In the course of the establishment of the basic medical insurance system, medical and health institutions at various levels are going to face the readjustment of functional orientation and transformation of the current pattern of medical setups will produce a far reaching effect on medical institutions. While “reducing burdens”, big hospitals must try actively to suit the needs of the medical market under the new circumstances, give full play to their strong points, such as high concentration of talents, knowledge and resources, and provide quality, high efficiency and high value added medical service. It must also be brought to peoples awareness that third tier hospitals are not just the supplement and extension of community medical service but should also serve as its guarantee and backing.

Objective To observe the development of endotoxemia and its treatment during swine orthotopic liver transplantation (OLT). Methods Blood perfusion was carried out in 12 swine OLT cases during anhepatic period. Results It was 0 18 EU/ml in anhepatic period and 0 48 EU/ml in reperfusion period in control group compared to 0 13 EU/ml and 0 13 EU/ml,respectively in activated charcoal perfusion group( P

0.05).Compared with the normal(P0.05).In the control group with G-6-PD deficieney,ROS,MDA of phototherapy of 24 hours were higher,the index of phototherapy was larger significantly than in the the G-6-PD normal.Conclusion Phototherapy can alleviate the ability of anti-oxgenize,it can be more extruding for the patients who are deficient for the G-6-PD by the damage of lipid over oxygenizing,the interference of vitamin E is more efficient.

Objective To investigate the relationship between three polymorphic sites of ZNF804A gene and cognitive dysfunction in schizophrenia.Methods Polymerase Chain Reaction (PCR) was used to determine the genotypes and allele frequencies of the three sites (rs1344706,rs12613195 and rs1583048) of ZNF804A gene in 320 patients with schizophrenia (case group) and 324 normal people (control group).The Montreal Cognitive Assessment (MoCA) was used to assess cognitive function.Results (1) The allelic and genotypic distributions in rs1344706 between patients with schizophrenia (T/T,T/G,G/G genotypes:20.3％,50.0％,29.7％),and healthy controls(T/T,T/G,G/G genotypes:13.7％,51.2％,35.1％)had statistically significance(P＞0.05).There was a statistically significant difference in the allele and genotype distribution of rs1344706 between the case group and the control group (P＜0.05),and the family transmission disequilibrium existed in rs1344706 and rs12613195.(2) The MoCA scores in the case group(＜26 points) were lower than those of the control group (P＜0.05).(3)There was a statistically significant difference between the total scores of MoCA (F=202.49,P＜0.05) and scores assessed in different time (F=53.34,P＜ 0.05) in patients with three genotypes of rs1344706.Moreover,the interaction between genotype and time was also statistically significant (F=3.88,P＜0.05),in which the patients with T/T genotype had the lowest total score.(4)There was a statistically significant difference between the total score of MoCA(F=367.78,P ＜0.05) and scores assessed in different time (F=27.35,P＜0.05) in patients with three genotypes of rs12613195,in which the patients with C/C genotype had the lowest total score.However,the interaction between genotype and time was not statistically significant(P＞0.05).(5)The effect of rs1344706 on cognitive function was slightly larger than that of rs12613195.(6)The cognitive function scores of patients carrying rs1344706 and rs12613195 sites decreased year by year.Conclusion ZNF804A gene rs1344706 and rs12613195 may be associated with cognitive dysfunction of schizophrenia,and rs1344706T and rs12613195C may be risk factors for schizophrenia and cognitive impairment.Furthermore,cognitive impairment in patients with rs1344706 is more pronounced and worsened with prolonged condition.rs1583048 may not be associated with cognitive function of schizophrenia.

Objective:To investigate the characteristic of ultrasound in diagnosing fetal intestinal volvulus.Methods:From April 2015 to May 2018, four cases of fetal intestinal volvulus indicated by prenatal ultrasound in the Affiliated Hospital of Jining Medical College and confirmed either by autopsy or by postnatal surgery, were retrospectively analyzed. A total of 11 ultrasound scans had been performed on the four cases, and the dynamic and static ultrasound features were summarized. Pregnancy outcomes and concomitant malformations were also followed up. Descriptive statistical analysis was used.Results:The direct ultrasonographic patterns of intestinal volvulus in the four cases were "whirlpool" signs (six times), clockwise wrapping of branch vessels of the superior mesenteric vein and the superior mesenteric artery (five times), and "coffee bean" sign (three times); the indirect signs included dilated small intestine (11 times), ascites (eight times), polyhydramnios (five times), peritoneal calcification(four times), pseudocysts(once). Out of the 11 ultrasound examinations, early-stage volvulus was detected on three occasions, all with "whirlpool" signs and clockwise wrapping of branch vessels of the superior mesenteric vein and the superior mesenteric artery. As the disease progressed to the meconium peritonitis stage, indirect signs emerged while the initial two signs can diminished. Postnatal surgery or autopsy after labor induction confirmed the segmental volvulus in the four cases, of which three were complicated by intestinal atresia. No intestinal malrotation was found.Conclusion:Typical direct signs and atypical indirect signs could be identified in the sonogram findings of fetal volvulus, and are important for diagnosing fetal volvulus.

