After the current situation of Internet medicine in our country was described from the aspects f policy support and mobile Internet-related technologies, the 4 construction models and 4 applications models of Internet medicine in our country were pointed out, and suggestions were put forward for the sustainable and healthy develop-ment of Internet medicine, namely promoting Internet medical service, strengthening guidance of relevant legisla-tions and policies, working out scientific management criteria, and establishing rational supervision organizations.

Objective To explore the combination of Astragalus injection combined with Danshen injection in the treatment of nephrotic syndrome. Methods 126 cases of primary nephrotic syndrome were recruited into a control group (66 cases) and a treatment group (60 cases). Both groups were given high-quality protein diet. On this basis, the treatment group was treated with Huangqi injection combined with compound Danshen injection, while the control group was treated with prednisone and furosemide. Both groups received a course of 28 days' treatment. Results The total effective rate was 92% and 56% in the treatment group and the control group respectively, with the difference showing statistical significance (t =4.56,P<0.05) .Conclusion Huangqi injection combined with compound Danshen injection is effective in treatment of nephrotic syndrome.

Objective To investigate the relationship between anti mutated citrullinated vimentin (MCV) antibody, anti-cyclic citrullinated peptide (CCP) antibody with disease activity and bone erosion in patients with rheumatoid arthritis (RA), so as to provide evidence for clinical diagnosis and treatment. Methods The anti-CCP antibody and anti-MCV antibody were detected using the enzyme-linked immune adsorption method (ELISA) for 634 patients with RA. At the same time, the clinical and laboratory data were collected, and the X-ray images of hands or feet were taken. Disease activity score (DAS)28 score was calculated, and all patients were divided into high disease activity group, moderatedisease activity group, low disease activity group and stable disease group on the basis of the DAS28 score. We analyzed the relationship between the degree of anti MCV, anti CCP antibodies, and disease activity of patients by Spearman correlation. And anti CCP, anti MCV antibodies, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) of these patients were compared at different period of bone erosion and disease activity by the Wilcoxon rank sum test and nemenyi. Results ① Positive correlation could be detected between anti-MCV antibody and ESR, CRP, number of tender joint, DAS28 score (r=0.115, P=0.004; r=0.120, P=0.003; r=0.124, P=0.002; r=0.085, P=0.032), and anti CCP antibody had no correlation with these index. The anti MCV antibodies in high disease activity group [694 (156, 1 000)] U/ml, and moderate activity group [911 (190, 1 000)] U/ml were higher than that of the low disease activity [248(150, 731)] U/ml or stable group [275(62, 928)] U/ml (U=2.29, P=0.023;U=2.25, P=0.024; U=2.45, P=0.014; U=2.4, P=0.018), and anti CCP antibody in the moderate disease activity group [499(180, 1 370)] U/ml was higher than low disease activity group [297(83, 574)] U/ml and stable group [187(67, 1 153)] U/ml (U=2.53, P=0.012; U=2.22, P=0.026). ②The anti MCV, anti CCP antibody in the bone erosion group were higher than those without bone erosion group (U=4.64, P<0.01;U=2.69, P=0.007). The anti MCV antibodies in stage Ⅱ[722(259, 1 000)] U/ml and Ⅲ group [714 (216, 1 000)] U/ml was significantly higher than that in stage Ⅰ [316(98, 1 000)] U/ml(U=3.46, P<0.01; U=4.28, P<0.01). The anti CCP antibody level in stage Ⅱ [394(180, 1 000)] U/ml and Ⅲ[391(181,1305)] U/ml was higher compared with stage Ⅰ[277 (98,898)] U/ml (U=1.99, P=0.046; U=2.92, P=0.004), and that in phase Ⅲ was higher than Ⅳ [218(71, 911)] U/ml (U=2.06, P=0.041). Conclusion Compared with anti-CCP antibody, anti-MCV antibody is closely related with disease activity, and has a better predictive value for bone erosion. Patients with higher ESR and CRP are more susceptible to bone erosion.

