目的 探讨营销服务理论（8P）在体检信息系统建设中的应用与实践效果。 方法 借鉴8P理论与理念，以现代信息技术为手段,设计和构建以客户为中心的体检信息系统。 结果 体检信息系统的建立，优化了体检流程，提高了服务效率和报告质量，增加了客户满意度，取得良好的经济和社会效益，为健康体检工作的数字化、规范化管理奠定了良好的基础。 结论 加强体检中心的信息化系统建设，能全面提升中心的工作效率和服务质量,增强市场竞争力。
ObjectiveTo explore the preparation method, physical and chemical properties, and biocompatibility of a conductive composite scaffold based on polypyrrole/silk fibroin (PPy/SF) fiber with " shell-core” structure, and to provide a preliminary research basis for the application in the field of tissue engineered neuroscience.Methods The conductive fibers with " shell-core” structure were prepared by three-dimensional printing combined with in-situ polymerization. PPy/SF fiber-based conductive composite scaffolds were formed by electrospinning. In addition, core-free PPy conductive fibers and SF electrospinning fibers were prepared. The stability, biomechanics, electrical conductivity, degradation performance, and biological activity of each material were tested to analyze the comprehensive properties of fiber-based conductive composite scaffolds.ResultsCompared with pure core-free PPy conductive fibers and SF electrospinning fibers, the PPy/SF fiber-based conductive composite scaffolds with " shell-core” structure could better maintain the stability performance, enhance the mechanical stretchability of the composite scaffolds, maintain long-term electrical activity, and improve the anti-degradation performance. At the same time, PPy/SF conductive composite scaffolds were suitable for NIH3T3 cells attachment, conducive to cell proliferation, and had good biological activity.ConclusionPPy/SF fiber-based conductive composite scaffolds meet the needs of conductivity, stability, and biological activity of artificial nerve grafts, and provide a new idea for the development of a new generation of high-performance and multi-functional composite materials.
ObjectiveTo comparatively analyze for the fundus characteristics of acquired immune deficiency syndrome (AIDS) with cytomegalovirus retinitis (CMVR) between first-visit and non-first-visit in ophthalmology.MethodsA retrospective study was performed for 22 patients (41 eyes) diagnosed as CMVR with AIDS by ophthalmology in the Affiliated Municipal Hospital of Xuzhou Medical University from July 2004 to September 2017. The patients were divided into two groups: one with the first-visit in ophthalmology (FVO) and the other with the first-visit in non-ophthalmology (FVNO). All patients underwent visual acuity, intraocular pressure, slit lamp microscope and indirect ophthalmoscope examinations. Thirty-nine eyes of 21 patients with clear refractive media were examined by color fundus photography, of which 5 patients were examined by FFA. Five patients examined by OCT and B-mode ultrasound. The CMVR were characterized as fulminant type or indolent type. All the 22 patients (41 eyes) except 2 patients (4 eyes) accepted highly active antiroviral therapy, and all patients were treated with ganciclovir intravenously. Nine patients (12 eyes) received intravitreal injection of ganciclovir, 7 patients (10 eyes) underwent vitrectomy because of retinal detachment, 6 patients (7 eyes) gave up surgery because of extensive retinal detachment, and the other 12 eyes did not undergo any eye surgery. All patients were followed for 6-58 months (average 23±39 months). The incidences and fundus characteristics of the patients with fulminant or indolent CMVR were compared and analyzed. Between the two groups, the difference of visual acuity and CD4+T cell count at the first vist and the last follow-up were analyzed by a t-test, and the macular involvement and spread of the two groups were compared by a chi-square test.ResultsFulminant CMVR showed dense yellow-white necrotic lesions along the great vessels with or without satellite lesions, while indolent CMVR showed sparse yellow-white granular lesions with a little bleeding. The concomitant signs included frost-like dendritic vascular sheath, retinal artery occlusion and optic disc edema. Fourteen eyes of 7 patients in FVO group were fulminant, including 2 patients (2 eyes) with retinal artery occlusion and 1 patient (two eyes) with optic disc edema. In FVNO group, there were 27 eyes of 15 patients, including 21 eyes of 13 cases identified as fulminant type and 6 eyes of 4 patients as indolent type. In the fulminant type, there were 4 patients (6 eyes) with frost-like dendritic vascular sheath, 10 patients (12 eyes) with retinal artery occlusion and 4 patients (4 eyes) with optic disc edema. There was no significant difference in initial visual acuity (t=－1.534, P=0.133), but there was a significant difference in visual acuity at the last follow-up (t=－3.420, P=0.001). There was no significant difference in CD4+ T cells between the two groups at the first visit (t=－0.902, P=0.378). The proportions of macular involvement and 3-4 quadrant involvement in FVO group were significantly higher than those in FVNO group (χ2=7.552, 7.865; P=0.006, 0.005).ConclusionFor AIDS patients with CMVR, the first-visit in ophthalmology showed more dense necrotic lesions involving macular and a wider range of lesions than the first-visit in non-ophthalmology.
Objective Investigate zinc finger protein 36 (ZFP36) and zinc finger protein 36L1 (ZFP36L1) expression in peripheral blood of patients with chronic obstructive pulmonary disease (COPD). Methods Peripheral blood samples were collected from 42 individuals with acute exacerbation of COPD (AECOPD), 21 with stable COPD, and 18 healthy participants. The levels of ZFP36 and ZFP36L1 proteins and mRNA expressions were evaluated using ELISA and qPCR techniques. Difference in expression levels among the three groups was examined. Spearman analysis and receiver operating characteristic (ROC) curve were carried out for assessment of diagnostic and predictive value of FP36 and ZFP36L1 for COPD and AECOPD. Results Compared with the healthy group, ZFP36L1 protein expression was downregulated in the COPD stable group. ZFP36 protein expression was downregulated in the AECOPD group compared with the COPD stable group. Similar differences were observed in mRNA expression levels. ZFP36 and ZFP36L1 levels were negatively correlated with inflammatory markers. ZFP36 levels were positively correlated with ZFP36L1 and lung function, and negatively correlated with smoking index, modified Medical Research Council score, occurrence of respiratory failure during hospitalization, exacerbation frequency within 3 months, and total hospitalizations. The area under the curve (AUC) for diagnosing AECOPD using ZFP36 was 0.980, with sensitivity of 95.2% and specificity of 90.5%. When combined with FEV1%pred, the AUC improved to 0.985, with sensitivity of 92.9% and specificity of 100%. For predicting post-discharge exacerbations in AECOPD when combined with neutrophil-to-lymphocyte ratio (NLR), sensitivity of ZFP36 alone was 66.7% and specificity was 88.9%. The AUCs for diagnosing COPD using ZFP36, ZFP36L1, and interleukin-8 (IL-8) were 0.889, 0.989, and 0.981, respectively. The sensitivities were 61.9%, 90.5%, and 95.2%, and specificities were 100%, 100%, and 94.4%, respectively. Conclusions Peripheral blood ZFP36 has good diagnostic value for AECOPD. Combined with FEV1%pred, it can further increase diagnostic value. As a predictive indicator for frequent exacerbations within 3 months of discharge in COPD patients, its predictive sensitivity and specificity are superior to inflammatory markers such as NLR. ZFP36 exhibits anti-inflammatory effects in AECOPD. Peripheral blood ZFP36L1 has good diagnostic value for COPD.