heart disease 5 months after operation.Functional outcome of the other 49 patient was assessed by Harris hip score one year after operation.Forty patients were excellent,6 good and 3 fair,giving an excellent to good rate of 93.9％.Conclusion Unstable fractures of intertrochanteric lateral wall should be treated using different surgical strategies based on the morphology classification system.

The quality of medical care shows characteristics of dynamic state with changes in time. However, many of appraisal and evaluation projects usually keep on the status of "past" or "present". Most of these models are static evaluation approach. In this study, besides the "past" and "present" status, we took one step further to unveil the future development trends of the medical therapeutical effects. Based on the index value and index increment, a dynamic TOPSIS method is presented. This method pays attention to both transverse and lengthwise information and can not only perform the evaluation on each time section but also can make the final dynamic evaluation. We applied this new method to the evaluation of quality of medical care, which was proved to be effective.
Humans ; Models, Theoretical ; Quality Assurance, Health Care ; methods

The TOPSIS method is a static comprehensive evaluation method for wide range applications. However, it encounters the reverse order problem in practical applications. Moreover, its evaluation value Ci only reflects the relative proximity of each evaluation object inside but not to the degree of closeness to the ideal optimal solution. The evaluation value is also limited to distinguish between the ranges of merit ranking. Since TOPSIS method has the wide range of applications, it is necessary to overcome the drawbacks of TOPSIS method. This article proposes a new improved TOPSIS method, which shows strict isotonicity and is more sensitive than the traditional TOPSIS method. The medical application based on this improved TOPSIS method is introduced.
Aged ; Decision Support Techniques ; Evaluation Studies as Topic ; Fuzzy Logic ; Health Services for the Aged ; Humans ; Models, Theoretical ; Quality of Life

OBJECTIVETo detect the expression and distribution of epidermal growth factor (EGF) and epidermal growth factor receptor (EGFR) in periodontal tissues, and analyze the role of EGF in orthodontic tooth movement.

METHODSAccording to Kings methods, 40 g mesial force was applied to pull the left maxillary first molar in the rat. Using immunohistochemical method (HI-SABC method) to localize and examine the expression of EGF and EGFR in decalcified alveodental connective tissues at 24 hours and 168 hours of tooth movement.

RESULTSEGF and EGFR were stained at some of periodontal ligament of furcation and radical regions in control group. These expressions of EGF and EGFR increased in periodontal tissues (P < 0.01), with the expressions at 168 hours higher than those at 24 hours (P < 0.01). And levels of EGF and EGFR at tension side were higher than those at pressure side at the same time (P < 0.01).

CONCLUSIONSEpidermal growth factor participated in the tissues remodeling during orthodontic tooth movement and especially played a more important role in orthodontic bone formation.

Animals ; EGF Family of Proteins ; Molar ; Periodontal Ligament ; metabolism ; Periodontium ; metabolism ; Rats ; Receptor, Epidermal Growth Factor ; Tooth Movement Techniques

Objective:To explore the calvarial critical size defect (CSD)in rats with type 2 diabetes mellitus(T2DM).Methods:T2DM model of SD rats(weighted 300-320 g)was induced by high fat and high sugar diet and low dose intraperitoneal streptozotocin (STZ)injection.The rats with T2DMand the normal controls were divided into 4 groups(n=3)respectively.Defects with the diame-ter(mm)of 2,3,4 and 5 were made on the central calvaria of each rat.General observation,X-ray examination and histological study were performed 8 weeks postoperatively.Results:In the T2DM group,only the defects of 2 mm diameter were healed completely,X-ray resistance and new bone formation were observed;the defects of 3,4 and 5 mm diameter were unhealed,X-ray transmission was observed and newly formed bone was insufficient.In the control group,the defects of 2,3 and 4 mm diameter were healed completely, X-ray resistance and new bone formation were observed;the defects of 5 mm diameter were unhealed,X-ray transmission was ob-served,newly formed bone was insufficient.Conclusion:The calvarial CSD of T2DM rat model can be defined as the defect with the diameter of 3 mm.

OBJECTIVETo investigate the effect and mechanism of emodin for regulating aquapoin-2 (AQP2) in NRK cells cultured in vitro.

METHODSExperiments on NRK cells cultured with alpha-DMEM medium in vitro were conducted in two steps. (1) Cells were randomly divided into 4 groups: the control group, and the three emodin treated groups treated with different dosages of emodin (5, 10 and 20 mg/L) respectively. After 24 h treatment, the location of AQP2 was decided by indirect immunofluorescene, and the AQP2 protein and mRNA expression levels were detected by Western blot and semiquantive RT-PCR. (2) Cells were randomly divided into 4 groups, the control group, and the three treated groups treated respectively with 10 mg/L 8-Bromo-cAMP, 20 mg/L emodin, and 20 mg/L emodin +10 mg/L 8-Bromo-cAMP. The activity of protein kinase A (PKA) in NRK cells after 24 h treatment was determined with non-radioactive detecting method.

RESULTSAQP2 was located at the cell membrane of NRK cells. Western blot and semiquantitive RT-PCR found that AQP2 protein and mRNA expressions were significantly decreased in NRK cells of groups treated by 10 mg/L and 20 mg/L emodin (P < 0.05). PKA activity determination showed significantly decreased phosphorylation level of PKA in NRK cells of groups treated with 20 mg/L emodin group (P < 0.05).

CONCLUSIONEmodin can inhibit the genetic transcription and the translation of AQP2 gene in NRK cells, which demonstrates that the change of AQP2 expression regulated by emodin may be correlated with the diuresis effect of rhubarb, and it is likely that the regulation is going through PKA signal pathway.

