Objective To explore and design quality assessment system of optimal medical service based on the BYOD and the SERVQUAL theory.Methods All items of medical service were quantified based on the theory of ERVQUAL to build a service bridge between patients and the medical team and at the same time change the traditional manual approach into a network assessment mode supported by information device.Results With the aid of BYOD technology and theory of SERVQUAL, a set of accurate service quality assessments system were built, and medical personnel could communicate with the patients timely and effectively through the system;to make comprehen-sive analysis of the hospital and to improve the quality of medical services continuously.Conclusion BYOD infor-mation technology combined with the theory of SERVQUAL can help enhance the quality of medical service and patients'satisfaction, improve staff quality and update concept and mode of service, optimize the hospital management and ultimately enhance the level of information management of medical service.

AIM:To explore the diagnosis and treatment methods of radioaction-induced optic neuritis ( RION) through the clinical dates of 17 patients.
METHODS: It was a retrospective case series study. From August 2008 to October 2013, 17 cases (24 eyes) of Rion clinical dates from Chinese PLA General Hospital were studied. The diagnosis methods including visual acuity, pupil, fundus, visual field, fundus fluorescein angiography (FFA), visual electrophysiological testing, and head MRI. To analysis the clinical date of patients with diagnosis of RION by statistical description.
RESULTS: The deterioration degree of vision: 13 eyes were classified as Ⅳ, 9 eyes as Ⅲ, 2 eyes as II. Ten eyes RAPD ( + ) , visual electrophysiology is extinguished. The retina of 5 eyes showed flame hemorrhages and cotton wool spots exudation. Optic nerve head edema in one eye. T1 - weighted MRI enhanced in 19 eyes which showed optic nerve of the intracranial and intratubal segments abnormal changed, optic chiasm and pituitary stalk signal abnormalities and enhancement of the optic nerve. Tortuous optic nerves and rough edges were observed in 5 eyes. Treatment effect: 4 eyes of visual acuity improved, 1 eye from blindness to light perception,1 eye from 0. 08 to 0. 2, 1 eye from 0. 4 to 0. 6,1 eye from 0. 04 to 0. 15, the rest of the cases did not see any improvement.
CONCLUSION: The unique clinical manifestation of RION can provide objective basis for clinical diagnosis in time, but there have not been proven any effective treatments.

Aim To study the effect of the total flavonoids of turpinia arguta seen (TFS) on immune function of rats with adjuvant arthritis. Methods Adjuvant arthritis (AA) was induced on d0 by intradermal injection of Complete Freund′s Adjuvant (FCA), containing 10 mg heat-inactive BCG in 1ml paraffin oil. On d 28 after immunization, AA rats were killed by cervical decollation. Immune cells (splenocytes and peritoneal macrophages) were obtained, then cultured in vitro with TFS. Some immune indexes were detected respectively such as the splenocytes proliferation and the productions of IL-1 and IL-2 were measured by the method of cell proliferation, the production of prostaglandin E2 was determined by radioimmunoassay. Results Compared with normal groups, the response of splenocytes to ConA and LPS was lowered, IL-2 syn-thesis was decreased, and IL-1 and PGE_2 released from PM? were elevated. TFS (10~ -8 ~10~ -4 mg?L~ -1 ) not only increased splenocytes proliferation, which induced by ConA and LPS, and IL-2 production of splenocytes, but also reduced the elevated productions of IL-1 and PGE_2 released from peritoned macrophate in AA rats in vitro. Conculsion TFS could adjust abnormal immune function in AA rats.

OBJECTIVETo study the effects of Shibao Powder on the expression of b-FGF and TGF-beta 1 in granulation tissues of rabbit models with soft tissue injuries, so as to explore mechanism of external Chinese drugs for repairing of soft tissues in molecular levels.

METHODSThe rabbit models were established by classical method of full-thickness skin wounds. After 8% sodium sulfide was used and routine disinfection completed, intra-peritoneal anaesthesia was adopted. The skin was cut to expose gastrocnemius muscle, and imcomplete sharp dissection was made near the tendon insertion. The length of the incision was 0.8 cm and the width was 0.4 cm. The rabbits in the experimental group were treated with spread of Shibao Powder at the wound; the rabbits in clean group were treated with routine dressing changes and disinfection; and the rabbits in the control group were treated with dressing changes only. The granulation tissues in different stages were collected and observed with high power microscope. The expression of Transforming Growth Factor-beta 1 (TGF-beta 1) protein and b-FGF protein in wound tissues were detected using StreptA-ridin-Biotin-Complex (SABC) method.

