Objective To investigate the cost-effect of tele-wound treatment platform with cellular phone terminator and traditional outpatient treatment on chronic lower limb ulcers in remote district.Methods Thirty seven cases with chronic lower limb ulcers from the key hospitals in the district of west Hunan Province were collected by cluster sampling,and randomly divided into the intervention group (25 cases)and the control group (12 cases).They chose remote wound treatment platform intervention with cellular phone terminator and traditional dressing change in clinic.All patients received a 1.5-year follow-up,or cure and amputations were set as the endpoint of the study.The cost-effect,including the incidence of complications in the course of treatment,number of switches,treatment time,the cost of treatment,as well as medical human resources consumption was analyzed and compared between the two groups.Results The incidence of complications in the course of treatment in the intervention was (76.0％) significantly lower than the control group(91.7％).There was a significant increase in the dressing times and the duration of treatment; and there was no significant difference in the cost of treatment and medical human resources consumption between two groups.Conclusions Compared to the traditional outpatients wound treatment,the multimedia message-based tele-wound treatment platform unlikely increased medical human resources consumption and the cost of treatment,and may reduce the incidence of complications and the treatment time.

OBJECTIVE: To retrieve the evidence for threshold setting of multi-parameter electrocardiograph (ECG) monitors in intensive care unit (ICU), and summarize the best evidence. METHODS: After literature retrieval, clinical guidelines, expert consensus, evidence summary and systematic review that met the requirements were screened. Guidelines were evaluated by the appraisal of guidelines for research and evaluation II (AGREE II), expert consensus and systematic review were evaluated by the Australian JBI evidence-based health care center authenticity evaluation tool, and evidence summary was evaluated by the CASE checklist. High-quality literature was selected to extract evidence related to the use and setup of multi-parameter ECG monitors in the ICU. RESULTS: A total of 19 literatures were included, including 7 guidelines, 2 expert consensus, 8 systematic reviews, 1 evidence summary, and 1 national industry standard. After evidence extraction, translation, proofreading and summary, a total of 32 pieces of evidence were integrated. The included evidence involved the environmental preparation for the application of the ECG monitor, the electrical requirements of the ECG monitor, ECG monitor use process, ECG monitor alarm setting principles, ECG monitor alarm heart rate or heart rhythm monitoring setting, ECG monitor alarm blood pressure monitoring setting, ECG monitor alarm respiratory and blood oxygen saturation threshold setting, alarm delay warning time setting, adjusting alarm setting method, evaluating alarm setting time, improving the comfort of monitoring patients, reducing nuisance alarm report the occurrence, alarm priority processing, alarm intelligent processing and so on. CONCLUSIONS This summary of evidence involves many aspects of the setting and application of ECG monitor. According to the latest guidelines and expert consensus, it is updated and revised to guide healthcare workers to monitor patients more scientifically and safely, and aims to ensure patient safety.
Humans ; Clinical Alarms ; Australia ; Intensive Care Units ; Arrhythmias, Cardiac ; Electrocardiography ; Monitoring, Physiologic

Objective To study the mutations of Env sequence of SIVmac239 after infection of Chinese rhesus monkeys, and compare the differences and characteristics of Gp120 sequences of enterotropic and neurotropic SIV strains. Methods Six strains of simian immunodeficiency virus were analyzed in this study: four separated from peripheral blood mononuclear cells of SIVmac239-infected monkeys and two neurotropic SIVmac251 strains.Isolated and cultured monoclonal virus was obtained by limiting dilution assay.Gp120 sequences were amplified after the RNA extraction and phylogenetic analysis was processed thereafter.So did the Gp120 amino acid sequence and N-glycosylation sites analysis of the enterotropic and neurotropic strains.Results SIVmac239 had different mutations in four rhesus monkeys.The diversity in amino acid sequences of the enterotropic and neurotropic strains concentrated in the V1 and V4 regions of Gp120.The enterotropic strains had an addition of glycosylation site in V4 but the glycosylation site changes of neurotropic strains were located in the conservative regions of C1, C2 and C3.Conclusions The addition of one glycosylation site in V4 region of GP120 and loss of one glycosylation site in C1 region are associated with enhanced enterotropism and neurotropism.The differences between the enterotropic and neurotropic strains are not dipicted in Gp120 V3 region which is closely related with the tropism of strains.

