By literature and network investigation,the paper sorts out development modes and typical practices of Internet medical treatment in China,sums up 6 kinds of modes existing domestically,analyzes the advantages and disadvantages of each mode.It is necessary to further probe into suitable operating modes and to give support on aspects of policies,laws and regulations and supervision,and provides reference for better promoting Internet medical treatment in different places.

Objective To explore the clinical effectiveness of urokinase perfusion and drainage in patients with hypertension cerebral hemorrhage broken into ventricles.Methods Patients with hypertension cerebral hemorrhage broken into ventricles(35 cases)underwent urokinase perfusion and drainage.Clinical effect was observed and the nursing point was summarized.Results Of the 35 patients,20 cases acquired good recovery,13 cases were mildly disabled,2 case were severely disabled,no death occurred.The complications mostly consisted of secondary hemorrhage,infection,disfunction.Conclusions The early lateral ventricle drilling operation,postoperative urokinase perfusion and drainage,active complications prophylaxis and treatment,rehabilitation training can reduce mortality and improve the quality of patients' life.

Objective To observe the clinical efficacy of Qingre Liangxue Recipe (QLR), a herbal prescription with the actions of clearing heat and cooling blood, for the treatment of gouty arthritis. Methods Sixty-five cases of gouty arthritis patients were randomly divided into treatment group (N=32) and control group (N=33). Both groups were given oral use of colchicine during the acute stage and being suspended when the pain was relieved, and then were given oral use of allopurinol tablets during the remission stage. Additionally, the treatment group was given oral use of QLR all through the acute stage and remission stage. The treatment lasted for 4 weeks in both groups. After treatment, clinical efficacy was evaluated in the two groups. The number of acute relapse cases and the changes of blood uric acid level were observed. Results At the end of the first treatment week, the treatment group had a total effective rate of 96.9%, significantly higher than that (81.8%) of the control group. At the end of the fourth treatment week, the treatment group had a total effective rate of 100.0%, significantly higher than that (90.9%) of the control group. The treatment group had better therapeutic effect than the control group at the end of the first or the fourth treatment week, the difference being significant ( P<0.01). The number of acute relapse cases and the serum uric acid level were lower in the treatment group than those in the control group during 4 treatment weeks or 12 weeks after treatment suspension, the difference being significant ( P<0.01). Conclusion QLR combined with anti-gout medicines can effectively relieve symptoms of gouty arthritis, reduce incidence of acute relapse, and have long-term effect on lowering blood uric acid level.

Objective To investigate the influence of acupuncture on promoting rat blastocyst nidation with Cx43 expression at the acupoints silenced, and to relate Cx43 with acupuncture's effects. Methods Ma-ted female rats were randomly divided into five groups: normal control, model, acupuncture, interference-control and interference. Mifepristone was used to induce a model of nidation disorder, and RNA interference technology was used to silence the expression of Cx43 at acupoints. P-Cx43-shRNA (1) was injected locally into the acu-points of rats in the interference group, and P-con-shRNA was injected in the interference-control group. Acu-puncture was administered to the acupuncture, interference-control and interference groups for 7 days. On the 8th day of pregnancy, the quality of blastocysts, pregnancy rates, and the average amount of blastocysts in each group were observed. Results ①The mRNA and protein level of Cx43 at the zusanli (ST36) acupoints in the interference group were significantly lower than in the acupuncture group ( P<0.05, P<0.01). There was no significant difference between the interference-control group and the acupuncture group. ② Compared with the normal control group, the quality of blastocysts in the model and interference groups was bad, and the amount was less. Their size was comparatively small, they were inhomogeneous, poorly distributed and had poor blood supply. The results improved in the acupuncture group and the interference-control group compared with the model group. ③The pregnancy rates in the normal control, model, acupuncture, interference-control and inter-ference groups were 100% , 50% , 75% , 75% , and 50% respectively, but these differences were not statisti-cally significant. ④The average amount of blastocysts in the model and interference groups was significantly less than in the normal group (P≤0.01). Compared with the acupuncture group, the average amount of blastocysts in the interference group was lower (P≤0.05). Conclusion Acupuncture can improve the quality and quan-tity of blastocysts in a rat model of nidation disorder. Local injection of Cx43 shRNA expression vector can si-lence the expression of Cx43 in acupoints and markedly influence acupuncture's effect. This demonstrated that Cx43 was involved in acupuncture's effects.

