ObjectiveTo explore the distribution characteristics of traditional Chinese medicine （TCM） syndrome elements of macroangiopathy in patients with type 2 diabetes mellitus （T2DM） and the key elements of occurrence， development and progression of disease. MethodsA multicenter cross-sectional study was conducted to enroll 445 T2DM patients from five hospitals， and according to the presence or absence of macroangiopathy， the patients were divided into a T2DM group （120 cases） and a diabetic macroangiopathy （DM） group （325 cases）. Patients in DM group were divided into grade Ⅰ， Ⅱ， Ⅲ and Ⅳ according to the peripheral vascular color Doppler ultrasound results and the vascular anomalies classification standard. The general data including gender， age， duration of T2DM and body mass index （BMI） were collected， and the data of four examinations were obtained for syndrome differentiation. According to the diagnostic criteria of TCM syndrome elements， the patients can be divided into 9 patterns including qi deficiency， blood deficiency， yin deficiency， yang deficiency， qi stagnation， blood stasis， excess heat， and excess cold. The general data and distribution of TCM syndrome elements were compared between the two groups. The distribution of TCM syndrome elements in different vascular anomalies grades in the DM group was analyzed. Logistic regression analysis was used to explore the influence of various TCM syndrome elements on the occurrence of macroangiopathy in T2DM. ResultsThere was no significant difference in gender and BMI between groups （P＞0.05）. The age and duration of diabetes in the DM group were older and longer than those in the T2DM group （P＜0.01）. With the increase of age and prolonged course of disease， the severity of diabetic macroangiopathy increases gradually （P＜0.05 or P＜0.01）. There was no significant difference in BMI and course of disease among the different TCM syndrome elements （P＞0.05）. The average age of patients with blood stasis syndrome was the oldest （P＜0.05）. There was significant difference in gender distribution between the excess heat syndrome and yin deficiency syndrome （P＜0.05）. A total of 240 TCM syndrome elements were extracted from the T2DM group， while 731 TCM syndrome elements extracted from the DM group. The top two high-frequency syndrome elements in the two groups were qi deficiency and yin deficiency， with a frequency of larger than 50%. The distribution of phlegm-damp syndrome and blood-stasis syndrome were significantly higher in the DM group than in the T2DM group （P＜0.01）. There were significant differences in the distribution of qi deficiency syndrome， yin deficiency syndrome， phlegm-damp syndrome， blood stasis syndrome， and excess heat syndrome among different grades of vascular anomalies （P＜0.01）； qi deficiency and yin deficiency were both high-frequency TCM syndrome elements in patients at grades 0 to Ⅲ； phlegm-damp syndrome increased in frequency with the progression of the disease from grades 0 to Ⅳ， and the frequency of blood stasis syndrome showed an overall upward trend. The frequency of phlegm-dampness syndrome increased from grades 0 to Ⅳ with the progression of the disease， and the frequency of blood stasis syndrome showed an overall upward trend. Logistic regression analysis showed that phlegm-damp syndrome and blood stasis syndrome were important TCM syndrome elements related to the vascular anomalies degree of macrovascular disease in T2DM （P＜0.05 or P＜0.01）. ConclusionQi deficiency and yin deficiency are the basic TCM syndrome elements throughout the whole process of T2DM and diabetic macrovascular disease. Phlegm-damp and blood stasis are related to the degree of vascular anomalies in diabetic macrovascular disease and are the key TCM syndrome elements in the progression of macroangiopathy in T2DM.

This paper interviewed a case of patient with gender dysphoria via a bio-psycho-social approach. The client， a 21-year-old college student of male sex， had been into female dressing since the age of ten. As an adult， he became increasingly convinced that he should become a woman and began taking hormone therapy in secret and on an irregular basis. He felt himself trapped in a cycle of anxiety and distress， due to the concerns about the side effects of hormone therapy， and the practical problems regarding the impact on his academic and career arrangements， as well as the ways to explain himself to his parents. Through a remote psychiatric consultation， therapists provided targeted interventions based on the bio-psycho-social model.

Coagulometer, known as blood coagulation analyzer, is a product that can provide accurate test results for medical diagnosis and treatment analysis by detecting a series of items closely related to thrombosis and hemostasis in coagulation reaction. On the basis of previous traditional methods, and with our deep understanding about the principles of hemagglutination detection, we propose a hemagglutination detection method by using the dual-magnetic circuit beads method. Then, the corresponding hemagglutination detection module is designed. The coagulation time of plasma can be measured by detecting the movement of the magnetic beads when the magnetic field intensity is appropriate. The activated partial thromboplastin time(APTT) of plasma is tested when the most suitable magnetic field intensity is found. The results preliminarily show that this blood coagulation test method is valid and the corresponding test module has a potential value in business.
Blood Coagulation ; Blood Coagulation Tests ; Magnetic Phenomena ; Magnetics ; Partial Thromboplastin Time

