Thanks to such perspectives as technology continued acceptance and cross-organizational knowledge sharing,and review of existing literature and practice,the authors found the existing literature,both domestic and overseas,with the following shortcomings.In theory,there is little study on the telemedicine continued-acceptance behavior and cross-organizational knowledge sharing model; in methodology,there is little empirical study to build the telemedicine continued acceptance behavior model; in practice,there is little study on the telemedicine service management model in China's medical context.Based on such findings,the authors hold that subsequent studies may proceed individually and organizationally to study the continued acceptance model of telemedicine service users and cross-organizational coordination model of medical institutions.It also proposed countermeasures to optimize China's telemedicine sector.

Objective To investigate the effectiveness and safety of peritoneal dialysis(PD) in premature infants with acute renal failure(ARF).Methods In the neonatal intensive care unit (NICU) of Guangdong Province Maternal and Children Hospital, 12 premature infants underwent continuous PD due to ARF from March 2012 to March 2015, without using any antibiotics in the dialysis fluid.Before and after dialysis, the changes of serum urea nitrogen, creatinine, potassium and pH were compared.The complications (blockage, leakage, infection and necrotizing enterocolitis) and gastrointestinal nutrition situation were observed.Wilcoxon signed rank sum test was used for statistical analysis.Results Among the 12 premature infants, the underlying causes of ARF were sepsis (n=9), perinatal asphyxia (n=2), twin twin transfusion syndrome (n=l).The average gestational age was (30.9±3.2) weeks, the average body weight (before PD) was (1 461 ±525) g, the duration of PD was (3.8±2.6) d.Complications associated with PD included leakage (n=3) and peritonitis (n=2) in which Candids albicans and Klebsiella pneumonia were identified in ascites.Gastrointestinal nutrition was built up in six cases within one to four days after dialysis, among which one developing necrotizing enterocolitis on the 7th d after feeding.Finally, eight babies died (six died after initiative discontinued treatment and two died because of critically illness) and four patients were cured and discharged.Lower serum urea nitrogen and potassium levels and higher pH value were shown after dialysis than before [(9.16 ± 3.15) vs (12.71 ±6.98) mmol/L;(4.36±0.82) vs (6.24± 1.72) mmol/L;7.32±0.17 vs 7.21 ±0.17;Z=-2.118,-2.197 and-2.981, all P ＜ 0.05).Conclusion PD is an alternative safe and effective treatment for premature infants with ARF due to its simplicity both in manipulation and equipment requirement.

Objective To compare the clinical efficacy of nasal intermittent positive pressure ventilation (NIPPV) and heated humidified high flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) among low-birth-weight premature infants.Method From May to December 2015,low-birth-weight premature infants with RDS who were born and treated in our hospital were randomly assigned into NIPPV group and HHHFNC group according to their initial ventilation mode.The incidence of initial treatment failure,the usage of pulmonary surfactant (PS),the parameters of respiratory support treatment and the incidence of complications were analyzed.Result A total of 70 cases with grade Ⅰ ～ llⅢ of RDS were included,including 33 males and 37 females.The birth weight ranged from 1 020 to 2 450 g,with a average of (1 845 ± 475) g.NIPPV and HHHFNC group each had 35 cases.No significant differences existed between the two group in the following items:the rate of mechanical intubation within 72 h (5.7％ vs.11.4％),use of PS (0％ vs.8.6％),incidence of severe apnea (11.4％ vs.14.3％),pneumonia (11.4％ vs.14.3％),the duration of invasive mechanical ventilation [76.3 (30.8,150.4) h vs.97.6 (56.2,142.6) h],non-invasive ventilation [65.0 (43.0,119.0) h vs.96.0 (65.0,134.0) h] and the duration of oxygen therapy [154.0 (47.0,340.0) h vs.148.0 (72.0,327.0) h,it was no (P ＞ 0.05).Also,no significant differences in the incidence of bronchopulmonary dysplasia,necrotizing enterocolitis,retinopathy of prematurity,patent ductus arteriosus,intra-ventricular hemorrhage,nose injury,pneumothorax between the two groups.Conclusion As an initial respiratory support for the treatment of low-birth-weight RDS preterm infants,HHHFNC has similar efficacy and safety with NIPPV,and further clinical research is needed.

Objective To study the relationship between the semen quality and age in infertile men in Qingyuan.Methods 727 cases of infertile men from Reproductive Medicine Center outpatient were enrolled and divided into 5 groups:≤ 25,> 25 - 30,>30-35,>35-40,>40 age groups.The semen characteristics were carried out by calculator assistance sperm analysis(CASA) technique and Diff-Quick staining method.Results The sperm density of >30 -35 age group was the highest,but there was no significantly difference from other groups(P >0.05).Semen analysis showed that the rates of PR,PR+NP and survival sperm were on downward trends with the increase of age,but not statistically significant(P >0.05).38.19% of >25 -30 age group reached WHO′s semen parameters standard,which was the highest proportion among 5 groups.And the proportion in >40 age group was the lowest,which counted for 27.42%.Conclusion The semen quality shows a down trend with the increase of age,however,the infertility could occur in the reproductive men at any stage.

Objective To compare conventional MRI manifestations of brain epithelioid glioblastoma(eGBM)and pleomorphic xanthoastrocytoma(PXA),and to explore the value of radiomics model for differentiating eGBM and PXA.Methods Forty-three cases of brain eGBM(eGBM group)and 79 cases of PXA(PXA group)confirmed by surgical pathology were retrospectively analyzed,and conventional MRI maniofestations were compared between groups.The patients were divided into training set(n=85,including 30 cases of eGBM and 55 cases of PXA)and test set(n=37,including 13 cases of eGBM and 24 cases of PXA)at the ratio of 7∶3.A radiomics regression model was established based on T2WI and enhanced T1WI.Receiver operating characteristic curve was drawn to assess the value of the model for discriminating eGBM and PXA.Results Patients in eGBM group were older than in PXA group,and the proportion of minors in eGBM group was lower than that in PXA group(both P＜0.05).Compared with PXA group,eGBM group showed higher proportion of multiple lesions,with high T1WI signals and peritumoral edema,more unclear boundary and uneven signals(all P＜0.05).After administration of contrast agents,circular enhancement was more often observed in eGBM group,while lesions in PXA group tended to present wall nodule enhancement(both P＜0.05).The sensitivity,specificity,accuracy and area under the curve(AUC)of the radiomics model based on 19 selected features was 88.91％,79.94％,86.75％and 0.892 in training set,respectively,which was 84.58％,79.20％,81.12％and 0.824 in test set,respectively.Conclusion Conventional MRI manifestations of eGBM and PXA were different to a certain extent.Radiomics model was valuable for distinguishing eGBM and PXA.

Red, white, blue, green, and yellow lights were applied to investigate their effects on folate accumulation in wheat seedlings. The different lights, especially red light, significantly increased the total folate content. Total folate showed maximum accumulation under 30 μmol/(m