Purpose: C5α receptor 1 (C5ΑR1) is associated with the development of various human cancers. However, whether it is involved in the development of hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) is poorly understood. We explored the expression, biological role, and associated mechanisms of C5AR1 in HBV-related hepatoma cells. Materials and Methods: The expression of C5ΑR1 mediated by HBV and HBV core protein (HBc) was detected in hepatoma cells. The function of nuclear factor кB (NF-κB) pathway in HBc-induced C5AR1 expression was assessed. The roles of C5ΑR1 in the activation of intracellular signal pathways, the upregulation of inflammatory cytokines, and the growth and migration of hepatoma cells mediated by HBc, were investigated. The effect of C5α in the development of HCC mediated by C5AR1 was also measured. Results: C5ΑR1 expression was increased in HBV-positive hepatoma cells. Dependent on HBc, HBV enhanced the expression of C5ΑR1 at the mRNA and protein levels. Besides, HBc could promote C5ΑR1 expression via the NF-κB pathway. Based on the C5ΑR1, HBc facilitated the activation of JNK and ERK pathways and the expression and secretion of interleukin-6 in hepatoma cells. Furthermore, C5ΑR1 was responsible for enhancing the growth and migration of hepatoma cells mediated by HBc. Except these, C5α could promote the malignant development of HBc-positive HCC via C5AR1. Conclusion We provide new insight into the mechanisms of hepatocarcinogenesis mediated by HBc. C5ΑR1 has a significant role in the functional abnormality of hepatoma cells mediated by HBc, and might be utilized as a potential therapeutic target for HBV-related HCC.

Purpose: C5α receptor 1 (C5ΑR1) is associated with the development of various human cancers. However, whether it is involved in the development of hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) is poorly understood. We explored the expression, biological role, and associated mechanisms of C5AR1 in HBV-related hepatoma cells. Materials and Methods: The expression of C5ΑR1 mediated by HBV and HBV core protein (HBc) was detected in hepatoma cells. The function of nuclear factor кB (NF-κB) pathway in HBc-induced C5AR1 expression was assessed. The roles of C5ΑR1 in the activation of intracellular signal pathways, the upregulation of inflammatory cytokines, and the growth and migration of hepatoma cells mediated by HBc, were investigated. The effect of C5α in the development of HCC mediated by C5AR1 was also measured. Results: C5ΑR1 expression was increased in HBV-positive hepatoma cells. Dependent on HBc, HBV enhanced the expression of C5ΑR1 at the mRNA and protein levels. Besides, HBc could promote C5ΑR1 expression via the NF-κB pathway. Based on the C5ΑR1, HBc facilitated the activation of JNK and ERK pathways and the expression and secretion of interleukin-6 in hepatoma cells. Furthermore, C5ΑR1 was responsible for enhancing the growth and migration of hepatoma cells mediated by HBc. Except these, C5α could promote the malignant development of HBc-positive HCC via C5AR1. Conclusion We provide new insight into the mechanisms of hepatocarcinogenesis mediated by HBc. C5ΑR1 has a significant role in the functional abnormality of hepatoma cells mediated by HBc, and might be utilized as a potential therapeutic target for HBV-related HCC.

