Based on the analysis of the existing medical service process,the paper takespatient centered as the ultimate objective,and transforms the health service process from the view of informatization including smart hospital,regional health and family health processes.The design includes the health service modes of smart hospital,family health and regional health sub-modules,and provides ideas for the achievement of wisdom medical in the future.

Hair Cells, Auditory, Inner ; cytology ; Synapses ; physiology ; ultrastructure

Adult ; Asthenopia ; epidemiology ; prevention & control ; Automobile Driving ; Color Perception ; Humans ; Middle Aged

The polymorphism and thermostability of nirmatrelvir, the main antiviral component of the oral COVID-19 treatment drug, were studied. Four polymorphs of nirmatrelvir were prepared by recrystallization methods. Among them, Form 1 and nirmatrelvir methyl tert-butyl ether solvate (Form 2) had been reported in the literature, while nirmatrelvir isobutyl acetate solvate (NMTW-IBAC) and nirmatrelvir ethyl acetate solvate (NMTW-EA) are two new solvates. The crystal structures were characterized by single-crystal X-ray diffraction, powder X-ray diffraction, thermogravimetric analysis and differential scanning calorimetry. The thermostability of polymorphism and crystalline transformation were also investigated by combining Hirshfeld surface analysis and interaction energy analysis. The results showed that nirmatrelvir Form 1 belongs orthorhombic crystal system with the space group P2₁2₁2₁ and one nirmatrelvir molecule included in the asymmetric unit, which has the same crystal structure as nirmatrelvir Form 4 reported in the literature. Owing to its larger thermal expansion, the differences in crystallographic parameters obtained at different temperatures were found between Form 1 and Form 4. Three solvates of nirmatrelvir belonged to the iso-structural with monoclinic crystal system and the space group P2₁, in which the asymmetric unit contains one nirmatrelvir molecule and one solvent molecule. The thermal analysis results showed that nirmatrelvir Form 1 was a solvent-free crystal form with the best thermal stability and the strongest intermolecular hydrogen bonding. Among the three solvates, NMTW-EA has the worst thermal stability and the weakest hydrogen bonding interaction between the nirmatrelvir molecule and the solvent molecule. The energy framework of nirmatrelvir solvates showed that the closer the arrangement between solvent and nirmatrelvir molecules, the greater the total interaction energy between solvent and nirmatrelvir molecules. The phase transition studies of the three solvates showed that NMTW-IBAC and NMTW-EA were transformed into amorphous after desolvation, respectively, while Form 2 undergoes oiling during desolvation. The research provides theoretical guidance for the analysis, identification and quality control of nirmatrelvir polymorphs.

Objective To find out iodine nutritional status of pregnant women in the third trimester and the relationship between pregnant women and their neonates thyroid function in a high iodine area.Methods From April to June 2010,210 copies of fasting morning urine and venous blood,and their neonatal umbilical cord blood samples were collected in Haixing Hospital,Cangzhou city,Hebei province.Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry.The levels of free triiodothyronine(FT3),free thyroxine (FT4) and sensitive thyroid-stimulating hormone (sTSH) in serum were measured by chemiluminescence.Results Median urinary iodine of 210 pregnant women(average age 27.69 ± 4.73 years) in the third trimester was 1240.70 μg/L,84.3％(177/210) of them was in excessive iodine nutrition,and only 0.5％(1/210) of them was in adequate iodine nutrition.The prevalence rate of thyroid diseases was 19.5％ (41/210),and the spectrum of diseases were subclinical hypothyroidism(16.2％,34/210),subclinical hyperthyroidism(0.9％,2/210),hypothyroidism(2.4％,5/210) and hyperthyroidism (0,0/210).The number of newborns with sTSH 5 - ＞ 10 mU/L were 104 persons (49.5％); 10 - ＞ 20 mU/L were 44 persons(21.0％),and ≥20 mU/L were 16 persons(7.6％).Of pregnant women suffer from thyroid disease,the ratio(50.0％,24/48 ) of sTSH equal to 10.18 mU/L and ＞ 10 mU/L of their neonates was higher than that of their corresponding non-ill pregnant women(6.78 mU/L,Z =- 2.867,P ＜ 0.05; 22.2％,36/162,x2 =14.000,P ＜ 0.05).There was a positive correlation between neonates' and their mothers' sTSH levels (r =0.278,P ＜ 0.05).There was also a positive correlation between neonates' (sTSH ＞ 10 mU/L) and their mothers' abnormal sTSH levels (r =0.240,P ＜ 0.05).Conclusions Most of the pregnant women in high iodine areas are iodine excess.The level of neonates' sTSH is higher,and it is due to their mothers' abnormal sTSH and suffering from thyroid diseases to some extent.As a result,the monitoring of pregnant women's iodine nutrition and thyroid function and sTSH level of their neonates should be strengthened.

