Objective The paper analyzes the operating patterns of the outpatient process and identifies the links needing reengineering so as to provide scientific basis for the optimal allocation of outpatient resources and process reengineering and prove the rationality and feasibility of using the queuing theory. Methods Using the methods of the queuing theory, the service time and the patients' arrival time at such service links as registration, billing and accounting, internal medicine, and gynecology in the outpatient department of a certain hospital were measured and the operational indexes at various links such as service intensity, average queuing length, average queuing time, average stay, probability of the service desks being idle, and the probability of the patients having to wait were calculated so as to estimate the rational number of service desks and the optimal value of the sum of the cost of waiting and the cost of service. Results Registration, billing and accounting , service intensity in internal medicine, personnel allocation, and queuing time were basically rational in the outpatient department of the hospital surveyed. One more physician should be added to the gynecology department so as to improve efficiency and reduce patients' waiting time and queuing length. There was currently a shortage of medical staff in the hospital. The cost of hospital input was moderate while the cost of waiting was on the high side. Conclusion It is rational and feasible to evaluate the efficiency of the outpatient process with the methods of the queuing theory. The method deserves to be spread.

Objective To explore the technique of maximum entropy model for extracting Oncomelania hupensis snail habi?tats in Poyang Lake zone. Methods The information of snail habitats and related environment factors collected in Poyang Lake zone were integrated to set up the maximum entropy based species model and generate snail habitats distribution map. Two Land?sat 7 ETM+remote sensing images of both wet and drought seasons in Poyang Lake zone were obtained,where the two indices of modified normalized difference water index(MNDWI)and normalized difference vegetation index(NDVI)were applied to ex?tract snail habitats. The ROC curve,sensitivities and specificities were applied to assess their results. Furthermore,the impor?tance of the variables for snail habitats was analyzed by using Jackknife approach. Results The evaluation results showed that the area under receiver operating characteristic curve(AUC)of testing data by the remote sensing?based method was only 0.56, and the sensitivity and specificity were 0.23 and 0.89 respectively. Nevertheless,those indices above?mentioned of maximum en?tropy model were 0.876,0.89 and 0.74 respectively. The main concentration of snail habitats in Poyang Lake zone covered the northeast part of Yongxiu County,northwest of Yugan County,southwest of Poyang County and middle of Xinjian County,and the elevation was the most important environment variable affecting the distribution of snails,and the next was land surface tem?perature(LST). Conclusions The maximum entropy model is more reliable and accurate than the remote sensing?based meth?od for the sake of extracting snail habitats,which has certain guiding significance for the relevant departments to carry out mea?sures to prevent and control high?risk snail habitats.

Objective To observe the clinical efficacy and safety of Danshen dripping pill combined with atorvastatin calcium tablets and metformin hydrochloride tablets in the treatmem of diabetic coronary heart disease.Methods Ninety-four patients with diabetic coronary heart diseases were randomly divided into control group (n =47 cases) and treatment group (n =47 cases).Control group was treated with atorvastatin calcium 20 mg qd + metformin hydrochloride 0.5 g tid.Treatment group was given Danshen dripping pill 270 mg per time,tid,on the basis of the control group.Two groups were treated for 3 months.The clinical efficacy,the levels of serum total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol(HDL-C),hemoglobinA1 c (HbA1 c),fasting blood glucose (FBG) and adverse drug reactions were compared between two groups,and the homeostasis model assessment insulin resistance (HOMA-IR) were calculated.Results After treatment,the total effective rates in treatment and control groups were 91.49％ (43/47 cases) and 74.47％ (35/47 cases) with significant difference(P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:TC were (3.05 ±0.21),(3.55 ±0.16)mmol · L-1;TG were(1.14 ± 0.16),(1.45 ± 0.14) mmol · L-1;LDL-C were(1.42 ±0.19),(1.74±0.19) mmol · L-1;HDL-C were(1.11 ±0.12),(1.40 ±0.15) mmol · L-1;HbA1c were (4.09 ± 0.50) ％,(5.06 ± 0.71) ％;FBG were (4.68 ± 0.61),(5.42 ± 0.93) mmol · L-1;HOMA-IR were (2.63 ±0.60),(3.66 ±0.59),the differences were statistically significant(P ＜0.05).The adverse drug reactions in two groups were based on increasing transaminase,flatulence,constipation,acute myocardial infarction,and so on.The incidences of treatment and control groups were 31.94％ and 34.04％ without significant difference (P ＞ 0.05).Conclusion Danshen dripping pill combined with atorvastatin calcium tablets and mefformin hydrochloride tablets has a definitive clinical efficacy in the treatment of diabetic coronary heart disease,which can improve the levels of blood lipid and function of islet cells,decrease blood glucose,without increasing the incidence of adverse drug reactions.

