Since γH2 AX was firstly found in 1998 , it has been one of the most important scientific topics and research tools in the related scientific fields. At present, a series of advanced testing methods and analytical technologies have been developed, which exhibited a quite attractive application prospect in the area of life science and medical science. This paper reviewed the latest progress about γH2AX in terms of molecular mechanism of phosphorylation/dephosphorylation, development of testing technologies, and the related applications.

Objective To explore the role of p170, MRP, bcl-2 in clinical drug- resistance and their correlation. Methods There are 44 acute leukemia(AL) patients, among them ANLL is 29, ALL is 15.The expression of p170, MRP, bcl-2 were detected. At last, the patients were divided into two groups: CR and NR according to efficacy after two periods standard chemotherapy. Results Overexpression of p170, MRP,bcl-2 were found in AL (P ＜0.05). The expression of p170 and MRP were lower in CR group than that in NR groups in AML and ALL; there were 22 of 24 patients expressed one or two proteins in NR groups and the expression of p170 in patients was concordant with that of MRP to certain extent (P ＜0.01). The overexpression of bcl-2 was related with the worse prognosis. The expression of bcl-2 was lower significantly in CR group than in CR and NR (P＜0.05). Conclusion p170, bcl-2, MRP are all associated with clinical MDR. High expression of these proteins is an unfavorable factor to prognosis. The expression of MRP and p170 showed coincidence, but showed no significance with expression of bcl-2 in untreated patients, it indicated that the drug-resistance mediated by p170 was different from bcl-2.

Objective To investigate the action mechanism of glutamate-mediated signaling pathway in malignant melanoma. Methods WM451LU melanoma cells in log phase were classified into 6 groups, negative control group treated with PBS (100 μl), MK801 group treated with the non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist MK-801 (100 μmol/L), CPCCOEt group treated with non-competitive metabotropic glutamate receptor 1 (mGluR1) antagonist CPCCOEt, MAP2 group transfected with adenovirus vector containing microtubule associated protein 2a (Ad-MAP2a), MK801 + MAP2 group treated with MK801 of 100 μmol/L and transfected with Ad-MAP2a, CPCCOEt + MAP2 group treated with CPCCOEt of 10 μmol/L and transfected with Ad-MAP2a. Western blot was performed to detect the expression of an ionotropic glutamate receptor, i.e., N-methyl-D-aspartate receptor type 2A (NMDAR2A) in WM451LU cells transfected with Ad-MAP2a. Scratch motility assay and cell invasion assay were conducted in vitro to detect the changes in migration and invasion ability of WM451LU cells after treated with Ad-MAP2a, MK-801, CPCCOEt alone or in combination. In vivo study was carried out to compare the inhibitory effect of the above treatments on melanoma. Results Western blot revealed a decrease in the expression of NMDAR2A in WM451LU cells after transfected with Ad-MAP2a. The scratch motility assay showed that the number of migrating cells per high power field was 117.04 ± 2.76 in MAP2 group,107.64 ± 6.50 in MK801 group,97.36 ± 4.79 in CPCCOEt group, 43.28 ± 3.02 in MK801 + MAP2 group,30.76 ± 3.97 in CPCCOEt + MAP2 group,significantly different from that in the negative control group (152.3 ± 5.75,all P ＜ 0.01 ). Cell invasion assay demonstrated that the average number of invading cells per high power field in the negative control was significantly higher than that in MAP2 group, MK801 group, CPCCOEt group, MK801+MAP2 group and CPCCOEt + MAP2 group (170.43 ±8.72 vs. 98.26 ± 3.84, 97.22 ± 5.54, 112.23 ± 7.21, 42.89 ± 5.06, 58.25 ± 6.68, P ＜ 0.05, 0.05, 0.05, 0.01and 0.01, respectively).A significant decrease was observed in the average volume of experimental melanoma in mice of MAP2 group, MK801 group, MK801 + MAP2 group, CPCCOEt group and CPCCOEt + MAP2 group compared with the negative control group (224.02 ± 46.19 mm3, 160.33 ± 33.91 mm3, 91.49 ± 21.48 mm3,202.30 ± 52.37 mm3, 111.13 ± 69.81 mm3 vs. 342.70 ± 60.92 mm3, all P ＜ 0.01 ). Conclusions To block the glutamate signaling pathway in vitro can inhibit the invasion and migration of melanoma cells, and to block the pathway in vivo can inhibit the growth of malignant melanoma and alter the morphology of melanoma cells.

