With the widespread use of smart phones, mobile medical class of applications use more widely. The regulation for medical applications is in the offing in domestic. How to effectively regulate such software to control its risks for patients is needed to solve. In this paper, the status of such simple software monitoring in domestic and abroad is analyzed, some problems of domestic mobile medical applications are summarized and some recommendations are proposed for the relevant departments.
Mobile Applications ; Smartphone

Objective To investigate the patterns for the recurrent and metastatic gastric cancer after curative resection and to indicate the strategy of treatment. Methods 162 patients who had received radical resection and presented post-operation failure during recent 9 years were analyzed. The failure patterns were confirmed by type-B ultrasonic or CT / MRI imaging. 15 of 34 patients with abdominal dropsy were diagnosed by adenocarcinoma cells in the abdominal dropsy. All superficial lymphadens and abdominal wall metastasis were diagnosed via punctuation. 31 patients with gastric remnant and (or) anastomoses recurrence were diagnosed via biopsy. Results Of 162 patients, 63 presented the recurrence or metastasis in multiple sites,including abdominal lymph node (LN) metastases in 46.9 % (76/162), peritoneum metastases in 21.0 % (34/162),gastric remnant and (or) anastomoses recurrence in 19.1% (31/162), liver metastases in 19.1% (31/162), the incidence rates of other parts were all ＜10 %. Meanwhile, out of 76 patients with abdominal lymph node metastases, 48.7 % (37/76) patients with peri-gastric LNs metastases, 31.6 % (24/76) with peri-pancreatic LNs metastases, 19.7 % (15/76) with para-aortic LNs metastases. The incidence of LN metastases was 57.7 % (56/97) in cancer arising from gastric fundus/cardia and 60.4% (29/48) in gastric body and 64.7 % (11/17) in pylorus antrum. Conclusion The regional failure sites for gastric cancer patients with radical resection were dominantly found in the gastric stump/stoma, the peritoneum and pelvic cavity implantation and abdominal cavity LN metastases, especially in the peri-gastric, peri-pancreatic and/or para-aortic LN metastases. The distant place failure sites were mainly in the liver, lung, brain, spondylus, cervical part LN and mediastinal LN metastases. Therefore, we should take chemotherapy, abdominal cavity chemotherapy and regional radiotherapy to prevent the regional district recurrences and distant metastasis after the gastric cancer patients with radical resection. Radiotherapy fields should focus on the gastric stump/stoma and the peri-gastric, peri-pancreatic and para-aortic LN regions.

Objective:To investigate the association of XPD rs13181 (codon751A/C, Lys751Gln), rs238406 (codon156C/A, Arg156Arg), XPC rs2279017 (i11C/A), and XRCC4 rs3734091 (codon247T/C, Ala247Ser) polymorphisms with colorectal cancer (CRC) susceptibility. Methods:A total of 338 patients with CRC who were treated at the Beijing Cancer Hospital from April 2013 to January 2016 (case group) and 315 healthy controls (control group) were genotyped using TaqMan technology. Results:The genotype GT and G alleles of XPD rs13181 increased the risk of CRC (GT>TT, adjusted OR=1.69, 95%CI=1.15-2.47, P=0.007;G>T, adjusted OR=1.77, 95%CI=1.19-2.64, P=0.005). The genotype GT and T alleles of XRCC4 rs3734091 increased the susceptibility of CRC (GT>GG, adjusted OR=9.02, 95%CI=5.61-14.50, P<0.001;T>G, adjusted OR=4.06, 95%CI=2.49-6.61, P<0.001). Analyses of XPD rs13181 and rs238406 indicated that the haplotype GT significantly decreased the risk of CRC (adjusted OR=0.39, 95%CI=0.18-0.85, P=0.018). Moreover, the combinations of the XPC rs2279017 G allele and the XRCC4 rs3734091 T allele (adjusted OR=28.43, 95%CI=6.85-117.95, P<0.001) and the XPD rs13181 G allele and the XRCC4 rs3734091 T allele (adjusted OR=10.24, 95%CI=4.69-22.35, P<0.001) exhibited significantly increased CRC risk. Conclusion:The polymorphisms of XPD rs13181 and XRCC4 rs3734091 increased the risk of CRC.