Objective To investigate the effect of bifidobacterial adhesin (BA) on nuclear factor of κB (NF-κB) and cytokines of intestinal mucosa of stressed rats.Methods Forty-eight rats were divided into stress group (n =24) and BA group (n =24) using the stochastic indicator method.After the stressed rat models were established withfettering as the stress condition,the experiment lasted 8 days.Both groups were given enteral nutrition (EN) with heat 125.4 kJ/(kg · d) and nitrogen 0.2 g/(kg · d).The BA group was fed with EN plus 5 mg/ (kg · d) bifidobacterial adhesin,and the stress group was fed with EN plus equivalent volume of normal saline [5 mg/ (kg · d)].The levels of NF-κB,interleukin-10 (IL-10),tumor necrosis factor (TNF-α),and interferon-γ (IFN-γ) were measured in both groups before modeling,after modeling,on the 3rd intervention day,and on the 8th intervention day.The changes in the morphology of intestinal mucosal were observed by transmission electron microscopy.Results (1) Expression of NF-κB:The positive expression rate of NF-κB in the intestinal mucosa was 0,79.2％,63.5％,and 66.7％ in the control group and 0,68.4％,55.7％,and 45.8％ in the BA group before modeling,after modeling,on the 3rd intervention day,and on the 8th intervention day.The expressions of NF-κB in both groups significantly increased after the modeling (both P =0.000).Even on the 3rd and 8th intervention days,the positive expression rates of NF-κB in the intestinal mucosa were still significantly higher than the pre-modeling level (both P =0.000).Compared with the levels after modeling and in the control group,the expression of NF-κB in the intestinal mucosa in the BA group on the 8th intervention day was significantly down-regulated (P =0.015,P =0.021).(2) Quantitative expressions of TNF-α and IFN-γ:Compared with the pre-modeling levels,the intestinal mncosa levels of TNF-α [stressed group:(154.63 ± 17.52) pg/g,(198.72 ±26.59) pg/g; BA group:(154.63 ±17.52) pg/g,(201.45 ±28.16) pg/g],IFN-γ [stressed group:(39.47 ±5.76) pg/g,(55.32 ±5.93) pg/g; BA group:(39.47 ± 5.76),(60.75 ± 7.68) pg/g] and the plasma levels of TNF-α [stressed group:(17.35±2.62) pg/g,(30.56±4.85) ng/L; BA group:(83.31 ±9.78) pg/g,(114.82±13.78) ng/L] and IFN-γ [stressed group:(17.35 ±2.62) pg/g,(28.73 ±4.17) ng/L; BA group:(17.35 ± 2.62) pg/g,(30.56 ± 4.85) ng/L] significantl increased (all P ＜ 0.05).On the 3rd and 8th intervention day,the intestinal mucosa levels of IFN-γ [(58.16 ± 7.38) pg/g,(56.37 ± 7.29) pg/g] and TNF-α [(215.76 ±31.54) pg/g and (211.83 ±33.61) pg/g] and plasma levels of IFN-γ [(29.35 ±4.76) ng/L,(30.25±3.67) ng/L] andTNF-α [(125.71 ±17.38) ng/L,(141.26±19.65) ng/L] in the stressed group were significantly higher than the pre-modeling levels (all P ＜ 0.05).On the 3rd and 8th intervention day,the intestinal mucosa levels of IFN-γ [(165.43 ± 24.58) pg/g,(171.57 ± 26.87) pg/g]and IFN-γ [(42.35 ±4.92) pg/g,(40.58 ±4.65) pg/g] and the plasma levels of TNF-α [(103.96 ±13.68) ng/L,(94.53±12.66) ng/L] and IFN-γ [(20.78±2.84) ng/L,(19.65±2.45) ng/L] in the BA group were significantly lower than the post-modeling levels (all P ＜ 0.05),whereas those of IL (intestinal mucosa:(62.82 ±8.34) pg/g,(75.16 ±9.65) pg/g; plasma:(43.32 ±5.28) ng/L,(55.64 ±6.87) ng/L] were significantly higher than the post-modeling levels (all P ＜ 0.05).Compared with the stressed group,the intestinal mucosa levels of TNF-α and IFN-γand plasma levels of IFN-γ and TNF-α significantly decreased while the IL-10 level significantly increased (all P ＜0.05) in the BA group.(3) Histomorphology showed that,compared that the ileal mucosal villi and crypt structure were recovered in the BA group on the 8th intervention day.Compared with the post-modeling conditions,the ileal mucosal villi and crypt structure were damaged in the stressed group,showing edema of the lamina propria,in which inflammatory cell infiltration was observed.Conclusions BA is helpful for the repair of the intestinal mucosa injury after stress by regulating the release of inflammatory mediators and cytokines of intestinal mucosa.

