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Objective:To analyze the usage intention and key issues of medical staff to use telemedicine, for improving telemedicine service system in China.Methods:From October to November 2019, medical workers of both the inviting party and invited party who experienced telemedicine in seven provinces of Fujian, Hainan, Henan, Hunan, Guizhou, Sichuan and Qinghai were selected for an online questionnaire survey. Areas covered included their usage intention, satisfaction and cognitive appraisal of telemedicine. Descriptive statistical analysis and non-parametric test were used to discuss the intention of further use, satisfaction and challenges of medical workers in various provinces and regions.Results:1 084 valid questionnaires were recovered. The data found the overall satisfaction was 98.62%, and the proportion of their intention of further use was 98.25%, and those from the eastern and western provinces presented higher intention of usage. The top challenges as reflected by these medical workers were named as follows: timeliness of consultation progress and information feedback; long latency time; low Internet speed, poor and interrupted Internet signal; inadequate system equipments and inconvenient operation; difficulties in remote physical checkup and overall understanding of patient conditions; as well as substandard, incomplete and poor medical records.Conclusions:These medical workers are satisfied with the telemedicine services and willing to continue to use telemedicine.For those existing problems, it is suggested to strengthen the infrastructure and optimize the process of telemedicine services, so as to encourage them in greater use of telemedicine.
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Objective To investigate the clinical significance of serum CEA , CA19-9, CA72-4, CA242, CA50, PGⅠand PGR ( PGⅠ/PGⅡ) in the Diagnosis of preoperative and postoperative gastric cancer.Methods Retrospective study.The levels of CEA , CA19-9, CA72-4, CA242, CA50, PGⅠand PGⅡin serum of 41 patients with gastric cancer preoperative and postoperative and 60 healthy people were detected by AutoLumo A2000 chemiluminescence immunoassay and compared.Statistical analysis was performed using Rank-sum test by SPSS 17.0.Results The median of CEA, CA19-9, CA72-4, CA242, CA50, PGI, PGII and PGR in postoperative gastric cancer group were 3.79 ng/ml, 17.85 U/ml, 3.50 U/ml, 14.52 U/ml, 17.62 U/ml, 32.81 ng/ml, 11.48 ng/ml, 3.35.The postoperative gastric cancer group were 1.67 ng/ml, 7.76 U ml, 1.73 U/ml, 6.30 U/ml, 7.57 U/ml, 20.56 ng/ml, 5.71 ng/ml, 2.94.The healthy group were 1.53 ng /ml, 7.59 U/ml, 1.47 U/ml, 6.08 U/ml, 5.68 U/ml, 90.86 ng/ml, 14.85 ng/ml, 6.67.There were statistical differences in the serum levels of CEA , CA19-9, CA72-4, CA242, CA50, PGⅠ, PGⅡand PGR among different groups (chi-squared values were 79.108, 20.678, 20.374, 7.252, 56.73, 131.212, 20.38, 86.37, P<0.05).By the Mann-Whitney rank sum test,the serum levels of CEA , CA19-9, CA72-4, CA242 and CA50 in patients with preoperative gastric cancer were significantly higher than those in healthy controls (Z values were -8.598, -4.425, -4.365, -2.000,-7.420, P<0.05).The level of postoperative group was significantly lower than that of preoperative group (Z value were -4.641, -2.383, -2.459, -2.399, -2.903, P<0.05).The serum PGⅠ, PGⅡand PGR levels in patients with preoperative gastric cancer were significantly lower than those in healthy controls (Z values were -10.309, -2.695, 8.637, P<0.05).The PGⅠlevel in the postoperative group was significantly lower than that in the preoperative group (Z value was -2.109, P<0.05).PGⅡ,PGR levels of postoperative group were lower than those of preoperative group , but the difference were not statistically significant.(Z values were -1.506,-0.838, P values were 0.132,0.402).Conclusion The detection of the seven serum markers can help to preoperative diagnosis and postoperative monitoring of gastric cancer .
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<p><b>OBJECTIVE</b>To investigate the characteristics of haemodynamically significant patent ductus arteriosus (hsPDA), and the indications of percutaneous transcatheter PDA occlusion.</p><p><b>METHOD</b>The data of a preterm infant admitted to West China Second Hospital in December. 2013, who finally underwent percutaneous transcatheter PDA occlusion were analyzed With the key words of"preterm"patent ductus arteriosus"transcatheter", Pubmed were searched and potentially relevant reports were retrieved and assessed by manual sorting from 2005 to 2015. Relevant reports in literature were reviewed.</p><p><b>RESULT</b>A preterm infnat at gestational age of 35 weeks with birth weight of 1 900 g was admitted to our department. Oral ibuprofen for closure of the patent ductus arteriosus failed, and the patient exhibited the features of"ventilator dependent"PDA of premature infants. On the 30th postnatal day, with the body weight of 1 950 g, under basal anesthesia, the infant underwent percutaneous transcatheter PDA occlusion, and the procedure successfully occluded the ductus with Amplatzer duct occluder (ADO). The ventilator was weaned 19 hours post procedure, and the child was discharged 7 days post operation with good recovery, and her growth and development was good. Follow-up for 13 months indicated that the intelligence and physical development evaluated by Bayley scales of infant development test were at the same level of normal age-matched infants. Fifty-two preterm infants treated with percutaneous transcatheter PDA occlusion in 8 reports were enrolled. The preterm infants were born at 23-35 gestational weeks, with PDA diameter of 1-4 mm. The occlusive device included coil, ADO, ADO Ⅱ, ADO Ⅱ AS, AVP Ⅱ and AVP Ⅳ respectively, with body weight of 870-2 610 g on operational days and age of 11-90 postnatal days. All those infants either failed or had contraindications to drug therapy, and exhibited as hsPDA cases. Percutaneous transcatheter PDA occlusions were performed successfully in all 52 cases, and there were no serious procedure-related complications.</p><p><b>CONCLUSION</b>Percutaneous transcatheter PDA occlusion in preterm infants is feasible and showed positive short-term and long-term effects, which provides an important alternative way for patients with the problem. The indications for transcatheter PDA occlusion include premature infants with hsPDA in whom drug therapy failed or is contraindicated.</p>
