Objective To evaluate outcomes of the reform and recommend on risk avoidance.Methods The retrospective descriptive analysis was called into play to compare the surveillance data of the medical institutions before and after the reform.Results Significant changes have been identified in such key elements of the institutions as medical service,quality of care,efficiency,and costs.Improvements include effective release of the medical needs of patients,much higher efficiency of medical staff,shorter days of stay,and drug proportion,in addition to reasonable control of the total inpatient expenses,and further cutback of the patient's out-of-pocket burden.Conclusion With other factors excluded,the reform can benefit the patients and help medical institutions development,if risks are avoided and measures improved.

AIM: To investigate the role of the nucleus tractus solitarius (NTS) in the regulation of paraventricular nucleus (PVN) AVP-ergic neurons on gastric ischemia- reperfusion injury (GI-RI). METHODS: Male SD rats were used in experiments. The celiac artery were clamped for 30 min and reperfused 1 h by removal of the clamp to obtain the ischemia-reperfusion state. The mechanism was analysed with nucleus electrical stimulation, electrolytic lesion and nucleus microinjection technique. RESULTS: Microinjection of arginine-vasopressin (AVP) into PVN obviously attenuated the GI-RI and dose-dependent effects were observed ( r= -0.477, P

AIM: To determine the effect of electrical stimulation of lateral hypothalamic area(LHA) on gastric ischemia-reperfusion injury(GI-RI) in rats and to analyse its possible neuroregulatory mechanisms. METHODS: The methods of electrical stimulation(ES), chemical stimulation, electrolytic lesion(EL) and denervation were used to investigate the effect of LHA ES on gastric mucosal injury in rats subjected to 30 min gastric ischemia followed by 60 min reperfusion and to analyse the role of dorsal vagal complex(DVC), vagus and sympathetic nerve in this effect. RESULTS: ①Electrical stimulation of LHA and microinjection of L-glutamic acid into LHA obviously aggravated GI-RI; ②Electrolytic lesion of the LHA attenuated the GI-RI;③DVC lesion eliminated the effect of electrical stimulation of LHA on GI-RI; ④Vagotomy or sympathectomy eliminated the effect of electrical stimulation of LHA on GI-RI too.CONCLUSION: These results indicate that the LHA is a specific area in the CNS for exerting aggravative effects on the GI-RI; the DVC, vagus and sympathetic nerve may be involved in regulatory effects of LHA on GI-RI.

Objective To investigate prevalence of cervical intraepithelial neoplasia (CIN) among the married women aged 25-54 years in Beijing.Methods With method of cross sectional survey,6339 married women at age of 25 to 54 years were selected randomly in 137 communities of 12 districts or counties in Beijing from March 2007 to September 2008.The cervical smear cytology and high-risk human papillomavirus (HPV) infection of cervical secretion were detected.Women with abnormal cervical cytology were underwent colposcopy and cervical biopsy.Results Among 6339 women,9.58% (607/6339) cases had abnormal cytological results,the colposcopy and cervical biopsy showed the rate of CIN was 5.84% (370/6339) in total selected women and 60.96% (370/607) in women with abnormal cervical cytology,including 4.65% (295/6339) in CIN Ⅰ,0.80% (51/6339) in CIN Ⅱ,0.38% (24/6339) in CIN Ⅲ; 0.06% (4/6339)in early invasive carcinoma (SCC).Based on geographical distribution,the rate of cervical lesions was 4.46% (42/942) in urban areas,6.27% (188/3000) in suburbs and 6.01% (144/ 2397) in outer suburbs (P > 0.05).Conclusion It was found that the incidence of CIN was 5.84% in married women aged 25-54 years in Beijing,which did not show significant prevalence in urban,suburb and outer suburbs region.

