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OBJECTIVE@#To solve the ESB bus performance and safety problems caused by the explosive growth of the hospital's business, and to ensure the stable interaction of the hospital's business system.@*METHODS@#Taking the construction of our hospital's information system as an example, we used AlwaysOn, load balancing and other technologies to optimize the ESB bus architecture to achieve high availability and scalability of the hospital's ESB bus.@*RESULTS@#The ESB bus high-availability architecture effectively eliminates multiple points of failure. Compared with the traditional dual-machine Cluster solution, the security is significantly improved. The nodes based on load balancing can be scaled horizontally according to the growth of the hospital's business volume.@*CONCLUSIONS@#The construction of the ESB bus high-availability architecture effectively solves the performance and security issues caused by business growth, and provides practical experience for medical information colleagues. It has certain guiding significance for the development of regional medical information.
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Hospital Information Systems , Information SystemsABSTRACT
The construction and operation of the hospital-wide radiation protection management information system is of great significance for improving the efficiency and quality of radiation protection management. A hospital has built a hospital-wide radiation protection management system, which consisted of four modules: radiation staff management module, protection items management module, site and equipment management module, and self-inspection module. The system adopted B/S mode, carried the lightweight J2EE framework-SpringBoot framework, and used mybatis, which was flexible and practical, as the persistence layer of the system, to store the data completely in the SQLServer database.Java language was used as the system development language, and the front and back-end separation architecture was used. Each of the four modules implemented the management responsibility departments and responsible personnel to carry out the all-round management of radiation protection, and realized the integrated, information-based and standardized management of radiation protection management in the hospital.
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Objectives:To investigate the effects of different plantarflexion resistance of an ankle foot orthosis (AFO) on the motion of the thorax and pelvis during the gait of stroke patients. Methods:From June, 2020 to January, 2021, 26 stroke inpatients in Beijing Bo'ai Hospital wore AFO with oil damper (OD) ankle hinge, and measured thorax and pelvis during stroke gait under three plantarflexion resistance (OD1, OD2.5, OD4) of the AFO with a three-dimensional motion capture system. The main parameters were pelvic (P) and thoracic (T) angles at the following time or phases: initial contact (IC), contralateral foot off (CFO), contralateral initial contact (CIC), foot off (FO); the change of thoracic angle in gait cycle (Tcyclex), the change of thoracic angle in stance phase (TSTx) and the change of thoracic angle in single stance phase (TSSx). Thoracic and pelvic motions were defined on three coordinate axes: forward/backward tilt (x), oblique (y) and rotation (z). Results:The loading response times were significant different among different plantarflexion resistance conditions (χ2 = 7.923, P = 0.019), as well as between OD2.5 and in OD4 (P = 0.017). PCFOx, PCFOz, PCICx and PFox; TCFOx, TCFOy, TCFOz and TFOx; relative angle of thorax to pelvis TPICx, TPCFOx and TPCICx; and TSSx were significant different among three resistance conditions (χ2 > 6.077, P < 0.05). Forward tilt of pelvis decreased in condition OD2.5 and increased in condition OD4 during each timing. When CFO, the thoracic forward/backward tilt angle was less in OD2.5 than in OD4 (P < 0.05), the thoracic rotation angle was less in OD1 than in OD4 (P < 0.05). Conclusion:Plantarflexion resistance has a significant effect on the motion of the thorax and pelvis in the gait of stroke patients. Under the middle magnitude of resistance, the pelvic and thoracic posture becomes more upright, the oblique angle is reduced, showing the improvement of the upright posture. On the contrary, the pelvic forward tilt and thoracic oblique are increased when resistance become low or high, compensation of rotational motion appeared in high resistance, posture getting worse.
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Objective:To design, fit and use a thoracic-weight-bearing socket and reciprocating gait prosthesis for amputee pelvis disarticulation. Methods:A case after pelvis disarticulation amputation was reported. The main weight of the socket bore on lower thorax, and the socket suspended with the pressure from anterior-posterior sides. Walking prosthesis was consisted of the socket, reciprocating hip joint, prosthetic knee joint and SACH foot. The prosthesis was adjusted alignment, and the patient was trained to walk with the prosthesis. Results:The patient could stand for four hours a time with the socket, and walk 200 meters in 30 minutes assisted with axillary crutches. The score of modified Barthel Index improved from 41.5 admitted to hospital to 93 (with socket) or 83 (with prosthesis) as discharged. Conclusion:Pelvis disarticulation amputees could stand up with socket with reasonable weight bearing and suspension and walk in reciprocating gait with reasonable components and joints, right alignment and gait training, to improve activities of daily living.