Objective To observe the expression levels of PI3K ,ERK ,IGF‐1R and ER in cervicitis and cervical squamous cancer tissues among Uighur and Han ethnic patients and their correlation .Methods The 90 paraffin embedding samples of cervici‐tis tissue( 46 cases for Han and 44 cases for Uighur) and 224 paraffin embedding samples of cervical squamous cancer tissue (36 ca‐ses for Han and 188 cases for Uighur) were collected and detected the protein expression levels by using immunohistochemistry .Re‐sults The positive expression rates of IGF‐1R and PI3K in cervical squamous cancer were 58 .04% and 92 .41% respectively ,which were higher than 13 .33% and 57 .78% in cervicitis tissue ,the positive expression rates of ER and ERK in cervical squamous cancer were 22 .32% and 68 .30% respectively ,which were lower than 63 .33% and 95 .56% in cervicitis tissue ;the positive expression rate of IGF‐1R and PI3K of cervical squamous cancer in Han and Uighur were 69 .44% ,88 .89% and 55 .85% ,93 .09% respective‐ly ,which were higher than 15 .22% ,54 .35% and 11 .36% ,61 .36% of cervicitis tissue ;the positive expression rate of ER and ERK of cervical squamous cancer in Han and Uighur were 13 .89% ,83 .33% and 23 .94% ,65 .43% respectively ,which were lower than 65 .22% ,93 .48% and 61 .36% ,97 .73% of cervicitis tissue respectively ;the expression of ERK in Uighur cervical squamous carci‐noma tissue was 65 .43% ,which was lower than 83 .33% in Han ,the difference was statistically significant (P<0 .01) .Conclusion PI3K ,ERK ,IGF‐1R and ER protein expression positive or deficiency is closely related to the occurrence of cervical cancer ,which may serve as the important biological indicators for detecting cervical cancer ,and the ethnic difference of ERK protein expression exists in cervical cancer .

The effects of insulin or insulin in combination with chemotherapeutic drugs on the proliferation and apoptosis of endometrial carcinoma cells were examined with an aim to determine the efficacy and safety of insulin in endometrial cancer therapy. Ishikawa and Hec-1A cells were treated with insulin and/or paclitaxel. Cell proliferation was assessed by MTT assay. Cell cycle and cell apoptosis were determined by flow cytometry (FCM). Survivin gene expression was detected by RT-PCR. Our results showed that in a certain range of working concentrations and action time, insulin could mildly augment cell proliferation and the percentage of S phase cells in endometrial cancer (Ishikawa/Hec-1A) cells. Insulin plus paclitaxel (combination group) could significantly inhibit cell proliferation (69.38%±2.32% vs 40.31%±4.52% with Ishikawa; 64.11%±6.33% vs 45.89%±3.27% with Hec-1A) and increase cell apoptosis compared with treatment with paclitaxel alone (paclitaxel group). Survivin gene expression was also significantly decreased in combination group as compared with paclitaxel group. We are led to conclude that insulin can mildly augment cell proliferation and present chemotherapy sensitivity in endometrial cancer cells. Insulin can be to used safely and efficiently in endometrial cancer therapy.

Objective To investigate the status of clinical nursing teaching in the department of infection.Method To investigated the teachers and nursing students in the department of infection with a self-designed questionnaire.Results The evaluation from students to the teachers are:overall satisfaction score is(4?90±0?04),the lowest points are the advanced nursing of common diseases and the teaching attitude.While the evaluations from teachers are:overall satisfaction score is(4?45+0?04),the lowest are communication with patients and their families,conducting basic nursing operation and familiarity of common drugs.Conclusions To enhance teaching quality of clinical nursing teaching in the department of infection,it is efficient by improving the quality of teachers and their teaching methods,consolidating students’knowledge,and exercising their skills?

Objective : To explore the mediating effect of sleep quality on mobile phone dependence and loneliness in university students, so as to provide evidence for prevention and intervention of mobile phone dependence. Methods : A survey was conducted from December 2019 and January 2020 among the students of Guangzhou Medical University. The general information questionnaire, mobile phone dependence index scale, UCLA loneliness scale and Pittsburgh sleep quality index scale were used to analyze the mediating effects of sleep quality on mobile phone dependence and loneliness. Results : A total of 575 questionnaires were distributed and 573 valid ones were collected, with an efficiency of 99.65%. The detection rate of 115 students with mobile phone dependence was 20.07%, and that of 203 students with sleep quality problems was 35.43%. The students scored ( 48.03±6.07 ) points in loneliness, and 405 of them had high level. Mobile phone dependence was positively correlated with loneliness and sleep quality ( r=0.299, 0.385, both P<0.05 ); loneliness was positively correlated with sleep quality ( r=0.553, P<0.05 ). Mobile phone dependence and sleep quality both could positively predict loneliness, mobile phone dependence could positively predict sleep quality, and sleep quality and gender had a significant interaction effect on loneliness ( all P<0.05 ). The mediating effect value of sleep quality on mobile phone dependence and loneliness was 0.290 ( 95%CI: 0.186-0.400 ) in males and 0.131 ( 95%CI: 0.084-0.187 ) in females. Conclusion Sleep quality has a mediating effect on mobile phone dependence and loneliness among university students. Male students are susceptible to the negative effects of mobile phone dependence.

OBJECTIVETo explore the differences in the expression of the ATP-binding cassette (ABC) transporter genes between normal nasopharyngeal tissue and nasopharyngeal carcinoma (NPC).

METHODSReal-time quantitative PCR was used to examine the gene expression of 10 ABC transporters in both NPC and normal nasopharyngeal tissue.

RESULTSThe 10 drug resistance-associated ABC transporters were expressed at different levels in NPC. ABCA2 and ABCC3 genes were strongly expressed in both the NPC and normal nasopharyngeal tissues, and ABCC1, ABCC5 and ABCG2 gene expressions were significantly higher in NPC than in normal nasopharyngeal tissue, whereas the ABCB1, ABCC2, ABCC3, ABCC4, ABCC6 and ABCC11 genes were all expressed at low levels in both the carcinoma and normal tissues.

