Objective To draw up a satisfaction rating scale utilized by outpatients in general hospitals,for the quality evaluation of the out-patient service.Methods Outpatients at four municipal general hospitals in Hangzhou City were as the subjects.The validity and reliability of the rating scale were estimated.Results The response rate to items was 98.82% ,and valid rate reached 96.8% ,the internal consistency coefficient was in the range of 0.76 to 0.87.The composition of the scale conforms well to the management practice,the relativity inside the factor was stronger than the relativity among the factors,which supported the contents validity.Factor analysis results demonstrated that both the factor loads and structures were consistent with the structures of the rating scale,which supported the structure validity.Conclusion All of validity indexes of the rating scale meet the requirements of psychometrics.This scale is practicable to estimate the satisfaction of outpatients to the service they received,and provides valuable evidence to estimate the quality of hospital therapeutic services.

Object To investigate the effect of dexamethasone(Dex)of different concentration on the differentiation of the bone marrow stromal stem cells(MSC).Methods MSC were isolated from mice and cultured in vitro.After the third passage,the cells were treated with Dex of different concentration,the expression of typeⅠcollagen mRNA(COL1mRNA),alkaline phosphatase mRNA(ALP mRNA)and adipocyte lipid-binding protein mRNA(ap2mRNA)were detected by quantitative RT -PCR technique.The ratio of the electrophoretic results of the ap2mRNA,COL1mRNA and the ALP mRNA with the house keeping gene of glyceraldehydes-3-phosphate dehydrogenase(GADPH mRNA)respectively,were used to show the relative content of the mRNA.Results COL1mRNA,ALP mRNA and ap2mRNA were ex pressed despite of the difference of the concentration of the Dex.When Dex was1?10 -7 mol/L,the COL1mRNA was0.47?0.12,and ap2mRNA was0.21?0.16;and when Dex was1?10 -8 mol/L,the COL1mRNA was0.96?0.17,and ap2mRNA was0.06?0.03.There was significant statistic difference be-tween the two groups respectively.But the expression of the ALP mRNA were0.35?0.13and0.46?0.24re spectively,there was no significant difference among them.Conclusion Dex could regulate the differenti-ation of the MSCs into adipocyte or osteoblast by regulating special gene expression.In addition,the differ-en tia tion of MSC induced by Dex was bidirectional depending on the concentration of the Dex.When the concentra tion of the Dex was high,it could induce MSC differentiating into adipocytes.This might be the molecular mechanism of the steroid induced osteonecrosis.And the results proved when Dex was1?10 -8 mol/L,it was suitable for inducing MSCs differentiation into osteoblasts.

A sectional survey with histochemical technique was carried out on Culex tritae-niorhynchus larvae infected with Coelomomyces indica in comparison to the noninfected larvae. Studies were pursued by using micrograph and imaging analysis. The results showed that the glycogen, protein and nucleic acid (RNA and DNA)reaction in the infected group were less than those of the control group. The gray level assessment in tissue imaging showed marked difference between the two groups. It is suggested that C. indica has significant effect on the above biochemical elements of the mosquito larvae, which might be considered an important mechanism in the pathogenicity of the fungus.

Objective To detect levels of interleukin?4(IL?4), IL?10, interferon?γ(INF?γ)and transforming growth factor?β(TGF?β)in the culture supernatant of peripheral blood mononuclear cells (PBMCs)from patients with atopic dermatitis(AD), and to evaluate regulatory effects of benvitimod on these cytokines. Methods PBMCs were isolated from 20 AD patients and 20 healthy controls. Then, PBMCs from AD patients were equally divided into 4 groups to be cultured with phosphate?buffered saline (PBS group), 400 nmol/L benvitimod solution (benvitimod group), 250 nmol/L dexamethasone solution (dexamethasone group) and 10 nmol/L tacrolimus solution (tacrolimus group), respectively. Enzyme?linked immunosorbent assay(ELISA)was performed to detect levels of IL?4, IL?10, INF?γand TGF?βin the culture supernatant of PBMCs. Results Compared with healthy controls, patients with AD showed significantly higher level of IL?4(83.4 ± 12.2 vs. 44.3 ± 5.7 pg/ml, P<0.05), but lower levels of INF?γ(12.5 ± 2.3 vs. 25.4 ± 3.4 pg/ml, P<0.05)and IL?10(144.4 ± 4.1 vs. 189.9 ± 6.5 pg/ml, P<0.05)in peripheral blood. However, no significant difference in the level of TGF?βwas observed between the patient group and control group(178.9 ± 17.40 vs. 158.7 ± 18.30 pg/ml, P>0.05). Compared with PBS, 400 nmol/L benvitimod could decrease the expression of IL?4(50.2 ± 10.1 vs. 83.3 ± 12.2 pg/ml, P < 0.05), IL?10 (124.7 ± 17.5 vs. 144.4 ± 4.1 pg/ml, P>0.05)and INF?γ(9.56 ± 5.1 vs. 12.5 ± 2.3 pg/ml, P>0.05), but increase the expression of TGF?β(203.6 ± 15.3 vs. 178.9 ± 17.4 pg/ml, P>0.05)by PBMCs. In addition, no significant differences in the expression of IL?4, IL?10, INF?γ or TGF?β were observed between the benvitimod group and dexamethasone group or tacrolimus group(all P>0.05). Conclusion Benvitimod can regulate the expression of IL?4, IL?10, INF?γand TGF?βby PBMCs in patients with AD.

