Introduction: We performed a scoping review of after-hours primary care to examine delivery models of after-hours house calls and their use, and conducted outcome evaluation studies of after-hours house calls. Methods: PubMed, Embase, Google Scholar, and Ichuu-shi were used to identify studies published between 2000 and 2021. We selected studies that explained the after-hours house call system or studies that included outcome evaluation. Results: We included 109 studies. The system of after-hours house calls varied in each country. There were one to four research reports on the actual situation of after-hours house calls in each country; however, there were no nationwide reports in Japan. After-hours house calls accounted for the lowest proportion of after-hours care. Only observational studies were found for the impacts of satisfaction and utilization of emergency department services as outcome evaluations for after-hours house-call services. Conclusion: Further research on the after-hours care system is needed, and further discussions based on the results of the study are required.

Objective To understand the abnormal status of alanine aminotransferase (ALT),fasting blood glucose (GLU),to-tal cholesterol (TC)and triglyceride (TG)in urban and rural residents,to provide the basis for making the effective prevention measures,health education and health promotion to community work more targeted and effective.Methods The data of physical ex-amination results of 4 042 residents were analyzed retrospectively,the levels and abnormal rates of ALT,TG,TC,GLU were com-pared between different gender and age.Results Among 4 042 residents,the abnormal rate of male was significant higher than that of female,but the abnormal rates of TG,TC of female were significant higher than those of male(P <0.05).The highest rates of ALT,TG,TC,GLU in male were in 20-<40 years old,40-<60 years old,60-<80 years old,≥80 years old.The highest rates of ALT,TG,TC,GLU in female were in 0-<20 years old,60 -<80 years old,≥ 80 years old,≥80years old.Conclusion The health status of urban and rural residents is not optimistic,the community intervention,health guidance should be strengthened to prevent and control the occurrence and development of diseases and improve the health level of urban and rural residents.

Objective To compare the difference in ischemic heart disease (IHD) incidence between left and right breast cancer treated with post-op radiation therapy.Methods We retrospectively reviewed electronic database of breast cancer patients treated in our cancer center from October 2006 to December 2011.Clinical data were recorded including clinical features,radiation fraction,and IHD.Statistical analysis was performed to compare the difference in IHD incidence between left and right breast cancer.Results Age on diagnosis was significantly associated with IHD (P ＜ 0.05).Compare to younger patients (≤60),the increased hazard ratio of IHD in older patients (＞60) was 3.84.The left breast cancer patients had greater incidence of IHD with the increased hazard ratio of 1.57 although this difference did not reach statistical power (P ＞ 0.05).No patients got IHD in the intensity-modulated radiation therapy group.Conclusions Left-side breast cancer patients may have more probability to get IHD after thoracic radiation therapy compared to right-side patients.We recommend that left-side breast cancer patients should be treated with intensity-modulated radiation therapy to spare heart if they receive prophylactic radiation therapy after surgery.

Objective To explore effect of irregular chemotatic factor fractalkine(FKN),phosphatidyl inositol 3 kinase and nuclear factor?κB(NF?κB)on interleukin?6(IL?6)expression in peripheral blood monocytes and the effect of valsartan intervention,so as to research the signal conduc?tive mechanism of FKN impacting on IL?6. Methods Peripheral blood monocytes were isolated from fresh blood of healthy volunteers by the densi?ty gradient centrifugation. The extractive peripheral blood monocytes were divided into seven groups:the control group,the FKN group,the LY294002 group(PI3K inhibitors),the PDTC group(NF?κB inhibitors),the FKN+valsartan group,the FKN+LY294002 group,and the FKN+PDTC group,the latter two were pretreated by LY294002 and PDTC respectively before FKN inducing PBMC cells. The IL?6 expression in cell me?dium was measured in each group by ELISA at 12 hours and 24 hours after PBMC treatment. Results After 12 hours of culture,compared with the control group,the expression of IL?6 in the FKN group was decreased(P<0.05),while LY294002 and PDTC groups had no significant difference (P>0.05). Compared with the FKN group,the expression of IL?6 was decreased in the FKN+valsartan group(P<0.05),increased in the FKN+LY294002 group(P<0.05),and was decreased in the FKN+PDTC group(P<0.05). After 24 hours of culture,the IL?6 expression in each group had no significant difference(P>0.05). Conclusion FKN can adjust the expression of peripheral blood PBMC IL?6 in a two?way pattern, inhibiting the expression of IL?6 by PI3K pathway and promoting the expression of IL?6 by NF?κB pathway,overall,FKN can inhibit the expression of IL?6. Valsartan can increase FKN to inhibit the expression of IL?6.

