Objective To analyze the current situation of senile nursing agency in Shanghai community and raise up the countermeasures. Methods The senile nursing system and model were analyzed in Shanghai community, and find out the current situation and existing problem in Shanghai community. Results Senile nursing system in Shanghai community lacked policy support, medical and nursing cost of senile people was over-burden, lacking specialized nursing staff. The existing problem included insufficient funding, unnormative establishment of nursing agency, undefined evaluation standard, lacking of nursing staff. Conclusions We should rationally allocate health resources by various ways, push forward various levels of senile medical and nursing service system, strengthening function orientation, perfecting admission sign in order to establish rational senile health care evaluation system.

Objective To evaluate the relationship between classification of clinical,the infarct size in patients with acute cerebral infarction and electrocardiographic(ECG)changes.Methods The ECG were done in 216 patients with acute cerebral infarction.ECG results of the patients were analyzed according to classification of the Oxfordshire Commumity Project Criteria(OCSP)and infarct size.Results The rates of ECG abnormality in classification of OCSP were 95.5% for total anterior circulation infarction(TACI),80.4% for partial anterior circulation infarction(PACI),62.5% for posterior circulation infarction(POCI)and 48.5% for lacunar cerebral infarction(LACI).The rates of ECG abnormality of TACI and PACI were signficantly higher than that of group of LACI(P

Objective To evaluate the risk of occupational noise-induced hearing loss in workers in a metal tool manufacturing enterprise, and to carry out risk classification and risk management. Methods A total of 91 male noise-exposed workers from a metal tool manufacturing enterprise in Hebei Province were selected as the research subjects using the convenience sampling method. The work site survey on occupational health and the measurement on individual noise exposure level were carried out. The ISO 1999：2013 (E) Acoustics-Estimation of Noise-Induced Hearing Loss was used to predict the risk of high frequency hearing loss (HFHL) and occupational noise-induced deafness (ONID). The risk classification and risk management were conducted using the WS/T 754-2016 Guideline for Risk Management of Occupational Noise Hazard (hereinafter referred to as WS/T 754-2016). Results The individual noise exposure intensity of workers in the six work sites of the enterprise, including blade workers, sheet punching workers, roller forging workers (hoe), hole punching workers, roller forging workers(shovels), and carpenters, exceeded the national occupational exposure limit, with the maximum volume of 91.2-104.1 dB(A). Among these workers, the positions of blade workers, sheet punching workers, and roller forging workers (hoe) were identified as critical control points for noise hazards in the enterprise. The detection rates of HFHL and ONID were 24.2% and 8.8%, respectively. The risk prediction results showed that, based on the actual noise exposure time and age of the study subjects, the risk of HFHL and ONID ranged from 1.7%-48.8% and 0.0%-29.5%, respectively. The risks of HFHL caused solely by occupational noise exposure when working up to 50.0, 55.0, and 60.0 years of age were 11.4% to 64.7%, 16.4% to 65.1%, and 17.2% to 59.4%, respectively. The risks of ONID caused solely by occupational noise exposure were 0.0% to 45.5%, 4.2% to 51.7%, and 5.9% to 57.4%, respectively. Except for the blade workers, the predicted median of potential noise-induced permanent threshold shifts (NIPTS) in the other five positions were lower than the actual values of NIPTS, with the difference ranging from 3.0-28.3 dB, and 73.3% of them underestimated by 10.0 dB or more. Conclusion The outcome of noise exposure on the hearing of workers in this enterprise are severe. Risk management should be conducted according to the WS/T 755-2016.

BACKGROUND:To reduce the amount of bleeding and the amount of hemoglobin after total knee replacement has been a key project in the clinical research in the division of bone and joint. Currently, ice therapy has been widely used in the clinic for tissue sweling and pain due to various physical and chemical factors. OBJECTIVE:To investigate the risk factors of postoperative hemoglobin after total knee replacement and discuss the effects of ice intervention. METHODS: 240 patients with osteoarthritis based on the random draw principles were equaly divided into the treatment group and the control group. The general information, disease status, diagnosis and treatment and prognosis of the two groups were investigated. Al patients were actively subjected to artificial total knee replacement. On the basis of the treatment in the control group, the treatment group received ice intervention at 2 hours after replacement for 7 consecutive days. RESULTS AND CONCLUSION:The postoperative hemoglobin decrease occurred in 34 patients, with the incidence of 14.2% among 240 patients at 7 days after replacement. Multivariate logistic regression analysis results showed that age, no ice treatment, body mass index were the main risk factors for hemoglobin decrease after total knee replacement (P < 0.05). Compared with the control group, the postoperative hemoglobin values of the treatment group were significantly higher (P < 0.05). Hemoglobin decrease values, total blood loss, blood transfusion rate, blood transfusion amount, and pain score at 3 and 7 days after replacement were significantly lower in the treatment group than in the control group (P < 0.05). The knee function excelent and good rate was 96.7% in the treatment group, and 95.8% in the control group, which showed no significant difference (P > 0.05). Results verify that clinical application of total knee replacement facilitated the knee recovery in patients with osteoarthritis, but hemoglobin decrease and bleeding existed. Active ice intervention can reduce the risk and relieve postoperative pain.

