Implementation and evaluation of a multifunctional telemedicine system in NTUH

In this article, we proposed a multifunctional telemedicine system supporting both telediagnosis and teleconsultation services. We attempted not only to insure that the implementation of this system satisfied most requirements, but also to evaluate the impact of the system. With regard to system architecture, we designed a unified multimedia database to store all types of data and used two kinds of network (ATM and ISDN) for different possible applications. As for data transmission, the REFRESH and PREFETCH mechanisms were implemented to enhance data transfer efficiency. A total of 1107 consultations employing the telemedicine system were performed during the past 3 years. This technology was used most frequently for radiology consultation (32.7%, n = 362) and ultrasonic examination (19.5%, n = 216). An evaluation of the impact on diagnosis (507 valid cases) indicated that the diagnosis in 80 cases (15.78%) were altered on the basis of second opinions from a medical center; and the number of patients transferred to the medical center was reduced from 24 (4.7%) to eight cases. Most of the rural-site physicians (97%) thought that they did benefit from specialists' experience and knowledge via the telemedicine system. Based on 431 valid questionnaires, the number of the patients with confidence in the telemedicine system at their local healthcare center increased from 72.6% to 87.5%. Overall, more than 90% of patients and physicians believed that the system was valuable and provided satisfactory services.     

人白细胞介素13cDNA的克隆及序列测定

用反转录－多聚酶链反应（ＲＴ－ＰＣＲ）技术从中国人外周血淋巴细胞中克隆了ＩＬ－１３ｃＤＮＡ，序列测定表明克隆的ＩＬ－１３ｃＤＮＡ含成熟的ＩＬ－１３蛋白全部编码，且存在编码第９８位Ｇｌｎ的密码子ＣＡＧ，这为进一步表达ＩＬ－１３并深入探究功能奠定了基础。     

X-box binding protein 1 (XBP1) C--116G polymorphisms in bipolar disorders and age of onset

X-box binding protein 1 (XBP1), a critical gene in the endoplasmic reticulum stress response, is located on chromosome 22q12, which has been linked with bipolar disorders in several studies. Recently, associations have been reported between a polymorphism (-116C --> G) in the promoter region of XBP1, and bipolar disorders in both case-control study and family-based association study, however, this finding is not yet confirmed by other research using independent sample populations. To replicate this finding and determine the association between onset age of bipolar disorders and the XBP1 C--116G polymorphism, we investigated the prevalence of this polymorphism in a Chinese population (153 bipolar disorder patients and 174 controls). We were unable, however, to demonstrate a significant association between the C--116G polymorphism and bipolar disorders (P = 0.674 for genotype and P = 0.436 for allele frequency) or age at onset (P = 0.563). Further, no association was demonstrated between this polymorphism and family history in bipolar disorder patients. These negative findings suggest that the XBP1 C--116G polymorphism does not play a major role in the pathogenesis of bipolar disorders in Chinese populations.     

利益传导视角下医疗服务价格改革对医务人员薪酬水平的影响*

目的：医疗服务价格改革对完善医疗服务合理定价,合理体现医务人员劳务价值,提高医务人员薪酬水平具有重要意义。方法：基于利益传导的视角,以医务人员劳务价值的体现为中介,采用定量研究方法,实证检验医疗服务价格对医务人员薪酬水平的影响。结果：医疗费用规模对医务人员薪酬水平有着显著的正向影响,但在门诊医疗和住院医疗二者间存在异质性,主要体现在劳务价值在医疗费用中的差异方面。结论：应持续深化医疗服务价格改革,提高医务人员薪酬水平。     

Foxtail Millet Improves Blood Glucose Metabolism in Diabetic Rats through PI3K/AKT and NF-κB Signaling Pathways Mediated by Gut Microbiota

Foxtail millet (FM) is receiving ongoing increased attention due to its beneficial health effects, including the hypoglycemic effect. However, the underlying mechanisms of the hypoglycemic effect have been underexplored. In the present study, the hypoglycemic effect of FM supplementation was confirmed again in high-fat diet and streptozotocin-induced diabetic rats with significantly decreased fasting glucose (FG), glycated serum protein, and areas under the glucose tolerance test (p < 0.05). We employed 16S rRNA and liver RNA sequencing technologies to identify the target gut microbes and signaling pathways involved in the hypoglycemic effect of FM supplementation. The results showed that FM supplementation significantly increased the relative abundance of Lactobacillus and Ruminococcus_2, which were significantly negatively correlated with FG and 2-h glucose. FM supplementation significantly reversed the trends of gene expression in diabetic rats. Specifically, FM supplementation inhibited gluconeogenesis, stimulated glycolysis, and restored fatty acid synthesis through activation of the PI3K/AKT signaling pathway. FM also reduced inflammation through inhibition of the NF-κB signaling pathway. Spearman’s correlation analysis indicated a complicated set of interdependencies among the gut microbiota, signaling pathways, and metabolic parameters. Collectively, the above results suggest that the hypoglycemic effect of FM was at least partially mediated by the increased relative abundance of Lactobacillus, activation of the PI3K/AKT signaling pathway, and inhibition of the NF-κB signaling pathway.     

Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: Cross-sectional Study in New York State at Census Tract Level

BackgroundOpioid overdose-related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP) and opioid use disorder (OUD).ObjectiveWe aimed to discover geospatial patterns in nonmedical opioid use and its correlations with demographic features related to despair and economic hardship, most notably the US presidential voting patterns in 2016 at census tract level in New York State.MethodsThis cross-sectional analysis used data from New York Statewide Planning and Research Cooperative System claims data and the presidential voting results of 2016 in New York State from the Harvard Election Data Archive. We included 63,958 patients who had at least one OUD diagnosis between 2010 and 2016 and 36,004 patients with at least one OP diagnosis between 2012 and 2016. Geospatial mappings were created to compare areas of New York in OUD rates and presidential voting patterns. A multiple regression model examines the extent that certain factors explain OUD rate variation.ResultsSeveral areas shared similar patterns of OUD rates and Republican vote: census tracts in western New York, central New York, and Suffolk County. The correlation between OUD rates and the Republican vote was .38 (P<.001). The regression model with census tract level of demographic and socioeconomic factors explains 30% of the variance in OUD rates, with disability and Republican vote as the most significant predictors.ConclusionsAt the census tract level, OUD rates were positively correlated with Republican support in the 2016 presidential election, disability, unemployment, and unmarried status. Socioeconomic and demographic despair-related features explain a large portion of the association between the Republican vote and OUD. Together, these findings underscore the importance of socioeconomic interventions in combating the opioid epidemic.     

藿香正气片增强镇静催眠药的镇静与催眠作用的研究

目的研究藿香正气片增强镇静催眠药对小鼠的镇静催眠作用.为临床增添了一个中西药结合的镇静催眠合剂提供药理依据.方法应用抖笼换能器法观察藿香正气片对小鼠的自发活动的影响.由此观察藿香正气片与镇静催眠药的协同作用.测定藿香正气片与镇静催眠药对小鼠的入睡时间及睡眠持续时间的作用.两个实验均分成四组,生理水组、藿香正气片组、安定组、安定+藿香正气片组.结果1.对小鼠自发活动的影响.(1)藿香正气片组与生理盐水组比较,具有极显著性差异(P＜0.01).(2)安定组与安定+藿香正气片组比较具有显著性差异(P＜0.05).2.藿香正气片增强镇静催眠药对小鼠的睡眠作用.(1)藿香正气片组与生理盐水组比较具有显著性差异(P＜0.05).(2)藿香正气片+安定组与安定组比较具有极显著性差异(P＜0.01).结论藿香正气片与安定合用对镇静及催眠确有协同作用.     

晚期喉癌扩大喉次全切除胸骨舌骨肌及筋膜喉成形的研究（附19例报告）

目的：探讨治疗晚期喉癌（T4）并能重建喉功能的手术方法。方法：对19例晚期喉癌患者行扩大喉次全切除术,并用胸骨舌骨肌及筋膜行喉成形术。结果：术后13例恢复全部喉功能,6例恢复部分喉功能,1、3、5年生存率为89.47%,68.42%,47.37%。结论：部分T4患者是可以施行喉次全切除术的,用胸骨舌骨肌及筋膜行喉成形术效果好,成功率高。     

肝硬化患者幽门螺杆菌感染的差异性

观察肝硬变患者幽门螺杆菌感染的差异性及其对病情的影响.结果发现随着肝功能的减退,ChildA组,ChildB组,ChildC组HP的感染率逐步升高,CagA、VacA阳性率也逐步升高,ChildC与各组比较HP的感染率,CagA、VacA的阳性率均显著增高,差异有显著性(P<0.05),胃排空无差异(P>0.05).其余各组间比较无差异(P>0.05).提示肝硬变患者与对照组比较HP的感染率及其菌株无显著差异,胃的排空与HP的感染无关,肝脏功能状况与HP感染相关性有待进一步研究.     

血链球菌丙酮酸氧化酶基因表达克隆的构建与鉴定

目的 构建血链球菌丙酮酸氧化酶基因Sopox的表达质粒,为研究丙酮酸氧化酶基因Sopox表达的调节奠定基础。方法 将从血链球菌ATCC10557克隆的丙酮酸氧化酶基因Soopox重组到pBV220,表达载体,并转化入大肠杆菌E.coliJM105,观察Sopox基因在大肠杆菌中的表达。结果 通过酶切后电泳鉴定,Sopox基因重组入pBV220并转化入E.coliJM105;经42℃yte nf rg ,SDS-PAGE显示pBV220/Sopox/JM105表达分子量约为65kd的蛋白,与根据Sopox基因DNA序列预测的蛋白分子量一致;pBV220/Sopox/JM105的蛋白表达在42℃诱导4小时后达高峰。结论 丙酮酸氧化酶基因Sopox已被成功地克隆到pBV220/Sopox/JM105的蛋白表达在42℃诱导4小时后达高峰。结论 丙酮酸氧化酶基因Sopox已被成功地克隆到pBV220,并在E.coliJM105中表达。