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The actor network theory, with reference to systems science, sociology and management science, offers a new perspective for research of the technology-society binary view. This theory as introduced by the authors, analyzed the constituent bodies and their relationship of the operation of the precise medical service system, and studied the translation process of the actor network. The analysis showed that the main factors affecting the operation of the precision medical service system were hospitals, patients, governments, scientific research institutions, technology-based enterprises, and universities, which were suppliers, demanders, managers, funders, and technical supporters of precision medical services. Among them, 82.72%(335/405) of clinicians believed that hospitals were the core actor that affected the operation of precision medical service system. 71.60%(290/405) of the clinicians thought that the training of medical workers was the current focus of the hospital, i. e., the mandatory access point for this actor network. Through training, the accurate medical service ability of medical workers and hospitals can be improved.
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The actor network theory, with reference to systems science, sociology and management science, offers a new perspective for research of the technology-society binary view. This theory as introduced by the authors, analyzed the constituent bodies and their relationship of the operation of the precise medical service system, and studied the translation process of the actor network. The analysis showed that the main factors affecting the operation of the precision medical service system were hospitals, patients, governments, scientific research institutions, technology-based enterprises, and universities, which were suppliers, demanders, managers, funders, and technical supporters of precision medical services. Among them, 82.72%(335/405) of clinicians believed that hospitals were the core actor that affected the operation of precision medical service system. 71.60%(290/405) of the clinicians thought that the training of medical workers was the current focus of the hospital, i. e., the mandatory access point for this actor network. Through training, the accurate medical service ability of medical workers and hospitals can be improved.
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OBJECTIVES@#To analyze the regional epidemic features of coronavirus disease 2019 (COVID-19) in Henan Province, China.@*METHODS@#According to the data of COVID-19 patients and the resident population at the end of 2018 in Henan Province, statistical description and analysis of epidemiological characteristics of COVID-19 in Henan Province were conducted, including the time distribution, population distribution, and regional distribution.@*RESULTS@#The cumulative incidence of COVID-19 in Henan Province was 1.32/100 000, the cure rate was 98.03%, and the fatality rate was 1.73% by March 9, 2020. The incidence curve showed that the epidemic peak reached from January 24 to January 28. The high-incidence area was Xinyang, with a standardized cumulative incidence rate of 4.36/100 000. There were 580 female COVID-19 patients (45.60%), 688 males (54.09%) in Henan Province. The incidence of males was 1.41/100 000, while the incidence of females was 1.23/100 000. The age with the highest incidence of COVID-19 in Henan Province was 20-69 years old (88.68%). The incidence rate was highest in men aged 30-39 (2.51/ 100 000), while the lowest rate in women aged 0-9 (0.16/100 000). There were 1 225 local patients (96.31%), and the rural patients (45.73%) were slightly higher than the urban patients (44.02%) in Henan Province. A total of 63.60% patients had traveled or lived in Hubei or contacted with people who came from Hubei to Henan. The proportion of patients whose family members suffered from COVID-19 was 32.70%. Global spatial autocorrelation analysis suggested that there was a statistically significant positive correlation in the spatial distribution of COVID-19 patients in Henan Province (Moran's =0.248, =2.955, <0.01).@*CONCLUSIONS@#There are differences in the morbidity and mortality of COVID-19 patients in different areas of Henan Province, with epidemic peak reaching from January 24 to January 28. Henan is dominated by local patients, male patients, and patients with contact history in Hubei. The space appears to be moderately clustered.