Objective To investigate the roles of glutamate signaling pathway in the activation of human peripheral blood lymphocytes(PBLs) and pathogenesis of vitiligo.Methods Peripheral blood lymphocytes (PBLs) isolated from 5 patients with generalized vitiligo and 5 healthy controls were cultured in vitro.Flow cytometry was performed to quantify the expression of CD25 and interferon-γ on PBLs derived from healthy controls and treated with MK801 (a non-competitive antagonist of N-methyl-D-aspartic acid receptor,NMDAR) at 100 μmol/L or phosphate buffered saline (PBS) for 48 hours,as well as the level of reactive oxygen species (ROS) in the controlderived PBLs treated with MK801 at 100 μmol/L,NMDA (an agonist of N-methyl-D-aspartic acid receptor) at 0.5 mmol/L or PBS for 48 hours.The protein and mRNA expressions of NMDAR1 and NMDAR2A were measured by flow cytometry and real-time PCR,respectively,in PBLs from the healthy controls and vitiligo patients.Immunohistochemistry was used to observe the expressions of NMDAR1 and NMDAR2A in tissue specimens from depigmented and postinflammatory hyperpigmentation lesions of the patients with vitiligo and from normal skin of the healthy controls.Results Compared with the PBS-treated PBLs from the healthy controls,the MK801-treated PBLs showed a downregulated expression of CD25 (7.28％ ± 0.18％ vs.16.02％ ± 0.42％,P ＜ 0.01),but an upregulated proportion of CD25+IFN-γ+ lymphocytes (1.79％ ± 0.09％ vs.0.78％ ± 0.06％,P ＜ 0.01),and the NMDA-treated PBLs displayed a higher ROS level (101.1 ± 3.50 vs.69.80 ± 2.08,P＜ 0.01 ).The protein expression of NMDAR1 in PBLs was significantly higher in vitiligo patients than in the healthy controls (3.85 ± 2.17 vs.0.97 ±0.55,P ＜ 0.05).Conclusion Glutamate signaling pathway may be involved in the immunopathogenesis of vitiligo via affecting the secretion of interferon-γ by,and ROS level in,activated lymphocytes.

Objective To assess the patient enablement level in a general hospital and its related factors,to investigate the relationship of patient enablement with patient's overall satisfaction and doctor's empathy levels.Methods Patients attending the Family Medicine Clinic of HKU-Shenzhen Hospital in September 2014 and met the inclusion criteria were asked to complete a questionnaire survey which included general characteristics,overall satisfaction;the Patient Enablement Instrument (PEI) and the Consultation and Relational Empathy Measure Scale (CARE) after the consultation.Results Total 2 326 questionnaires were issued and 1 818 were retrieved,of which 1 478 were qualified questionnaires.The qualified rate of PEI was 81.3％ and the qualified rate of patient overall satisfaction was 96.28％.The positive rate of patient enablement was 97.70％ (1 444/1 478),and the mean score of PEI was 8.21 ±3.33.Multivariate linear regression analysis showed that the PEI scores were not influenced by gender and education level of the patients,gender of the consulting doctors and initial/follow up consultation.The PEI scores were influenced by the age of the patients,the types of clinic (general practice/chronic practice clinic) and the reasons for consulting (P ＜ 0.05).There were correlations between PEI score and overall satisfaction of patients (r =0.383,P ＜ 0.001),patient's recommendation of the clinic (r =0.595,P ＜ 0.001) and CARE scores (r =0.546,P ＜ 0.001).Conclusion The results show that the PEI scores of patients visiting family medicine clinic of this hospital are higher than those reported in other studies.The PEI score may be influenced by the age of the patients,the types of clinic and the reasons for consulting.Positive correlations between patient enablement and the overall satisfaction,patient's recommendation and doctor empathy were observed.