BackgroundPterygium is an ocular surface disease of abnormal cell proliferative kind and angiogenesis plays an important role in its development and recurrence.Several anti-angiogenic therapies have been used to treat pterygium,but there very few studtes for the in vivo observation of the microvessles in pterygium.ObjectiveThis study was to observe angiogenesis in pterygium with a high-resolution confocal microscope in vivo and to perform immunohistochemical study in vitro.MethodsA prospective case-controlled study was designed.Twenty eyes of 20 consecutive patients with primary pterygia and 20 age- and sex-matched patients with inner eye diseases and strabismus with normal conjunctiva were enrolled in this study.An in vivo confocal microscopy imaging system (Heidelberg Retina Tomograph Ⅱ Rostock Cornea Module) was used to collect microvascular pictures from the anterior part of pterygia and normal nasal conjunctiva of controls,and then immunochemistry was performed to examine the expression of CD31 in microvessel in vitro.The vascular density values were compared between these two groups.The correlation of vascular density values between in vivo Heidelberg Retina Tomograph and in vitro immunohistochemistry was calculated.Written informed consent was obtained from pationts before any examination and surgery.ResultsUnder the in vivo confocal microscope,the microvessel density was (8929±2993) μm/mm2 and (4202 ±692)μm/mm2,respectively,in pterygium and the normal conjunctiva group with a statistically significant difference between them (t =6.881,P＜0.01 ).Immunochemistry revealed that the expression of CD31 to measure vascular density was ( 21.00 ± 4.06/400 × field ) and ( 6.07 ± 1.75/400 × field ) in pterygium and the normal conjunctiva group,showing significant difference (t =12.312,P＜0.01 ).Positive correlations were found in the vascular density values between in vivo corneal laser confocal microscopy examination and in vitro immunochemistry examination in both the pterygium group and normal conjunctiva group (pterygium group:r=0.649,P＜0.01 ;normal conjunctiva group: r=0.572,P＜0.01 ) ConclusionsIn vivo confocal microscopy imaging is superior to in vitro immunochemistry in evaluating the microvessel of pterygium.The results of this study offer a new way index for further investigation of the biological behavior of pterygium and its mechanism.

Humans ; Low Back Pain ; therapy ; Medicine, Chinese Traditional ; Meridians ; Spinal Diseases ; therapy ; Vertigo ; therapy

According to the supply and demand equilibrium research on stomatological professionals, a conclusion could be drawn that the stomatological professionals are in serious shortage. Some strategies to support the demand of stomatological professionals are raised in this essay, such as widening the teaching objectives, stratified recruiting, enhancing the school-running ability of the main stomatological university and so on.
China ; Humans ; Oral Medicine

Objective To investigate plasma glutathione S-transferase(GSTs) activity and GSTP1 gene Ile105Val polymorphism in Bijie City, Guizhou Province, a coal-burning fluorosis endemic area. Methods One hundred and sixty villagers from Yachi Twon using non-improved cooking stoves were selected as the non-intervened group in Bijie City, Guizhou Province where coal-burning fluorosis was prevailing; 153 villagers as the intervented group were chosen from Changchun Twon, where cooking stoves were improved; 151 villagers were served as the control group from Baiyunshan Twon, Changshun County without endemic fluorosis. The activity of GSTs was tested by colorimetric analysis with spectrophotometer. The genotype of the GSTP1 gene Ile105Val polymorphism, presenting as either homozygous wild-type (AA), or heterozygous mutation type (AG), or homozygous mutation type (GG), was detected through the PCR-RFLP procedure. Results The activity of GSTs in plasma of non-intervened group [(12.44±4.97) kU/L]was significantly lower than that of intervened group (P < 0.05), and that of intervened group[(20.78±6.20)kU/L]was significantly lower than that of control group[(24.30±6.27)kU/L, P< 0.05]. The difference of the enzyme activity of three groups were statistically significant (F = 51.71, P < 0.05), but this enzyme activity did not vary significantly in each sex of each grnup(P > 0.05). Compared intervened group [AA:67.3%(103/153), AG:29.4%(45/153),GG:3.3%(5/153)]and non-intervened group[AA:66.9%(107/160), AG:30%(48/160), GG:3.1%(5/160)]with control group[AA:74.8%(113/151), AG:25.2%(38/151), GG:0 (0/151)], the Ile105Val polymorphism site of GSTP1 gene had significant difference(χ2= 6.04,6.07, both P< 0.05), but not significant between intervened and non-intervened groups(χ2 = 0.02, P>0.05). Conclusions Fluorosis can decrease the activity of GSTs and introduce the GSTP1 gene Ile105Val polymorphism, intervention with the fluorine intake will improve the effect of fluoride on the body.