Objective To evaluate the tolerance and safety of sorafenib for elderly patients with advanced renal cell carcinoma.Methods Forty cases with advanced renal cell carcinoma were enrolled,26 were males and 14 were females,the average age was 70 years.Recurrence or metastasis was found in 32 patients who had received nephrectomy,22 of the 32 cases had received cytokine therapy before recurrence or metastasis.Primary renal lesions of 8 cases could not be resected,so patients get renal tumor biopsy.Pathological type of all patients was clear cell carcinoma.KPS of all the patients were ≥70 points.Sorafenib was used as first-line treatment,with 400 mg twice per day,until intolerance or disease progression occurred.Results The average treatment time was 7.5 months (3-18 months),CR 0 case,PR 6 cases,SD 29 cases,PD 5 cases.The overall objective response rate and disease control rate were 15.0% (6/40)and 87.5%(35/40),respectively.The median follow-up period was 11 months.The adverse reaction included hand-foot skin reaction(70.0%),alopecia (62.5%),rash(52.5%),diarrhea(37.5%),loss of appetite(32.5%),fatigue(27.5%).Most adverse reactions occurred around the second week after drug therapy initiation,their duration did not equal.And most of these adverse reactions could be released by symptomatic treatment,they did not affect the treatment.Conclusions The types of adverse reactions of sorafenib for elderly patients with advanced renal cell carcinoma are similar to those reported in the literature.Generally the degree of adverse reactions is minor,with good tolerance and safety.

Objective To study human bocavirus (HBoV) induced respiratory tract infection in Guangdong Province in China. Methods HBoV was deteced by using polymerase chain reaction (PCR) technology and was identified by DNA sequences. Results One strain of HBoV was detected and identified from 50 samples collected from children with acute respiratory tract infections. This was the first clinical case of HBoV infection reported in Guangdong and was named as GD-1 strain. The HBoV capsid protein (VP) gene amplified from the specimen by PCR was identified by sequencing and was compared with gene sequences in GenBank. Phylogenetic trees were constructed for sequence homology analysis. The nucleotides similarities between GD-1 and Beijing strains, France strains and Canada strains were over 98%, while the simlilarity was over 36% compared with Korea KNIH-2K6GJ2713 strain and over 77% compared with US NH4549 strain. Conclusion HBoV infection does exist in Guangdong Province. It is valuable to start systemic study on it.

Objective To investigate high risk factors associated with cervical intraepithelial neoplasia (CIN) in married women aged 25 to 54 years in Beijing. Methods From Mar. 2007 to Sep.2008, 6339 married women at age of 25 to 54 years were selected randomly by cross sectional survey in a total of 137 communities of 12 districts or counties in Beijing. The interview was carried out with unified questionnaires, gynecological examination. The cervical smear cytology and high-risk human papillomavirus (HR-HPV) infection of cervical secretion were detected. Women with abnormal cervical cytology underwent colposcopy and cervical biopsy. Odd ratio (OR) and 95% confidence interval (CI) of related high risk factors with CIN were studied by logistic regression analysis. Results Among 6339 women, the prevalence rate of CIN including 4 squamous cell carcinoma (SCC) was 5. 90% (374/6339). By multinomial regression analysis, HR-HPV infection (95% CI: 9. 953 - 15.811 ), History of trichomonas vaginitis (95 % CI: 1. 046 -2. 104), oral contraceptives (95% CI: 1. 087 - 1. 806), age less than 45 years old ( 95% CI: 1. 069 -1. 828) were related with CIN. Conclusion Infection rate of HR-HPV is an independent risk factor of CIN, however, the history of trichomonas vaginitis, oral contraceptives and age less than 45 years old are related risk factors of CIN.