Objective To assess the empathy level of general practitioners (GPs) in the outpatient clinics of a general hospital,and to investigate the related factors.Methods Patients attending the Family Medicine Clinic of HKU-Shenzhen Hospital in September 2014 and met the inclusion criteria were asked to complete the questionnaire which included general characteristics,overall satisfaction and the Measure-Consultation and Relational Empathy Measure (CARE) Scale after the consultation.Results Of the 1 818 questionnaires retrieved,1 690 CARE scales were completed (intact rate was 92.96%).The overall satisfaction rate was 95.92% (1 621/1 690).And 97.28% (1 644/1 690) of the patients would recommend family medicine service to their friends or relatives.The total score of CARE scale was (45.47±6.26),and the scores of 4 CARE components were (4.63 ± 0.59),(4.43 ± 0.81),(4.54 ± 0.69) and (4.55 ± 0.66),which showed significant difference (P<0.01).The multivariate linear regression analysis showed that the mean CARE scores were not influenced by gender and education levels of the patients,gender of the consulting doctors,initial/follow up consultation,and the location of the consultation.The mean CARE scores were influenced by age of patients and the reasons for consulting (P<0.05).There was a moderate correlation of the CARE scores with the overall satisfaction of patients (r=0.613,P<0.001) and patient's recommendation of the clinic (r=0.466,P<0.001).Conclusion Doctors who were evaluated in this study have a higher empathy level than results from other countries.There is positive correlation between doctor's empathy level and patient's overall satisfaction.The result of doctor's empathy level may be influenced by patient's age and the reasons for consulting.

Nitrites play multiple characteristic functions in invasion and metastasis of hepatic cancer cells, but the exact mechanism is not yet known. Cancer cells can maintain the malignant characteristics via clearance of excess mitochondria by mitophagy. The purpose of this article was to determine the roles of nitrite, reactive oxygen species (ROS) and hypoxia inducing factor 1 alpha (HIF-1 α) in mitophagy of hepatic cancer cells. After exposure of human hepatocellular carcinoma SMMC-7721 cells to a serial concentrations of sodium nitrite for 24 h under normal oxygen, the maximal cell vitality was increased by 16 mg x (-1) sodium nitrite. In addition, the potentials of migration and invasion for SMMC-7721 cells were increased significantly at the same time. Furthermore, sodium nitrite exposure displayed an increase of stress fibers, lamellipodum and perinuclear mitochondrial distribution by cell staining with Actin-Tracker Green and Mito-Tracker Red, which was reversed by N-acetylcysteine (NAC, a reactive oxygen scavenger). DCFH-DA staining with fluorescent microscopy showed that the intracellular level of ROS concentration was increased by the sodium nitrite treatment. LC3 immunostaining and Western blot results showed that sodium nitrite enhanced cell autophagy flux. Under the transmission electron microscopy (TEM), more autolysosomes formed after sodium nitrite treatment and NAC could prevent autophagosome degradation. RT-PCR results indicated that the expression levels of COX I and COXIV mRNA were decreased significantly after sodium nitrite treatment. Meanwhile, laser scanning confocal microscopy showed that sodium nitrite significantly reduced mitochondrial mass detected by Mito-Tracker Green staining. The expression levels of HIF-1α, Beclin-1 and Bnip3 (mitophagy marker molecular) increased remarkably after sodium nitrite treatment, which were reversed by NAC. Our results demonstrated that sodium nitrite (16 mg x L(-1)) increased the potentials of invasion and migration of hepatic cancer SMMC-7721 cells through induction of ROS and HIF-1α mediated mitophagy.

