[Exploration and Application of ESB High-availability Architecture Construction Based on Hospital Information System].

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.

Local Hyperthermia Versus Cryotherapy for Treatment of Plantar Warts: A Prospective Multi-centre Non-randomized Concurrent Controlled Clinical Trial.

Cryotherapy is one of the most common treatments for warts; however, pain during treatment and relatively high recurrence rates limit its use. Local hyperthermia has also been used successfully in the treatment of plantar warts. The aim of this study was to compare the clinical effectiveness of local hyperthermia vs cryotherapy for the treatment of plantar warts. This multi- centre, open, 2-arm, non-randomized concurrent controlled trial included 1,027 patients, who received either cryotherapy or local hyperthermia treatment. Three months after treatment, local hyperthermia and cryotherapy achieved complete clearance rates of 50.9% and 54.3%, respectively. Recurrence rates were 0.8% and 12%, respectively. Pain scores during local hyperthermia were significantly lower than for cryotherapy. Both local hyperthermia and cryotherapy demonstrated similar efficacy for clearance of plantar warts; while local hyperthermia had a lower recurrence rate and lower pain sensation during treatment.

The Effect of Vertebral Augmentation Procedure on Painful OVCFs: A Meta-Analysis of Randomized Controlled Trials.

STUDY DESIGN: Meta-analysis. OBJECTIVE: To systematically compare the effectiveness and safety of vertebral augmentation procedure (VAP) with non-surgical management (NSM) for the treatment of osteoporotic vertebrate compression fractures (OVCFs). METHODS: Systematic reviews and meta-analyses with the comparison between VAP and NSM were identified to extract randomized controlled trials from electronic database. Additionally, recently published RCTs were identified. Two researchers independently extracted the data. The primary outcome of this meta-analysis was pain relief evaluated by visual analogue scale (VAS). RESULTS: Twenty RCTs involving 2566 patients with painful OVCFs were included. Significant differences were found between percutaneous vertebroplasty (PVP) and conservative treatment (CT) in VAS at each time point during follow-up period. The differences of VAS were not significant between PVP and sham procedure at most time points during follow-up period. In subgroup analysis based on fracture type and fracture location, significant differences of VAS were found between PVP and CT and were not found between PVP and sham procedure. In subgroup analysis of duration of back pain, significant differences were found between PVP and CT in VAS at 1 week, 3 month and 1 year. And the differences of VAS were not significant between PVP and CT at 1 month and 6 month. CONCLUSION: BKP is considered sufficient to achieve good clinical outcomes. PVP is associated with on beneficial effect on treatment of painful OVCFs compared with sham procedure. The indication and timing of VAP need further research. More independently high-quality RCTs with sufficiently large sample sizes reporting cost-effectiveness are needed.

Serum Detection of Anti-thyroid Peroxidase and Anti-thyroglobulin Antibodies in Chinese Patients With Pemphigus Vulgaris and Pemphigus Foliaceus and Literature Review.

Background: Pemphigus is a rare but life-threatening autoimmune skin disease characterized by blistering on skin and/or mucous membranes. The physiological process of blister formation involves IgG antibodies against the desmogleins (Dsgs) and desmocollins (Dscs). Additional autoAbs have also been suggested to mediate the disease heterogeneity, such as anti-thyroid peroxidase (anti-TPO) and antithyroglobulin (anti-Tg) antibodies, the essential culprits of the immune system in autoimmune thyroid diseases. Purpose: To investigate the levels and antibody positivity of anti-TPO and anti-Tg antibodies in pemphigus patients. Methods: Antibody positivity and levels of anti-TPO and anti-Tg antibodies in pemphigus patients as compared to healthy controls were examined. A meta-analysis was conducted by reviewing six similar studies. Results: 98 Chinese pemphigus patients and 65 healthy controls were enrolled in the study. Our meta-analysis revealed a significant correlation between increased presence of positive anti-TPO and anti-Tg antibodies and pemphigus, particularly for pemphigus vulgaris (PV). Such correlation was also observed in our own hospitalized PV patients, but not in pemphigus foliaceus (PF) patients. In addition, the status of anti-TPO and anti-Tg antibodies were also compared between females and males within PV patients, PF patients or controls, as well as compared for females or males between pemphigus patients and controls. In the analysis of T cell counts, we found abnormal low CD3 + T cell counts (< 690 n/µl) were only detected in patients whose thyroid antibody levels were less than 20 IU/ml. Conclusion: Pemphigus patients showed higher levels and antibody positivity of anti-TPO and anti-Tg antibodies than healthy controls. Further investigations are needed to identify the pathogenic functions of these antibodies in pemphigus, as well as to identify the potential shared susceptibility genes.

Sonoelastography for differential diagnosis between malignant and benign parotid lesions: a meta-analysis.

