Objective To construct the sequential management model of networked drug-cognitive behavior in patients with chronic insomnia,and to explore the effects of this model on treatment and management of patients with chronic insomnia. Methods A total of 160 patients with chronic insomnia treated from January 2014 to June 2015 were randomly divided into the experimental group and the control group. The experimental group was treated with networked drug-cognitive behavior sequential therapy and management. Through the establishment of patient management files in the network management system,the disease was assessed,treatment programs were developed, remote implementation of 8 weeks of drug-cognitive behavior sequential treatment was conducted,12 months of net-work remote dynamic management and efficacy evaluation was performed. The control group received 8 weeks of traditional medical care with face-to-face drug-cognitive behavior sequential treatment and 12 months outpatient fol-low-up management. Results Comparison of management core indicators:there were significant differences between two groups in number of visiting hospital,exit status,treatment completion and documentation,sleep diary comple-tion,sleep scale completion and patient satisfaction. Comparison of sleep quality:after 2 months of treatment,there was no difference in quality of sleep between two groups; after 12 months of treatment,there were significant dif-ferences in sleep latency,awakening time after sleep,total sleep time and sleep efficiency between two groups. Scale score:after 12 months of treatment,there were significant differences in Pittsburgh sleep quality index,sleep personal beliefs and attitude scale score between two groups. Conclusion Network-based management improves the compliance of patients with chronic insomnia,reduces the loss of follow-up rate,improves sleep cognition,increases sleep quality,saves patients' time and cost,increases patient satisfaction,which is worth promoting in clinical application.

[ ABSTRACT] AIM:To investigate the effect of microwave radiation at different intensities on the rat myocardium and its possible mechanism.METHODS:The rats were radiated by the intensity of 500, 1 000, 1 500 and 2 000 W/m2 with 2 450 MHz microwave for 6 min.The heart tissue was collected 6 h after microwave radiation.ATP and mitochondria complexⅣandⅤwere measured.The changes of the tissue structures were observed under transmission electron micro-scope.The apoptosis of the myocardial cells was detected by a cell analyzer.The protein level of cleaved caspase-3 was de-termined by Western blotting.RESULTS:The concentration of ATP and activity of mitochondria complexⅣandⅤsigni-ficantly decreased compared with control group in the cardiac tissues.The decreased number, morphological abnormalities such as dissolved cavitation, matrix and obvious tumefaction of mitochondria were observed under transmission electron mi-croscope.The microwave radiation induced the apoptosis of myocardial cells in the rats.The cell apoptotic rate and the pro-tein level of cleaved caspase-3 increased with increasing intensity of microwave radiation ( P<0.05 ) .CONCLUSION:Microwave radiation has obvious injury effect on the rat heart, which can cause cardiac energy metabolism dysregulation and cardiac myocyte apoptosis.

Objective To analyze the function of let-7e in the carcinogenesis of non-small-cell lung cancer.Methods The microRNA let-7e expression levels in cancer tissues and adjacent normal lung tissues were detected by quantitative real-time reverse transcription-PCR from 35 non-small-cell lung cancer patients,U6 RNA as an actin.Results The expression of microRNA let-7e in cancer tissues was significantly higher than adjacent normal lung tissues (10.111±6.135,P ＜ 0.0001),there was a significantly different between squamous carcinoma group (9.635±8.300) and adenocarcinoma group (10.301 ±5.228,P ＜ 0.05),independently of sex,smoking history,stage,and histologic characteristics of the tumor.Conclusion The expression of microRNA let-7e in cancerous tissues is high,microRNA let-7e should play oncogene role in process of non-small-cell lung cancer,and would be an useful biomarker.

Objective To investigate transmission routes of healthcare-associated infection(HAI)caused by methi-cillin-resistant Staphylococcus aureus (MRSA),and make effective measures for preventing and controlling the oc-currence and epidemic of HAI caused by multidrug-resistance bacteria.Methods From February 24 to March 29, 2012,12 MRSA-infected patients were performed epidemiological study,these patients underwent bronchoscopy be-cause of tracheal stenosis,strains were identified by amplifying the sequences of 16S rRNA ,femA and mecA with real-time quantitative polymerase chain reaction (PCR),homology analysis of strains were performed by Spa geno-typing.Results All 12 MRSA-infected patients were susceptible to multidrug-resistance bacterial infection,5 cases of MRSA infection occurred during this hospitalization.Detection of specimens from health care workers and envi-ronment were all negative;Spa gene of all 12 MRSA isolates was type t 030 ,which was the main epidemic strain in Asia;Spa gene of Staphylococcus aureus isolated from nurses’noses was type t1425 .Conclusion The assumption of MRSA spread among health care workers aren’t supported by the epidemiological investigation results,genotypes of 12 MRSA isolates are identical,but the result of gene typing can’t be as the evidence of homology of infection ;patients at high risk for MRSA infection should be screened as early as possible,early contact isolation should be performed,so as to prevent and control the occurrence of HAI.

