Medical service products have a lot of features, such as differences, intangibility and difficulty in evaluating, which greatly increase the difficulty in the transition of customer development from customers to service experiencers. Customer transition is mainly based on the pre-evaluation of service providers. In other words, credence evaluation of service providers is conducted from the combination of information from service providers, customers and self-awareness. When the results of the evaluation are dependable, customers will be under the transition. This article was based on the differences in customer cognition and experience background. It set the group that had never received TCM services as objects and conducted analysis on customer development. It established measurement indexes and questionnaire for customer pre-evaluation. PCA and Logistic regression analysis were used to deeply deal with data to unveil the key factors that influence credence evaluation. Credence mechanism was established according to the results to promote customer development in TCM service consumption.

Objective To investigate the diagnosis and treatment of abdominal compartment syn-drome (ACS)aftergiantabdominal incisional hernia surgery.Methods The diagnosis and treatment of eight cases of ACS after giantabdominal incisional hernia surgery in our hospital from June 201 0 to June 201 4 were retrospectively analyzed.Results Seven cases of ACS were cured,with a cure rate of 87.5%. One case with chronic pulmonary heart diseasedied ofsevere lung infection caused by ARDS,with a mor-tality of 1 2.5%.The cured patients discharged and werefollowedup for threeto six months,without any signs of recurrence and organ dysfunction.Conclusion Abdominal compartment syndrome is a serious complication aftergiantabdominal incisional hernia surgery,with treatment difficult and high mortality.The keysinreducingmortalityare early diagnosis and comprehensive treatment.

Animals ; Carcinogenicity Tests ; Cytotoxicity Tests, Immunologic ; Humans ; Mutagenicity Tests ; Soot ; toxicity

Animals ; Aorta ; Cells, Cultured ; Chloride Channels ; physiology ; Male ; Muscle, Smooth, Vascular ; drug effects ; metabolism ; physiology ; Pyrazines ; pharmacology ; Rats ; Rats, Sprague-Dawley

Objective To study the effect of autonomic nerve activity on emotion experience.Methods 71 healthy males were asked to see a neutral film STICK and conduct a computer game,then evaluated emotion experience.All participants were recorded skip temperature,skin conduction,heart rate,LF and HF during baseline and game periods.Results (1) There was significant difference in fear experience among high,middle and low synchronous groups (2.64 ± 2.05,2.50 ± 2.01,4.46 ± 2.41; P＜ 0.01),and low synchronous group was significantly higher than high synchronous group (P ＜ 0.01).The main effects of three periods were significant in basis of three response types of autonomic nerve activity(skin conduction:F(2.68) =76.083,P＜0.01; heart rate:F(2.68) =71.692,P ＜ 0.01),and skip temperature,skin conduction and heart rate were no significant difference among three response types.Types and periods had no significant interaction.(2) Different response modes of autonomic nervous system has different distributions in high fear and low fear groups (x2 =9.763,P ＜ 0.01).Skip temperature,skin conduction and heart rate were no significant difference between high fear group and low fear group.Conclusion The modes of autonomic nervous system have an effect on intensity of fear experience,but not the same in skip temperature,skin conduction and heart rate.

Spontaneous miscarriage is the most common complication of the first trimester,among which 90% are early miscarriage that occurs prior to the 12th week of the gestation.Low progesterone level may be the main cause of the early miscarriage.This article discusses the incidence,pathogenesis,progesterone treatment,and prediction marker of early miscarriage to provide clues for the clinical work.

Objective To investigate the expression of eukaryotic initiation factor 4E(eIF4E) ,vascular endothelial growth factor (VEGF)‐A and VEGF‐C in gastric cancer tissues and their correlation with invasion and metastasis of gastric carcinoma .Methods The expressions of eIF4E ,VEGF‐A and VEGF‐C were detected in tissues of 58 gastric carcinomas and 25 normal gastric mucosa by using immunohistochemical method .Results The positive rate of eIF4E、VEGF‐A and VEGF‐C protein expression were 89 .7%(52/58) ,65 .5% (38/58) ,60 .3% (35/58) in gastric carcinoma ,which were higher than those in normal gastric mucosa tissues which were 4 .0% (1/25) ,12 .0% (3/25) ,8 .0% (2/25) respectively .Expressions of eIF4E ,VEGF‐A and VEGF‐C were significantly correlated with the depth of invasion and lymph node metastasis(P<0 .05) ,but not with the age ,sex of patients(P>0 .05) .Ex‐pressions of eIF4E and VEGF‐C were significantly correlated with tumor differentiation .The expression of eIF4E was being found positively correlated with VEGF‐A and VEGF‐C .Conclusion eIF4E may play certain roles in the oncogenesis and progression of gastric carcinoma .VEGF‐A and VEGF‐C may be helpful in lymph metastasis .Combined detection of eIF4E ,VEGF‐A and VEGF‐C may be helpful to assess the malignant degree and prognosis of gastric carcinoma .

