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Joe J.R.,University of Arizona | Young R.S.,University of Arizona | Knoki-Wilson U.,Community Relations Liaison for the Chinle Comprehensive Healthcare Facility | Dennison J.,Medicine Men
American Indian and Alaska Native Mental Health Research | Year: 2016

National concerns about reducing the persistent health disparities found among varying racial and ethnic populations have led to initiatives to improve health care delivery systems. Many of these initiatives also promote the cultural competence of health care providers as a way to meet unique patient needs that go beyond immediate health problems, and to account for other critical components of patient care, such as health literacy, health beliefs and behaviors, and cultural practices. This case study describes a patient-centered care model developed by the Chinle Comprehensive Health Care Facility on the Navajo Reservation in Arizona, a model that has added a cadre of traditional tribal practitioners as part of its hospital and other clinical service resources. © Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus.


Joe J.R.,University of Arizona | Young R.S.,University of Arizona | Knoki-Wilson U.,Community Relations Liaison for the Chinle Comprehensive Healthcare Facility | Dennison J.,Medicine Men
American Indian and Alaska Native Mental Health Research | Year: 2016

The growing national racial and ethnic diversity has created a greater need for health care delivery systems and health care providers to be more responsive to unique patient needs, that goes beyond meeting the immediate health problems to include attention to other critical component of patient care that take into account cultural competency such as health literacy, health beliefs and behaviors, cultural practices, etc. © Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus.


PubMed | China Japan Friendship Hospital, Peking Union Medical College, Harbin Medical University, Medicine Men and 4 more.
Type: Journal Article | Journal: Clinical rheumatology | Year: 2016

The aim of this study is to compare the three classification criteria for rheumatoid arthritis (RA) in a large cohort of early arthritis patients. Patients who had at least one clinically swollen joint with disease duration no more than 1year and age more than 18years were enrolled. The clinical and laboratory parameters were recorded. The patients were diagnosed by two experienced rheumatologists. Undiagnosed patients were followed up every 3months until 1year. The sensitivity, specificity, and predictive value were compared among the early RA (ERA) criteria, the 1987 ACR criteria, and the 2010 ACR/EULAR criteria in this inception cohort of early arthritis patients. A total of 417 patients with inflammatory arthritis were recruited. By the end of 1year follow-up, there were 399 patients (95.7%) with a definitive diagnosis and 18 (4.3%) patients remained as undifferentiated arthritis. Among the patients with definitive diagnosis, 202 (50.6%) patients were diagnosed with RA and 197 (49.4%) with non-RA. The sensitivity of ERA criteria was equal to 2010 ACR/EULAR criteria (both were 72.3%), but much higher than 1987 ACR criteria (72.3 vs. 39.1%, P<0.001); the specificity of ERA criteria was comparable to 2010 ACR/EULAR criteria (87.8 vs. 83.2%) and slightly lower than 1987 ACR criteria (87.8 vs. 92.4%, P<0.001). Unlike the complicated scoring system of 2010 criteria, the ERA criteria were more feasible to use in practice with five criteria only. The ERA criteria have a high sensitivity and more clinically feasibility in daily practice for early RA diagnosis.


Yu T.,Sun Yat Sen University | Zhao L.-N.,Sun Yat Sen University | Lan S.-Y.,Guangzhou University of Chinese Medicine | Fan M.-J.,Sun Yat Sen University | And 5 more authors.
BMC Cell Biology | Year: 2011