OBJECTIVES: To assess the performance of sonoelastography for differential diagnosis between malignant and benign parotid lesions using a meta-analysis. METHODS: An independent literature search of English medical databases, such as PubMed, Embase and Medline ( Embase.com ), Web of Science, Cochrane Library and Ovid was performed. The diagnostic accuracy of sonoelastography was compared with that of histopathology and/or cytology, which was used as reference standard. The pooled sensitivity, specificity, diagnostic odds ratio (DOR) and area under the curve (AUC) were calculated to evaluate the accuracy of sonoelastography. A meta-regression analysis evaluating imaging mechanisms, shear wave elastography techniques, assessment methods and QUADAS scores was performed. RESULTS: Ten eligible studies that included a total sample of 711 patients with 725 parotid lesions were included. Sonoelastography showed a pooled sensitivity of 0.67 (95% CI 0.59-0.74), specificity of 0.64 (95% CI 0.60-0.68), DOR of 8.00 (95% CI 2.96-21.63) and an AUC of 0.77. The results of the meta-regression analysis revealed that no heterogeneity was due to the imaging mechanism (p = 0.119), shear wave elastography technique (p = 0.473) or QUADAS score (p = 0.462). However, the assessment method was a significant factor that affected the study heterogeneity (p = 0.035). According to the subgroup analysis, quantitative and semiquantitative methods performed better than qualitative ones. CONCLUSION: Overall, sonoelastography has a limited value for differential diagnosis between malignant and benign parotid lesions. Quantitative and semiquantitative methods perform better than qualitative ones. KEY POINTS: • Overall, sonoelastography has a limited value for differential diagnosis between malignant and benign parotid lesions. • Quantitative and semiquantitative assessment methods perform better than qualitative ones. • Semiquantitative and quantitative methods are automatically calculated by an ultrasound machine and are thus less operator-dependent.

Accuracy of shear wave elastography for the diagnosis of prostate cancer: A meta-analysis.

Many studies have established the high diagnostic accuracy of shear wave elastography (SWE) for the detection of prostate cancer (PCa); however, its utility remains a subject of debate. This meta-analysis sought to appraise the overall accuracy of SWE for the detection of PCa. A literature search of the PubMed, Embase, Cochrane Library, Web of Science and CNKI (China National Knowledge Infrastructure) databases was conducted. In all of the included studies, the diagnostic accuracy of SWE was compared with that of histopathology, which was used as a standard. Data were pooled, and the sensitivity, specificity, area under the curve (AUC), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated to estimate the accuracy of SWE. The pooled sensitivity and specificity for the diagnosis of PCa by SWE were 0.844 (95% confidence interval: 0.696-0.927) and 0.860 (0.792-0.908), respectively. The AUC was 0.91 (0.89-0.94), the PLR was 6.017 (3.674-9.853), and the NLR was 0.182 (0.085-0.389). The DOR was 33.069 (10.222-106.982). Thus, SWE exhibited high accuracy for the detection of PCa using histopathology as a diagnostic standard. Moreover, SWE may reduce the number of core biopsies needed.

Bioinformatics analysis of the proteins interacting with LASP-1 and their association with HBV-related hepatocellular carcinoma.

LIM and SH3 domain protein (LASP-1) is responsible for the development of several types of human cancers via the interaction with other proteins; however, the precise biological functions of proteins interacting with LASP-1 are not fully clarified. Although the role of LASP-1 in hepatocarcinogenesis has been reported, the implication of LASP-1 interactors in HBV-related hepatocellular carcinoma (HCC) is not clearly evaluated. We obtained information regarding LASP-1 interactors from public databases and published studies. Via bioinformatics analysis, we found that LASP-1 interactors were related to distinct molecular functions and associated with various biological processes. Through an integrated network analysis of the interaction and pathways of LASP-1 interactors, cross-talk between different proteins and associated pathways was found. In addition, LASP-1 and several its interactors are significantly altered in HBV-related HCC through microarray analysis and could form a complex co-expression network. In the disease, LASP-1 and its interactors were further predicted to be regulated by a complex interaction network composed of different transcription factors. Besides, numerous LASP-1 interactors were associated with various clinical factors and related to the survival and recurrence of HBV-related HCC. Taken together, these results could help enrich our understanding of LASP-1 interactors and their relationships with HBV-related HCC.

HSPB1 deficiency sensitizes melanoma cells to hyperthermia induced cell death.