The adhesion properties of tumor cells with extracellular matrix(ECM) are closely associated with their invasion and metastasis.Our work reported here was intended reveal the relevant biomechanical and biorheological manifestations of human lung cancer. Using micropipette aspiration technique, we investigated quantitatively the adhesive mechanics properties of high metastatic human giant cell carcinoma(PG) cells as well as low metastatic adenocarcinoma(PAa) cells of lung based on cell culture in vitro. The results showed that the adhesion forces of PAa and PG cells to collagen Ⅳ were significantly higher than those to glass surfaces, but at the lower concentrations(1.00μg/ml and 2.00μg/ml) of collagen Ⅳ, the amplitude for the increase of adhesion forces of PG cells were less than the amplitude for that of PAa cells, and most of the adhesion force values of PAa cells to the coated surfaces of incorporation of laminin along with 2 μg/ml collagen Ⅳ were significantly greater than those of PG cells. At the lower concentrations(0.625μg/ml for PAa cells,and 0.625 μg/ml, 1. 25 μg/ml for PG cells) of laminin tested,the adhesion force values of PAa and PG cells all decreased, but the amplitude and level for the decreased values of adhesion forces of PG cells were greater than those for the PAa cells. In conclusion, the adhesive and proteolytic behaviour of cancer cells to extracellular matrix might be mediated mainly by tumor cell membrane receptors such as integrin receptors and laminin receptors, it might affect the biological characteristics and the metastasis of the tumor cells. The results may benefit to explain some questions in biomechanical views about how the highly metastatic PG cells are prone to migration and invasion.

Human ribosomal DNA (hrDNA) targeting vector pHr is a homologous recombinant plasmid for human genome which developed in the State Key Laboratory of Medical Genetics. pHr was used to construct a recombinant plasmid pHr-CMG expressing mda-7/GFP fusion gene and its efficacy in the hepatocellular carcinoma cell line Bel-7402 was investigated. The expression of mda-7/GFP fusion gene was detected by fluorescent microscope, RT-PCR and Western blotting, and its function was detected by cell-cycle analyses, MTT assay and Hoechst33258 staining. The results demonstrated that pHr-CMG vector could express MDA-7/GFP fusion protein effectually and the mda-7 gene could induce cell apoptosis and proliferation suppression in Bel-7402 cell line, which might be caused by the G2/M cell cycle arrest. These results also suggested that human ribosomal DNA targeting vector system and the pHr-CMG vector may be applied in further gene therapy researches for hepatocellular carcinoma.

OBJECTIVETo discuss the clinical findings and treatment of paraneoplastic pemphigus (PNP) with Castleman's disease.

METHODSTo investigate the clinical, histopathologic and CT findings of 8 cases paraneoplastic pemphigus with Castleman's disease.

RESULTSAll of 8 patients were diagnosed PNP first and were found Castleman's tumor incidently during routine examination. All 8 cases showed severe erosion or ulcer of the oral mucosa with various skin lesions. Histopathologically, there were intraepidermal acantholytic vesicle, basal cell liquefaction, necrotic keratinocytes in the epidermis and lymphocyte infiltration in the upper dermis. CT scan appeared solitary mass in these patients. Some of them were attacked by bronchiolitis obliterans. All 8 patients were failed by use of predisone. Obvious relief of PNP and pulmonary lesion occurred after tumor was rescted.

CONCLUSIONSParaneoplastic pemphigus with Castleman's disease is a rare disease. The key step is to find and resect the tumor in abdomen. CT scan should be used to detect the tumor in patients with PNP, especially, when predisone was failed in treatment.

Adolescent ; Adult ; Castleman Disease ; complications ; diagnosis ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Paraneoplastic Syndromes ; complications ; diagnosis ; therapy ; Pemphigus, Benign Familial ; complications ; diagnosis ; therapy ; Retrospective Studies