Background Orthostatic intolerance (Ol) is a common disease at pediatric period which has a serious impact on physical and mental health of children.The purpose of this study was to investigate the effect of related factors on the prognosis of children with Ol.Methods The subjects were 170 children with Ol,including 71 males (41.8％) and 99 females (58.2％) with age from 6 to 17 (12.0±2.6) years.The effect of related factors on the prognosis of children was studied by using univariate analysis.Then,the impact of children's age,symptom score,duration,disease subtype,and treatment on patient's prognosis was studied via analysis of COX proportional conversion model.Results Among 170 cases,48 were diagnosed with vasovagal syncope,including 28 cases of vasoinhibitory type,16 cases of mixed type,and 4 cases of cardioinhibitory type; 115 cases were diagnosed with postural tachycardia syndrome and 7 cases with orthostatic hypotension.By using univariate analysis of Cox regression,the results showed that symptom score had a marked impact on the time of symptoms improvement of children after taking medication (P ＜0.05),while other univariates had no impact (P ＞0.05).Multivariate analysis using Cox proportional hazards regression model showed that the symptom score at diagnosis had a significant effect on holding time of symptoms improvement of children after taking medication (P ＜0.05).Kaplan-Meier curve showed that symptom-free survival was higher in children with symptom score equal to 1 than children with symptom score equal to or greater than 2 during follow-up (P ＜0.05).Conclusion Symptom score is an important factor affecting the time of symptom improvement after treatment for children with Ol.

Objective:To study the relationship between neutrophil to lymphocyte ratio (N/L) and traditional cardio‐vascular risk factors among community 35~64‐year‐old residents .Methods :A total of 1884 residents (548 males and 1336 females) from urban Shenyang city received baseline condition questionnaire on cardiovascular diseases and re‐lated diseases from Apr 2011 to Feb 2012. According to presence of cardiovascular risk factors or not ,subjects were divided into healthy control group (n=675) and risk factor group (n=1209);according to number of risk factors , risk factor group was further divided into one risk factor group (n=491) ,two risk factors group (n=263) and ≥3 risk factors group (n=455) .Morning blood sample and urine sample were retained to measure blood and urine rou‐tine ,blood glucose and blood lipid profile etc in all subjects .N/L was compared and analyzed among all groups .Re‐sults:Among patients with only one of following risk factors [hypertension ,diabetes mellitus (DM) ,dyslipidemia and obesity] ,N/L levels of patients with hypertension or DM were significantly higher than that of healthy control group [1.55(1.15 ,1.95) ,1.60(1.21 ,2.07) vs .1.45(1.09 ,1.91)] , P<0.05 both ,and there were no significant difference between any other one risk factor group and healthy control group , P>0.05 all .Among risk factor sub‐groups ,N/L level of ≥3 risk factors group was significantly higher than that of two risk factors group [1.57(1.16 , 2.04) vs .1.41(1.07 ,1.89) ,P<0.05] ,and there was no significant difference between any other two groups (P>0.05) .Conclusion:N/L significantly related to hypertension or DM ,and N/L level of ≥3 risk factors group was sig‐nificantly higher than that of two risk factors group ,N/L is helpful to assess risk of cardiovascular diseases .

Objective To compare the therapeutic effect of preoperative chemoradiotherapy or postoperative adjutant chemoradiotherapy for locally advanced rectal cancer.Methods The clinical data of 76 patients with locally advanced rectal cancer from 2011 to 2016 in Guizhou Provincial People's Hospital were retrospectively analysed.A total of 30 cases received preoperative chemoradiotherapy (group A),5 of them received concurrent chemoradiotherapy combined with bevacizumab target treatment.The other 46 cases (group B) were given post-operative adjutant chemoradiotherapy.Both group A and group B were treated with intensity-modulated radiation therapy (IMRT).The chemoradiotherapy regime was as follows:the median of target volume dose was 50.4 Gy (45.0-55.8 Gy);the median of chemotherapy sessions was 26 times (24-28 times).Capecitabine tablets (825 mg/m2,twice a day) were also given on the date of chemotherapy.The clinical data and follow-up results of all patients were compared between the two groups.Results The five-year disease free survival rates of group A and group B were 66.7％ and 57.7％,respectively;and the five-year overall survival rates of group A and group B were 81.8％ and 73.0％,respectively,no statistically significant difference was found between the two groups (P=0.599,0.489).The anus-preserving rates of patients with tumor below peritoneal reflection in group A and group B were 56.52％ and 25.00％,there was statistically significant difference (P=0.045).In the group A,86.6 ％ patients resulted in down-staging,including 3 cases with complete pathologic response.Conclusion Preoperative chemotherapy could down tumor stage and improve rates of anal preservation and local control without increasing possibility of postoperative complications.Preoperative chemotherapy in combination with bevacizumab target treatment may be more effective in lowering tumor stage.