Animals ; Aquaporin 2 ; genetics ; metabolism ; Cell Line ; Cyclic AMP-Dependent Protein Kinases ; metabolism ; Emodin ; pharmacology ; Kidney ; cytology ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Signal Transduction ; drug effects

Rhubarb is well-known for its cathartic effect, and this cathartic effect, which is closely correlated with "whter" of traditional Chinese medicine (TCM), is brought into play in colon. Recent researches about the relation between formation and effects have identified that the anthraquinone glycosides with 1,8-dio-hydroxy and without hydroxyl in the 2, 3, 6, 7 location, such as emodin, rhein, chrysophanol, et al, can bring about fairly obvious effects of "Watery Diarrhea". Aquaporins (AQPs) are expressed abundantly in colonic epithelial cells, and the abnormal expression of AQPs can lead to the less absorption of water in colon and/or the more secretion of intestinal juice, which suggest that AQPs might be one kind of the effector molecules, which some drugs playing pharmacologic actions in colon depend on. This assumption provides a novel field of vision. Is this "Watery Diarrhea" effect induced by rhubarb concerned with the location alteration or the expression change of AQPs. We deduce that the regulative effects of AQPs by rhubarb in colon might provide a new pharmacologic explation about the cathartic effect through the exploration of TCM and Chinese herbal drugs, with TCM theory and the analysis of data about efficiency and pharmacologic researches of rhubarb and the researches of AQPs. This deduction might be used to reveal why rhubarb can bring about multi-efficiency.
Cathartics ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Humans ; Rheum ; chemistry

Objective To investigate the effects of artesunate combined with arsenic trioxide (ATO) on the proliferation and apoptosis of NB4 cells.Methods The NB4 cells were treated with different concentrations of artesunate and arsenic trioxide respectively for 48 h.The cell proliferation was detected by methyl thiazolyl tetrazolium (MTT) method.The cells were divided into 4 groups:control group,artesunate group,arsenic trioxide group,and the combination of artesunate and arsenic trioxide group.The cell cycle and apoptosis were detected by flow cytometry (FCM).The protein expression levels of Bcl-2 and Bax were detected by Western blot.Results The MTT results showed that compared with the control group,the proliferation inhibition rates of 0.25,0.50,1.00,2.00,4.00 μmol/L artesunate group (19.26％ ± 3.59％,36.53％ ± 2.67％,61.32％ ± 2.50％,70.30％ ± 3.15％,86.92 ± 0.02％) significantly increased (P＜0.05);the proliferation inhibition rates of 1,2,4,8,16 μmol/L arsenic trioxide group (12.69％ ± 2.43％,64.26％ ± 2.02％,85.10％ ± 2.67％,92.06％ ± 2.21％,93.67％ ± 3.36％) significantly increased (P＜0.05);and the proliferation inhibition rate (40.17％ ± 5.49％ vs.32.23％ ± 3.52％) of combination of artesunate and arsenic trioxide group significantly higher than the arsenic trioxide group (P＜0.05).Compared with the arsenic trioxide group,the percentage of G0/G1 phase cells (74.20％ ± 1.43％ vs.66.14％ ± 1.78％),the apoptosis rate (58.00％ ± 2.41％ vs.34.57％ ± 1.22％),and the expression level of Bax protein (1.35 ± 0.09 vs.1.13 ± 0.09) in the combination of artesunate and arsenic trioxide group significantly increased (P＜0.05),the expression level of Bcl-2 protein (0.45 ± 0.09 vs.1.03 ± 0.10) in the combination of artesunate and arsenic trioxide group significantly decreased (P＜0.05).Conclusions Artesunate can significantly enhance the proliferation inhibition and apoptosis induced by arsenic trioxide on NB4 cells.The possible mechanism of proliferation inhibition and apoptosis of NB4 cells by artesunate combined with arsenic trioxide may be related to reduce the expression of anti-apoptotic protein Bcl-2 and increase the expression of apoptotic protein Bax.

Objective To explore the application values of GeneXpert MTB/RIF assay (Xpert assay) for rifampicin resistance and multidrug resistant tuberculosis (MDR-TB).Discordance of Xpert and L-J proportion DST of rifampicin was analyzed.Methods Specimens of 1 300patients from January 2014to June 2016in our hospital were collected for solid culture, Xpert assay and L-J proportion drug susceptibility test (DST).Rifampicin resistance detected by Xpert assay was compared with L-J proportion method as a gold standard.Sequencing of rpoB gene and determination of minimum inhibition concentration were accomplished on the discordant MTB strains between Xpert and L-J proportion DST.Results Compared with the DST, the sensitivity, specificity, positive and negative predictive value of Xpert assay for rifampicin resistance were 99.31％, 97.82％, 92.88％and 99.80％, respectively.Among 1 300culture-positive specimens, mutations were detected from 309specimens by Xpert assay, which included 125initial treatment and 184retreatment patients.Among309specimens with rpoB gene mutations, mutations detected by probes E, D and B were common, and the rates were 65.70％, 14.56％and 10.68％, respectively.Totally 239patients were MDR-TB[77.35％ (239/309) ], of which 94initial treatment patients[75.20％ (94/125) ]and 145retreatment patients[78.80％ (145/184) ]were MDR-TB.Among 22strains which were detected rpoB gene mutations by Xpert, but sensitive by L-J proportion DST, 6strains had no mutation in rpoB gene rifampicin resistance determining region (RRDR);16strains had mutations, which were mainly located in L511Pcodon (8strains) and L533Pcodon (4strains).Among 2strains which had no rpoB gene mutation by Xpert, but were resistant by L-J proportion DST, 1strain had no mutation in rpoB gene RRDR region;1strain had mutation which was located in E546G codon outside RRDR region.Conclusion Xpert assay can be used to rapidly detect rifampicin resistance and to screen MDR-TB.Mutations in codon 511and 533are related to low-level resistance to rifampicin.