Background: Purifying stem cells is an inevitable process for further investigation and cell-therapy. Sorting side population (SP) cells is generally regarded as an effective method to enrich for progenitor cells. This study was to explore whether sorting SP could enrich for the Musashi1 (Msi1) positive cells from Msi1 high expression cells (Msi1 highcells) derived from mouse embryonic stem cells (ESCs) in vitro.Results: In this study, Msi1 highcell population derived from ESCs were stained by Hoechst 33342, and then the SP and non-SP (NSP) fractions were analyzed and sorted by fluorescence activated cell sorter. Subsequently, the expressions of Msi1 and other markers for neural and intestinal stem cells in SP and NSP were respectively detected. SP and NSP cells were hypodermically engrafted into the backs of NOD/SCID mice to form grafts. The developments of neural and intestinal epithelial cells in these grafts were investigated. SP fraction was identified and isolated from Msi1 highcell population. The expression of Msi1 in SP fraction was significantly higher than that in NSP fraction and unsorted Msi1 highcells (P< 0.05). Furthermore, the markers for neural cells and intestinal epithelial cells were more highly expressed in the grafts from SP fraction than those from NSP fraction (P< 0.05).Conclusions: SP fraction, isolated from Msi1 highcells, contains almost all the Msi1-positive cells and has the potential to differentiate into neural and intestinal epithelial cells in vivo. Sorting SP fraction could be a convenient and practical method to enrich for Msi1-positive cells from the differentiated cell population derived from ESCs. © 2011 Yu et al; licensee BioMed Central Ltd.


PubMed | Wenzhou University and Medicine Men
Type: Journal Article | Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association | Year: 2015

The aim of the present study was to investigate changes in the expression of CD163 and hemoglobin oxygenase-1 (HO-1) in brain tissue surrounding hematomas after intracerebral hemorrhage (ICH), and correlations with other factors.Brain tissues in the close surrounding of ICH hematomas (n = 27, ICH group) were collected at 6 hours or less, 6-24 hours, 24-72 hours, and more than 72 hours after bleeding onset, and more distant tissues (n = 12, control group) were histologically analyzed with hematoxylin and eosin staining and transmission electron microscopy. Interleukin (IL)-1, IL-10, and tumor necrosis factor-alpha, as well as the expression of CD163 and HO-1, were assessed using immunochemistry, Western blotting, and reverse transcription-polymerase chain reaction. Apoptosis rates were determined with terminal deoxynucleotidyl transferase dUTP nick end labeling assays.The expressions of the inflammatory cytokines IL-1 and tumor necrosis factor-alpha were increased at 6-24 hours (P <.05), reached a peak at 24-72 hours (P <.001 and P <.01), at which time histopathological changes became most obvious and apoptosis rates were highest, but diminished for more than 72 hours after ICH onset. The anti-inflammatory cytokine IL-10 peaked at 6-24 hours (P <.01) after ICH onset but dropped in the following periods to lower levels than the control (P <.05). CD163 and HO-1 expressions gradually increased from 6 to 24 hours to peaks at more than 72 hours after ICH onset (P <.001).The highest inflammation level in tissues surrounding ICH hematomas occurred 2-3 days after bleeding onset, but was accompanied by an anti-inflammatory factor IL-10 expression enhancement. In the period of more than 72 hours after ICH onset, CD163 and HO-1 expressions reached peaks and inflammatory cytokine expressions dropped.


Jin C.,Chinese Academy of Sciences | Zhou X.,Medicine Men | Pang R.,Chinese Academy of Sciences
Acupuncture in Medicine | Year: 2015

Background Placebo and sham acupuncture are common control strategies in acupuncture studies. However, the perception and practice of these approaches in acupuncturists are poorly documented. Objective To investigate knowledge of, attitude towards and practice of sham and/or placebo acupuncture among Chinese acupuncturists. Method A cross-sectional survey conducted in six different tertiary care hospitals of traditional Chinese medicine in Beijing, China. A total of 92 licensed acupuncturists were asked to complete a predesigned and structured questionnaire on-site. Results A response rate of 92.4% (n=85) was achieved. Almost all participants (99%, n=84) had moderate knowledge about sham and/or placebo acupuncture, but only a minority (27%, n=23) reported an excellent understanding. The general attitude towards sham and/or placebo acupuncture was positive. Most respondents (99%, n=84) thought such controls were necessary and the majority (81%, n=69) believed they were feasible in acupuncture research. More than two-thirds of participants (71%, n=60) had applied sham and/or placebo acupuncture, but only a few (8%, 5/60) used it as the most common control strategy in clinical trials. Conclusions The result of our survey suggests that Chinese acupuncturists have a moderate knowledge of, and a positive attitude towards, sham and/or placebo acupuncture. Research into sham and/or placebo acupuncture is limited in comparison with other control strategies. Therefore, an in-service education programme for acupuncturists and standardisation of sham and/ or placebo acupuncture need to be developed.