Objective:To study the expression of miR-496 in gastric cancer cells, and explore its role and mechanism in the proliferation and apoptosis of gastric cancer cells. Methods:Real-time fluorescence quantitative PCR (qPCR) was used to detect the expression of miR-496 in normal gastric epithelial cell lines and gastric cancer cell lines AGS and MKN45. miR-496 was knocked down in AGS cells with the lowest expression level, and a negative control group and a blank control group were set up. Cell proliferation and apoptosis were detected by CCK8 assay and flow cytometry. LYN, the target gene of miR-496, was screened using bioinformatics software, and the effect of transfection of miR-496 on LYN expression was detected by qPCR. Subsequently, rescure experiment was conducted to further study the mechanism of miR-496 on gastric cancer cells through regulation of LYN. Data were analyzed by GraphPad Prism 9 software. Measurement data were presented as mean ± standard deviation, and the comparison between the two groups was performed by t test. Results:The expression of miR-496 in AGS and MKN45 was significantly lower than that in normal gastric epithelial cells ( P<0.05). After overexpression of miR-496, the proliferation of AGS cells could be inhibited and the apoptosis ratio of AGS cells could be significantly increased ( P<0.05). QPCR results showed that miR-496 overexpression group could inhibit the expression of LYN ( P<0.05). Bioinformatics analysis showed that miR-496 binds to LYN kinase ( LYN) 3 ′UTR region, and overexpression of miR-496 can inhibit the expression of LYN in AGS cells, while CCK8 rescue experiment showed that overexpression of LYN could remove the inhibitory effect of miR-496 on cell proliferation. Flow cytometry showed that LYN expression could cancel the promoting effect of miR-496 on apoptosis ( P<0.05). Conclusion:miR-496 is low expressed in gastric cancer cells, and it inhibits the proliferation and promotes apoptosis of gastric cancer cells by targeting the expression of LYN in gastric cancer cells.

Objective:To provide reference for the construction and development of medical colleges and universities by comparing the scientific research competitiveness of four newly-established medical universities in Shanghai, Shaanxi, Zhejiang and Fujian of China.Methods:Four young state-owned medical universities, founded successively from 2015 in Shanghai, Shaanxi, Zhejiang and Fujian provinces, were selected as the research samples. Both CNKI and WoS databases were used to conduct comparative bibliometric analysis of high-quality literature published in core Chinese and foreign journals during 2016 to 2020 from such perspectives as number of papers, discipline distribution, source titles and funding, etc.Results:All four universities have displayed an increasing trend of publishing literature in core Chinese and foreign journals, but there are relatively fewer literature published in top international journals. The university from Shaanxi leads the other three with most indexes, and the two universities from Shanghai and Zhejiang stand close, while the one from Fujian lags behind, indicating a gap of scientific research competitiveness among the four.Conclusion:The reasons for the existing gap are potentially related to different college foundation and history, orientation and objectives, as well as the strength of scientific research team. Newly-built medical universities should keep deepening the comprehensive reform of medical education and strengthening comprehensive power of scientific research competitiveness.

