The paper collects the network data from www.haodf.com to establish a model,conducts an empirical study on the factors influencing the selection of doctors in online medical websites,and puts forward the suggestions for the construction of online medical websits from 4 aspects of normalizing management,focusing on propaganda,highlighting online public praise,and expanding profit channels.

A case of pyogenic granuloma occurred in inferior turbinate was reported and the literatures were reviewed. A 32 years old male patient with left side progressive stuffy nose and repeated epistaxis. Nasal endoscopic examination showed a dark red neoplasm in left nasal cavity and blocked the anterior naris. Nasal cavity enhanced CT showed the neoplasm located in the front of left nasal cavity with marked enhancement. Bilateral sinuses were normal and there was no significant bone destruction. Nasal endoscopic surgery was performed under local anesthesia. Postoperative pathology report showed pyogenic granuloma (granulation tissue type of angioneoplasm).
Adult ; Endoscopy ; Epistaxis ; Granuloma, Pyogenic ; pathology ; surgery ; Humans ; Male ; Nasal Cavity ; pathology ; surgery ; Postoperative Period ; Turbinates ; pathology ; surgery

Objective To investigate the therapeutic role of Xuebijing injection on acute lung injury (ALI) in a rat model of cecal ligation puncture (CLP) and the potential mechanism.Methods A total of 110 SD rats were divided into sham group (n =30),CLP group (n =40) and Xuebijing treatment group (n =40),according to the random number table.Survival was observed up to 7 days.Rats in each group were sacrificed 12 h after the CLP surgery.Blood samples were obtained by abdominal aorta puncture and inflammatory cytokines and blood gas were detected.Samples of the lung tissue were excised to measure mRNA expression of cytokines,activation of signaling molecules,wet to dry ratio and histopathological changes.Peripheral neutrophils were isolated in vitro and divided into negative control group,high-dose Xuebijing (1 ∶ 30 dilution) group,lipopolysaccharide (LPS,100 ng/ml) group,LPS plus low-,middle-and high-dose Xuebijing (1∶ 300,1∶ 100,1∶30 dilution respectively) groups.Supernatant levels of tumor necrosis factor (TNF-α),interleukin (IL)-6 and neutrophil elastase (NE) in each group were detected.Activation of intracellular signaling molecules was measured as well.Results In animal survival observation,the mortality was 65 ％ in CLP model group and reduced to 30％ in Xuebijing treatment group (P ＜ 0.01).Compared to sham group,serum levels of TNF-α,IL-6,PaCO2 and lactate in CLP group were increased markedly to (32.213 ± 9.802) pg/ml,(21.592 ± 5.427) ng/ml,(39.575 ± 5.295) mmHg and (3.438 ± 0.192) mmol/L respectively,mRNA expressions of TNF-α and IL-6 in CLP group were increased to 5.223 ±0.525 and 12.097 ±2.535 respectively,activation of IκB-α,p38,extracellular regulated protein kinases (ERK) and c-Jun N-terminal kinase (JNK)in CLP group were significantly up-regulated,and water content of rat lung tissue in CLP group were significantly increased to (78.226 ±0.894) ％ (all P ＜0.01).Moreover,histopathological appearance of bleeding,exudation and increased infiltration of neutrophils to the alveolar septum were detected in the lung tissue of CLP rats.Compared to CLP group,Xuebijing treatment reduced the serum levels of TNF-α [(21.592 ± 5.427)pg/ml],IL-6 [(2.252 ± 0.905) ng/m],PaCO2 [(34.088 ± 2.260) mmHg] and lactate [(2.563 ± 0.250)mmol/L],suppressed the up-regulation of TNF-α and IL-6 mRNA expressions [6.866 ± 1.604,3.398 ± 0.334],and reduced the water content of rat lung tissue [(77.159 ± 0.626)％] (P ＜0.05 or 0.01).Compared to CLP group,Xuebijing treatment ameliorated the histological appearance of ALI.In vitro study,negative control group and high-dose Xuebijing group showed basal levels of TNF-α,IL-6 and neutrophil elastase (NE).Levels of TNF-α,IL-6 and NE in cell supernatant were elevated in LPS group [(7 102.520 ± 528.026) pg/ml,(3 109.598 ± 191.291) pg/ml and (63.985 ± 2.823) ng/ml respectively],with significant differences from these detected in negative control group (P ＜0.01).While the release of TNF-α,IL-6 and NE was significantly inhibited in LPS plus middle-and high-dose Xuebijing groups,compared to LPS group (P ＜ 0.05 or P ＜0.01).LPS also increased the degradation of IκB-α and phosphorylation of p38 and ERK in neutrophils,and Xuebijing in higher concentration markedly suppressed the degradation of IκB-α and phosphorylation of p38 and ERK.Conclusions CLP surgery results in the appearance of typical ALI in rats.Administration of Xuebijing can effectively inhibit the proinflammatory response in CLP rats and attenuate ALI.And such effects may be attributed to its inhibition on the proinflanunatory activation of neutrophils in lung tissue.