Objective To detect the molecular characteristics of the serum samples of rats suffered from sudden unexpected death of acute myocardial ischemia (experimental group) and death caused by air embolism (control group) applied by ATR-FTIR, and to discuss the forensic signiifcance of identiifcation of causes of death by sudden unexpected death of acute myocardial ischemia by two-dimension infrared spectroscopy. Methods Adult male SD rats were randomly divided into SCD group and DCAE group. The serum samples were analyzed by ATR-FTIR. The similarity coefifcient of spectra between two groups was analyzed by OMNIC software. The spectra with higher signal-noise ratio were obtained and used to build two-dimension spectra model by Matlab 2010a software. Results The peak shapes, positions and intensities of the spectra were extremely similar between two groups, and the similarity coefifcient reached 99.78%. Meanwhile, the similarity coefifcient of second derivative spectra decreased to 98.62% between two groups. Moreover, on the two-dimension spectra model, the component differences were present at about 1 625cm-1, 1 550cm-1, 1 080cm-1 and 860cm-1, and the number of auto-peaks was different, which suggested that the evident differences were related to the molecular contents of protein, glycogen, nuclear acid, and so on. Conclusion It is hard to differentiate the molecular differences of serum samples of rats between SCD and DACE based on one-dimension spectra. However, two-dimension infrared spectra could intuitively and effectively relfect the molecular differences, and it would apply to determining the cause of death in forensic science.

Animals ; Cisplatin ; adverse effects ; Drugs, Chinese Herbal ; pharmacology ; Kidney ; drug effects ; metabolism ; Male ; Proteinuria ; etiology ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism

AIM:To evaluate the optic nerve and axon impairment of relapsing - remitting multiple sclerosis ( RRMS) and neuromyelitis optica spectrum disorders ( NMOSD ) via detecting the peripapillary retinal nerve fiber layer (pRNFL) and the ganglion cell complex( GCC) thickness by optic coherence tomography(OCT).
METHODS: Retrospective case control study. Two hundred three cases were collected from August 2014 to January 2016 in Beijing Tian Tan Hospital. They were divided into four groups, including the normal group (n=60), the RRMS group ( n = 60 ), the NMOSD anti -aquaporin- 4 autoantibody seropositive( NMOSD- AQP4 -Ab seropositive) group (n= 48), and the NMOSD-AQP4-Abseronegative group (n = 35). All people were detected for the average and four quadrants ( superior, inferior, nasal, temporal) of pRNFL thickness and the average and two quadrants (superior, inferior) of GCC thickness with OCT. One way analysis of variance or nonparametric tests was used to compare the differences of pRNFL and GCC thickness between groups.
RESULTS: Comparing with the normal group, the average and all quadrants of pRNFL and GCC thickness in the RRMS, the NMOSD - AQP4 - Ab seropositive and the NMOSD-AQP4-Ab seronegative group were thinner (P<0. 01). Among them, the pRNFL and GCC thickness in the NMOSD- AQP4 - Ab seropositive group was the thinnest. Differences between groups in the pRNFL thickness:compared with the RRMS group, all quadrants of pRNFL and GCC thickness in the NMOSD-AQP4-Ab seropositive group were significantly thinner(P<0. 01); compared with the NMOSD- AQP4- Ab seronegative group, the inferior, nasal and temporal pRNFL thickness in the NMOSD-AQP4-Ab seropositive group were significantly thinner(P<0. 05), while the superior quadrant did not show significant differences( P > 0. 05); compared with the RRMS group, the superior pRNFL thickness in the NMOSD - AQP4 - Ab seronegative group was significantly thinner ( P < 0. 05), while the inferior, nasal and temporal quadrants did not show significant differences ( P > 0. 05 ). Differences between groups in the GCC thickness: compared with both the RRMS and the NMOSD- AQP4- Ab seronegative group, all quadrants of GCC thickness in the NMOSD -AQP4-Ab seropositive group were significantly thinner (P<0. 05); compared with the RRMS group, the superior GCC thickness in the NMOSD - AQP4 - Ab seronegative group was significantly thinner(P<0. 01), while the inferior quadrant did not show significant difference(P>0.05).
CONCLUSION: The optic nerve and axon impairment in NMOSD - AQP4 - Ab seropositive group was the most severe and the impairment in RRMS group was the least severe. The impairment in NMOSD - AQP4 - Ab seronegative group was between the former two, and could be more similar to that of RMMS.

A new sesquiterpenoid, 8α-hydroxy-6β-methoxy-1-oxoeremophila-7 (11), 9 (10) -diene-12, 8-olide (1) and five known compounds, petasin (2), caffeic acid (3), hepta-cosanol (4), β-sitosterol (5) and β-daucosterol (6) have been isolated from the roots of Ligularia intermedia. The compounds were isolated by column chromatography on silica gel and Sephadex LH-20, and identified based on spectral analyses (MS, 1H-NMR, 13C-NMR).
Asteraceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Magnetic Resonance Imaging ; Molecular Structure ; Plant Roots ; chemistry ; Spectrometry, Mass, Electrospray Ionization