Diabetes is a chronic noncommunicable disease,which is can't be cured,and only can be suppressed by long-term treatment and self-management.The clinical decision support system can simulate the thinking process of diabetes specialists in disease diagnosis,and can provide the regular medical treatment plans and recommend the optimal plans to doctors.Most of the existing clinical decision support systems are based on clinical guidelines,rule-based and case-based reasoning as well as ontology-based systems.The big data technology can acquire and process multiple heterogeneous data,and provide a more scientific personalized treatment plan.In recent years,a variety of big date processing methods have been applied to the clinical diagnosis of diabetes based on decision tree,neural network,fuzzy logic,support vector machine,APRIORI association rules and multidimensional analysis,and timing mining.However,these methods are still in preliminary stage.The framework of diabetes clinical decision support system based on big data technology was analyzed,and the future diagnostic and treatment methods were forecast.

Objective To evaluate the relationship between Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway and propofol-induced inhibition of endotoxin-induced release of tumor necrosis factor-alpha (TNF-α) from alveolar macrophages (AMs) of rats.Methods AMs extracted from adult male Sprague-Dawley rats were cultured and inoculated in 6-well plates (1 × 106 cells/well)and in 96-well plates (1×104 cells/well).The cells were divided into 5 groups (n=18 each) using a random number table:control group (group C),dimethyl sulfoxide group (group D),lipopolysaccharide (LPS) group (group L),propofol group (group P) and LPS plus propofol group (group L+P).The cells were continuously cultured with phosphate buffer solution in group C.Dimethyl sulfoxide was added at the final concentration of 5 mg/ml in group D.LPS was added at the final concentration of 1 μg/ml in group L.Propofol was added at the final concentration of 25 μmol/L (4.46 μg/ml) in group P.LPS and propofol were added at the final concentration of 1 μg/ml and 25 μmol/L (4.46 μg/ml),respectively,in group L+P.At 24 h of culture or incubation,the cell viability was detected by CCK-8 assay,the morphological changes of cells were observed using Wright's staining,the concentration of TNF-α in the supernatant was determined by enzyme-linked immunosorbent assay,and TLR4 expression and NF-κB activities were measured by Western blot.Results Compared with group C,the cell viability and concentration of TNF-α in the supernatant were significantly increased,the expression of TLR4 was up-regulated,and the activity of NF-κB was enhanced in L and L+P groups (P＜0.05),and no significant change was found in the parameters mentioned above in D and P groups (P＞0.05).Compared with group L,the cell viability and concentration of TNF-α in the supernatant were significantly decreased,the expression of TLR4 was down-regulated,and the activity of NF-κB was weakened (P＜0.05),the morphological changes of cells were significantly attenuated,and the number of pseudopodia was reduced in group L+P.Conclusion The mechanism by which propofol inhibits endotoxin-induced release of TNF-α from AMs is related to inhibited activation of TLR4/NF-λB signaling pathway in rats.

Cerebral Hemorrhage ; complications ; Child ; Humans ; Intussusception ; complications ; Male ; Purpura, Schoenlein-Henoch ; complications

Cutaneous Fistula ; Digestive System Abnormalities ; therapy ; Endoscopy, Gastrointestinal ; methods ; Female ; Humans ; Infant ; Treatment Outcome

Objective To report three cases of localized primary sclerosing cholangitis (PSC) mimicking a hilar cholangiocarcinoma (Klatskin tumor) and to summarize their clinical characteristics and the ways to differentiate them through a literature review.Method The clinical data of three patients with localized PSC mimicking a hilar cholangiocarcinoma were retrospectively analyzed.The characteristics of laboratory tests and imaging examination were reviewed,and therapy and prognosis were discussed.Results The three patients were all diagnosed to have a hilar cholangiocarcinoma preoperatively,but the diagnosis of PSC was confirmed by histopathology post-operatively.All the three patients had elevated CA19-9,2 patients had elevated anti-nuclear antibody (ANA) and 2 patients had elevated IgG.All the three patients underwent surgical resection and histopathological study showed chronic inflammation of the hilar bile ducts and cholangitis of the intrahepatic portal area.The three patients were followed up from 7 months to 8 years with no symptoms.Conclusions Localized PSC is rare and it can casily be misdiagnosed as a hilar cholangiocarcinoma.Biopsy before surgery is helpful for the differential diagnosis but it is difficult to get a good biopsy sample.Surgical resection is an effective treatment.

ObjectiveTo study the present human resources of TCM hospitals in China, for decision making of TCM hospitals HR strategy in the future. Methods Collection of statistics released by the Ministry of Health and the State Administration of Traditional Chinese Medicine from 2005 to 2009, for analysis of the general structure and trends of hospital staff at large, headcount and makeup of medical personnel, and the structure and trends of TCM professionals in TCM hospitals. Results In 2009, there were 2,728 TCM hospitals, employing 518, 5000 staff, including 427, 900 medical personnel, accounting for 82.52％ of the total; TCM practitioners account for 45. 61％ of clinicians in TCM hospitals;a shortage of nursesisfoundin TCM hospitals as comparedto general hospitals. ConclusionIt is imperative to revise the staff quota standard of TCM hospitals, and to increase the number of TCM practitioners and nursing staff in TCM hospitals.