Objective To study the interaction between human microRNA ( miRNA) and 5′trailer regions of Ebola virus genome from the perspective of bioinformatics so as to facilitate prevention and treatment of Ebola virus .Method The miRNA target prediction software Pita and RNAhybrid were used to predict the human miRNAs which could bind the 5′trailer regions of Ebola virus genomes before the miRNAs were annotated by g:Profiler web server .Results and Conclusion There may be complex interactions between human miRNAs and the 5′trailer regions of Ebola virus .Previous reports about the interaction between host miRNA and 5′trailer region of virus genome suggest that the interaction between human miRNA and 5′trailer region of Ebola virus may have effect on replication of Ebola virus and human cells .This work may provide new ideas on prevention and treatment of Ebola virus .

Objective To study the characteristic and management method of steroidogenic diabetes in patients with rheumatic disease. Methods The follow-up data of steroidogenic diabetes in 38 patients with rheumatic disease were analyzed retrospectively. Results The nosogenesis of steroidogenic diabetes and fast blood sugar level was related with steroid dosage, using time, age, obesity and hypertipoidemia. The blood-fasting sugar level was not so obviously increased. Blood sugar at bedtime was (24.40±5.92)mmol/L,before breakfast was (9.52±3.64)mmol/L, after breakfast was (20.38±7.19)mmol/L, before lunch was(10.69±3.23)mmol/L, after lunch was (21.81±6.92) mmol/L, before dinner was (12.17±3.63)mmol/L. There was significant difference between blood sugar at bedtime and that in others (P<0.01 or<0.05). Most patients needed insulin to control blood sugar. Decreasing the daily dosage of steroid might be beneficial to the reduction of corticosteroid induced diabetes. Most patients could stop insulin injection when the daily dosage of steroid decreased to a certain level. Conclusions The prescription of corticesteroid in rheumatic diseases can cause temporal increase of blood sugar. Intensive follow-up aad blood sugar monitor is important for the diagnosis of steroidogenic diabetes. Promptly administration of insulin is required for blood sugar control.

Objective To assess the feasibility of nuclear matrix protein 22(NMP22)and urinary bladder cancer,antigen (UBC) for the early diagnosis of bladder transitional cell carcinoma and its influencing factors.Methotis 105 subjects,including 60 patients of bladder cancer,25 patients of urological benign disease and 20 normal (healthy)individuals were enrolled in this study.Urine NMP22 and UBC wag assessed by enzyme-linked immunosorbent assay(ELISA).Urine NMP22 and UBC as well as exfoliocytology were conducted for the purpose to compare the sensitivity,specificity,positive and negative predictive value of these three ways.Results The sensitivity of NMP22(88.3%)and UBC(86.7%)were significantly better than exfolioeytology(40.0%,P<0.01).The specificity of NMP22,UBC and exfoliocytology were 80.0%,84.0%and 92.0%,respectively, the positive predictive values were 91.4%,92.9%and 92.3%,and the negative predictive values were 74.1%.72.4%and 38.9%.Conclusions NMP22 and UBC are sensitive,specific,simple,feasible and noninvasive diagnostic markers for the early detection of urinary bladder transitional cell cancer.