Background: We found microRNA (miR)-1246 to be significantly differentially expressed between severe active alopecia areata (AA) patients and healthy individuals. Objective: To explore the role and mechanism of miR-1246 in severe AA. Methods: Expression of miR-1246, dual-specific tyrosine phosphorylation-regulated kinase 1A (DYRK1A), and nuclear factor of activated T cells 1c (NFATc1) in peripheral CD4+ T cells and in scalp tissues of patients were detected using RT-qPCR, Western blot, and immunohistochemistry assays. Peripheral CD4+ T cells from the AA patients were transfected with lentiviral vectors overexpressing miR-1246. RT-qPCR and Western blot analysis were used to measure mRNA or protein expression of retinoic-acid-receptor-related orphan nuclear receptor gamma (ROR-γt), interleukin (IL)-17, DYRK1A, NFATc1, and phosphorylated NFATc1. Flow cytometry was used to assay the CD4+ IL-17+ cells proportion. ELISA was used to measure cytokine levels. Results: miR-1246 levels decreased and DYRK1A and NFATc1 mRNA levels significantly increased in the peripheral CD4+ T cells and scalp tissues of severe active AA samples.NFATc1 protein expression was also significantly increased in the peripheral CD4+ T cells but not in the scalp tissues. NFATc1 positive cells were mainly distributed among infiltrating inflammatory cells around hair follicles. In peripheral CD4+ T cells of severe active AA, overexpression of miR-1246 resulted in significant downregulation of DYRK1A, NFATc1, ROR-γt, and IL-17 mRNA and phosphorylated NFATc1 protein, as well as a decrease in the CD4+ IL-17+ cells proportion and the IL-17F level. Conclusion miR-1246 can inhibit NFAT signaling and Th17 cell activation, which may be beneficial in the severe AA treatment.

AIM:To investigate the effects of chronic hypoxia on the aggressiveness of MCF-7, a human breast cancer cell line , and the underlying mechanisms .METHODS: MCF-7 cells were cultured under hypoxia ( 1% O2 , 5%CO2 and 94%N2 ) or control (95%O2 and 5%CO2 ) condition.The viability, proliferation, and invasion and migration abilities of the MCF-7 cells were determined by MTT assay , CCK-8 assay, cell counting, and cell invasion and migration assays.Anchorage-independent growth and the alteration of cellular polarization of the MCF-7 cells were tested by soft agar colony formation assay and Matrigel-3D culture assay, respectively.The effects of chronic hypoxia on the growth and metas-tasis of MCF-7 cells in vivo were investigated by xenograft in nude mice .The morphological changes of the MCF-7 cells were observed under an inverted microscope .Hypoxia-induced alterations in the levels of hypoxia inducible factor-1 ( HIF-1 ) and phosphorylated glycogen synthase kinase-3β( p-GSK-3β) as well as epithelial-mesenchymal transition ( EMT) mol-ecules, such as E-cadherin, N-cadherin, vimentin, matrix metalloproteinase ( MMP)-3 and MMP-9, were determined by Western blot .RESULTS:Chronic hypoxia significantly increased the viability , proliferation , and invasion and migration abilities of MCF-7 cells in vitro, enhanced the anchorage-independent growth , facilitated cellular polarization alteration in Matrigel-3D culture, and promoted cancer metastasis in vivo.Hypoxia up-regulated HIF-1, activated GSK-3β, down-regu-lated E-cadherin and increased the protein levels of N-cadherin, vimentin, MMP-3 and MMP-9.CONCLUSION:Chronic hypoxia enhances the aggressiveness of breast cancer cells probably through EMT .