In addition to obtaining DNA-STR typing of an evidentiary stain for individual identification and paternity tests, knowing the time since deposition (TSD) is also highly desired in forensics. To provide a reference for the research of predicting the TSD, this article reviews the reported optical, cell biological and molecular biological methods of determining the age of bloodstains domestic and overseas, and also introduces the application of microbial forensics, a new field of forensic science, to provide space-time clues of evidentiary stains.

OBJECTIVE:To study in vivo tissue distribution of genistein-loaded MePEG-PLGA copolymer micelle in mice. METHODS:HPLC method was used to determine the concentrations of genistein in plasma and tissues (heart,liver,spleen, lung, kidney) of mice. The determination was performed on Dikma Diamonsil C18 colunm with mobile phase consisted of methanol-water (60:40,V/V) at the flow rate of 1.0 mL/min. The detection wavelength was set at 260 nm,and the column temperature was 35 ℃. The sample size was 10 μL. 48 mice were divided into emulsion group and micelle group,with 24 mice in each group. They were given 40 mg/kg genistein emulsion or genistein-loaded MePEG-PLGA copolymer micelle via tail vein. The contents of genistein in plasma and tissues (heart,liver,spleen,lung,kidney) were detected 5,30,90 min after medication. AUC0-90 min and mean residence time(MRT)were compared. RESULTS:The content of genistein in micelle group was higher than emulsion group 5,30,90 min after medication,and the content of genistein in liver tissue was lower than emulsion group 5,30 min after medication. Compared with emulsion group,AUC0-90 min and MRT of genistein in plasma of mice in micelle group were increased significantly(P<0.01);AUC0-90 min and MRT of genistein in liver tissue were decreased significantly(P<0.05). AUC0-90 min of genistein in renal tissue was increased significantly (P<0.05),without statistical significance of other differences (P>0.05). CONCLUSIONS:genistein-loaded MePEG-PLGA copolymer micelle can increase the distribution of genistein in plasma,reduce the distribution of it in liver tissue so as to improve therapeutic efficacy and reduce drug hepatotoxicity.

Objective: To explore the relationship between venous blood routine test parameters and syncopal recurrence of children with vasovagal syncope (VVS). Method: Sixty-three children (male 32, female 31) diagnosed as VVS in Department of Pediatrics, Peking University First Hospital from November 2010 to October 2015 were included in a case observational study.Their mean age was (11.2±2.7) years and basic treatment such as predisposing causes avoiding, standing training, autonomic nervous function exercise and oral rehydration salts were advised to them.The clinical data were obtained by out-patient visit and over telephone from December 2015 to January 2016, with a median follow-up period of 10 (4, 26) months. The effects of baseline venous blood routine test parameters, gender, age, and body mass index (BMI) on syncopal recurrence were studied via univariate and multivariate Cox regression analysis.Kaplan-Meier curve was used to evaluate the long-term prognosis. Result: Among the 63 VVS children in this study, 31 cases were diagnosed as VVS vasodepressor type, 4 cases as VVS cardioinhibitory type and 28 cases as VVS mixed type, 16 cases (25%) had experienced recurrence of syncope while 47 cases (75%) had not.The result of univariate analysis of Cox regression showed that baseline platelet count (PLT) (HR=1.012, 95%CI: 1.003-1.022) had a marked impact on the survival rate.And the result of multivariate analysis of Cox regression showed that baseline hemoglobin concentration (HGB) (HR=1.055, 95%CI: 1.007-1.105), mean corpuscular hemoglobin (MCH) (HR=0.612, 95%CI: 0.423-0.884) and PLT(HR=1.015, 95%CI: 1.006-1.024) had significant effects on survival rate of VVS children.In this study, the one-year, two-year, and three-year survival rate were 83% (52/63), 79% (50/63) and 75% (47/63), respectively. Conclusion The baseline venous blood routine test parameters HGB, MCH and PLT might be the influencing factors of the syncopal recurrence of VVS children.