Humans ; Occupational Diseases ; epidemiology ; prevention & control ; Risk Assessment

Objective To detect plasma progranulin (PGRN) level in subjects with newly diagnosed type 2 diabetes mellitus and to investigate the relationship of plasma PGRN level with glycolipid metabolism,inflammation,and insulin resistance.Methods Eighty patients with newly diagnosed type 2 diabetes (T2DM) and 88 subjects with normal glucose tolerance (NGT) were recruited in the study.Both of them were divided into normal weight (NW)subgroup and obesity (OB) subgroup.Obesity was defined as body mass index (BMI) ≥ 25 kg/m2 according to the World Health Organization-Western Pacific Region diagnostic criteria(2000).Body fat parameters were measured and BMI,waist-to-hip ratio were determined.Fasting plasma PGRN and interleukin-6 (IL-6) levels were determined by ELISA,fasting plasma glucose (FPG),2 h plasma glucose after glucose loading (2hPG),HbA1C,fasting insulin (FINS),and lipids were also detected.Insulin resistance and pancreas β cell function were assessed by homeostasis model assessment (HOMA-IR,HOMA-β).Results Plasma PGRN level was significantly higher in T2DM group than that in NGT group(P＜0.01).Within groups of T2DM and NGT,plasma PGRN level in OB subgroups was higher than that in NW subgroups [(225.22 ± 34.39 vs 195.59 ± 50.47 and 183.79 ± 61.63 vs 148.69 ± 55.27) ng/ml,P＜0.05].Bivariate correlation analysis showed that plasma PGRN level was positively correlated with weight,waist circumference,BMI,systolic blood pressure,FPG,2hPG,HbA1C,triglyceride(TG),IL-6,FINS,and HOMA-IR (P＜0.05 or P＜0.01),and was negatively correlated with HOMA-β (P＜0.05).Multiple linear regression analysis showed that BMI,HbA1C,IL-6,and TG were independently related to plasma PGRN level(P＜0.05).Conclusions Plasma PGRN level was increased in patients with type 2 diabetes as well as in obesity,and was closely related with glycolipid metabolism,inflammation,and insulin resistance.

To investigate the relationships among plasma secreted frizzled-related protein ( sfrp) 5 level and body fat parameters, glucolipid metabolism, insulin resistance index, and inflammation. 89 subjects with normal glucose tolerance(NGT) and 87 patients with type 2 diabetes mellitus (T2DM) were enrolled and each group was divided into no-obese and obese subgroups. Obesity was defined as body mass index ( BMI)≥25 kg/m2 according to the World Health Organization -Western Pacific Region diagnostic criteria ( 2000 ) . Body fat parameters were measured and BMI, waist-hip ratio were evaluated, meanwhile, the levels of blood glucose-lipid parameters and fasting insulin were also determined. Insulin resistance index ( IR) was assessed by homeostasis model assessment ( HOMA) . The concentrations of plasma sfrp5 and interleukin 6 were detected by enzyme-linked immunosorbent assay. Plasma sfrp5 level in T2DM group was significantly lower than that in NGT group [(8. 35±3. 38 vs 11. 35±3. 69)ng/ml, P<0. 01]. The levels of plasma sfrp5 in subjects with obesity were also lower than those in subjects with no-obesity in both NGT and T2DM groups [(9. 46±2. 70 vs 13. 12±3. 62)ng/ml and(6. 70±2. 34 vs 10. 12±3. 45) ng/ml, both P<0. 01]. Plasma concentrations of sfrp5 in T2DM-obese group were significantly lower than that in NGT-obese group(P<0. 01). Correlation analysis showed that plasma sfrp5 levels were negatively correlated with waist-hip ratio, HbA1C, fasting insulin, triglycerides, waist circumference, fasting plasma glucose, interleukin 6, natural logarithm of HOMA-IR [ln(HOMA-IR)], and BMI(P<0. 01 or P<0. 05). Multiple linear regression showed that ln(HOMA-IR), BMI, triglycerides were independent related factors in influencing the levels of plasma sfrp5 (r2=0. 216, 0. 177, 0. 113, all P<0. 05). Plasma sfrp5 levels were decreased in obesity and T2DM subjects and were correlated with body fat disposition, glucose-lipid metabolism, insulin resistance and inflammation. Lack of sfrp5 may contribute to the pathophysiology of obesity and T2DM.