Bombyx mori bidensovirus (BmBDV) has been identified as causing chronic densonucleosis in Bombyx mori specifically. The replication mechanism of BmBDV remains unknown. Its genome comprises two single stands DNA (VD1 and VD2). In order to rescue infectious virions in vitro, we obtained the total viral DNA extracted from the BmBDV-infected larvae midguts, subsequently cloned the full-length sequence of BmBDV genome fragments by PCR and constructed recombinant plasmids pMD18T-VD1 and pUC-VD2. The linear genome fragments were obtained by digesting recombinant plasmids with corresponding restriction enzymes, and then collectively transfected BmN cells by the method of liposome-embedding. We determined the replication of the virus gene by PCR with the template of demethylated total DNA extracted from the post-transfect BmN cells. Meanwhile, we collected the total proteins from the post-transfect BmN cells and the larvae midgut of feeding the post-transfect BmN cells to perform Western blotting analysis, and detected the expression of viral genes. Here we firstly confirm that infectious virions can be rescued in BmN cells by linear co-transfect method.
Animals ; Bombyx ; DNA, Viral ; Densovirus ; growth & development ; Larva ; Transfection ; Virion ; Virus Cultivation

OBJECTIVETo observe the efficacy and safety of Danlong Oral Liquid (DOL) combined Western medicine (WM) in treating mild-to-moderate bronchial asthma patients (heat wheezing syndrome) at acute onset.

METHODSTotally 480 mild-to-moderate bronchial asthma patients (heat wheezing syndrome) at acute onset were randomly assigned to two groups in the ratio 3:1, the treatment group (360 cases) and the control group (120 cases). All patients received basic WM treatment. Patients in the treatment group took DOL, 10 mL each time, 3 times per day for 7 days in total, while those in the control group took Kechuanning Oral Liquid (KOL) , 10 mL each time, 3 times per day for 7 days in total. Efficacy for asthma symptoms, lung functions and scores of TCM syndrome and/or main symptoms were evaluated.

RESULTSThe percentage of clinical control and significant effectiveness of asthma symptoms in the treatment group was significantly higher than that of the control group (77.36% vs 56.07%, P < 0.01). The percentage of clinical control and significant effectiveness of lung functions in the treatment group was significantly higher than that of the control group (74.28% vs 50.00%, P < 0.01). The anterior-posterior difference in scores of TCM syndrome was significantly superior in the treatment group than in the control group (-11.26 ± 4.70 vs -9.21 ± 5.09, P < 0.01). The anterior-posterior difference in scores of main symptoms was significantly better in the treatment group than in the control group (-6.58 ± 3.08 vs -5.16 ± 3.45, P < 0.01). The incidence of adverse reactions was significantly lower in the treatment group than in the control group [1.73% (6/346 cases) vs 10.17% (12/118 cases) , P < 0.05].

CONCLUSIONDOL combined WM was superior to KOL in treating mild-to-moderate bronchial asthma patients (heat wheezing syndrome) at acute onset.

Anti-Asthmatic Agents ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; Biomedical Research ; Drug Therapy, Combination ; methods ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Hot Temperature ; Humans ; Lung ; Medicine, Chinese Traditional ; Phytotherapy ; Respiratory Sounds ; Syndrome

OBJECTIVETo analyze the cervical cancer mortality and distribution profiles by areas and population in 2004 - 2005 and the changes in the last 30 years.

METHODSThe demographic information and cervical cancer death data came from the Third National Retrospective Sampling Survey of Death Causes which including 158 sampling areas (including 61 cities and 97 villages; 52 in the east region, 49 in the middle region and 57 in the west region) covered 31 province-level regions in the interior of China by multiple stage stratified clustering sampling. The total number of the samples were 142 660 482 person years (72 970 241 person years in male and 69 690 241 person years in female). The crude and age-specific death rate was calculated. The standardized death rate was calculated by using 5 years interval from the census data of 2000. In addition, the mortality data was compared with the two previous national death surveys in 1970's and 1990's, respectively.