Objective To investigate the clinical effects of Dexmedetomidine on analgesia and postoperative cognitive function in elderly patients with lumbar spine surgery.Methods The patients were randomly divided into the control group (n=88) and the study group (n=100).The patients in the study group were treated with Dexmedetomidine at a loading dose of 1.0 μg/kg for 15 min,and 0.3 μg · kg-1 · h 1 was continuously pumped.The anesthetic mode and drugs in the control group were similar to those in study group,except that Dexmedetomidine in the study group was replaced with physiological saline in the control group.Intraoperatively used dose of analgesic drugs,and pain and cognitive function changes were compared between the two groups.Results The intraoperatively used doses of Remifentanil,Fentanyl and propofol were significantly lower in the study group than in the control group (P＜0.05).The VAS scores were markedly lower in the study group than in the control group (2.6±0.5 vs.4.5± 1.2,t=4.9398,P=0.0000).The MMSE scores were higher in the study group than in the control group (28.0 ± 1.3 vs.26.0 ± 2.5,t =-6.6484,P=0.0000).Conclusions Intraoperative use of Dexmedetomidine for treatment of the elderly patients with lumbar surgery will not only reduce the perioperatively used dose of analgesic and sedative drug,but also reduce postoperative pain and improve postoperative cognitive function.

Objective To investigate the in vitro effect of lncRNA UCA1 on gemcitabine(GEM)resistance of blad-der cancer cell line T24 and its related molecular mechanism.Methods The mRNA expression of UCA1 in T24 cells and in T24/GEM cells was detected by RT-qPCR.The T24/GEM cells were incubated with varying concentra-tions(0.1,1,and 10 μmol/L)of GEM for 48 hrs.LC3 staining microscopy was employed to visualize autophagic puncta,while the expression of autophagy-related proteins was assessed by Western blot.UCA1-shRNA and UCA1-shRNA+pcDNA-Bcl-2 were transferred into T24/GEM cells,the sensitivity of cells to GEM was evaluated by MTT method and flow cytometry;the expressions of p53 and Bcl-2 were detected by Western blot.Results The expres-sion level of UCA1 in T24/GEM cells was significantly higher than that of parental T24 cells(P＜0.05).The con-centration of GEM in the range of 0-10 p.mol/L significantly induced dose-dependent autophagy in T24/GEM cells(P＜0.05).Knockdown of UCA1 enhanced the sensitivity of T24/GEM cells to GEM(P＜0.05),while reducing autophagy(P＜0.05)and down-regulating the expression of p53 and Bcl-2(P＜0.05).Over-expression of Bcl-2 partially reversed the GEM sensitization and autophagy inhibition of UCA1-shRNA in T24/GEM cells(P＜0.05).Conclusions Knockdown of lncRNA UCA1 reduces GEM resistance of T24/GEM cells by inhibiting Bcl-2 mediated autophagy.

Background/Aims: Previous studies have shown that diet and physical activity can influence constipation. However, the combined effect of diet and physical activity on constipation remains unclear. Methods: Constipation was defined based on stool consistency and frequency, while overall diet quality was assessed using Healthy Eating Index (HEI)-2015 scores. Participants were categorized into low (metabolic equivalent [MET]-min/wk < 500) and high physical activitygroups (MET-min/wk ≥ 500). The association between diet and constipation across physical activity groups was analyzed using surveylogistic regression and restricted cubic splines. Results: Higher HEI-2015 scores were associated with reduced constipation risk in the high physical activity group when constipation was defined by stool consistency (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97-0.99). However, in the low physical activity group, increased HEI-2015 scores did not significantly affect constipation risk (OR, 1.01; 95% CI, 0.97-1.05). Similar results were found when constipation was defined based on stool frequency. In the high physical activity group, increased HEI-2015 scores were significantly associated with a reduced constipation risk (OR, 0.96; 95% CI, 0.94-0.98). Conversely, in the low physical activity group, increased HEI-2015 scores did not affect the risk of constipation (OR, 0.96; 95% CI, 0.90-1.03). Conclusions Our findings suggest that a higher HEI-2015 score is negatively associated with constipation among individuals with high physical activity levels but not among those with low physical activity levels. This association was consistent when different definitions of constipation were used. These results highlight the importance of combining healthy diet with regular physical activity to alleviate constipation.