Objectives:This study aims to summarize the research progress of multiple-site physician practice to determine further research directions. Methods:Literature on Chinese multiple-site physician practice between 1949 and 2013 was obtained from CNKI, Wan fang database and CQVIP database, the annual volume distribution of se-lected documents was been described and the topics and content of literature cited at least once were summarized through literature content analysis. Results:The volume of literature increased rapidly from 2009, guided by related government policies. Content analysis is insufficient in the research areas of supporting policies, international experi-ences, relevant laws and empirical studies. Suggestions: Further research should focus on multiple-site physician practice policies themselves and supporting policy analysis, international comparisons of multiple-site physician prac-tice systems, studies into relevant laws and regulations and empirical studies based on quantitative methods.

Objective To observe the changes in expressions of spleen regulatory T cells (Tregs)and the related factor forkhead box protein-3 (Foxp3) after irradiation with different doses of X-ray in mice at different times,and to elaborate the effects of X-rays on regulatory T cells and Foxp3.Methods 112male ICR mice were randomly divided into 2 groups and irradiated by X-rays at the doses of 0.075 and 2 Gy,respectively.The mice were killed at 0,4,8,16,24,48,and 72 h post-irradiation and the spleens removed.Flow cytometry was used to detect the percentage of CD4 + CD25 + Treg and protein expression of (Foxp3),and RT-PCR was used to exmiamine the mRNA expression of Fox3.Results Compared with those before irradiation,the CD4 + CD25 + Treg positive rates began to increase and peaked at 8 h post-irradiation with 0.075 Gy at 8,16,24,72 h(t = 8.73,10.55,4.21,4.65 ,P ＜ 0.05) and 2 Gy at 8,16,48,72 h(t = 4.65,4.28,3.71,2.88,P ＜ 0.05),and then slightly decreased,but still remained at high levels.The mRNA protein levels of Fox3 did not change significantly after exposure to the dose of 0.075 Gy,but began to significantly increase at 8 h after exposure to the dose of 2 Gy.However,the Foxp3 protein level began to increase 4 h post-irradiation,peaked at 16 h,and then slightly decreased,but still ramained at high levels (t =2.59,3.37,3.70,3.20,P＜0.05).Conclusions The changes in expressions of Tregs and Foxp3 after high- and low-dose X-ray irradiation may be used to explain the differences in immune effects induced by ionizing radiation at different doses.

Animals ; Diazepam ; pharmacology ; Drug Antagonism ; Electroencephalography ; Female ; Male ; Pyrazoles ; poisoning ; toxicity ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo compare the clinical effects of different surgical methods for the epicanthus corrective surgery.

METHODSCanthoplasty with asymmetric Z-flap is applied in 46 cases, Y-V advancement procedure for epicanthoplasty is applied in 42 cases. The epicanthus aesthetic measurement were measured and calculated by software before and after surgery, the diameter of the iris was measured as a reference value,and the postoperative scar was assessed by VSS scale. At the same time, by measuring the lateral canthal distance, the accuracy of the measurement method can be verified.

RESULTSAll patients were satisfied with the long-term results and there were no recurrences of the epicanthal fold. The shortening ratio of the ICD is 8.36% in the group with the Z-plasty, and 5.88% in Y-V plasty. the lateral canthal distance have no diffrence before and after surgery.

CONCLUSIONSTwo surgical methods can get good results. The magnitude of correction in Z-plasty may larger than Y-V plasty, but postoperative retraction may existed in Z plasty.

Blepharoplasty ; methods ; Cicatrix ; Esthetics ; Eyelids ; surgery ; Humans ; Recurrence ; Software ; Surgical Flaps

ObjectiveTo assess the current situation of postgraduates knowledge about medical research design and optimize the curriculum setting of research design.MethodsAn investigation was carried out in the postgraduates of 2011 using questionnaires in a medical university..The questionnaire ineluded basic information of participants and cognition of basic methods of research design.ResultsA total of 473 postgraduates participated in the investigation.Among them,311 systematically learned medical statistics before enrollment,and 275 ( 58.14％ ) once participated in scientific researches.Most of them ( ＞80％ ) knew about the 10 basic methods of research design listed in the questionnaire,but only a few of them were familiar with them,and some even didn't know about the methods.ConclusionWe should pay attention to the culture of scientific research thought in statistical design,strengthen the practice of research design teaching,and the curriculum of research design should be led into undergraduate course.