Objective To study the expression of Toll-like receptor-2 (TLR-2) and caspase-3 in the intestine of premature rats with necrotizing enterocolitis (NEC),and to explore the protective effects and possible regulatory mechanism of glutamine (Gln) in the NEC.Methods Sixty premature rats (gestational age 21 d) were divided into three groups (n = 20 each) according to the random number table: control group,model group and Gln intervention group.Rats in model group were given formula feeding,hypoxia and cold stress.Rats in Gln intervention group were given Gln 0.3 g/kg to the formula feeding,hypoxia and cold stress.All the premature rats were sacrificed and the intestine tissues were obtained on the third day after birth.The histological changes of ileal tissues were scored after HE staining.The expression of TLR-2 and caspase-3 in jejunum,ileum and colon were detected by inmunohistochemistry,and the expression of TLR-2 mRNA in jejunum,ileum and colon were detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction.Results Pathology score of ileum in model group,Gln intervention group and control group were 3.10 ±0.99,2.40 ± 0.69 and 0.30 ±0.48,respectively.The expressions of TLR-2 protein in ileum were 2.53±0.94,2.15±0.82 and 1.57 ± 0.62 in the three groups respectively,and the expression of caspase-3 protein were 2.83 ± 0.45,2.70 ± 0.04 and 0.91 ± 0.29.The content of TLR2 mRNA in model group was 1.46 times higher than that of Gln intervention group and was 2.10 times higher than that of control group.Compared with the control group,the pathology score,expression of TLR-2 and caspase-3 protein,and TLR-2 mRNA in model group were significantly higher,P＜0.01.However,compared with the model group,those changes were improved in Gln intervention group,P＜0.05.Expression of TLR-2 mRNA positively correlated to the expression of caspase-3 protein (r=0.71,P＜0.01) and pathology score (r = 0.69,P＜ 0.01).Expression of caspase-3 protein positively correlated to the intestine injury pathology score (r=0.81,P＜0.01).Conclusions TLR-2 may be involved in the pathogenesis of NEC.Gln might reduce the expression of TLR-2 in the intestine,and decrease the apoptosis of intestinal epithelial cells to protect the intestine of preterm birth rats.

Objective To investigate the effects of laporoscopic resection applied to colorectal cancer patients on metabolism. Methods According to patients' choice of operation, either laparoscopic-assisted (n = 22, experimental group) or open(n = 27, control group) resection of colorectal cancer was performed. The levels of electrolyte were assayed preoperatively, postoperatively and on the time of 24 hours after opera-tion. Rseults There was no significant difference in the level of electrolyte before operation between the two groups (P > 0. 05). Compared with the preoperative period, the level of serum potassium in the both groups were significantly increased after operation(P < 0. 05), and 24 hours later, the levels of electrolyte was not significantly different in both the two groups (P > 0. 05). During the postoperative period, the level of serum potassium in the experimental group was lower than the control group(P <0. 05), while the level of HCO_3~- was higher than the control group(P <0. 05), and there were no significant differences in the level of serum sodium, chloride and calcium between the two groups(P > 0. 05). Conclusions Laparoscopic-assisted re-section of colorectal cancer gives lower levels of stress responses compared to open surgery. However, it shows higher effect on the level of HCO_3~- , and must be paid more attention during operative and postopera-tive period.

Objective To report a consanguineous family with lamellar ichthyosis and to detect the mutations in transglutaminase 1 (TGM1) gene in this family. Methods Genomic DNA was extracted from the blood samples of a 19-year-old male patient with lamellar ichthyosis, his family members and 100 normal human controls. PCR was carried out to amplify all the encoding sequences (15 exons) and adjacent flanking sequences of TGM1 gene followed by bidirectional sequencing. Results A C1666T mutation in the 11th exon in TGM1 gene, which resulted in the substitution of ACA (threonine) by ATA (isoleucine) at codon 529, was detected in the proband, while both his parents carried the C1666T mutation in heterozygous form, and his sister was a C/C homozygote. None of the 100 normal control individuals carried the mutation in TGMlgene. Conclusions The de novo mutation from ACA (threonine) to ATA (isoleucine) at codon 529, may contribute to the development of lamellar ichthyosis. Consanguineous marriage can increase the risk for lamellar ichthyosis by raising the probability of homozygosis of C 1666T mutation in TGM 1 gene.