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Hyperglycemia and hyperosmolar state (HHS) is an acute complication of diabetes with a higher mortality rate. Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) , among which fatal PTE is one of the main causes of sudden death in hospitalized patients. There are relatively few clinical reports about the simultaneous occurrence of HHS and VTE. This article introduces the successful treatment of an elderly patient with HHS combined with VTE and gastrointestinal bleeding to improve clinicians’ understanding of the disease.
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There are many unknown genetic factors that lead to infertility in nonobstructive azoospermia men. Here, we performed whole-exome sequencing in blood samples obtained from 40 azoospermia patients with meiotic arrest and found a novel c.151_154del (p.D51fs) frame-shift mutation in exon 3 of the testis expressed 11 (TEX11) gene in one patient. Sanger sequencing analysis of the patient and 288 fertile men was performed to validate the mutation. Immunohistochemical analysis showed TEX11 expression in late-pachytene spermatocytes and in round spermatids in fertile human testes. In contrast, testes of the patient with TEX11 mutation underwent meiotic arrest and lacked TEX11 expression. Western blotting of human embryonic kidney (HEK293) cells transfected with a vector for the p.D51fs TEX11 variant detected no TEX11 expression. In conclusion, we identified a novel frame-shift mutation in the TEX11 gene in an azoospermia patient, emphasizing that this gene should be included in genetic screening panels for the clinical evaluation of azoospermia patients.
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OBJECTIVE@#To perform dried blood spots thalassemia gene detection in patients with positive blood phenotypes by microarray technology, and evaluate its value in clinical detection.@*METHODS@#DNA samples were extracted from dried blood spots of 410 patients. Microarray technology was used to detect 3 deletion and 3 non-deletion types of α-thalassemia and 19 β-thalassemia point mutations which were common gene mutions in China.@*RESULTS@#There were 357 positive cases in all the 410 tested samples with the positive rate 87.07%, among which 299 cases (72.93%) carried deletion or point mutations of α-thalassemia, 29 cases (7.07%) carried point mutations of β-thalassemia and 29 cases (7.07%) carried gene mutations of complex αβ-thalassemia syndrome. The mutations of α-thalassemia were involved with --@*CONCLUSION@#The most common genetic mutations are --
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Humans , China , Mutation , Oligonucleotide Array Sequence Analysis , alpha-Thalassemia/genetics , beta-Thalassemia/geneticsABSTRACT
OBJECTIVE@#To proceed the clinical evaluation of DNA microarray for thalassemia gene detection.@*METHODS@#Peripheral blood samples of 166 thalassemia gene test subjects were collected and tested for thalassemia genes by microarray chip method and Gap-PCR method combined with PCR-reverse dot blot hybridization method according to double-blind control test. The specificity, sensitivity, positive predictive value, negative predictive value, and total coincidence rate of the microarray chip method were evaluated. When the two methods were inconsistent, multiplex ligation dependent probe amplification (MLPA) was used to verify the deletional α-thalassemia.@*RESULTS@#Compared with Gap-PCR method, specificity, sensitivity, positive predictive value, negative predictive value, Youden index, and total coincidence rate of microarray chip method was 100% (70/70), 96.88% (93/96), 100% (93/93), 95.89% (70/73), 0.969, and 97.59% (162/166), respectively, while compared with PCR-reverse dot blot hybridization method was 100% (125/125), 100% (41/41), 100% (41/41), 100% (125/125), 1, and 100% (166/166), respectively.@*CONCLUSION@#The microarray chip method for α-thalassemia gene detection shows the advantages of high specificity, sensitivity, and throughput.
Subject(s)
Humans , Genetic Testing , Multiplex Polymerase Chain Reaction , Oligonucleotide Array Sequence Analysis , alpha-Thalassemia/geneticsABSTRACT
The treatment and functional rehabilitation of spinal cord injury is globally concerned. It is of significance to study the follow-up since people with different levels and completeness of traumatic spinal cord injury experience different patterns or profiles of both neurological and functional recovery. This review systematically analyzed the assessment scales of spinal cord injury and the selection of follow-up period, the prognostic studies, the prognostic factors and prediction models.