Wang S.,Medicine Men | Cui J.,Medicine Men | Peng W.,Medicine Men | Lu M.,Medicine Men
Cardiology | Year: 2010

Background/Objectives: A large number of patients with coronary artery disease experience angina that is not suitable for revascularization and is refractory to conventional medical therapy. Laboratory and preclinical studies have provided evidence for the safety and potential efficacy of autologous CD34+ stem cell therapies as treatment for angina. Clinical studies investigating intramyocardial transplantation of autologous CD34+ stem cells by catheter injection for patients with refractory angina show that this is safe and feasible. It remains unclear whether intracoronary infusion of CD34+ stem cells exerts beneficial effects in patients with angina as well. We addressed this question with a controlled clinical trial by enrolling 112 patients with refractory angina. Previous trials have investigated the safety and beneficial effects of CD34+ cells isolated from granulocyte colony-stimulating factor-mobilized peripheral blood; in our trial, we isolated CD34+ cells directly from the patient's bone marrow. Methods: One hundred and twelve patients with diffuse triple-vessel disease and Canadian Cardiovascular Society class III or IV angina were enrolled in a double-blind, randomized (1:1), placebo-controlled study. Patients received optimal medical treatment but were not candidates for mechanical revascularization (percutaneous coronary intervention or coronary artery bypass grafting). Fifty-six patients (27 women and 29 men aged 42-80 years) were enrolled in the treatment group, and 56 patients (28 women and 28 men aged 43-80 years) who received optimal medical treatment and intracoronary saline injections were enrolled in the placebo control group. Bone marrow was collected from all enrolled patients at a volume of 120-150 ml each in both groups. Selections of CD34+ cells were performed by a CE-marked device approved by the Security, Food and Drug Administration of China. Coronary angiography had been performed before enrollment in this study. Results: No myocardial infarction was observed during intracoronary infusion. The intracoronary infusion of cells or saline did not result in cardiac enzyme elevation, cardiac perforation or pericardial effusion. No arrhythmia, such as ventricular tachycardia or ventricular fibrillation, was induced by intracoronary infusion. No serious adverse events occurred in either group. The reduction in the frequency of angina episodes per week 3 and 6 months after infusion was significantly higher in the treatment group (-14.6 ± 4.8 at 3 months and -15.6 ± 4.0 at 6 months) than in the control group (-4.5 ± 0.3 and -3.0 ± 1.2, respectively; p < 0.01). Other efficacy parameters such as nitroglycerine usage, exercise time and the Canadian Cardiovascular Society class also showed an improvement in the treatment group compared to the control group. A significant improvement in myocardial perfusion was noted in the treatment group compared to the control group, as measured by single-photon emission computed tomography. Conclusions: This randomized trial investigating intracoronary infusion of autologous CD34+ cells in patients with intractable angina shows the safety and feasibility of this therapy and provides evidence for efficacy. Copyright © 2010 S. Karger AG, Basel.