Objective To investigate the relationship of antithrombin‐Ⅲ activity and thrombosis risk in liver cirrhosis with Child‐Pugh classification .Methods In our hospital from June to December 2014 ,60 liver cirrhosis patients were selected randomly included into this experiment group ,The 60 cases of control group were from medical examination of health in our hospital .The plasma AT‐Ⅲ activity and D‐D concentration in all these cases were detected and analyzed .Results The AT‐Ⅲ in cirrhosis patients were significantly lower than which in healthy persons(P<0 .05) .The lower level of AT‐Ⅲ is in these patients which were in seri‐ous condition(P<0 .05) ,the abnormal rate of D‐D concentration is also higher at the same time(P<0 .05) .Conclusion The detec‐tion of AT‐Ⅲ level in patients with liver cirrhosis is directly related to the severity of clinical and thrombosis risk .The AT‐Ⅲ de‐tection level can be used to judge the patient′s condition and develop appropriate treatment strategies .

Aim To establish experimental colitis model in Balb/c mice by Trinitrobenzene Sulfonic Acid (TNBS) enema. Methods Several doses of TNBS instilled into mice colon induced experimental colitis, then mortality rates of mice were observed. Severity of colitis was evaluated by the Disease Activity Index (DAI),Morphologic and Histologic analysis and Myeloperoxidase (MPO) analysis. We also observed the T cell proliferation of spleen. Results It showed that the mice mortality rate was increased when the mice were given the higher dose of TNBS. Most survived mice showed chronic inflammation in reduction colon. Histological examinations of the colon showed multiple erosive lesions and inflammatory cell infiltration composed of macrophages, lymphocytes, neutrophils in lamina propria and beyond mucosal layer. Some colon showed crypt distortion or reduction and high vascular density. Conclusion A TNBS dose of 1.5mg for each mouse was chosen for an appropriate experimental dose since the group showed less mortality rate and appropriate experimental colitis.

A survey on professional knowledge levels was conducted from April to October 2019 among 388 general practitioners (GPs) from 46 community health service centers and 30 township health centers of 6 provinces selected by stratified random sampling method. The overall knowledge test score was 31.82—84.09(56.94±9.19) points, and the pass rate was 36.3% (141/388). There were significant differences in test scores among participants with different types of work units, regions, provinces, marital status, educational background, professional titles, types of employment, length of service, and training status (all P<0.05). Multivariate regression analysis showed that educational background ( B=-2.835), professional title ( B=-8.867), and participation in professional course training ( B=2.214) were the influencing factors of knowledge level (all P<0.05). The pass rates in knowledge of prevention/health management (13.7%, 53/388) and policies and regulations (12.1%, 47/388) were low. The results show that the levels of professional knowledge among GPs working in grassroots health institutions are relatively low, and suggest that continuing education should be strengthened to improve the professional knowledge level of GPs in primary care institutions, particularly, knowledge of health policies and regulations, disease prevention and health management.