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Whiplash-associated disorders usually appear as symptoms of neck pain, headache, and limited cervical spine activities, etc. Its mechanism is complicated, which is related with the sudden acceleration-deceleration mechanism conducted to the cervical vertebral joint, ligaments, muscles and nerves. Recently, it was found that low capacity of cerebrospinal fluid, fibromyalgia, and injury of central nervous system are also associated with those symptoms. The focus of exercise on equal length contraction and endurance of neck deep muscles can significantly improve the symptoms of patients without neurological injury. Ultrasound can be used to dynamically detect deformation and deformation rate patterns of both deep and shallow muscle in the exercise group and the conservative observation group. It is suggested that exercise can improve muscle movement patterns and repair damaged neck muscles at the same time.
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Cardiovascular diseases are characterized by cardiac and vascular dysfunction. Prokineticin 2 ( PK2 ) is a newly found secretory peptide which plays a key role in the physiology homeostasis via prokineticin receptor 1 and 2 ( PKR1 and 2). Furthermore, PK2/PKR1 signaling pathway plays an important role in protecting cardiovascular diseases. Here we discuss the effect of PK2/PKR1 signaling in myocardial infarction, conges-tive heart failure and vascular endothelial dysfunction.
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Objective To explore the role of signal transducer and activator of transcription 3 (STAT3) phosphorylation in the pathogenesis of Behcet's disease (BD),and to investigate the association between STAT3 phosphorylation and disease activity in BD patients.Methods Peripheral blood mononuclear cell (PBMC) was isolated from 15 mL peripheral boood of 10 active BD patients (BD-A),10 BD patients in remission (BD-R) and 10 healthy controls (HC) respectively.The blockade of STAT3 phosphorylation was performed by Stattic.The PBMC was divided into Stattic subgroup (treated with 2.5 μmol/L stattic and 1 640 medium,5 mL) and blank control subgroup (treated with 5 mL 1 640 medium),respectively.The protein levels of phosphorylated STAT3 (pSTAT3) and STAT3 were examined by flow cytometry and Western blot.The protein and mRNA levels of TNF-α,IFN-γ and IL-17 were tested by RT-PCR and ELISA.Two-way ANOVA and Bonferroni post hoc test were used to analyze the results.Results Compared with HC,the BD patients showed higher protein levels of pSTAT3 and STAT3,and higher protein and mRNA levels of TNF-α,IFN-γ and IL-17;compared with blank control subgroup,the protein levels of pSTAT3 and STAT3,and protein and mRNA levels of TNF-α,IFN-γ and IL-17 decreased in Stattic subgroup.In the BD-A group,the protein level of pSTAT3,and protein and mRNA levels of TNF-α,IFN-γ and IL-17 were significantly higher than those in the BD-R group.Conclusions An increased activation of the STAT3 pathway may contribute to the pathogenesis of BD and relate to disease activity in BD patients by inducing TH1 and Th17 cells activation.
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Objective To compare the contents of hospital information disclosure in China and the United States, and provide reference to improve hospital information disclosure in China. Methods Systematic collection was made for hospital information disclosure data from government documentation, statistical yearbooks, and hospital website portals like Hospital Compare of the United States and China. By means of inductive method and comparative analysis, hospital's medical services that were openly and freely accessible to the public of the two countries were studied in terms of structural indexes, medical quality indexes and patient experience assessment. Results The disclosed structure indexes of the US were abundant and distinctive. Its disclosed medical service quality indexes include such four diseases as myocardial infarction, cardiac failure, pneumonia and childhood asthma, as well as classification indexes under surgery infection prevention, comprising ten core process indexes and nine outcome indexes. In addition, the US also discloses patient experience survey results of ten aspects. Given the rich hospital information structure openly accessible in China, there lacks medical service quality information for disclosure. The only information directly comparable was the ranking of hospitals and specialties, instead of patient experience results. Conclusions China can learn from the experiences of American hospital information disclosure, establish an easy-to-understand and comparable index system; enrich the disclosure content, and build an authoritative and unified disclosure platform.