RESULTSIn the sampling region of the third retrospective death causes survey from 2004 to 2005, the crude death rate of cervical cancer was 2.86/100 000 (1995/69 690 241), which accounting for 2.86% (1995/69 667) and ranking 9th of all cancer death causes in female population. The crude death rates of cervical cancer were 2.88/100 000 (1326/46 091 419) and 2.83/100 000 (669/23 598 822) for rural areas and urban areas, respectively, the Chinese population adjusted death rates of rural and urban areas were 2.01/100 000 and 1.67/100 000, respectively. The standardized death rates of cervical cancer in 1973 - 1975 and 1990 - 1992 were 11.10/100 000 and 3.25/100 000, respectively, which accounting for 17.91% and 4.86%, respectively; in 2004 - 2005, the crude death rates increased by age, rose remarkably from the age of 40 and arrived the peak of 20.83/100 000 (82/393 624) at the age of 85. The mortality among 35 - 44 year-old group was higher than those in 1990's. The crude death rates of the middle, west and east areas were 3.41/100 000 (827/24 225 738), 3.25/100 000 (636/19 563 647) and 2.05/100 000 (532/25 900 856), respectively, the Chinese population adjusted death rates of the middle and west areas were about twice that of the east (2.35/100 000 in the middle, 2.38/100 000 in the west, and 1.19/100 000 in the east).

CONCLUSIONThe mortality of cervical cancer was higher in rural areas than that in urban, as well as higher in the middle and west areas than that in east area in the interior of China in 2004 - 2005. Younger trend of cervical cancer death was observed; the mortality of cervical cancer and constituent ratio in the female tumor death continued to decline compared to those in 1973 - 1975 and 1990 - 1992.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; trends ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Health Surveys ; Humans ; Infant ; Infant, Newborn ; Middle Aged ; Neoplasms ; Uterine Cervical Neoplasms ; epidemiology ; mortality ; Young Adult

Acupressure ; methods ; Adolescent ; Adult ; Cervical Vertebrae ; pathology ; Female ; Humans ; Male ; Spinal Curvatures ; pathology ; physiopathology ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the relationship between CD8+ T-cell CD28 molecular expression in peripheral blood and TCM type in patients with chronic aplastic anemia (CAA).

METHODSUsing flow cytometry to detect the CD28 expression in 45 in-patients or out-patients and 24 healthy subjects for control. And the relation with TCM type was analyzed from the immunological aspect.

RESULTS(1) The levels of CD8, CD28, CD8+ CD28+ expression and CD8+ CD28+/CD8+ CD28- were all higher in the CAA patients than those in the healthy subjects (P < 0.05 or P < 0.01). (2) The levels of CD28, CD8+ CD28+ expression and CD8+ CD28+/CD8+ CD28- were all higher in the CAA patients of Shen-Yin deficiency type than those in the CAA patients of Shen-Yang deficiency type (P < 0.05 or P < 0.01).

CONCLUSION(1) The abnormal high expression of peripheral blood co-stimulatory molecules CD28 suggested CD28 disorder may play an important role in immuno-pathogenesis of CAA. (2) The levels of peripheral CD28, CD8+ CD28+ expression and CD8+ CD28+/CD8+ CD28- can be taken as an objective indexes for TCM typing of CAA, which was disordered more severe in patients of Shen-Yin deficiency type than in those of Shen-Yang deficiency type.

Adult ; Anemia, Aplastic ; classification ; diagnosis ; immunology ; CD28 Antigens ; biosynthesis ; CD8-Positive T-Lymphocytes ; immunology ; Chronic Disease ; Diagnosis, Differential ; Humans ; Kidney Diseases ; immunology ; Male ; Medicine, Chinese Traditional ; Yang Deficiency ; immunology ; Yin Deficiency ; immunology