Subject(s)
Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Betacoronavirus , China , Epidemiology , Coronavirus Infections , Epidemiology , Incidence , Pandemics , Pneumonia, Viral , Epidemiology , Spatial AnalysisABSTRACT
Objective To investigate the curative efficacy of buyang huanwu decoction in combination with cyclophosphamide in treating patients with Takayasu arteritis(TA)at active stage and its improvement on vascular endothelial injury.Methods 88 patients with TA at active stage who received therapy in The Hospital of Beijing Armed Police Corps from January 2015 to April 2016 were selected as research objects.According to therapeutic schemes,those patients were divided into the control group(n=42)and the observation group(n=46).The control group was given cyclophosphamide,while the observation group was given cyclophosphamide in combination with buyang huanwu decoction.Then,the total therapeutic efficacy ratio,laboratory-related indices and indices of vascular endothelial injury were compared between the two groups.During the treatment,incidence of adverse reactions were compared.Results The observation group had a total therapeutic efficacy ratio of 89.1％,which was statistically higher than that of 71.4％in the control group(P<0.05).After the treatment,in comparison with the control group,laboratory-related indices of erythrocyte sedimentation rate(ESR),C reactive protein(CRP)and vascular endothelial injury indices of vascular endothelial growth factor(VEGF),endothelin-1(ET-1)in the observation group were statistically lower(all P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 26.1％,which was statistically same with that of 21.4％in the control group.Conclusion Cyclophosphamide in combination with buyang huanwu decoction is effective for patients with TA at active stage with a high total therapeutic efficacy ratio.And it can significantly improve laboratory-related indices and vascular endothelial injury without increasing incidence of adverse reactions.
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<p><b>OBJECTIVE</b>To evaluate the influence of extreme ambient temperature on mortality and years of life lost (YLL) in Chongqing.</p><p><b>METHODS</b>The daily mortality, meteorology and air pollution index data in Chongqing from the 1(st) January 2010 to the 31(st) December 2013 were collected. Distributed lag non-linear model (DLNM) was used to assess the influence of daily ambient temperature on daily number of deaths and daily YLL respectively. The delayed and cumulative effects of extreme temperature on sex, age, and cause-specific mortality were also assessed.</p><p><b>RESULTS</b>The relationships between ambient temperature and non-accidental, cardiovascular disease and respiratory disease mortalities and YLL were U-shaped or W-shaped. The effect of heat was obvious on that day, peaked on day 7, and lasted for two weeks, whereas the effect of cold was obvious a week later and lasted for a month. As 1 ℃ increase of ambient temperature, the cumulative relative risks (CRR) of high temperature across lag 0-7 days on non-accidental, respiratory disease and cardiovascular disease mortalities were 1.05 (95%CI: 1.03-1.07), 1.08 (95%CI: 1.05-1.11) and 1.05 (95%CI: 1.01-1.09) respectively. The effects of heat on YLL for each cause were 23.81 (95%CI: 12.31-35.31), 14.34 (95%CI: 8.98-19.70) and 4.43 (95%CI: 1.64-7.21), respectively. On cold days, 1 ℃ decrease of ambient temperature was correlated with an increase in CRR of 1.06 (95%CI: 1.04-1.08), 1.09 (95%CI:1.06-1.12) and 1.06 (95%CI: 1.02-1.11) from lag 0 to 14 for non-accidental, respiratory disease and cardiovascular disease mortalities, respectively. The estimated YLL were 23.34 (95%CI: 10.04-36.64), 16.39 (95%CI: 10.19-22.59) and 2.61 (95%CI: -0.61-5.82). People aged ≥65 years tend to have higher CRR and YLL than those aged <65 years. On high temperature days, the CRR in women was higher than that in men, while the YLL in women was lower than that in men. On low temperature days, both the CRR and YLL in women were higher than those in men.</p><p><b>CONCLUSIONS</b>Both high and low ambient temperature have adverse health effects. People aged ≥65 years are more sensitive to both high and low ambient temperature. Younger men are more sensitive to high ambient temperature and women and elder men are sensitive to low ambient temperature. It is necessary to take targeted measures to protect the population in Chongqing from the adverse influence of extreme ambient temperature.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Cardiovascular Diseases , Mortality , China , Epidemiology , Cold Temperature , Hot Temperature , Life Expectancy , Mortality , Nonlinear Dynamics , Respiratory Tract Diseases , Mortality , TemperatureABSTRACT
Objective The renin-angiotensin system ( RAS) is involved in myocardial anoxic injury .This study aimed to in-vestigate the expressions of AT 1-R, AT2-R, and angiotensin-converting enzyme ( ACE ) in bone marrow mesenchymal stem cells (MSCs) under hypoxia. Methods Rat MSCs were isolated, cultured, and identified with CD29 and CD11b/c antibodies.The is-chemic injury model was established by exposing the MSCs to hypoxia and serum deprivation ( Hypoxia/SD) for 24 hours, while the control cells were cultured in L-DMEM with 10%FBS.The vitality and apoptosis of the cells were detected by trypan blue staining , CCK8 assay, and Annexin V-FITC staining.The mRNA and protein expressions of AT 1-R, AT2-R, and ACE were determined by real-time quantitative PCR and Western blot , respectively. Results The positive rate of CD29 was >97%and that of CD11b/c was <1% in the MSCs.Compared with the control group, Hypoxia/SD significantly increased the rate of cell apoptosis ([6.73 ±0.78]%vs [19.93 ±4.92]%, P<0.01), decreased the rate of cell viability ([78.49 ±4.94]%vs [37.33 ±2.91]%, P<0.01), and up-regulated the mRNA and protein expressions of AT 1-R, AT2-R, and ACE. Conclusion Hypoxia/SD activates the RAS in MSCs and improves the protective function of the cells against myocardial anoxic injury .