CONCLUSIONThe transporters with high expressions in both the cancer and normal samples are correlated to the naturally occurring multidrug resistance of NPC, and those with high expression only in NPC may play an important role in drug resistance to chemotherapeuatic agents. The agents targeting the ABC transporters that are lowly expressed in both the carcinoma and normal tissues might serve as sensitivitive chemotherapeutics against NPC.

ATP Binding Cassette Transporter, Sub-Family G, Member 2 ; ATP-Binding Cassette Transporters ; biosynthesis ; genetics ; Carcinoma, Squamous Cell ; genetics ; pathology ; Gene Expression Regulation, Neoplastic ; Humans ; Multidrug Resistance-Associated Proteins ; biosynthesis ; genetics ; Nasopharyngeal Neoplasms ; genetics ; pathology ; Neoplasm Proteins ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

Objective To investigate the changes of iodide uptake and the expression of thyroidspecific genes in poorly differentiated follicular thyroid carcinoma (FTC) cells after transfection of human TSH receptor (hTSHR) gene in vitro. Methods The recombinant eukaryotic expression plasmid PcDNA3. 1/hTSHR-cDNA was transformed into DH5a bacterial for amplification and then the recombinant plasmid was extracted. The recombinant was identified with PCR amplifying, restriction enzyme digestion analysis and DNA sequencing. The recombinant plasmid pcDNA3.1/hTSHR was transfected into FTC-133 cell line by lipofectin methodin vitro. Immunofluorescence, iodide uptake studies and real time-PCR were applied to detect target protein expression. Statistical analysis was performed with t-test using SPSS 13. 0 software. Results Kpn Ⅰ and Xba Ⅰ restriction enzyme digestion, PCR amplifying and DNA sequencing confirmed that pcDNA3. 1/hTSHR was successfully constructed. After transfection of the recombinant plasmid pcDNA3. 1/hTSHR-cDNA and the stimulation of hTSH, the tumor cells displayed the expression of hTSHR protein at cell surface and cytoplasm. The iodine uptake in pcDNA3. 1/hTSHR transfected cells was 2. 9 times higher than that of control(pcDNA3.1(+) transfected cells) group(t = 28.63, P ＜0. 01). The expression of TSHR,NIS, TPO and Tg (mRNA levels) in pcDNA3. 1/hTSHR transfected cells were also significantly elevated by 1.74 (t =5.959, P＜0.01), 7.2 (t =3.807,P＜0.05), 2.88 (t=4.769,P＜0. 01) and 2.67 times (t=6.388,P ＜0.01) respectively compared to those of the control group. Conclusion The study demonstrates that iodide uptake may be reactivated by hTSHR receptor gene transfection in poorly differentiated FTC cell.

Objective:To investigate the impact of obstructive sleep apnea(OSA)on cardiac structure and function in elderly patients with type 2 diabetes mellitus(T2DM).Methods:This was a case-control study.Elderly patients with T2DM aged 65 years and above at the Department of Geriatrics of Tianjin Medical University General Hospital were consecutively enrolled in this study, and eventually 61 patients with complete general information were included.All patients were examined with polysomnography(PSG). They were divided into the T2DM group and the T2DM+ OSA group based on whether there was concurrent OSA.Differences in cardiac structure and function were compared between the two groups and between patients with mild OSA and those with moderate-severe OSA.The correlation of OSA with cardiac structure and function in T2DM patients was analyzed by using Pearson correlation and multiple linear regression analysis.Results:The left ventricular ejection fraction(LVEF)was lower in the T2DM+ OSA group than in the T2DM group(52.38±4.70 % vs.56.34±5.92%, t=2.892, P=0.005). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness increased in the T2DM+ OSA group compared with the T2DM group(21.50±1.49 mm vs.20.55±1.05 mm, 10.21±0.88 mm vs.9.52±1.04 mm, 10.42±0.83 mm vs.9.83±0.83 mm, t=-2.670, -2.770 and -2.716, P=0.010, 0.007 and 0.009). LVEF was lower in patients with moderate-severe OSA than in those with mild OSA group(50.58±3.55% vs.55.83±4.83%, t=3.813, P=0.001). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness were greater in patients with moderate-severe OSA than in those with mild OSA(21.86±1.39 mm vs.20.79±1.46 mm, 10.48±0.82 mm vs.9.69±0.75 mm, 10.68±0.80 mm vs.9.92±0.64 mm, t=-2.231, -2.871 and -2.943, P=0.032, 0.007 and 0.006). Pearson correlation analysis showed that the Apnea Hypopnea Index(AHI)was correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( r=-0.425, 0.340, 0.458 and 0.473, P=0.001, 0.007, <0.001 and <0.001). After adjusting for age, body mass index, systolic blood pressure and triglycerides, multiple linear regression analysis showed that AHI was also correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( β=-0.385, 0.520, 0.604 and 0.388, P=0.036, 0.011, 0.001 and 0.039). Conclusions:OSA aggravates cardiac remodeling and systolic insufficiency in T2DM patients and may be related to the severity of intermittent hypoxia.