RESULTSThe results showed that the expression of b-FGF protein had significant differences among 3 groups at the 6th day after trauma (P<0.05). The TGF-beta 1 protein expression also had significant differences among 3 groups at the 10th and 14th days after trauma (P<0.05). At the same time, the growth states of granulation tissues had difference among 3 groups at the same trauma stage, and within the same group among different trauma stages.

CONCLUSIONThis experimental study shows that Shibao Powder is effective to promote the repair of soft tissues after trauma by stimulating production of endogenous growth factor from cells in wound.

Animals ; Disease Models, Animal ; Fibroblast Growth Factors ; metabolism ; Gene Expression Regulation ; drug effects ; Granulation Tissue ; drug effects ; metabolism ; pathology ; Male ; Medicine, Chinese Traditional ; Powders ; Rabbits ; Soft Tissue Injuries ; drug therapy ; metabolism ; pathology ; Transforming Growth Factor beta1 ; metabolism ; Wound Healing ; drug effects

Objective To investigate whether pro-inflammatory cytokines ( PICs) in the paraventricular nucleus ( PVN) regulate the enhanced sympathetic activities in spontaneously hypertensive rats ( SHR) , and whether N-methyl-Daspartate receptor ( NMDAR ) in PVN mediate the effects of PICs on sympathetic activities. Methods SHR and normotensive wistar-Kyoto( WKY) rats were used in this experiment. TNF receptor and IL-1β receptor ( IL-1RI) protein levels were measured by Western blot. PICs, including TNF-α and IL-1β levels were measured by ELISA. Rats were placed in a stereotaxic instrument to complete the microinjection of drugs. The coordinates for the PVN were determined according to the Paxinos and Watson rat atlas. The raw RSNA and integrated RSNA were simultaneously recorded on a PowerLab data acquisition system. The right carotid artery was cannulated for recording of mean arterial pressure ( MAP) . Results TNF-α receptor p55TNFR, p75TNFR and IL-1βreceptor IL-1RI protein expression and TNF-αand IL-1βlevels in PVN were all increased in SHR compared with WKY rats (P< 0. 05). Bilateral microinjection of etanercept or IL-1ra into PVN to block the effects of TNF-αor IL-1βdecreased the sympathetic activities in SHR rats significantly (P< 0. 05). Bilateral microinjection of NMDAR blockers, both DL-2amino-5-phosphonovaleri acid ( APV) and MK-801 ( Dizocilpine) into PVN decreased the RSNA and MAP in both SHR and WKY rats. APV or MK 801 caused greater decreases in RSNA and MAP in SHR than WKY rats. In addition, pretreatment with APV or MK 801 attenuated the increased RSNA and MAP caused by microinjection of TNF-αor IL-1βinto PVN to a lower level in SHR than in WKY rats (P< 0. 05). Conclusions TNF and IL-1βreceptor protein as well as TNF-αand IL-1βcytokines levels in PVN are all increased in SHR rats. NMDAR in PVN mediates enhanced sympathetic activities and elevated blood pressure caused by TNF-αand IL-1βin SHR.

OBJECTIVETo observe the effect of rosuvastatin on left ventricular cardiac function, arteriosclerotic plaque and high sensitive C-reactive protein (hs-CRP) in hypertensive patients with mild elevation of LDL-C.

METHODSSeventy-nine patients with a SBP of 140-179 mmHg and/or a DBP of 90-109 mmHg and mild elevated LDL-C were treated with rosuvastatin for 12 months (n=40) or not (n=39). The changes of hs-CRP, arteriosclerosis plaque and cardiac function at the end of the 12-months treatment relative to the baseline levels were analyzed.

RESULTSAfter 12 months of treatment, LDL-C was decreased by 33.2% in rosuvastatin group but remained unchanged in patients without rosuvastatin treatment. The left ventricular peak filling rate (LVPFR) increased significantly from 1.85 to 2.59 (P<0.05) and the serum levels of hs-CRP reduced significantly (P<0.05) after rosuvastatin treatment. The size of the plaques reduced significantly after a 12-month rosuvastatin therapy.

CONCLUSIONRosuvastatin therapy on the basis of conventional anti-hypertensive drugs can obviously improve the left ventricular diastolic function and produce favorable effects on arteriosclerotic plaques.