Objective To understand the ehealth literacy of coronary disease patients and to explore the problems encountered when searching for disease related health task by computer so as to provide a reference for constructing the ehealth literacy intervention for coronary disease patients. Methods From June 2018 to December 2018, this study selected 20 coronary disease inpatients at a class Ⅲ grade A hospital in Hangzhou by purposive sampling to carry out operational experiment. Subjects operated 6 experimental tasks related to coronary network health designed by researchers in computers. In the experiment, subjects were required to use the method of think-aloud. At the same time, screen video experts recorded the screen activity track, image and sound produced when subjects operated tasks to collected subjects' experimental data. Moreover, two researchers recorded the completion, expression and time of subjects when operating 6 tasks. Colaizzi 7-step analysis was used to summary and analyze the experimental data. Results Problems encountered when coronary disease patients searched for disease related health task by computer included four themes, operating computers and browsers, navigation and location on the Web, using search strategy as well as evaluating the information correlation and reliability. Conclusions Health professionals should pay attention to the basic computer skills of patients,health information search strategy and quality evaluation ability of network health information when providing ehealth literacy training for coronary disease patients to improve the ehealth literacy of coronary disease patients.

Objective To investigate the effect of long-term walking exercise on the health status of low-labor-intensity population under long-term walking exercise.Methods A total of 100 volunteer teachers from universities in Beijing were enrolled.After physical examination,they were randomly divided into control group and observation group.The observation group regularly carried out corresponding encouragingactivities and recorded the daily number of steps.The corresponding indexes were measured again after 450 days.Results 45.24％ participants in the observation group got more than 75％ participation rate.The lower the participation rate,the lower the average daily steps (P ＜ 0.05).The fasting blood glucose,systolic blood pressure,LDL and total cholesterol were lower than other groups in the group participation rate ＜25％ (P ＜0,05).The body mass index,systolic blood pressure,fasting blood glucose,total cholesterol,ratio diabetes and hypertension in low activities group (＜ 7 500 steps/day) were lower than those in other groups (P ＜ 0.05).Conclusions Walking exercise can achieve good long-term persistence with constant feedback.For those who are older and whose initial indicators are higher,participation rate and exercise volume are more likely to be better under the guidance of encouragement.Persisting long-term walking exercise can help reduce blood pressure and blood lipids.

Objective To evaluate cytotoxic effects of cytokine-induced killer cells (CIK cells) transfected with the interleukin-2 (IL-2) gene on malignant melanoma cells.Methods Mouse spleen cells were extracted,lymphocyte cells were separated,and CIK cells were prepared from these lymphocyte cells.PEGF-N1 plasmids containing IL-2 gene (PEGF-NI-IL-2) were transfected into CIK cells.Fluorescence microscopy was used to observe transfection products,and reverse transcriptase-polymerase chain reaction (RT-PCR) was conducted to determine the IL-2 mRNA expression.Then,effector cells such as CIK cells and IL-2-transfected CIK cells were separately co-cultured with target cells (B16 melanoma cells) at effector-target ratios of 10∶ 1,20∶1 and 40∶1,then 4-hour lactate dehydrogenase release assay was performed to evaluate cytotoxic effects of the two kinds of CIK cells on B 16 cells.After effector cells were cocultured with target cells at the effector-target ratio of 40∶1 for 48 hours,enzyme-linked immunosorbent assay (ELISA) was conducted to detect levels of IL-2,interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) in the supernatant of the two kinds of CIK cells.Finally,mouse models of melanoma were established,and a total of 28 melanoma-bearing mice were divided into 4 groups to be peritumorally injected with 0.2 ml sodium chloride physiological solution (control group),100 IU IL-2 solution (IL-2 group),CIK cell suspension at a cell density of 1 × 106 cells per milliliter (CIK group) and IL-2-transfected CIK cell suspension at a cell density of 1 × 106 cells per milliliter (IL-2-transfected CIK group) respectively.Tumor morphology,tumor inhibition rate and cell apoptosis rate were used to evaluate tumor growth in the above groups.If data were normally distributed,t-test was used for comparing means between two groups,and analysis of variance and least significant difference (LSD)-t test were used for comparing means among multiple groups.Results Fluorescence microscopy and RT-PCR both showed that IL-2 was successfully transfected into CIK cells.The cytotoxic effect of IL-2-transfected CIK cells on B16 cells was strongest at the effector-target ratio of 40:1.Levels of IL-2,IFN-γ and TNF-α were also significantly higher in the supernatant of IL-2-transfected CIK cells [(1107.26 ± 6.49) pg/ml,(50.01 ± 3.35) pg/ml,(39.86 ± 3.25) pg/ml] than those in that of CIK cells [(51.09 ± 3.85) pg/ml,(32.71 ± 2.43) pg/ml,(30.11 ± 3.08) pg/ml,t =442.60,14.93,6.89,all P ＜ 0.01].Animal experiments showed that the tumor volume obviously increased in the control group (P ＜ 0.05),but significantly decreased in the IL-2 group,CIK group and IL-2-transfected CIK group (all P ＜ 0.001) after intervention compared with those before intervention.Furthermore,the tumor volume in the IL-2-transfected CIK group was significantly less than that in the other three groups (all P ＜ 0.01),but no significant difference was observed between the IL-2 group and CIK group (P ＞ 0.05).In addition,the apoptosis rate was significantly higher in the IL-2 group,CIK group,and IL-2-transfeeted CIK group than that in the control group (all P ＜ 0.01).The apoptosis rate and tumor inhibition rate were significantly higher in the IL-2-transfected CIK group than those in the IL-2 group and CIK group (all P ＜ 0.01),but insignificantly different between the IL-2 group and CIK group (P ＞ 0.05).Conclusion IL-2-transfected CIK cells had stronger killing effects on malignant melanoma.

