Objective:To construct an extended care programme for type 2 diabetes patients based on the App and "hospital-community-family" linkage.Methods:Through literature review and qualitative interviews, an extended care programme for type 2 diabetes patients based on the App "Hospital-community-family" linkage was initially constructed, and two rounds of expert consultation were used to evaluate the usability and adjust the program.Results:This extended care program is led by a diabetes specialist nurse, mediated by a diabetes App, and based on the mechanism of "hospital-community-family" linkage. The intervention included two stages: establishment of patient health records, comprehensive assessments, discharge plan formulation, discharge referrals before discharge, and health monitoring and reminders, health education and consultation, health follow-up, health assessment, consultation and referral after discharge.Conclusion:The construction process of this protocol is scientific and feasible, which can realize continuous and personalized management of patients and promote "integration of resources and complementary advantages".

Objective:To understand the continuing care needs of patients based on the App and "hospital-community-home" linkage.Methods:With descriptive qualitative research, a semi-structured in-depth interview was conducted in 15 patients with type 2 diabetes in Gongli Hospital, Pudong New Area, Shanghai City, and community hospital from January to February 2020. Thematic analysis and the software NVivo 10.0 were used for data analysis.Results:Five themes were extracted: desire a "hospital-led,community-implemented, family-supported" model of continuing care; desire an appropriate, convenient and personalized access to information and follow-up; expect continuous, comprehensive, professional health guidance; expect to receive continuing care service led by specialized nurses and managed by multidisciplinary team; expect diabetes App to be simple and practical, satisfying various needs such as post-hospitalization condition monitoring, assessment feedback, health education and health intervention,ensure information security and free use.Conclusions:Patients have a strong willingness to receive continuing care based on the App and "hospital-community-family" linkage. A mechanism of "hospital-community-family" linkage continuing care service with clear division of labor should be established, multidisciplinary cooperation should be strengthened, and team advantages should be utilized. Providing comprehensive, professional and evidence-based continuing care services for patients, while further optimizing software functions and focusing on information security construction and following evidence-based guidelines to standardize App content in order to adapt to more patient characteristics and needs.

Humans ; Stroke/therapy* ; Thrombectomy ; Treatment Outcome ; Brain Ischemia/therapy* ; Retrospective Studies

OBJECTIVETo investigate the expression of octamer-binding transcription factor 4A(Oct4A) in human dental pulp cells(DPC)and the effect of Oct4A on the proliferation and multiple differentiation ability of DPC.

METHODSExpression of Oct4A in DPC was detected by realtime quantitative PCR(RT-qPCR). siRNA-Oct4A was constructed and transfected (50 nmol/L) into DPC with Lipofectamine(TM) RNAiMAX for 24, 48, 72, 96 and 120 h. The proliferation rate of DPC was examined using cell counting kit 8 (CCK-8) assay. The alizarin red staining was used to observe the formation of calcification nodules in DPC with 14 d of osteogenic induction, and oil red O staining to observe the formation of lipid droplet in DPC with 14 d of adipogenic induction. The expression of osteogenesis-related genes dentin sialophosphoprotein (DSPP) and adipogenesis-related genes lipoprotein lipase (LPL) was detected using RT-qPCR and Western blotting.

RESULTSThe expression of Oct4A reached the peak in P3 DPC (2.10 ± 0.10), which was 2.10 times as much as that in P1 (P = 0.000 vs. P1 and P7), and decreased along passages. The interference efficiency of DPC transfection peaked at 72 h (69.7%). Compared with control group and negative control group (IR-siRNA), the proliferation rate and multiple differentiation ability of DPC in interference group (Oct4A-siRNA) were downregulated (P = 0.000), and DSPP and LPL in DPC from interference group significantly decreased (P = 0.000).

CONCLUSIONSThe interference of Oct4A significantly downregulated the cell proliferation rate and multilineage differentiation capability of DPC.