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Female , Humans , Infant , Infant, Newborn , Birth Weight , Body Weight , China , Ductus Arteriosus, Patent , General Surgery , Gestational Age , Ibuprofen , Therapeutic Uses , Infant, Premature , Septal Occluder DeviceABSTRACT
Objective To study the serum levels of progastrin-releasing peptide (pro-GRP) and neuron-specific enolase (NSE) for the clinical diagnosis,therapy monitoring and survival time analysis of small cell lung cancer (SCLC).Methods All 41 SCLC samples (30 males,11 females,age range from 46 to 78 years),95 NSCLC samples (55 males,40 females,age range from 42 to 88 years),and 127 normal individuals samples (80 males,47 females,age range from 35 to 78 years) which were diagnosed by People's Hospital of Zhengzhou from May 1,2008 to April 30,2011 were collected.Serum levels of pro-GRP,NSE and their changes in SCLC patients before and after therapy were evaluated.ANOVA analysis,randomized block design analysis of variance and the log-rank test were collected SPSS 16.0 to evaluate the survival time.Results The serum levels of pro-GRP (median 357.8 ng/L) and NSE (median 89.5 μg/L) in SCLC group were significantly higher than those in the NSCLC group (pro-GRP:39.9 ng/L;NSE:11.43 μg/L) and normal individuals group (pro-GRP:12.7 ng/L;NSE:10.03 μg/L) (P=0.000).The sensitivity of pro-GRP and NSE for the diagnosis of SCLC were 80.4% and 78.0%,while the specificity were 92% and 87%,respectively.There is a poor correlation between pro-GRP and NSE serum levels,but when combined the sensitivity can be 95% and specificity can be 85%.Significantly statistical difference of pro-GRP levels was observed in the different stages of treatment (before and after therapy) in SCLC-LD patients (F =3.53,P =0.038),and significant statistical difference of NSE levels was also observed in SCLC-ED patients in different stages (F =16.049,P =0.000).In partied response SCLC patients,the group with NSE level lower than cut-off value had longer survival time than the other group with NSE level higher than cut-off value (P =0.001).Conclusions The sensitivity of the combined analysis of pro-GRP and NSE is better than single marker for the diagnosis of SCLC.The serum level of pro-GRP has better correlation with therapeutic effect of SCLC-LD patient than NSE.The serum level of NSE are well correlated with therapeutic effect in SCLC-ED patients.There are some certain value of NSE level for evaluation the survival time of SCLC patients who were in partial response.
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Objective To observe the effect of inferior vena cava filter (IVCF) on prevention of bone cement implantation syndrome (BCIS). Methods Ten sheep were divided into 2 even groups, BCIS and LVCF intervention ones. First IVCF was implanted into the inferior vena cava through cervical vena-right atrium pathway under fluoroscopic monitoring to observe the influence of IVCF on BCIS. Then BCIS was es-tablished in the same sheep by compressing 10 mL of bone cement into a sheep medullary canal after mutilation of the left femur. Arterial blood pressure, heart rate, central venous pressure (CVP) and blood gas were monitored, while an ultrasonic device was utilized to monitor fat embolisms in the right atriums of the sheep. Oil red staining was performed to detect fat embolisms in pulmonary arteries after the sheep were executed. Results In BCIS group, dotted uneven resonances were found in the right atrium and right ventricle when the medullary canal pressure was increased to 120 mm Hg, indicating embolisms in the right chambers. The dotted resonances were increased to ponderous, snowflake-like ones as the medullary canal pressure climbed up. At the same time, blood pressure and Pa02 dropped significantly, the systolic blood pressure dropped to (80±11) mm Hg and PaO<.2> to the minimum 25 minutes after cone cement implantation. The heart rate and CVP increased continuously. The blood gas assay indicated respiratory and metabolic acidosis. The oil red staining showed bulk fat embolus in pulmonary arteries. But in IVCF group, the similar resonances were not observed throughout the surgery and the medullary canal pressure climbed to 400 mm Hg, reaching the maximum of our pressure gage range. The blood pressure, PaO2, heart rate and CVP did not change much compared to those before implantation. The blood gas and pulmonary oil red staining showed few changes either. Conclusion IVCF implantation can prevent the genesis of BCIS.
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Objective:To observe the effects of auto-dendritic cell vaccine on T cells of patients with condyloma acuminatum(CA) related human papilloma virus(HPV) and its clinical outcome.Methods:73 patients with condyloma acuminata(CA) in the present study were positive of HPV-DNA and have been unsuccessfully treated with freezing,laser,or electric therapy combined with interferon anti-virus treatment for half a year.The peripheral blood samples were harvested from patients and the monouclear cells were extracted to cultivate DCs in presence of cytokines.Auto DCs were sensitized with corresponding HPV virus antigen of a patient to prepare the auto-dendritic cell vaccine.Then the vaccine were cultivated with auto T-cells and the proliferation of T cells were examined.Meanwhile,the auto-DC vaccine(1-4)?107 was also injected into the patients' inguinal lymph glands and its therapeutic effectiveness was observed.Results:The prepared DC-vaccine significantly promoted the proliferation of auto T cells compared with control group(P