Objective To study the clinical effect of subtotal parathyroidectomy on secondary hyperparathyroidism(SHPT) in uremic patients undergoing hemodialysis.Methods The data of 10 uremic patients undergoing hemodialysis who received subtotal parathyroidectomy from Jun.2006 to Jun.2011 in our hospital were retrospectively analyzed.Intact parathyroid hormone (iPTH),serum calcium,phosphorus and calcium-phosphorus product were analyzed statistically before operation,1 week,1 month,3 months,and 6 months after the operation.The joint pain relief and postoperative complications were studied.Results ①All of the 10 patients were successfully operated.No complication occurred.The intraoperative site of the parathyroid was consistent with that positioned by the preoperative B ultrasound guidance.②Postoperative bone pain and pruritus were obviously relieved.③iPTH decreased significantly at 1 week,1 month,3 months,6 months after surgery compared with that before surgery.The difference had statistical significance(P ＜ 0.05).④Postoperative serum calcium,serum phosphorus and calcium-phosphorus product decreased significantly at 1 week,1 month,3 months,6 months after surgery compared with that before surgery.The difference had statistical significance (P ＜ 0.05).Conclusions Preoperative localization for neck parathyroid by ultrasound scan is feasible.Subtotal parathyroidectomy can be effective in treatment of SHPT in uremic patients.The surgery were safe and with satisfactory treatment outcome.

To observe the protective effects of drug-contained serum of Lingqi Huangban Granule (LQHBG), a compound traditional Chinese herbal medicine, on oxidative stress-induced injury in rabbit retinal pigment epithelial (RPE) cells in vitro.

Objective To investigate the cognitive difference between uni-modal (V,A) and bi-modal (VA)target stimuli from both vision and audition,and then to study the neural mechanisms of bi-modal enhancement.Methods This experiment adopted a speeded target stimuli detection task, both behavioral and electroencephalographic responses to uni-modal and bi-modal target stimuli which were combined from visual and auditory target stimuli,were recorded from 14 normal subjects using a 64-channel EEG NeuroScan system.The differences of cognitive between uni-modal and bi-modal stimulus were tested from both behavioral (reaction time (RT) and error rate (ER)) and event-related potentials (ERPs) (P2 latency and amplitude,P3 latency and amplitude)data,and the correlation between behavioral and ERPs results were analyzed.Results As a result,the RT,ER and P3 latency has significant difference between uni-modal and bi-modal target stimuli.In addition,there were significant correlation between behavioral data and P3 latency,especially from the RT and P3 latency.Conclusion By comparing the difference between uni-modal and bi-modal from both behavioral and ERPs results,we could reached the conclusion that the neural mechanism of bi-modal target detection was predominant over that of vision and audition uni-modal target detection,the enhancement take place not only involved in early ERP components (such as P1 and N1),but engaged at the late ERP components (such as P2 and P3).

Objective: To investigate the effects of Ginkgo biloba extract (EGb 761) on the morphology and function of retinal ganglion cells (RGC) in guinea pigs with optic nerve transection. Methods: Seventy-five albino guinea pigs were randomly divided into five groups: normal control group, sham-operated group, untreated group, normal saline group and EGb 761 group. No operation was performed in the normal control group. Optic nerve was merely exposed in the sham-operated group, but transected at 1.0 mm from posterior pole of the eye ball in the untreated, normal saline and EGb 761 groups. Guinea pigs in the EGb 761 group or the normal saline group received daily intraperitoneal injection of EGb 761 (100 mg/kg) or corresponding volume of normal saline from 7 days before experiment to 28 days after experiment. Three guinea pigs in each group were sacrificed for apoptosis assay (TUNEL method) of RGC. Pattern electoretinograms (PERGs) were recorded 14 and 28 days after transection, respectively. At the end of the examination, six guinea pigs were killed for histological examination and RGC count. Results: No TUNEL-positive cells were observed in the normal control, sham-operated and EGb 761 groups, but there were TUNEL-positive cells in the untreated group and the normal saline group. The numbers of RGCs in the untreated and normal saline groups were less than those in the normal control and sham-operated groups at 14 days or 28 days (P<0.05). Although the number of RGCs in the EGb 761 group was less than those in the normal control and sham-operated groups (P<0.05), it was more than those in the untreated and normal saline groups (P<0.05). N(95) amplitude in EGb 761 group was higher than those in the untreated and normal saline groups (P<0.05) and close to those in the normal control and sham-operated groups (P>0.05) at 14 days or 28 days. The number of RGCs was positive correlated to N(95) amplitude (r=0.859, P=0.001 5). Conclusion: EGb 761 can inhibit the apoptosis of RGCs in guinea pigs after optic nerve transection, thus protect the morphology and function of RGCs.