Aged ; Arteriosclerosis ; complications ; pathology ; C-Reactive Protein ; metabolism ; Cholesterol, LDL ; blood ; Female ; Fluorobenzenes ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Hyperlipidemias ; drug therapy ; pathology ; physiopathology ; Hypertension ; drug therapy ; pathology ; physiopathology ; Male ; Middle Aged ; Pyrimidines ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; therapeutic use ; Ventricular Function, Left ; drug effects

BACKGROUNDOld pelvis fractures are among the most challenging fractures to treat because of their complex anatomy, difficult-to-access surgical sites, and the relatively low incidence of such cases. Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture. The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures.

METHODSFirst, 16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data. Next, nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models. The pelvic injuries were all type C, and the average time from injury to reconstruction was 11 weeks (range: 8-17 weeks). The workflow consisted of: (1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans, (2) virtual fracture reduction using the printed 3D anatomic template, (3) virtual fracture fixation using Kirschner wires, and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation. These models aided communication between surgical team members during the procedure. This technique was validated by comparing the preoperative planning to the intraoperative procedure.

RESULTSThe accuracy of the 3D printed models was within specification. Production of a model from standard CT DICOM data took 7 hours (range: 6-9 hours). Preoperative planning using the 3D printed models was feasible in all cases. Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases. The patients were followed for 3-29 months (median: 5 months). The fracture healing time was 9-17 weeks (mean: 10 weeks). No delayed incision healing, wound infection, or nonunions occurred. The results were excellent in two cases, good in five, and poor in two based on the Majeed score.

CONCLUSIONSThe 3D printing planning technique for pelvic surgery was successfully integrated into a clinical workflow to improve patient-specific preoperative planning by providing a visual and haptic model of the injury and allowing patient-specific adaptation of each osteosynthesis implant to the virtually reduced pelvis.

Adolescent ; Adult ; Female ; Fractures, Bone ; diagnosis ; pathology ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Pelvic Bones ; surgery ; Reconstructive Surgical Procedures ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of entecavir (ETV) as a long-term treatment in patients with lamivudine (LAM)-refractory chronic hepatitis B (CHB).

METHODSIn this phase II study of ETV-056, 32 CHB patients with resistance to LAM monotherapy were administered ETV at 1.0 mg/day and monitored over a period of 8 years. The virologic, serologic and biochemical responses were measured throughout the treatment course. Outcomes analysis was conducted according to intention-to-treat principles.

RESULTSAt baseline and treatment weeks 8, 12, 24, 48, 96, 144, 192, 240, and 420, the proportion of patients with HBV DNA less than 300 copies/ml was 0, 6.3% (2/32), 9.4% (3/32), 18.8% (6/32), 18.8%(6/32), 46.9% (15/32), 43.8% (14/32), 50.0% (16/32), 50.0% (16/32), and 62.5% (20/32). At treatment weeks 48, 96, 168, 192, 240, and 420, the proportion of patients experiencing virological breakthrough was 6.1% (2/32), 9.4% (3/32), 12.5% (4/32), 18.8%(6/32), 25.0%(8/32), and 28.1% (9/32). In the 8 year study period, 32.3% (10/31) of patients achieved HBs seroconversion and four patients achieved HBe seroconversion.

CONCLUSIONWhile treatment with 1.0 mg/day ETV for up to 8 years resulted in mild HBV DNA suppression and increase of HBeAg seroconversion, the safety profile of this therapy was good but the economic cost was high and virological breakthrough rates were high.

Adolescent ; Adult ; Antiviral Agents ; adverse effects ; therapeutic use ; Drug Resistance, Viral ; Female ; Guanine ; adverse effects ; analogs & derivatives ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Treatment Failure ; Treatment Outcome ; Young Adult

Astrocytoma ; genetics ; metabolism ; Brain Neoplasms ; genetics ; metabolism ; Frizzled Receptors ; genetics ; metabolism ; Glioblastoma ; genetics ; metabolism ; Glioma ; genetics ; metabolism ; Humans ; Paraffin Embedding ; RNA, Messenger ; metabolism ; Receptors, G-Protein-Coupled ; genetics ; metabolism ; Signal Transduction ; Wnt2 Protein ; genetics ; metabolism ; beta Catenin ; genetics ; metabolism

Acetic Acid ; administration & dosage ; therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Cysts ; therapy ; Female ; Humans ; Liver Diseases ; therapy ; Male ; Middle Aged