Objective To compare the number of DARPP-32 positive cells yield in the grafts based on the application of single cell suspension by neural micro-transplantation technique and by traditional cell delivery technique and to explore effects and mechanisms of different approaches.Methods Cells derived from the whole ganglionic eminence of E15 rat embryos,ubiquitously expressing Green Fluorescent Protein(GFP) were implanted into unilaterally QA-lesioned rat striatum in a single-tract with an ultra-thin glass capillary with an outer diameter of 50 μm or using traditional cannula tip with a diameter of 500 μm.Results Histological assessment at 4 months after transplantation showed that there was about two-fold DARRP-32 positive striatal-like neurons in the micro-transplantation group(TT group) than that in the traditional group(MT group).Total graft volume was similar in both groups[(2.8±0.2) mm3 vs(2.5±0.4)mm3,F =0.25,P ＞ 0.05].And DARRP-32positive plaque volume[(0.6±0.1) mm3 vs(0.6±0.2) mm3,F =0.90,P ＞ 0.05]and TH staining plaque volume[(1.0±0.1) mm3 vs(0.7±0.1)mm3,F =1.44,P ＞ 0.05]also had the same performance in both groups.Number of DARRP-32 positive cells was calculated by Abercrombie correction formula,and the result showed that the number of DARRP-32 positive cells in MT group was two-fold of that in TT group[(20.1 ×103±1.2 × 103) vs(9.8 × 103±3.2 × 103),F =8.62,P ＜ 0.05].Higher DARRP-32 positive cells in MT group indicated that grafts had a better condition of growth and development.Conclusion Micro-transplantation approach can increase the number of new born striatal-like neurons,potentially due to the enlargement of the graft-host border area intensifying the graft's exposure to host derived factors and the minimized mechanical injury.

Objective To discuss the different contrast injection rate on the 64 -slice spiral CT scan liver arterial phase reinforced effect.Methods 60 patients who received abdominal CT scan were selected from January 2014 to April 2015.According to the different conditions,they were divided into control group (30 cases)and liver cirrhosis group (30 cases).Then each group based on packet injection rate into 2.5 mL/s (control group 1,cirrhosis group 1)and 3.5 mL/s (control group 2,cirrhosis group 2).Select Smartprep technology contrast agent tracking all patients,when the abdominal aorta CT value ≥150 HU start scanning.The departure time,CT value of each group were recorded,abdominal aortic artery,simultaneous analysis of each component of image quality comparison.Results When the contrast agent injection rate of 3.5 mL/s,excellent rate of the control group (95.5%)compared with the contrast injection rate of 2.5 mL/s (91.7%)had no significant difference (χ2 =0.021,P =0.638);The cirrhosis good rate (94.7%)compared with the contrast agent injection rate of 2.5ml/s (72.7%)had obvious advantages, the difference was statistically significant (χ2 =5.233,P =0.032).When the contrast agent injection rate of 2.5mL/s, cirrhosis abdominal aorta average peak enhancement [(187.25 ±21.00)HU]and the control group [(195.35 ± 19.00)HU]had no significant difference (t =0.826,P =0.436).The average trigger time of the control group (21.68 ±1.93)s was significantly less than the cirrhosis group (25.13 ±2.13)s,the difference was statistically significant (t =2.064,P =0.047).When the contrast agent injection rate of 3.5 mL/s,the control group,the mean abdominal aortic peak enhancement [(247.82 ±39.00)HU]was significantly greater than the cirrhosis group [(223.81 ±35.00)HU],the difference was statistically significant (t =2.652,P =0.037).The average trigger time of the control group (18.62 ±1.36)s was significantly less than the cirrhosis group (24.57 ±0.92)s,the difference was statistically significant (t =3.362,P =0.033).Conclusion The greater the contrast injection rate,arterial peak at the same time it increases the peak time come to shorten.When the contrast agent injection rate consistent with the control group,the average trigger time is short,high average peak enhancement.Cirrhosis needs higher contrast injec-tion rate.