Adolescent ; Adult ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Dental Pulp ; cytology ; metabolism ; Extracellular Matrix Proteins ; metabolism ; Humans ; Lipoprotein Lipase ; metabolism ; Octamer Transcription Factor-3 ; genetics ; metabolism ; Osteogenesis ; genetics ; physiology ; Phosphoproteins ; metabolism ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Sialoglycoproteins ; metabolism ; Transfection ; Young Adult

OBJECTIVETo compare the shaping quality in curved canals of two single-file technique systems with other two traditional full-sequential systems.

METHODSEighty mature molar canals with the curvature between 20 and 45 degrees were randomly divided into four groups. Specimens in each group were prepared to size 25 at working length using A (Reciproc), B (OneShape), C (MTwo) and D (Revo S), respectively. Each canal was scanned by micro-computed tomography before and after preparation. Parameters including changes in dentine volume, percentage of uninstrumented area, degree and tendency of transportation were analyzed. The operating time was also recorded.

RESULTSIn full canal length, there was no difference in canal dentine removal, instrumented percentage and transportation degree among four groups (P > 0.05). In the apical 4 mm region, group A removed more dentine [(2.14±0.76) mm(2) of canal surface area and (0.38 ± 0.15) mm(3) of canal volume] than groups B and C(P < 0.05). At 1 mm level, median of transportation degree of group A was 0.05 (0.03)mm, which was smaller than other groups (P < 0.05). Groups A and B took (86.3±24.6) s and (85.9±21.3) s, while groups C and D took (147.4±28.3) s and (126.3±27.7) s srespectively to finish preparation. Single file techniques were significantly faster than the two full-sequential systems (P < 0.01).

CONCLUSIONSCompared with the continuous rotary systems, the reciprocating single-file system A showed better apical shaping ability. Both single-file techniques were more efficient than full-sequential systems for curved canal preparation. Single-file techniques appear to be the effective and efficient method for curved canal preparation.

Dental Pulp Cavity ; Dentin ; Humans ; In Vitro Techniques ; Molar ; Nickel ; Root Canal Preparation ; Titanium ; X-Ray Microtomography

BACKGROUNDHemifacial spasm (HFS) is a facial nerve disorder characterized by episodic involuntary ipsilateral facial muscle contraction. Information on Chinese patients with HFS has not been well-characterized. This study aimed to evaluate the clinical feature and the treatment status of HFS across China.

METHODSA cross-sectional study including 1003 primary HFS patients had been carried out in 15 movement disorder clinics in China in 2012. The investigated information was acquired from questionnaires and medical records including demographic data, site of onset, aggravating and relieving factors, treatments prior to the investigation, etc.

RESULTSIn this study, the ratio of male to female was 1.0:1.8, the mean age at onset was (46.6 ± 11.5) years. About 1.0% patients were bilaterally affected. The most often site of initial onset was the orbicularis oculi muscle. The most often affected sites were orbicularis oculi, zygomatic, and orbicularis oris muscles. Stress/anxiety and relaxation were most often aggravating and relieving factors, respectively; 2.3% patients had family history, 28.4% cases were combined with hypertension, and 1.4% patients were with trigeminal neuralgia. Botulinum toxin type A (BTX-A) injection was the most commonly used treatment, followed by acupuncture and oral medication. BTX-A maintained the highest repeat treatment ratio (68.7%), while 98.4% patients gave up acupuncture. The mean latency of BTX-A effect was (5.0 ± 4.7) days, the mean total duration of the effect was (19.5 ± 11.7) weeks, and 95.9% patients developed improvements no worse than moderate in both severity and function. The most common side effect was droopy mouth.

CONCLUSIONSThe onset age of HFS in China is earlier than that in western countries. The most often used two treatments are BTX-A injection and acupuncture, while the latter kept the poor repeat treatment ratio because of dissatisfactory therapeutic effect.

Adult ; Botulinum Toxins, Type A ; therapeutic use ; China ; Cross-Sectional Studies ; Female ; Hemifacial Spasm ; diagnosis ; drug therapy ; Humans ; Male ; Middle Aged ; Neuromuscular Agents ; therapeutic use