Objective To evaluate the functional changes of visual cortex (V1) in patients with primary open angle glaucoma (POAG) by fMRI retinotopic mapping technology. Methods Fifteen POAG patients and 15 healthy volunteers underwent stimulations with fMRI retinotopic mapping stimulus and contrast-reversing checkerboard patterns stimulus on a Siemens Trio 3.0 T MRI whole-body scanner for functional data collection. Comparisons of V1 fMRI responses between the glaucomatous eyes and the healthy eyes of the patients were carried out using paired samples t-test, while independent samples t-test was used to compare V1 fMRI responses and activations between the healthy eyes of patients and the age-, gender- and side- matched eyes of normal people. Differences of V1 cortical functions and visual functions were analyzed by linear correlation analysis when the glaucomatous and the healthy eyes were simulated individually. Results (1) V1 fMRI responses of the individually stimulated glaucomatous eyes[(1.24±0.72)%]were weaker than those of the healthy eyes[(2.18±0.93)%](t=4.757,P<0.01). Comparisons of V1 fMRI responses between the glaucomatous eyes and matched eyes of normal people, as well as between the healthy eyes of patients and the matched eyes of normal people, were performed respectively: the responses in the glaucomatous eyes[(1.24±0.72)%]were weaker than those in the matched eyes of normal people[(2.01±0.65)%](t=-3.011,P<0.01). There was no statistical difference of the responses between the healthy eyes from patients[(2.18±0.93)%]and the matched eyes of normal people[(1.95±0.75)%](t=0.742,P＞0.05). (2) Differences of V1 cortical functions were negatively correlated with those of visual functions in the individually stimulated glaucomatous and healthy eyes (r=-0.887, P<0.01). (3) The activated area indexes of V1 cortexes in the healthy eyes from patients (0.72±0.12) were lower than those in the matched eyes of normal people (0.85±0.09) (t=-3.801, P<0.01). Conclusion Cortical function impairment was in accordance with visual function impairment in glaucoma. Located and quantified measurement with fMRI retinotopic mapping was a useful method for clinical follow-up and evaluation of functional alteration of glaucomatous visual cortex, and a potentially useful means of studying trans-synaptic degeneration of visual pathways of in vivo glaucoma.

Objective To acquire normative values of anorectal manometry and sensation in population of our country with different gender and age.Methods Healthy individuals from four medical centers were collected and divided into three group according to their age,group Ⅰ 18 - 39 years old, group Ⅱ 40-59 years old and group Ⅲ ≥60 years old.The parameters of anal of subjects at resting status was examined by pneumohydraulic capillary perfusion system and high resolution PC Polygraf HR desktop gastrointestinal dynamic monitoring system.Subjects were asked to simulate defecation and then the defecation related indexes were recorded.In the end rectoanal inhibitory reflexes (RAIR)and rectal sensation were assessed by aired balloon.One-way analysis of variance and independent sample test were performed to compare indexes among three groups with different age and between different genders. Results A total of 166 healthy subjects were enrolled,79 in group Ⅰ with 40 male,68 in group Ⅱ with 29 male and 19 in group Ⅲ with 11 male.There was no significant difference in anal sphincter length (ASL),valid anal sphincter length (VASL),resting anal sphincter pressure (RASP),squeeze anal sphincter pressure (SASP)and duration of valid squeeze anal sphincter pressure (VSASP)among three groups with different age (all P > 0.05 ).Compared between male and female,only SASP of male ((180.13±8.10)mmHg,1 mmHg=0.133 kPa)was significantly higher than that of female ((143.93± 6.59)mmHg,t = -3.489,P <0.001 ),no difference in other parameters was found (all P >0.05 ). There was no significant difference in rectal pressure (RP),rectoanal pressure gradient (RAPG),anal sphincter relaxation rate (ASRR),and rectoanal coordination (RAC)among three groups (all P >0.05). During simulated defecation,RP and RAPG of men ((61 .23±3.46)mmHg and (40.04±4.08)mmHg) were significantly higher than those of women ((44.47 ± 2.32)mmHg and (24.00 ± 2.59 )mmHg, t=-4.075 ,-3.367,both P <0.01 ).There was no significant difference in other parameters between men and women (all P >0.05).All participants had RAIR,and there was no significant difference neither among three groups nor between men and women (both P >0.05).There was no significant difference in first rectal sensation (FRS)and constant rectal sensation (CRS)among three groups with different age (all P >0.05).However,the maximum rectal tolerable sensation (MRTS)of group Ⅱ and group Ⅲ was significantly higher than that of group Ⅰ ((194.41 ±6.32)mL and (200.00±12.75)mL vs (167.80 ± 5 .00)mL,F = 6.698,P = 0.002).There was no significant difference in rectal sensation between different gender (all P >0.05 ).Conclusions In our country,SASP,RP and RAPG during simulated defecation of male are higher than those of female.The value of MRTS increases along with the age.