Objective To compare the blood-saving effect when acute hypervolemic hemodilution (AHH) was performed with hydroxyethyl starch (HES) 130/0.4 dissolved in electrolyte injection (HES-E) and HES 130/0.4 in sodium chloride injection (HES-NaCl).Methods Thirty patients of both sexes,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18-25 kg/m2,hemoglobin (Hb) ＞100 g/L,hematocrit (Hct) ＞ 35％,scheduled for elective abdominal operations under general anesthesia,were randomly divided into HES-E group and HES-NaCl group using a random number table,with 15 patients in each group.AHH was performed after induction of anesthesia.In HES-E and HES-NaCl groups,HES-E and HES-NaCl 15 ml/kg were intravenously infused over 30 min,respectively,and the infusion was conpleted before skin incision.Immediately after onset of AHH (T1),at 2 h after the end of AHH (T2),and at the end of operation (T3),arterial blood samples were collected for blood gas analysis and blood routine test,and pH value,base excess,HCO3-,K+,Na+,Cl-,Ca2+,Hb and Hct were recorded.Venous blood samples were collected at T1 and T2 for measurement of blood coagulation parameters including prothrombin time,activated partial thromboplastin time and fibrinogen and thrombelastography parameters.The volume of liquid intake and output and requirement for allogeneic blood transfusion were recorded,and the blood volume expansion rate was calculated.Results Compared with group HES-NaCl,no significant changes were found in the total volume of liquid infused,requirement for allogeneic blood transfusion,blood volume expansion rate,blood coagulation parameters at each time point,Hb and Hct (P＞0.05),pH value,base excess,HCO3 and K+ were significantly increased,and Na+ and Cl-were significantly decreased in group HES-E (P＜0.01).Conclusion There is no significant difference in the blood-saving effect between AHH with HES-E and HES-NaCl clinically,but HES-E can maintain homeostasis better.

Objective To investigate the role of hypoxia-inducible factor-1α/ hexokinase Ⅱ (HIF-1α/HKⅡ) signaling pathway in the inhibition of hypoxia/reoxygenation (H/R)-induced apoptosis in the rat cardiomyocytes by hypoxic preconditioning (HPC).Methods Primarily cultured cardiomyocytes obtained from the neonatal rats were seeded in culture dishes at the density of 5× 105cells/ml.The cardiomyocytes were attached to the wall for 72 h and then randomly divided into 6 groups (n=15 each) using a random number table:control group (group C);group H/R;group HPC;HIF-1o inhibitor YC-1 group (group YC-1);group HPC + YC-1;dimethyl sulfoxide (DMSO) group.The ceils were exposed to D-Hank solution saturated with 95％ N2 and 5％ CO2 for 4 h,and then cultured in the normal culture atmosphere for 2 h.The cells in YC-1 and DMSO groups were incubated in the culture medium containing 10 μmol/l YC-1 and 0.1％ DMSO (100 μl) for 24 b,respectively.HPC was induced by 3 cycles of 10 min hypoxia followed by 30 min reoxygenation,and H/R injury model was then established in group HPC.In group HPC+YC-1,the cells were incubated for 5 min in the M199 culture medium supplemented with 10 μmol/L YC-1 and 10％ fetal bovine serum,and the other treatments were similar to those previously described in group HPC.After the end of treatments,the apoptosis in cardiomyocytes was detected by TUNEL,the expression of HIF-1α,HKⅡ and cytochrome c was detected by Western blot,and the mitochondrial membrane potential was quantitatively measured using fluorescence.Apoptotic rate was calculated.Results Compared with group C,the apoptotic rate was significantly increased,the mitochondrial membrane potential was significantly decreased,and the expression of HIF-1α,HKⅡ and cytochrome c was significantly up-regulated in group H/R (P＜0.05).Compared with group H/R,the apoptotic rate was significantly decreased,and the mitochondrial membrane potential was significantly increased,and the expression of HIF-1αt and HKⅡ was significantly up-regulated,and the expression of cytochrome c was significantly down-regulated in group HPC (P＜0.05).Compared with group HPC,the apoptotic rate was significantly increased,the mitochondrial membrane potential was significantly decreased,the expression of HIF-1α and HKⅡ was significantly down-regulated,and the expression of cytochrome c was significantly up-regulated in group HPC+YC-1 (P＜0.05).Conclusion The mechanism by which HPC inhibits H/R-induced apoptosis in rat cardiomyocytes is associated with activation of HIF-1α/HKⅡ signaling pathway.