AIM:To investigate the potential of differentiatng into myocytes of the granulocyte colony-stimulating factor(G-CSF)-mobilized CD34 + cells. METHODS: Three hours after intraperitoneal injecction of isoprenaline(ISO) to develop acute ischemic model, rats' bone marrow hematopoietic stem cells were mobilized to the site of myocardial infarction by G-CSF. The techniques of immunohistochemisty and HE stain were used to detect the infiltration of CD34 + cells and the regeneration of myocytes in the infarct zones. RESULTS: 24 hours after administration of ISO , a large amount of infiltrative monocytes and regenerative myocytes which were CD34 positive expression could be found in the infarct zones of the G-CSF treatment group, while majority of the infiltrative inflammatory cells in control group were neutrophils and there was no infiltrative cells and myocytes which were CD34 positive expressio, 2 weeks after administration of ISO, there were a plenty of scar in control group, but not in the G-CSF treatment group. CONCLUSION: G-CSF-mobilized CD34 + cells possess the potential to differentiate into myocytes and it may be used in treating acute myocardial infarction.

Objective T o observe the expression changes of hypoxia inducible factor-1α (H IF-1α) and vascular endothelial grow th factor-A (V E G F-A ) in rats w ith arrhythm ias, and to explore the differences of the expression pattern in the tw o indicators of acute m yocardial ischem ia caused by arrhythm ias and coronary insufficiency. Methods T he arrhythm ia w as induced by C aC l2, and the expression changes of H IF-1α and V E G F-A w ere detected by im m unohistochem istry, W estern blotting and real-tim e PC R w ithin 6 h after the arrhythm ia in rats. Results T he expression of H IF-1α and V E G F-A show ed diffuse in the m yocardial tissue of rats died from arrhythm ias. B oth of them increased in the early arrhythm ia, then decreased. E xtensive m yocardial ischem ia happened at the beginning of arrhythm ia occurrence and its range didn't expand w ith tim e. Conclusion T he expressions of H IF-1α and V E G F-A in m yocardium of the rats w ith arrhythm ia can provide evidence for the differential diagnosis of acute m yocardial is-chem ia caused by fatal arrhythm ia and coronary insufficiency.

Polyacrylamide resin was synthesized via surface-initiated atom transfer radical polymerization ( SI-ATRP) method. Acrylic amide ( AM) was grafted onto the surface of the chloromethyl polystyrene resin via SI-ATRP in the CuBr/2, 2'-bipyridine ( Bpy) system as catalyst at room temperature. The compositions of polyacrylamide resin were determined by means of elementary analysis, FT-IR analysis and scanning electron microscopy ( SEM) . The adsorption properties, the parameters of kinetics and the thermodynamics of the resin were evaluated in details, respectively. As the results, adsorption capacity of 2,4-dichlorophenoxyacetic acid (2,4-D) increased with the initial concentrations of solution increasing at room temperature, and its highest adsorption capacity was 111. 0 mg/g with solution concentration of 8 mmol/L. Adsorption isotherm at room temperature was determined and modeled with Langmuir and Freundlich equations. The thermodynamic equilibrium functions were calculated to be ΔG<0,ΔH=268. 2 kJ/mol, ΔS>0, hence, the adsorption was spontaneous, endothermic and entropy increasing. The kinetics fitted the pseudo-second-order well. The polyacrylamide-chloromethyl polystyrene (PAM-CMCPS) resin was used for the adsorption of 2,4-D in orange sample, and good results were obtained.

Objective To explore some reasonable ways of anticoagulation for pregnant women with mechanical prosthetic valves.Methods Retrospective analysis was conducted for 27 women with mechanical prosthetic valves who have born children after their cardiac surgeries.Numbers of pregnancies,ages,ways of anticoagulation during pregnancy,ways of anticoagulation before pregnancy,valve thrombosis events,thromboembolism events,bleeding events,outcomes of pregnancy and ways of delivery were collected and studied.Comparing adverse events and outcomes of different ways of anticoagulation which those women used during their pregnancies.Results 27 women with mechanical prosthetic valves experienced 41 pregnancies,and bore 28 children.24 pregnancies used oral low does warfarin(＜ 5 mg/day) to anticoagulate,2 minor bleeding events and 10 early abortion occurred,no abnormal neonates were found,14 healthy neonates were born.6 pregnancies used low-molecularweight heparin to anticoagnlate from 6th week to 12th week,they used oral warfarin to anticoagulate in rest weeks of pregnancy.1 late abortion occurred,1 fetus with hydrocephalus was found at 20th week,then induced labour was conducted.4 healthy neonates were born.11 pregnancies used low-molecular-weight heparin to anticoagulate until delivery,1 early abortion,2 minor bleeding events and 1 valve thrombosis occurred.10 neonates were born,and 1 of them has hypoxic-ischemic encephalopathy,the other 9 neonates were healthy.Conclusion For pregnant women with mechanical prosthetic valves,using oral low does warfarin throughout pregnancy is a reasonable way of anicoagnlation with low risk of maternal and fetal adverse events except high risk of abortion.Low-molecular-weight heparin is hopeful anticoagulant agent for pregnant women with mechanical prosthetic valves,but more studies about its safety and effectiveness should be conducted.