Objective To investigate the risk factors of sexual dysfunction in male patients with obstructive sleep apnea and hypoventilation syndrome (OSAHS).Methods One hundred and twenty-one OSAHS male patients aged 22-50 years were stratified into two groups based on scores on the rating scales of international index of erectile function-5 (IIEF-5).Patients' characteristics and polysomnography data of the sexual dysfunction group (n =56) were compared with that of the normal group (n =65).Continuous positive airway pressure(CPAP) treatment was carried out in some patients with abnormal sexual function.Results There were significant differences between the two groups in body mass index (BMI),history of hypertensive disease and diabetes mellitus,the rise of morning blood pressure,respiratory disturbance index (RDI),the longest apnea time(Tmax),the lowest oxygen saturation(LSpO2),percentage of recording time with oxygen saturation of 90％ or less(T90％),slow wave sleep(S1 + S2) over total sleep time(TST),rapid wave sleep (S3 + S4) time over TST,and rapid eye movement (REM) sleep time over TST in bivariate analysis (P ＜ 0.05).There were statistical significance of the history of diabetes mellitus,slow wave sleep (S1 + S2) over TST,RDI,and LSpO2shown in Logistics regression analysis,and ORs were 2.10 (1.17-5.01),3.52 (1.33-5.97),1.45 (1.08-2.95),and 0.86 (0.67-0.93) respectively (P ＜ 0.05).Moreover,20 OSAHS patients with sexual dysfunction were revaluated after the CPAP treatment in two months,and 14 patients returned to the normal scores.Conclusion The history of diabetes mellitus,slow wave sleep (S1 + S2) over TST,RDI,and LSpO2 were independent risk factors for sexual dysfunction in male patients with OSAHS,and treatment with CPAP could significantly improve sexual function in male patients.

This study was aimed to create a method for content determination of quercetin, luteolin and kaempferol in flowers of Dimocarpus longan Lour. from different habitats of Guangxi province by HPLC. The samples were sepa-rated on the Hypersil C18 column (250 mm í 4.6 mm, 5 μm) which was eluted with methanol-0.2% phosphoric acid solution (47:53) with detective wavelength at 360 nm, flow rate at 1.0 mL·min-1, and column temperature at 30℃. The results showed that this method had a good linear relationship within the range of 0.18 to 2.88 μg for quercetin, 0.059 to 0.944 μg for luteolin, and 0.024 to 0.384 μg for kaempferol (r = 0.9999). The average recovery rate was 100.06% (RSD = 1.72%), 99.77% (RSD = 1.18%) and 98.67% (RSD = 1.99%, n = 9), respectively. It was conclud-ed that this method is simple, rapid, reliable and with good repeatability, which can be used in the quality control of flowers of Dimocarpus longan Lour.

BACKGROUND: Up to now, no universally successful therapy to treat substantial articular cartilage defects has been available. Numerous therapeutic approaches can only improve clinical symptoms of joint lesions, but not stimulate the regenerative and reactive capacity of the biological tissue in the defect, and not restore an articular surface capable of functional load bearing.OBJECTIVE: To investigate the curative effects of homograft of mesenchymal stem cells (MSCs) seeded onto cancellous demineralized bone matrix (DBM) on articular cartilage defects.DESIGN, TIME AND SETTING: A randomized controlled study which conducted in Orthopaedics Institute, the Second Hospital of Lanzhou University from January to March 2005 and Central Laboratory of Guilin Medical Collage from May to August 2008.MATERIALS: Bone metaphysis and vertebral cancellous bone were derived from rabbits to prepare DBM materials. MSCs were seed on DBM stent and cultured in vitro. All 36 rabbits were randomly divided into combination group (DBM/MSCs), DBM alone group, and blank control group, with 12 rabbits per group.METHODS: Full-thickness cartilage defect model of knee joint was frilled using a cylinder of 4 mm diameter and 3 mm thickness on intercondylar fossa. The cartilage defects in the intercondylar fossa were filled with MSCs/DBM in combination group A, with only DBM in the DBM group, and nothing was treated in the blank control group.MAIN OUTCOME MEASURES: Four rabbits were killed at three time points, which were 4, 8 and 12 weeks after the operation in each group, and the reparative tissue samples were evaluated grossly, histologically, immunohistochemically and graded according to gross and histological scale.RESULTS: Tirty-six rabbits were included in the final analysis. The defects of MSCs/DBM transplantation were repaired by byline-like tissue, and the other defects were repaired by fibrous tissue. Gross and histological grading scale was made on 12 weeks postoperatively. Gross and histological scores in the MSCs/DBM group were significantly lower than DBM group and control group (P<0.05); while, the scores in the DBM group was significantly lower than control group (P<0.05).CONCLUSION: The full-thickness cartilage defects of rabbits were repaired with homograft of mesenchymal stem cells seeded onto cancellous demineralized bone matrix, which is a promising way for the treatment of cartilage defects.