Objective:To clarify the effects of bortezomib combined with or without siramesine on the proliferation of multiple myeloma cell lines, the expression changes of transcription factor EBC (TFEB) nuclear translocation and the level of autophagy, and to provide basis for further exploring the regulation mechanism of transcription factor TFEB on autophagy.Methods:The multiple myeloma cell lines RPMI8226 and U266 were cultured in vitro, and the multiple myeloma cells were treated with a certain concentration of bortezomib and siramesine. The changes of cell proliferation inhibition were detected by CCK-8 method. Real time PCR and Western blot were used to detect the relative expression of TFEB, autophagy-related factor LC3B, Beclin1, p62, LAMP1 mRNA and protein.Results:As the concentration of bortezomib increased and the duration of action increased, the proliferation inhibition rates of the two cell lines gradually increased ( P<0.05) . The combination of the two drugs has a synergistic inhibitory effect on the proliferation of the above-mentioned multiple myeloma cell lines ( P<0.05) . In the blank control group, single drug group, and combination drug group, the relative expression of TFEB mRNA and protein in the cytoplasm decreased sequentially ( P<0.05) , and the relative expression of TFEB mRNA and protein in the nucleus increased sequentially ( P<0.05) . The relative expression of autophagy-related factors LC3B, Beclin1, LAMP1 mRNA and protein increased sequentially, and the relative expression of p62 mRNA and protein decreased sequentially ( P<0.05) . Conclusion:Bortezomib and siramesine can synergistically inhibit the growth of multiple myeloma cells, which is related to the increased autophagy expression in multiple myeloma cell lines and the expression of TFEB with nuclear translocation is also enhanced.

Objective This study aims to investigate the impact of cultivation time on dendritic cells(DCs)and their derived exosomes′ expression of immune-related membrane proteins(CD80,MHC-Ⅰ,MHC-Ⅱ)and provides experimental evidence for future research.Methods Mouse bone marrow cells were induced to differentiate into DCs using GM-CSF and IL-4,followed by maturation stimulation withTNF-α.Exosomes were extracted using ultracentrifugation.Western blot and Amnis image flow cytometry were used to identify exosomes derived from mouse DCs.Amnis image flow cytometry was used to detect the expression of immune-related proteins CD80,CD11c,MHC-Ⅰ,and MHC-Ⅱ in mouse DCs and their exosomes.Results After 5 days of in vitro cultivation,more than 50%of dendritic cells expressed CD80,CD11c,MHC-Ⅰ,and MHC-Ⅱ,reaching the highest level on day 13.The positivity rates were as follows:CD80(97.29±0.63)%,CD11c(92.31±1.18)%,MHC-Ⅰ(97.91±0.49)%,and MHC-Ⅱ(97.91±0.49)%.The differences were statistically significant(P<0.001).The expression gradually decreased after day 13,but approximately 80%of DC cells still expressed MHC-Ⅰ and MHC-Ⅱ immune molecules on day 30.The expression levels of CD80,CD11c,and MHC-Ⅱ on the exosome membrane were highest on day 5 and then decreased overall with prolonged cultivation time,except for MHC-Ⅰ molecules.The differences were statistically significant(P<0.01).Conclusions In vitro-cultured mouse dendritic cells express high levels of immune-related membrane proteins and can be stably maintained for a long time under suitable culture conditions.The secreted exosomes also carry abundant immune-related membrane proteins,but no significant correlation was found between the immune-related proteins on the dendritic cell surface and the exosome membrane surface.

Objective : To investigate the effect of glycyrrhizin on the fibrosis of silica⁃treated mice. Methods : C57BL/6 male mice were randomly divided into control group , silicosis model group and glycyrrhizin treatment group ,with 6 mice in each group. The pathological changes of lung tissues were observed by HE and Sirius red stai⁃ ning. Lung function indexes were detected by respiratory function instrument. The content of hydroxyproline in the lung tissues was detected by corresponding kit. The mRNA levels of monocyte chemotactic protein 1 (MCP⁃1) , fibronectin (FN) and alpha⁃smooth muscle actin ( α ⁃SMΑ) were detected by real⁃time fluorescent quantitative PCR. The number of leukocytes in the bronchoalveolar lavage fluid (BALF) was counted and the secretion of transforming growth factor⁃β1 (TGF⁃ β1) in BALF was detected by ELISA. Results : HE and Sirius red staining showed that the inflammatory cells and the collagen were accumulated in the lung tissue of mice in silicosis model group. After treatment with glycyrrhizin , the accumulation of inflammatory cells and the collagen was ameliorated. Compared with the control group , pause (PAU) and enhanced pause (Penh) increased in the model group (P < 0. 05) . Glycyrrhizin treatment improved the respiratory function in mice. Furthermore , glycyrrhizin also effectively reduced the increase in the content of hydroxyproline , the expression of MCP⁃1 , FN and α ⁃SMΑ mRNA , the number of leukocytes and the secretion of TGF⁃ β1 induced by silica treatment in mice (P < 0. 05) . Conclusion Glycyrrhizin can improve the pulmonary function and alleviate the fibrosis in mice with silicosis.