Objective To objectively study the current progress of China Healthcare Improvement Initiative, and its effectiveness and shortcomings for further improvement. Methods Questionnaires were customized by expert consultation and pre-investigation, and distributed by the National Health Commission in April 2018 to the hospitals.Data of 5 469 hospitals were recovered and analyzed with a statistics software for descriptive analysis.Results Implementation progress of the five working systems varied with regions, and rooms of improvement were found in such aspects as outpatient appointment, clinical pathway management and social work system.In 2017, the proportion of outpatient appointments of 5 469 hospitals averaged 19.1%.Progress of the ten major service models also varied, as defects were found in such service models as continuous medical service, intelligent service, and interconnection service.In 2017, only 6.7% of the 5 469 hospitals had put in place hierarchical integrated clinical pathways within their medical alliances.Conclusions Improvement of the medical services calls for not only the efforts of medical institutions themselves, but also top-level design by the local health authorities. In particular, an online information platform should be established for the whole region, to unify the information standards and processes, and corresponding mechanisms and system support are needed.

Objective To translate Moral Distress Scale(MDS-R), and to test the reliability and validity of the Chinese version of MDS-R. Methods The MDS-R was translated, back translation and adapted according to Chinese culture. The reliability and validity of Chinese version of MDS-R was tested in 750 nurses in Quzhou city by item correlation analysis, content validity, exploratory factor analysis, confirmatory factor analysis, Cronbach′s Alpha coefficient and test-retest reliability. Results The internal consistency coefficient of the Chinese version of MDS-R ranged from 0.119-0.756 (P<0.01). The content validity was 0.952. validity.Factor analysis extracted three common factors, which explained 64.537％ of variance of the total scale. Based on the exploratory factor analysis, a theoretical model was established for the scale and each factor, and the fitting degree of the theoretical model was verified by the data. After fitting the model, the fitness values of the first and the second order confirmatory factor analysis were all up to the standard level. The Cronbach's Alpha coefficient of the scale was 0.925, and the test-retest reliability was 0.900. Conclusions The Chinese version of MDS-R is reliable and valid, and can be used to measure the moral distress of nurses.

Objective: To explore the turnover intention of nurses in Quzhou and its influential factors. Methods: From July to August in 2017 cross-sectional study and self-filled questionnaire are used to investigate 980 nurses from 7 hospitals in Quzhou, including two third-level hospitals and five second-level ones. T-test, F-test, Pearson and linear regression are used in data with the method of statistical analysis. Results: The total score of turnover intention of nurses was (14.95±3.17) points, and the index value was 62.27%, of which the turnover intention was above 78%. The analysis of Single factor showed that age (F=4.895) , Department (F=2.971) , title, nursing age (F=5.863) , self-assessment of physical conditions (F=4.092) were closely related to nurses’ turnover intention(P<0.05). According to Person’s correlation analysis, there are positive correlations between turnover intention and source of stressor, and moral distress (P<0.05) . Multiple linear regression showed that the nurses’ turnover intention was age, Department, health selfevaluation, stressor and moral distress. Conclusion The turnover intention of nurses is high, which is related to age, Department, self-evaluation of health, stressor and moral distress.

OBJECTIVE:To explore losses and gains (L&G) and L&G ratio induced by Essential Medicine System in a county. METHODS:By choosing a county in western China as sample area,field investigation was used to collect outpatient and inpatient visits,outpatient and inpatient income,drug income,total length of stay and medical insurance reimbursement criteria in primary medical institutions (township health centers,village health rooms) of the county during 2009-2015. By setting the year 2009 as the baseline year,the drug cost reimbursed by medical insurance was simulated and calculated when Essential Medicine System were not implemented;L&G and L&G ratio of medical insurance were calculated by comparing with actual drug cost reimbursed by medical insurance. RESULTS:The year 2012,in which the sample county fully implemented the Essential Medicine System was the turning year. Medical insurance funds lost in primary medical institutions of the county during 2010-2011(lost 437000,915000 yuan,respectively),but gained during 2012 to 2015(gained 199000,494000,858000,1290000 yuan, respectively);the L&G ratio increased from -0.67％ to 1.21％. For reimbursed outpatient drug cost and inpatient cost,L&G of medical insurance were different. For reimbursed drug cost of village health room and township health center,L&G of medical insurance were also different. CONCLUSIONS:The implementation of Essential Medicine System benefits to medical insurance within the county and Medical insurance funds can be saved.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

To screen the best genotypeⅠJapanese encephalitis virus subunit vaccine candidate antigens, the prMEIII gene, the polytope gene and the prMEIII-polytope fusion gene of the GenotypeⅠJapanese encephalitis virus GS strain were cloned into prokaryotic expression vector pET-30a. The recombinant proteins were obtained after the induction and purification. The prepared recombinant proteins were immunized to mice, and the immunogenicity of the subunit vaccine candidate antigens was evaluated through monitoring the humoral immune response by ELISA, detecting the neutralizing antibody titer by plaque reduction neutralization test, and testing the cell-mediated immune response by lymphocyte proliferation assay and cytokine profiling. The recombinant proteins with the molecular weights of 35 (prMEIII), 28 (polytope antigen) and 57 kDa (prMEIII-polytope) induced strong humoral and cellular immune responses in mice. Compared with prMEIII-polytope and polytope proteins, the prMEIII protein induced a significant expression of IL-2 and IFN-γ (P<0.05) and the significant lymphoproliferation of splenocytes (P<0.05). The neutralizing antibody titer induced by the prMEIII protein was close to that induced by the commercial attenuated vaccine SA14-14-2 (P>0.05). The study suggests that the prMEIII protein can be used for the development of the Japanese encephalitis virus subunit vaccine.
Animals ; Antibodies, Viral ; blood ; Antigens, Viral ; immunology ; Encephalitis Virus, Japanese ; immunology ; Encephalitis, Japanese ; immunology ; prevention & control ; Immunogenicity, Vaccine ; Mice ; Mice, Inbred BALB C ; Vaccines, Subunit ; immunology ; Viral Vaccines ; immunology