Objective To evaluate the effect of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing.Methods The clinical data of 36 patients with multiple rib fractures and focal abnormal breathing who were treated by Chrisofix chest backplate were analyzed.Results Thirtyfour patients were cured by chest backplate and other conservative treatments,and 2 patients underwent rib internal fixation surgery.The numeric rating scales scores before and after the application of the chest backplate were (8.1 ± 0.7) scores and (5.2 ± 0.5) scores respectively(P ＜ 0.01).Seven patients had skin blisters forming around the shield,which were cured by liquid extraction with a syringe and gauze covered with povidone iodine.No patients stopped treatment because of allergy.Conclusions Chest backplate is an effective,easy and inexpensive method for patient with multiple rib fractures and focal abnormal breathing who doesn't need exploratory thoracotomy.It is worthy to spread in clinical treatment.

Objective To investigate the role of molecular allergen diagnosis in respiratory allergic diseases, and measure the prevalence and the allergen molecular mapping of the asthma and allergic rhinitic patients.Methods Totally 80 cases of asthma or allergic rhinitis patients with two or more inhaled allergens from First Affiliated Hospital of Guangzhou Medical University during 2013 January to 2014 December were tested for serum specific immunoglobulin E ( sIgE ) against 112 allergen components by ImmunoCAP ISAC.Results About 78.8% ( 63/80 ) patients is three or more allergen components sensitization, the most prevalence allergen components were house dust mites′Der f 1 67.5%(54/80), Der f 2 66.2%(53/80), Der p 1 and Der p 2 were 63.8%(51/80) and 61.2%(49/80), Der p 10 was only 12.5%(10/80), follewed by Fel d 1 22.5%(18/80), Cyn d 1 16.2%(13/80), Phl p 4 15.0%(12/80), Pen m 1,Pla a 2,Jug r 2 and Can f 1were all 11.2%(9/80), Lep d 2, Blo t 5, Bla g 7 and Ani s 3 10.0%(8/80).Other allergen components positive rates were low.Conclusions Molecular allergen diagnosis can provide more comprehensive diagnostic information for allergic patients, by providing allergen map.Allergen microarray can discover the neglected allergens such as bermuda grass, timothy grass and plane tree pollen allergens in southen China.

Objective To establish and evaluate three different necrotizing enterocolitis models,established by combination of formula feeding, hypoxia and cold exposure, hypoxia-reoxygenation, and intraperitoneal injection of lipopolysaccharides (LPS) in premature rats. Methods Group A was given formula feeding, hypoxia by exposing to 100% N2 for 90 s and 4 ℃ cold stress for 10 minutes, the hypoxia and cold stress were given twice a day for 2 d. Group B was put into 100% N2 for 5 min and then 100% O2for 5 min, twice a day for 3 d. Group C was injected intraperitoneally 5 mg/kg LPS. Group D, E and F were served as the corresponding controls for group A, B and C. Ileocecal junction, liver, kidney and lung tissues were harvested and evaluated by HE staining for histological analysis, histological changes of ileal tissues were scored, and rats with score higher than two were diagnosed with NEC. Results Premature rats in group A, B and C showed various degrees of decreasing activity, abdominal distention, diarrhea,intestinal dilatation and congestion. Histological score in group A to F were 3. 13 ± 0. 64, 1.40 ±0. 52,2. 00±0. 42,0. 30±0. 48, 0. 30±0. 48 and 0. 40±0. 52, respectively. There were significant differences between model groups and their corresponding control groups (P＜0. 01 ). Among the model groups, the histological score of group A was higher than group B (P＜0.01) and group C (P＜0.05). The incidences of NEC in group A, B and C were 6/8, 20% (5/10) and 4/8, respectively, while of zero in all control groups. Liver, kidney and lung injures were more serious in group C compared with the other groups.Conclusions Compared with the single-factor modeling approaches of intraperitoneal injection of LPS and hypoxiareoxygenation, the NEC animal model in preterm rats established by formula feeding, repeated hypoxia and cold exposure, is more similar to the etiological factors of neonatal NEC in human, with higher incidence, better reproducibility and specificity.