Purpose: Tamoxifen showed individual differences in efficacy under different CYP2D6*10 genotypes. Our study evaluated the prognosis of tamoxifen or toremifene in hormone receptor (HR)–positive breast cancer patients under different genotypes. Materials and Methods: CYP2D6*10 genotypes of HR-positive breast cancer patients were determined by Sanger sequencing, and all the patients were divided into tamoxifen group or toremifene group. Results: A total of 268 patients with HR-positive breast cancer were studied. The median follow-up time was 72.0 months (range, 5.0 to 88.0 months). Of these, 88 (32.9%), 114 (42.5%), and 66 (24.6%) patients had C/C, C/T, and T/T genotypes, respectively. Among patients who received tamoxifen (n=176), the 5-year disease-free survival (DFS) rate in patients with C/C and C/T genotype was better than that in patients with T/T genotype, and the difference was statistically significant (p < 0.001 and p=0.030, respectively). In patients receiving toremifene, CYP2D6*10 genotype was not significantly associated with DFS (p=0.325). Regardless of genotypes, the 5-year DFS rate was higher in patients treated with toremifene than in patients with tamoxifen (91.3% vs. 80.0%, p=0.011). Compared with tamoxifen, toremifene remained an independent prognostic marker of DFS in multivariate analysis (hazard ratio, 0.422; p=0.021). For all the 180 patients with CYP2D6*10 C/T and T/T genotypes, the 5-year DFS rate was significantly higher in the toremifene group than in the tamoxifen group (90.8% vs. 70.1%, p=0.003). Conclusion Toremifene may be an alternative adjuvant endocrine therapy for patients with CYP2D6*10 mutant genotypes.

Focusing on the requirements of visual traceability for reprocessing of reused medical devices under the background of deep integration of intelligent medical treatment, a quality and safety traceability system for disinfection of reused medical devices is developed. The multi-dimensional data of the reprocessing chain of reusable medical devices are acquired in real time by the RFID mobile terminal handset and stored temporarily. The data package is formatted based on LoRa protocol and uploaded to the management and control platform in multi-threaded transmission mode for in-depth analysis and traceability. The corresponding prototype system is developed. The first-line operation and maintenance test results show that the prototype system has strong cooperation, strong operation robustness, and obvious advantages in the identification rate and other layers of sterile equipment package.
Disinfection ; Radio Frequency Identification Device ; Technology

Objective:To compare the long-term clinical outcomes between cannulated screw internal fixation for stable femoral neck fractures and arthroplasty for unstable ones in the elderly patients.Methods:A retrospective study was conducted to analyze the 542 patients with femoral neck fracture who had been admitted to Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University from May 2015 to April 2017. The 542 patients were divided into 2 groups based on fracture stability and treatment method. In the stable group (Garden type Ⅰ, type Ⅱ, and abduction compression type) of 121 cases who underwent cannulated screw internal fixation, there were 28 males and 93 females with a mean age of (77.6±8.1) years, and 20 cases of type Ⅰ, 101 cases of type Ⅱ, and 34 cases of abduction compression type by the Garden classification. In the unstable group (Garden type Ⅲ, type Ⅳ, and type Ⅱ with a posterior tilt angle >20°) of 421 cases who underwent arthroplasty, there were 130 males and 291 females with a mean age of (78.7 ± 6.9) years, and 14 cases of type Ⅱ, 403 cases of type Ⅲ, and 4 cases of type Ⅳ by the Garden classification. The postoperative mortality, reoperation rate, and mobility at the last follow-up were compared between the 2 groups.Results:There were no statistically significant differences in the baseline characteristics, except for serum albumin concentration and peripheral white blood cell count at admission, between the 2 groups, indicating comparability ( P>0.05). The hospital stay in the stable group [5.0 (4.0, 6.0)d] was significantly shorter than that in the unstable group [6.0 (5.0, 8.0)d], and the follow-up time for the stable group [54.4 (49.3, 58.7) months] significantly longer than that for the unstable group [52.2 (46.0, 59.3) months] ( P<0.05). A total of 158 patients (45 cases in the stable group and 113 cases in the unstable group) were lost to the last follow-up. At the last follow-up, the mortality in the stable group (18.4%, 14/76) was significantly lower than that in the unstable group (31.5%, 97/308), the reoperation rate in the former (15.8%, 12/76) significantly higher than that in the latter (3.6%, 11/308), and the capability of daily activities in the former (by the fracture mobility scoring: level 1 in 35 cases, level 2 in 13 cases, level 3 in 3 cases, level 4 in 2 cases, and level 5 in 1 case) significantly better than that in the latter (level 1 in 99 cases, level 2 in 47 cases, level 3 in 24 cases, level 4 in 22 cases, and level 5 in 5 cases) (all P<0.05). Conclusion:Compared with the arthroplasty for unstable femoral neck fractures, cannulated screw internal fixation for stable femoral neck fractures leads to a lower long-term mortality and a better capability of daily activities, but a significantly higher reoperation rate.