PubMed | Capital Medical University, Medicine Men and University of Versailles
Type: Journal Article | Journal: Journal francais d'ophtalmologie | Year: 2016

To present the change in the prevalence of blindness caused by trachoma between 1987 and 2006 by secondary data analysis based on two China National Sample Surveys on Disability (CNSSD).Secondary data analysis was performed on two China National Sample Surveys on Disability (CNSSD), which were national representative household surveys conducted in 1987 and 2006. The prevalence of blindness caused by trachoma was estimated by 10-year age group. In addition, the proportion of various causes of blindness was evaluated. The geographical distribution of blindness caused by trachoma both in 1987 and 2006 was analyzed in order to visualize the hot spots of blinding trachoma in China.The prevalence of blindness caused by trachoma in China decreased from 51.5/100,000 in 1987 to 17.6/100,000 in 2006. In addition, the proportion of blindness attributed to trachoma also decreased from 10.1% (1987) to 0.9% (2006). Moreover, the prevalence of blindness caused by trachoma was over 200/100,000 in 2.2% of sampled counties in 2006 as compared to 8.6% in 1987. The hot spots of blinding trachoma were shown to be limited to underdeveloped mountain areas in Hubei and Guizhou provinces.Although blinding trachoma is no longer the leading cause of blindness in China since the 2000s, the prevalence of trachoma should still be monitored in some underdeveloped mountain areas. Therefore, health organization must continue to fight against blinding trachoma in underdeveloped areas.


PubMed | Chinese Academy of Sciences and Medicine Men
Type: Journal Article | Journal: Acupuncture in medicine : journal of the British Medical Acupuncture Society | Year: 2015

Placebo and sham acupuncture are common control strategies in acupuncture studies. However, the perception and practice of these approaches in acupuncturists are poorly documented.To investigate knowledge of, attitude towards and practice of sham and/or placebo acupuncture among Chinese acupuncturists.A cross-sectional survey conducted in six different tertiary care hospitals of traditional Chinese medicine in Beijing, China. A total of 92 licensed acupuncturists were asked to complete a predesigned and structured questionnaire on-site.A response rate of 92.4% (n=85) was achieved. Almost all participants (99%, n=84) had moderate knowledge about sham and/or placebo acupuncture, but only a minority (27%, n=23) reported an excellent understanding. The general attitude towards sham and/or placebo acupuncture was positive. Most respondents (99%, n=84) thought such controls were necessary and the majority (81%, n=69) believed they were feasible in acupuncture research. More than two-thirds of participants (71%, n=60) had applied sham and/or placebo acupuncture, but only a few (8%, 5/60) used it as the most common control strategy in clinical trials.The result of our survey suggests that Chinese acupuncturists have a moderate knowledge of, and a positive attitude towards, sham and/or placebo acupuncture. Research into sham and/or placebo acupuncture is limited in comparison with other control strategies. Therefore, an in-service education programme for acupuncturists and standardisation of sham and/or placebo acupuncture need to be developed.


PubMed | Medicine Men
Type: Journal Article | Journal: International journal of molecular sciences | Year: 2013

The DNA repair gene X-ray cross-complementary group 4 (XRCC4), an important caretaker of the overall genome stability, is thought to play a major role in human tumorigenesis. We investigated the association between an important polymorphic variant of this gene at codon 247 (rs373409) and diffusely infiltrating astrocytoma (DIA) risk and prognosis. This hospital-based case-control study investigated this association in the Guangxi population. In total, 242 cases with DIA and 358 age-, sex-, and race-matched healthy controls were genotyped using TaqMan-PCR technique. We found a significant difference in the frequency of XRCC4 genotypes between cases and controls. Compared with the homozygote of XRCC4 codon 247 Ala alleles (XRCC4-AA), the genotypes of XRCC4 codon 247 Ser alleles (namely XRCC4-AS or -SS) increased DIA risk (odds ratios [OR], 1.82 and 2.89, respectively). Furthermore, XRCC4 polymorphism was correlated with tumor dedifferentiation of DIA (r = 0.261, p < 0.01). Additionally, this polymorphism modified the overall survival of DIA patients (the median survival times were 26, 14, and 8 months for patients with XRCC4-AA, -AS, and -SS, respectively). Like tumor grade, XRCC4 codon 247 polymorphism was an independent prognostic factor influencing the survival of DIA. These results suggest that XRCC4 codon 247 polymorphism may be associated with DIA risk and prognosis among the Guangxi population.

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