Objective:To evaluate the precision of digital impressions taken under simulated clinical impression taking conditions with TRIOS and to compare with the precision of extraoral digitalizations . Methods:Six #14 -#17 epoxy resin dentitions with extracted #16 tooth preparations embedded were made.For each artificial dentition , ( 1 ) a silicone rubber impression was taken with individual tray , poured with type IV plaster ,and digitalized with 3Shape D700 model scanner for 10 times;(2) fastened to a dental simulator , 10 digital impressions for each were taken with 3Shape TRIOS intraoral scanner .To assess the precision , best-fit algorithm and 3 D comparison were conducted between repeated scan models pairwise by Geomagic Qualify 12.0, exported as averaged errors (AE) and color-coded diagrams.Non-parametric analysis was performed to compare the precisions of digital impressions and model images .The color-coded diagrams were used to show the deviations distributions .Results:The mean of AE for digital impressions was 7.058 281 μm, which was greater than that of 4.092 363 μm for the model images (P<0.05).However, the means and medians of AE for digital impressions were no more than 10 μm, which meant that the consistency between the digital impressions was good .The deviations distribution was uniform in the model images ,while nonuniform in the digital impressions with greater deviations lay mainly around the shoulders and interproximal surfaces .Conclusion:Digital impressions with TRIOS are of good precision and up to the clinical standard .Shoulders and interproximal surfaces scanning are more difficult.

OBJECTIVE: Dynamic observation of Epstein-Barr virus (EBV) DNA load before and after the treatment in patients with Nasopharyngeal carcinoma (NPC), predicting the incidence of distant metastasis and offering more personalised choice of therapies. METHOD: Fifty-four cases of patients with NPC were taken by fluorescence quantitative PCR assay of EBV DNA load before and after the treatment, all patients were followed up according to plan and carried out the progression-free survival (PFS) and overall survival (OS). RESULT: EBV DNA load in plasma of patients with NPC can partly reflect the clinical characteristics of patients; EBV DNA load in some patients with distant metastasis was higher than those patients with continuous remission when they were not started treatment (P < 0.05); For those patients whose EBV DNA copies were lower than 20,000 copies/mI before the treatment, the progression-free survival and overall survival rates were higher than those high expression patients, and the difference were statistically significant (PF < 0.01 and P < 0.05). CONCLUSION The EBV DNA load in the plasma of NPC patients can partly predict the occurrence of distant metastases before treatment.
Adolescent ; Adult ; Aged ; Carcinoma ; DNA, Viral ; blood ; Female ; Herpesvirus 4, Human ; genetics ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; therapy ; virology ; Neoplasm Metastasis ; Viral Load ; Young Adult

Objective To determine the correlation of plasma brain natriuretic peptide(BNP) with severe degree of dilated cardiomyopathy in children.Methods Thirty children with dilated cardiomyopathy and 30 healthy subjects were selected in this degree of study, plasma BNP concentration was measured and compared among groups by using t test.Correlation of BNP levels with left ventricular ejection fraction and heart function was investigated using linear regression analysis.Results Children with dilated cardiomyopathy had significantly higher mean BNP levels compared with healthy children [(429.4?270.2) ng/L vs (67.0?10.2) ng/L].Significantly positive correlations were found between BNP and heart classification(r=0.950 P

A systematic review was undertaken, including studies that evaluated the incidence of the blood system adverse events of Tripterygium wilfordii (TWP). Medline, Embase and the Cochrane library were searched for relevant studies, including RCT, cohort studies and case series, of patients treated with TWP published in English and Chinese from inception up until May 25th, 2013 with the keywords including "Tripterygium wilfordii", "toxicity", "reproductive", "side effect", "adverse", "safety" and "tolerability". Relevant information was extracted and the incidence of the blood system adverse events was pooled with MetaAnalyst software. Besides, subgroup and sensitivity analyses were performed based on age, mode of medicine, observation time and disease system. According to inclusion and exclusion criteria, a total of 49 articles were included in the meta-analysis, they were split into 54 researches incorporated in the analysis. There is a large degree of heterogeneity among the studies, so data was analyzed using random-effects model and the summary estimates of incidence of the blood system adverse events was 6.1%. The weighted combined incidence of three major blood system adverse events were white-blood cells decreasing 5.6% (95% CI, 4.3% - 7.3%), hemoglobin decreasing 1.7% (95% CI, 0.5% - 5.0%) and platelet decreasing 1.8% (95% CI, 1.0% - 3.1%), respectively . Sensitivity analyses based on 45 studies with high quality showed the combined value was close to the summary estimate of total 54 studies. The current evidence indicates that the incidence of the blood system adverse events induced by TWP was high; attentions should be paid on to the prevention and treatment of the blood system adverse events.
Blood Cells ; drug effects ; Hemoglobins ; analysis ; Humans ; Tripterygium ; adverse effects