Objective To clone express and purify Schistosoma japonicum fructose?1 6?bisphosphate aldolase SjFBPA in E. coli and observe its expression in different developmental stages of S. japonicum. Methods FBPA gene was amplified from S. japonicum adult worm cDNA by using PCR. The amplified product was recombined into pET28a plasmid and inducibly expressed with IPTG in E. coli BL21. SDS?PAGE and Western blotting were employed to analyze and identify the recombinant protein SjFBPA rSjFBPA . Then rSjFBPA was purified by chromatographic purification and its purity was analyzed by SDS?PAGE. The protein concentration of rSjFBPA purified was measured by the BCA method. Furthermore SjFBPA mRNA was ana?lyzed in different developmental stages of S. japonicum by RT?PCR. Results SjFBPA was successfully amplified by using PCR and identified by restriction enzyme digestion and sequencing. The Western blotting analysis confirmed that the recombinant pro?tein could specifically reactive to the anti?His?tag monoclonal antibody. The concentration of the purified recombinant protein was about 4 mg/ml. The result of RT?PCR showed that SjFBPA mRNA was expressed in cercaria schistosomulum adult worm and egg of S. japonicum. Conclusion SjFBPA is successfully recombined and expressed in a prokaryotic system and SjFBPA mRNA is expressed in cercaria schistosomulum adult worm and egg of S. japonicum.

Objective To analysis long-term effects and safety of arsenic trioxide (ATO)-based induction and maintenance therapy in newly diagnosed acute promyelocytic leukemia (APL). Methods Retrospective analysis induction remission and post-remission treatment of 62 newly diagnosed APL patients was performed. These cases were followed up for 5 and 7 years. Results The complete remission (CR) rate was similar in ATO/all-trans retinoic acid (ATRA) induction group and ATRA/chemotherapy induction group.However, the former group has the shorter time to CR. The negative rate of PML-RARα fusion gene after induction without ATO was less than that of ATO group (86.2 % vs 56.3 %, P ＜0.05). After CR, the 5-year overall survival (OS) between ATO-base rotation maintenance group and chemotherapy-base rotation maintenance group showed that the former was (94.4±5.4) %, the latter is (45.5±10.2) %; 7-year OS was (52.5±23.7) % and (27.3±9.3) %; 5-year disease free survivals (DFS) was (94.7±5,5) % and (41.3±10.1) %; 7-year DFS was (52.6±23.7) % and (27.5±9.4) %. There was significant different in 5-year or 7-year OS and DFS between two groups (P ＜0.05). The relapse rates of the two groups in post-remission treatment were 14.7 % and 37.0 % (P ＜0.05). Conclusion ATO combined ATRA induction therapy increased the negative rate of PML-RARα fusion gene. ATO-base rotation maintenance improved long-term outcome and decreased the rate of relapse. Furthermore, ATO appeared to be generally safe and well tolerated.

ObjectiveTo establish pediatric serum CysC reference intervals based on the children's hospital laboratory data in Zhejiang Province and analyse the effects of CysClevels on age and gender. MethodsCysC was one of tests of a routine biochemical screening panel employed for most outpatients and inpatients in the children's hospital, and 8 127 subjects (4 264 boys and 3 863 girls) were selected from 13 567 subjects from laboratory information system according to the exclusion criterion with seriously systemic diseases, cardiovascular diseases, kidney diseases, elevated values of creatinine, urea or ALT for which 1.5-fold upper limit, serum samples with hemolysis, icterus or lipid turbidity, same patients with non-first-time CysC results and living addresses which were not in Zhejiang. The serum CysC was determined by transmission turbidimetry on Roche DPP modular automatic biochemical analyzer. SPSS 17.0 software and EXCEL 2003 were employed for statistical analysis in this study. Results The serum CysC concentration was a Gaussian distribution after log transformation. The mean Log-transformated CysC lg (CysC) concentration of boys in five age groups ( ＜ 1 month, 1 to 3 months, 4 to 11 months, 1 to 2 years and 2 to 16 years) were 0. 224,0. 170,0. 112,0. 061, -0. 011 (mg/L,lg) respectively, and the mean Log-transformated CysC lg(CysC) concentration of girls in five age groups were 0. 222, 0. 164, 0. 089, 0. 057,-0. 010 ( mmg/L, lg) respectively, and no statistically significant differences between Ig( CysC ) and gender in five age groups were found ( t values were 0. 174, 0. 362, 0. 445,- 1. 464 and - 0. 093, respectively,and corresponding P values all were greater than 0. 05 ). The mean lg ( CysC ) concentrations in five age groups were 0. 222,0. 166,0. 100,0. 059, - 0. 010 ( mmg/L, lg), and significant differences between Lg ( CysC ) and ages by Analysis of Variance were observed ( F = 309. 785 and P = 0 in between-groups totally,P = 0 in any two groups). Serum CysC levels were highest in the age of ＜ 1 month, then declined to the age of 2 years and kept stable in the age of 2 to 16 years. The serum CysC reference intervals for children were as follows:0. 95 -2. 92 mg/L in the age of ＜ 1 month, 0. 81 -2.67 mg/L in the age of 1 to 3 months, 0. 65 -2.45 mg/L in the age of 4 tol2 months, 0. 56 -2. 35 mg/L in the age of 1 year and 0. 45 -2. 13 mg/L in the age of 2 to 16 years. ConclusionsThere is no significant effect on pediatric CysC levels with gender but close correlated with age below 2 years old. It is necessary to establish appropriate age-related reference intervals of serum CysC for efficiently evaluating renal function in local children.