Ear Neoplasms ; pathology ; Ear, External ; pathology ; Humans ; Infant ; Male ; Pilomatrixoma ; pathology

Pulmonary vein isolation (PVI) is a new ,effective and radical method to cure atrial fibrillation .Within a period after radiofrequency ablation (RFA) ,coagulation system is activated in patients ,then thrombus incident such as cerebral embolism may happen .The present article made a review on its mechanism .

Objective:This study aims to explore recent developments in DEA-based hospital efficiency studies in China, so as to provide reference for further research in DEA-based hospital efficiency. Methods:In this study, a 30-year retrospective systematic review is conducted for the classification of 85 hospital efficiency studies that have been published in China with DEA. The characteristics are summarized and compared with those of international liter-ature according to the selection of input and output indicators to evaluate the normalization of studies in China. Re-sults:The classification reveals several problems existing in DEA-based hospital efficiency studies in China, such as too few studies on hospital allocation efficiency, the application of simple classical models, imprecise selection of in-put-output indicators, inappropriate application of monetary variables as output indicators, etc. Conclusions and sug-gestions:The normalization and rationality of DEA methods applied in China’s hospital efficiency research need to be improved, so as to shorten the gap between China and the international world. Chinese researchers should pay more attention to studying the latest international research findings, so as to scientifically select input and output indicators. In depth analysis of methods and application conditions should be conducted so as to improve the normalization and science of China’s hospital efficiency research.

Objective To investigate the mitral annular three dimensional configuration changes after application of two dimensional mitral annuloplasty.Methods Includes criteria:serious mitral prolapse without other cardiac disorders,with age ranged from 18 to 60 years old.Three dimensional echocardiography was performed before the surgery in the operation room.The mitral annular three dimensional configuration,the mitral prolapse and regurgitation grades were examined.And same procedure was done after the mitral repair.All the measure results were expressed as x ± s and the statistical analysis was performed using SPSS 19.0 software.Results Totally 42 cases were enrolled,including 28 posterior prolapse and 14 anterior prolapse cases.All the mitral repair got satisfied none or mild regurgitation.The mitral annulus moved consistently as saddle shape during the whole cardiac cycle,the lowest annulus part was at the commissure and the highest part was at the anterior and posterior annulus centers.During the systolic phase the non-planer angel between anterior and posterior annuls was bigger than in diastolic phase.The annulus circumference,transverse,longitudinal diameters decreased compared with before the surgery.Preoperative mitral transverse diameter and longitudinal diameter values are almost the equal size,indicating the mitral annulus was in nearly round shape.However the longitudinal/transverse ratio reached 0.88 after surgery which implied the annulus configuration recovery after annuloplasty.After the mitral annuloplasty the annular height decreased from (8.4 ± 0.6) mm to (3.2 ±0.1) mm while the annular height/transverse diameter ratio decreased from 0.24 to 0.15,which may be affected by the application of the two dimensional rigid artificial annulus.Non-planar angle between the anterior and posterior mitral annuls increased from(136 ± 13)degrees to(145 ± 14) degrees after mitral repair.Conclusion The mitral annulus configuration may have planarization changes due 1o the apply of two dimentional artificial annulus.

Objective To investigate the data of gene expression microarray by protein interaction network analysis,establish an interaction network of differentially expressed genes between Kashin-Beck disease (KBD) and osteoarthritis (OA) and choose the central nodes of the network.Methods The articular cartilage samples of degrees Ⅱ ° and Ⅲ ° KBD and OA patients were selected according to the national diagnosis criteria for KBD and the Western Ontario and McMaster Universities (WOMAC) for OA.Chondrocytes of 8 patients with KBD and 7 with OA were selected.About 1 000 different genes detected by gene expression microarray were inputted into STRING 9.1 database online for analysis and establishment of the interaction network.The interaction data were imported into Cytoscape 3.2.1 software for screening the central nodes of the network.KEGG database was exploited for pathway analysis and functional study of the central node genes,Real-time PCR (RT-PCR) was used for verification.Results The protein products of 334 differentially expressed genes between KBD and OA had interrelation,forming a complicated interaction network.About 150 central nodes were selected by Cytoscape 3.2.1 that involved in more than ten signal pathways involved in mitochondria,bone metabolism and inflammatory cytokine.Conclusion The interaction network of the differentially expressed genes between KBD and OA,especially the central nodes of this network,can provide clues to the mechanism and early diagnosis and molecular targeted therapy of KBD and OA.