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Objective: To evaluate the efficacy and safety of overlapping biodegradable polymer sirolimus-eluting stents (EXCEL) in treating the patients with diffuse long coronary lesions (total stent length for per lesion>60 mm). Methods: A total of 71 patients with diffuse long coronary lesions with overlapped EXcellstents implantation in our hospital from 2010-08 to 2012-05 were retrospectively studied. The average age of patients was (62.85 ± 10.26) years and 74.56%with male gender. The clinical endpoints were the major adverse cardiac events (MACE) at in-hospital time and at 2-year follow-up period. Results: The average target lesion was implanted (2.61 ± 0.52) stents, the mean stent diameter was (3.21 ± 0.35) mm and the length was (73.34 ± 13.11) mm. The in-hospital MACE rate was 4.23%, the 2-year target vessel revascularization and MACE rates were 9.86%and 18.31%respectively. Cox regression analysis indicated that smoking (HR 12.102, 95%CI 1.460-100.309, P=0.021), previous history of MI (HR 11.948, 95%CI 1.144-124.726, P=0.038) and previous history of PCI (HR 0.097, 95%CI 0.010-0.990, P=0.049) were the independent risk factors of out of hospital MACE occurrence. Conclusion: EXcellstent implantation was safe and effective for treating the patients with diffuse long coronary lesions, the long term follow-up study revealed that there was the increased risk for MACE and target vessel revascularization.
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BACKGROUND: Obesity has become the most common and costly metabolic problem in the world, and the genetic and environmental effects on the generation of obesity have become one of the focus factors in obesity research. Gene-chips have been reported as a useful tool in human adipose tissue research. OBJECTIVE: To determine the peripheral blood gene expression profile of Chinese adult obesities by gene chip technique for the first time. DESIGN: Randomized controlled observation. SETTING: Beijing University of Traditional Chinese Medicine. PARTICIPANTS: The experiment was performed at the Basic Medical College of Beijing University of Traditional Chinese Medicine between August 2003 and May 2004. Five obese patients, 4 males and 1 female, aged (21.4±0.9) years and three non-obese persons, 2 males and 1 female, aged (26.0±5.3) years were selected by the international body mass index (BMI) standard. The written informed consent was obtained from all subjects, and the research was approved by the medical ethical committee of Beijing University of Traditional Chinese Medicine. METHODS: Total RNA was extracted from peripheral blood, amplified and labeled. The quality and quantity of the processed samples were checked by Test3 array. The gene expression profiles were monitored by U133A set. The data was analyzed statistically, and the gene symbols with significant difference were searched in Gene BANK database. MAIN OUTCOME MEASURES: Gene expression signal. RESULTS: Compared with non-obese adults, 66 genes showed up-regulated expression and 28 genes showed down-regulated, of which 11 genes were up-regulated above twofold, and 6 genes were down-regulated above twofold. The results demonstrated that HLA-DQAI (human leucocytic antigens), CRAT, MAPKSI3 and DKFZP434N1923 genes were up-regulated above 4 fold, and HLA-DQA1 gene was even up-regulated above 20 fold. CONCLUSION: Significant differences in peripheral blood gene expression profiles in Chinese adult obesities are found for the first time. The results indicate that obesity is strongly associated with MHC class II antigen HLA-DQA1, and HLA-DQB 1, etc.