Objective To evaluate the application value of virtual touch tissue quantification (VTQ)for evaluating small focal liver lesions.Methods Seventy-seven patients with 89 small focal liver lesions,whose largest diameter were less than or equal to 3 cm were evaluated with VTQ.The shcar wave velocity (SWV) of the tumor and background liver parenchyma were calculated,and their results were compared with those of 40 healthy subjects.Statistical analysis was performed on the SWV for the differentiation of normal liver,background liver parenchyma and lesions.The cut-off point for SWV was obtained by using ROC curve analysis which was used to predict malignancy lesions.Results The SWV of malignant lesions was significantly higher than that of benign ones [(2.56-± 0.67) m/s vs (1.70 ± 0.55) m/s,P =0.000].The SWV of metastatic liver carcinoma which came from lung cancer and breast cancer were higher than that of gastrointestinal tract cancer transfers (P =0.000).Based on 1.93 m/s as the cut-off point of SWV value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for diagnosing malignancies were 82.0 ％,84.6％,83.15 ％,87.23 ％ and 78.57 ％ respectively.Conclusions VTQ technique can help the differential diagnosis of small focal liver lesions.

Objective To evaluate the therapeutic efficacy and safety of endoscopic sphincterotomy (EST) combined with large balloon dilation for bile duct stones.Methods A total of 83 patients with common bile duct stones were randomly divided into 2 groups to receive standard EST (n =41,EST group) or EST plus large balloon dilation (n =42,EPLBD group),respectively.The number of endoscopic session,operation time,rates of successful complete stone retrieval,mechanical lithotripsy,and procedure related complication were compared between the two groups.Results The rate of early procedure-related complications was similar in 2 groups (9/41 vs.7/42,P ＞0.05),including perforation ( 1/41 vs.0/42,P ＞0.05),bleeding (5/41 vs.2/42,P＞0.05) and pancreatitis (3/41 vs.5/42,P＞0.05).The rate of successful complete stone removal was also similar in 2 groups (39/41 vs.41/42,P ＞ 0.05 ).However,EST group needed more procedure time (38.8 ±4.3 min vs.29.2 ±5.3 min,P ＜0.01 ) and use of mechanical lithotripsy to achieve complete stone removal (9/41 vs.2/42,P ＜ 0.05 ).Only one patient in EPLBD group ( 1/42,2.4％ ) needed a second ERCP to clear bile duct stone,while in EST group,8 patients underwent a second procedure ( 19.5％,P ＜ 0.05 ).Conclusion For endoscopic removal of common bile duct stones,EST combined with larg4e balloon dilation is as safe and effective as EST,while easier in manipulation.

To evaluate the automated segmentation algorithm for detection of intra - retinal layers to process images obtained from ultra- high resolution optical coherence tomography ( OCT ) . Graph theory and the shortest path search based on dynamic programming were applied to automatically segment the 8 intra - retinal layers. We experimentally verified the accuracy and reliability of the algorithm. The results showed that the intra-retinal layer boundaries between automated and manual segmentations matched well. The algorithm successfully segmented the intra- retinal layers in glaucoma, high myopia, and retinitis pigmentosa patients. The proposed automatic segmentation for intra-retinal layers provides a promising tool for quantitative analysis in clinical diagnosis and treatment.