The paper probed into the reform of healthcare personnel′s payroll system , identifying such problems as the staffing quota management system curbing rational flow of healthcare personnel ,lack of enthusiasm of such personnel ,delayed progress of the implementation of the occupational pension and the shortage of talents in urgent need.With current outcomes confirmed ,the authors recommended to remove the staffing quota system and introduce a market mechanism ;to build an income growth mechanism for higher incentives ;to enhance primary institutions′team building ,and develop talents in urgent need ;to unify social insurance standards and enhance local fiscal support .

Objectives:To investigate the antibacterial effects of Acinetobacter baumannii on Acinetobacter SPP. Methods:A Acinetobacter baumannii strain named SL- A.baumannii that can inhibit other Acinetobacter baumannii strains was isolated from the bronchoalveolar lavage fluid of a critically infected patient in the department of neurology, Henan Provincial Hospital on December 10, 2020. To better understand this inhibition effect, the drug resistance, homology and protein fingerprint of the new Acinetobacter baumannii strain, along with 40 other Acinetobacter SPP isolates, were analyzed. Results:Multilocus sequence typing (MLST) revealed that a novel allele combination (gltA/gyrB/gdhB/recA/cpn60/gpi/rpoD) 33, 12, 40, 26, 48, 54, 5 was found in SL- A.baumannii, and ST-2442 was assigned by PubMLST (Oxford). Moreover, 36 isolates, including 30 Acinetobacter baumannii strains, 2 Acinetobacter lwoffii strains, 3 Acinetobacter pittii strains and 1 Acinetobacter ursingii strain, were inhibited by SL- A.baumannii, the inhibition rate was 90% (36/40). Among those strains, 18 (50%) were sensitive to all the antibacterial drugs; 16 (44.44%) showed multi-drug resistance(MDR), including 2 pan-drug resistance(PDR) and 11 extensive drug resistance (XDR) strains; the other 2 (5.56%) were only resistant to Trimethoprim/Sulfamethoxazole(SXT). Conclusion:The new sequence type (ST-2442) Acinetobacter baumannii isolate SL- A.baumannii (PubMLST/Acinetobacter baumannii isolates database/id: 6942) had shown a significantinhibitory effect on Acinetobacter SPP with different drug-resistant phenotypes.

Objective To analyze the prevalence of common chronic diseases and comorbidities in the elderly ≥65 years old in Xinzhou District, Wuhan. Methods A questionnaire survey, physical examination and a retrospective analysis of 12 common chronic diseases comorbidities were conducted in 2016 and 2018 in the resident elderly ≥65 years old. Results In 2016, the medical examination rate of the elderly aged ≥65 years old, the prevalence rate of ≥1 chronic disease, and the comorbidity rate of ≥2 chronic diseases in Xinzhou District were 57.37%, 82.53%, and 48.13%, respectively; in 2018, the medical examination rate, The prevalence of ≥1chronic diseases and the prevalence of ≥2 comorbidities were 47.57%, 83.13%, and 50.02%, respectively. The comparison of the three rates in two years was statistically significant (P＜0.006).The comorbidity of chronic diseases in the elderly accounted for more than 58.32%. The physical examination rate of the elderly is higher in women than in men, and higher in rural areas than in urban areas. The prevalence of chronic diseases is higher in women than in men, and the prevalence of chronic diseases is gradually increasing as the elderly ages. The prevalence of chronic diseases in people with normal BMI is lower than those with abnormal BMI, and the prevalence tend increased gradually with the increase of BMI in abnormal people. Hypertension (70.75%), hyperlipidemia (24.97%), diabetes (16.61%), osteoarthropathy (12.65%), hyperuricemia (9.35%), stroke (8.32%), eyes and appendages (5.88%)ranked the same in 2016 and 2018. Except for hyperuricemia, the prevalence of the other six diseases decreased in 2018 compared with 2016. Conclusion The prevalence of chronic diseases in the elderly ≥65 years old in Xinzhou District is relatively high, showing a slow upward trend. About 50.00% of the elderly suffer from comorbidities. The situation of chronic disease prevention and control is still severe. It is recommended to develop comprehensive prevention and control interventions among this population.