Hyperthermia has shown clinical potency as a single agent or as adjuvant to other therapies in cancer treatment. However, thermotolerance induced by thermosensitive genes such as the heat shock proteins can limit the efficacy of hyperthermic treatment. In the present study, we identified HSPB1 (HSP27) is hyperthermically inducible or endogenously highly expressed in both murine and human melanoma cell lines. We used a siRNA strategy to reduce HSPB1 levels and showed increased intolerance to hyperthermia via reduced cell viability and/or proliferation of cells. In the investigation of underlying mechanisms, we found knock down of HSPB1 further increased the proportion of apoptotic cells in hyperthermic treated melanoma cells when compared with either single agent alone, and both agents leaded to cell cycle arrest at G0/G1 or G2/M phases. We concluded that hyperthermia combined with silencing of HSPB1 enhanced cell death and resulted in failure to thrive in melanoma cell lines, implying the potential clinical utility of hyperthermia in combination with HSPB1 inhibition in cancer treatment.

[Meta-analysis on the relationship between 25-hydroxyvitamin D level and hypertension].

OBJECTIVE: To explore the association between 25-hydroxyvitamin D level and hypertension so as to provide rationales for developing preventive strategies and understanding the etiology of hypertension. METHODS: The articles on the association of 25-hydroxyvitamin D level and hypertension were retrieved by searching international and national databases from 2000 to 2011. The relationship between 25-hydroxyvitamin D level and hypertension was assessed by Meta-analysis with Stata11.0 software. RESULTS: The results of Meta analysis showed that the pooled OR values of hypertension with 25-hydroxyvitamin D level deficiency and sufficiency was 1.37 (95%CI 1.23 - 1.53). Subgroup analysis revealed in 25-hydroxyvitamin D level, can be drawn between 25-hydroxyvitamin D level and the incidence of hypertension was statistically significant. The pooled OR values of hypertension with 25-hydroxyvitamin D level in 35 nmol/L and 35 - 68 nmol/L were 2.02 (95%CI 1.49 - 2.74) and 1.23 (95%CI 1.02 - 1.49) (P < 0.05). CONCLUSIONS: The 25-hydroxyvitamin D level is associated with hypertension. With regards to the question of whether or not the 25-hydroxyvitamin D level deficiency serves as one of the potential risk factor for hypertension, prospective studies of larger sample sizes are warranted.

[Meta analysis on the relationship between subclinical hypothyroidism and the levels of systolic blood pressure].

OBJECTIVE: To investigate the association between subclinical hypothyroidism and levels of systolic blood pressure (SBP), so as to provide evidence for the development of prevention strategy and understanding the etiology of hypertension. METHODS: The articles on the association of subclinical hypothyroidism and systolic blood pressure levels were retrieved by searching international and national databases from 1999 to 2010. The relationship between subclinical hypothyroidism and systolic blood pressure levels was assessed by meta analysis with Stata 11 software. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated, and the publication bias was assessed by Begg's test and Egger's test. RESULTS: (1) There was significant difference in SBP levels between patients with subclinical hypothyroidism and normal subjects (WMD=2.04 mm Hg, 95%CI: 0.64 to 3.45, P<0.05). (2) Subgroup analysis indicated that there was significant difference seen in thyroid stimulating hormone (TSH) mean difference values <7 mU/L group (WMD=2.33 mm Hg, 95%CI: 0.60 to 4.06, P<0.05) but not in the group that TSH mean difference values were >7 mU/L. There was significant difference seen in the Asian group (WMD=2.62 mm Hg, 95%CI: 1.69 to 3.55, P<0.05) in the community group (WMD=2.77 mm Hg, 95%CI: 1.61 to 3.93, P<0.05) but not in the European group and or in the hospital group. There was significant difference in the cross-sectional group (WMD=2.77 mm Hg, 95%CI: 1.61 to 3.93, P<0.05), but not in the case-control group. (3) Results from both Begg's test and Egger's test did not show significant difference, indicating that there was no publication bias existed. CONCLUSION: Subclinical hypothyroidism was associated with the elevated systolic blood pressure. In terms of the role of subclinical hypothyroidism that might serve as one of the potential risk factor for the elevated systolic blood pressure. Well designed and large sample-sized prospective studies were necessary to confirm the association between subclinical hypothyroidism and systolic blood pressure. Random controlled trials were also needed to study whether the treatment could lower the risk. Active treatment for subclinical hypothyroidism might be useful for prevention and treatment of hypertension.

[The characteristics of nuclear/cytoplasmic genomes of asymmetric somatic hybrid of Daucus carota var. sativa and Swertia mussotii].

Protoplasts of Swertia mussotii irradiated by ultra-violet light (UV) 260 microW/cm(2) were fused with protoplasts of Daucus carota var. sativa using the PEG method. Analysis of 5S rDNA spacer sequences and random amplified polymorphic DNA (RAPD) showed the presence and combination of nuclear DNA from both parents. All hybrids mainly contained genomes of D. carota (receptor) RAPD bands, and a few donor RAPD bands of S. mussotii. There is no obvious relationship between the nuclear DNA composition was not affected by UV-dosage. SSR analysis of chloroplast DNA of the hybrid clones further revealed that cpDNAs of the parents were integrated and recombined in the hybrids randomly.