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Objective To investigate the efficacy of acupoint selection at distant places and local tenderness points in treating migraine without aura.Method Sixty patients were randomly allocated, using a random number table, to two groups, 30 cases each. The treatment group received acupuncture at distant points selected along meridians and local tenderness points and the control group, acupuncture at conventionally selected points. The therapeutic effects were evaluated using the visual analogue scale (VAS) and the short-form McGill Pain Questionnaire (SF-MPQ).Result After treatment, the VAS pain score was lower in the treatment group than in the control group; there was a statistically significant difference (P<0.05). The total efficacy rate was 93.3% in the treatment group and 73.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Both acupuncture at distant points selected along meridians and local tenderness points and acupuncture at conventionally selected points have a certain therapeutic effect on migraine, but the former produces a better effect than the later and can markedly relieve the pain and improve the quality of life in the patients. The outcome of this study provides a certain reference value for clinical treatment of this disease.
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Through the literature combing the interest groups of hospital information disclosure in the United States, the demand and practice of the main interest groups are analyzed. This paper uses policy maker4. 0 software to further analyze the interests of various interest groups, power and the degree of influence by the policy of hospital information disclosure. The results showed that interest groups involved in hospital information disclosure in the Unit-ed States can be mainly divided into five categories:consumers, employers, health insurance companies, hospitals, and decision makers ( government) . In order to balance the cost-effectiveness of various insurance schemes, health insurance companies choose high-quality service providers to restrict poor-service providers and insurers, and hospi-tals need to use public information to manage and improve health care. In order to monitor and improve the quality of medical services, employers need to weigh various insurance plans, health insurance companies have to measure the service quality of themselves and competitors, and hospitals need to manage and improve the medical quality and in-crease market share. As the largest stake in the hospital information disclosure, the results show that the consumer's position on the hospital information disclosure is low support. From the consumer as a main, although the hospital in-formation disclosure practices but the right to speak and other small powers have a limited participation. Analyzing the of the interest groups of hospital information disclosure in the United States, they all push forward the hospital infor-mation disclosure work to provide evidence to support.
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Objective To observe the protective effect and mechanism of 2,3,5,4 '-tetrahydroxystilbene-2-O-beta-D-glucoside ( THSG) on atherosclerosis in ApoE konck-out mice. Methods A total of 24 ApoE knock-out mice were randomly divided into normal control group (n=8), model control group (HFD, high-fat diet, n=8) and treated group (THSG, 20 mg· kg-1, i. g. , n=8). The atherosclerosic plaque of aorta wall and aorta root were measured by oil red O staining;The expression of lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) in human umbilical vein endothelial cells (HUVEC) through C-reaction protein ( CRP) was studied by Western blotting. Results The atherosclerosis plaque in normal control group was not observed. The lipid accumulation decreased in the aorta and the plaque areas in the aortic sinus in THSG treated-group compared with model control group. Moreover, THSG down-regulated CRP-induced LOX-1 expression in HUVEC. Conclusion The atheroscletosis plaque in ApoE knock-out mice was decreased by THSG. The mechanism might be related to the inhibition of the expression of LOX-1 protein.
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Objective To summarize the domestic design for placebo acupuncture and the placebo effect and explore an ideal design for placebo acupuncture.Method Three large Chinese databases CNKI, Wan Fang and Vip were searched to systematically review the application of placebo acupuncture in randomized controlled trials published at home in recent 5 years (2011.01—2016.11).Results and conclusions A total of 48 articles were included according the inclusion and exclusion criteria. An analysis was made of the kinds of diseases for acupuncture study, the methods of designing placebo acupuncture, the effects of placebo acupuncture and comparisons with foreign placebo acupuncture. Pain syndrome and insomnia were the main kinds of diseases for acupuncture study, accounting for 10 and 8 articles respectively. Acupuncture needles were the main kind of needles for placebo acupuncture, accounting for 66.6%. Sites beside acupoints were the main positions selected for placebo acupuncture, accounting for 58.3%. Not penetrating the skin predominated in the depth of needle insertion, accounting for 37.5%. The kinds of needles for placebo acupuncture were fewer than abroad. The effects of placebo acupuncture were not superior to those of acupuncture.