Objective To study clinical features, diagnosis and treatment of allergic bronchopulmonary aspergillosis (ABPA) . Methods Clinical data and auxiliary examinations of eight patients with ABPA were analyzed, as well as relevant literatures were reviewed. Results All patients had symptom of cough, expectoration, out of breath and wheezing tale, seven of them with history of asthma, and all of them had increased peripheral blood eosinophil (EOS) count, serum levels of total immunoglobulin E (IgE) and lgE specific for Aspergillus fumigatus and showed positive prick test specific for Aspergillas fumigatus. Six of them showed infiltration shadows and six of them showed bronchiectasis in their chest CT images. Lung function test indicated obstructive ventilation dysfunction or mixed ventilation dysfunction with reversible airflow obstruction after administration of bronchodilator. Conclusions Diagnosis for ABPA should be made by integration of clinical features, increased blood eosinophil count and serum level of IgE, and result of prick test specific for Aspergillus fumigatus. Corticosteroid is a mainstay therapy for ABPA, ancillary with anti-fungi therapy. Patients with ABPA should be followed-up to prevent its recurrence.

Objective To investigate the association of excessive daytime sleepiness(EDS) and the quality of life in patients with moderate to severe obstructive sleep apnea and hypoventilation syndrome (OSAHS).Methods 123 patients with moderate to severe OSAHS were diagnosed by polysomnography(PSG),and 52 cases ruled out by PSG were controls.Patients and controls were completed the Calgary sleep apnea quality of life index (SAQLI) and the Epworth sleepiness score(ESS).Results There were statistical significance of body mass index (BMI),respiratory disturbance index(RDI),the lowest oxygen saturatioo( LSpO2 ),the longest apnea time( Tmax),the percentage of recording time with oxygen saturation of 90％ or less(T90) between the patients and the controls.Daily Functioning,Social Interactions,Emotional Functioning,Symptoms,and total scores of SAQLI in patients with moderate to severe OSAHS were(3.88 ± 1.05),(4.48 ± 1.39),(4.76 ± 1.59),(2.98 ± 1.10),(3.94 ± 1.22),which were less than that of controls respectively.The ESS scoree of patients with moderate to severe OSAHS were higher than that of controls[ ( 13.98 ± 4.05 ) vs (5.78 ± 2.45) ],( P ＜ 0.01 ).ESS were related to the daily Functioning,social interactions,emotional functioning,symptoms,and total scores of SAQLI in patients with moderate to severe OSAHS,and the coecient of correlation were - 0.52,- 0.48,- 0.40,- 0.48 and - 0.44,respectively,and all p value were less than 0.01.Conclusion Patients with moderate to severe OSAHS have the EDS,which associate with the impairment of quality of life.The higher ESS may indicate the decrease of quality of life in patients with moderate to severe OSAHS.

Objectives To study the correlations between stroke-preventive knowledge,health belief and health behaviors in community hypertensive patients.Methods The questionnaire of SPKQ,CHBMS and HPLPⅡwere used to take the investigation among 94 hypertensive patients from a community hospital in Guangzhou.Results The total score on SPKQ was 62.70±18.39 and the average scores on CHBMS and HPLPⅡwere 3.51±0.24 and 2.48±0.37,respectively.The stroke-preventive knowledge was positively correlated with health belief,health motivation and self-efficacy(r=0.289,P<0.01;r=0.246,P<0.05;r=0.350 (P<0.01,respectively).The health motivation was positively correlated with health behaviors(r=0.304,P<0.01)and the seriousness negatively correlated with health behaviors(r=-0.279,P<0.01).Conclusion Medical staff should provide much more stroke education with community hypertensive patients and promote patients’health motivation and self-efficacy of health belief in stroke prevention,help patients understand stroke seriousness,establish and sustain healthy lifestyles.