Objective To detect anti-cell membrane DNA ( cmDNA) antibody with human B lym-phocyte Raji cells and human promyelocytic leukemia HL60 cells as substrates and to compare the diagnostic value of anti-cmDNA antibody with that of anti-nucleosome antibody ( AnuA ) , anti-Sm antibody and anti-double-stranded DNA ( dsDNA) antibody in juvenile systemic lupus erythematosus ( JSLE) patients. Meth-ods We recruited 92 JSLE patients and 71 patients with other rheumatic diseases. Anti-cmDNA antibody an-dantinuclear antibody ( ANA ) was detected in patient serum by indirect immunofluorescence assays ( IIF ) . Anti-dsDNA antibody were detected by combining enzyme-linked immuno sorbent assay ( ELISA) and IIF. Anti-Sm antibody were detected by double immunodiffusion assay and immunoblotting, while anti-nucleosome antibody ( AnuA) were detected by ELISA. We collected concurrent clinical data. Results Anti-cmDNA antibody demonstrated stronger intensity of fluorescent patterns in using Raji cells as substrate than HL60 cells. JSLE patients had a significantly higher positive percentage of anti-cmDNA than patients with other rheu-matoid diseases. The sensitivity of anti-cmDNA on cell line Raji was higher than that of anti-dsDNA and anti-Sm (P<0. 01), the specificity of anti-cmDNA was close to anti-dsDNA (P>0. 05) and was lower than anti-Sm and AnuA (P<0. 01). The sensitivity of anti-cmDNA was similar to AnuA (P>0. 05) and the specificity was lower than AnuA (P<0. 01). The sensitivities of anti-dsDNA, anti-Sm and AnuA by combining with an-ti-cmDNA were much higher than that of the above antibody detected respectively ( P<0. 05 ) . Anti-cmDNA had no correlation with SLE disease activity index ( P=0. 907 ) . Conclusion The high sensitivity and speci-ficity of anti-cmDNA antibody make it a valuable diagnostic tool for JSLE. Combined detection of anti-cmDNA and other autoantibody might further improve the sensitivity in JSLE. Anti-cmDNA detected with IIF on cell line Raji was better than cell line HL60.

Objective:To construct a discharge preparation service program for elderly lung cancer patients and their caregivers based on binary coping theory, evaluate its clinical feasibility.Methods:To develop discharge preparation service for elderly lung cancer patients and their caregivers by literature retrieval, expert correspondence consultation and theoretical research. The program included three themes: binary evaluation, binary management behaviorand binary health, and six intervention strategies: evaluation of symptoms, care goals and intentions, decision making, emotional communication support, management of physical function changes and general health behavior. From July to September 2021, 30 pairs of elderly lung cancer patients and their caregivers were recruited and assigned into the control group and the experimental group with 15 pairs in each group according to random numbers generated by computer. The feasibility and clinical effect of the program were evaluated by feasibility evaluation index, discharge readiness, dual coping and comprehensive needs scale of caregivers.Results:In this study, the recruitment rate was 76%(32/42), the retention rate was 94%(30/32), and the acceptance rate of the intervention plan in the experimental group was 100%. After intervention, the total scores of discharge readiness was (83.00 ± 2.59), the patient dyadic coping was (136.80 ± 4.54), caregiver dyadic coping was (136.33 ± 3.56) and caregiver comprehensive needs was (124.37 ± 11.69) in the experimental group, which were better than those of in the control group, (74.40 ± 4.17), (129.07 ± 4.83), (120.33 ± 9.17) and (206.57 ± 9.14), the differences were statistically significant ( t values were -6.78- 5.54, all P< 0.05). Conclusion:The discharge preparation service plan for elderly lung cancer patients and caregivers based on dyadic coping theory is scientific and feasible, but the plan still needs further optimization, improvement and large sample randomized controlled trial to verify.