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Objective To summarize the domestic design for placebo acupuncture and the placebo effect and explore an ideal design for placebo acupuncture.Method Three large Chinese databases CNKI, Wan Fang and Vip were searched to systematically review the application of placebo acupuncture in randomized controlled trials published at home in recent 5 years (2011.01—2016.11).Results and conclusions A total of 48 articles were included according the inclusion and exclusion criteria. An analysis was made of the kinds of diseases for acupuncture study, the methods of designing placebo acupuncture, the effects of placebo acupuncture and comparisons with foreign placebo acupuncture. Pain syndrome and insomnia were the main kinds of diseases for acupuncture study, accounting for 10 and 8 articles respectively. Acupuncture needles were the main kind of needles for placebo acupuncture, accounting for 66.6%. Sites beside acupoints were the main positions selected for placebo acupuncture, accounting for 58.3%. Not penetrating the skin predominated in the depth of needle insertion, accounting for 37.5%. The kinds of needles for placebo acupuncture were fewer than abroad. The effects of placebo acupuncture were not superior to those of acupuncture.
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Objective To study the auditory perception and speech ability outcomes after cochlear implantation in prelingually deaf children with extremely severe neurosensory hearing loss and comorbid leukoencephalopathy.Methods Our study included 14 prelingually deaf children with leukoencephalopathy (confirmed by preoperative MRI scanning) who were treated with cochlear implantation in the Department of Otorhinolaryngology Head and Neck Surgery of Hainan Provincial People''s Hospital, including 8 males and 6 females of 1~6 yr with a mean age of 3.8 yr.Sixteen synchronous prelingually deaf children without central nervous system (CNS) diseases were also included as the control group, including 11 males and 5 females of 1~6 yr with a mean age of 4.4 yr.All the patients underwent pre-surgical assessments of audiology, radiology, speech ability and intelligence before cochlear implantation via transmastoid facial nerve recess approach was done, after which rehabilitation was provided at the Hainan Rehabilitation Center for Deaf Children.Categories of auditory performance (CAP) and speech intelligibility rate (SIR) were employed as the assessment criteria for the outcome of surgery, the scores of which at different timepoints after surgery were statistically compared through paired t-test between the two groups.Results All the patients gained post-surgical hearing and speech abilities to different degrees, whereas CAP and SIR scores both chronologically improved in the both groups.No statistical difference was revealed either in CAP or in SIR scores between the two groups at 6, 12 and 24 months after surgery (P>0.05).Conclusion Children with extremely severe neurosensory hearing loss can be reated with cochlear implantation even if they have comorbid leukoencephalopathy.The effects of auditory and speech rehabilitation for the same age patients with leukoencephalopathy are similar to those without leukoencephalopathy in 2 years after surgery.
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Objective To investigate the role of transcriptional-coactivator with PDZ-binding motif( TAZ) in genistein-induced osteoblastogenic differentiation of mouse bone marrow-derived mesenchymal stem cells ( BMSCs) .Methods Mouse BMSCs were cultured in phenol red-freeα-MEM containing osteogenic supplements for inducing osteogenic differentiation.BMSCs were transfected with siRNA-TAZ and treated with genistein.The temporal sequence of osteoblastic differentiation in BMSCs cultures was assayed by measuring alkaline phosphatase activity (ALP) and calcium deposition.The mRNA expression of bone sialoprotein ( BSP) and osteocalcin ( OC) were detected by reverse transcription-polymerase chain reaction(RT-PCR).The binding interaction between TAZ and cbfa1 was identified by co-immunoprecipitation.Results TAZ expression was detected during the induction of osteogenic differentiation, the ALP activity and calcium deposition were significantly decreased in BMSCs which were transfected with siRNA-TAZ.Genistein(0.01-1 μmol/L) exhibited a dose-dependent effect on TAZ expression in mouse BMSCs cultures.Treatment with genistein ( 1 μmol/L ) resulted in increased ALP avtivity and calcium deposition of BMSC cultures as function of time.Genistein(1μmol/L) also promoted the nuclear localization of TAZ and augmented the interaction between TAZ and cbfa1, and by which upregulated cbfa1-mediated gene expression such as BSP and OC.However, the ALP avtivity and calcium deposition, as well as the expression of BSP and OC were not promoted by genistein in BMSCs transfected with siRNA-TAZ.Conclusion These data suggest that the TAZ plays an important role in genistein-induced osteoblastic differentiation of mouse BMSCs cultures.