The main factors which affect the farmers'participation in the new rural cooperative medical service are the problems,which exist in the system of the rural cooperative medical service,the institutions of medical service,the government and the farmers themselves etc.Only by constituting the corresponsive policy measures according to these factors can the farmers actively participate in the new rural cooperative medical service.

Objective:To distinguish lung adenocarcinoma (ADC) from squamous cell carcinoma (SCC) using 18F-fluorodeoxyglucose (FDG) PET-based radiomic features. Methods:A retrospective analysis was performed in 182 patients (109 males, 73 females, age (59.0±8.3) years) with non-small cell lung cancer (NSCLC) who underwent 18F-FDG PET/CT scan between January 2018 and December 2019 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. All patients had been diagnosed pathologically with lung ADC or SCC. The patients were divided into a training set ( n=91) and a validation set ( n=91) using simple random sampling method. Radiomic features were extracted from the PET images of segmented tumors using the Python package. The minimum redundancy maximum relevance feature selection algorithm and least absolute shrinkage and selection operator were employed to select informative and non-redundant features, and a radiomics signature score (rad-score) was developed. Differences of rad-score between groups were compared by Mann-Whitney U test. Multivariate logistic regression was applied to select the important factors. A combined model was constructed based on the clinical variable and radiomics signature. The predictive performance of models was analyzed and compared using receiver operating characteristic (ROC) curves and Delong test. Results:Four radiomic features, namely HHL_first order_maximum, LHL_first order_entropy, HHH_ gray level dependence matrix_large dependence high gray level emphasis (GLDM_LDHGLE), HHL_GLDM_LDHGLE (H/L represent the high/low pass filter) were selected to build the rad-score. The rad-score showed a significant ability to discriminate between different histological subtypes in the two sets(training set: -1.30(-1.70, -1.04) vs -0.60 (-1.11, 0.20), z=-4.61, P<0.001); validation set: -1.31(-1.66, -0.96) vs -0.73(-1.02, -0.24), z=-4.76, P<0.001). The area under the curve (AUC) of the rad-score were equal to 0.815 (95% CI: 0.723-0.906) in the training set, and 0.813 (95% CI: 0.726-0.901) in the validation set, respectively, which were larger than those of the clinical variables (smoking had the best prediction performance, training set: 0.721 (95% CI: 0.617-0.810), validation set: 0.726 (95% CI: 0.623-0.814)), however, the difference was not significant ( z values: 1.319, 1.324, both P>0.05). When the clinical variable (smoking) and radiomics signature were combined, the complex model showed a better performance in the classification of histological subtypes, with the AUC increased to 0.862 (95% CI: 0.785-0.940; sensitivity: 88.00%(22/25), specificity: 72.73%(48/66)) in the training set and 0.854 (95% CI: 0.776-0.933; sensitivity: 75.00%(21/28), specificity: 84.13%(53/63)) in the validation set. The AUC values were significantly higher than those of the clinical variable (smoking; training set: z=3.257, P<0.001; validation set: z=3.872, P<0.001). Conclusion:Individualized diagnosis model incorporating with smoking and radiomics signature can help differentiate lung cancer subtypes in a non-invasive, repeatable modality.

Recently,much interest has been focused on the clinical application and biology of tumor-derived DNA in the plasma/serum of cancer patients.Such interest has resulted in the demonstration of human papillomavirus(HPV) DNA in the plasma/serum of patients with cervical cancer(CC).The studies used different materials(plasma /serum),different DNA extraction methods and different primers to detect circulating free HPV DNA,so the positive rates varied from(6.9%) to 50%.The HPV DNA in the plasma/serum of patients suffering from CC most likely originates from the tumor itself,which will probably provide us with a new tool for CC monitoring after primary treatment,especially in patients in advanced stages.It is expected that this promising molecular tumor marker would soon be put into routine clinical use.

Objective:To explore the infuence of calf spleen extractive injection combined with chemotherapy on immune function of the patients after colorectal carcinoma. Methods:Totally 128 cases of postoperative colorectal carcinoma patients were randomly di-vided into two groups with 64 ones in each. The control group only received FOLFOX 4 regimen, while the study group received calf spleen extractive injection additionally from the first day to the tenth day, 10ml, ivd, and 14-day was one cycle. After 4 weeks, im-mune function, peripheral blood leukocytes ( WBC) , hemoglobin ( Hb) and platelet ( Plt) in the two groups were compared, and the adverse reactions were evaluated as well. Results: After the treatment, CD3 +, CD4 +, CD8 + and CD4/CD8 were increased in the study groups, and those in the study group were much higher than those in the control group (P<0. 05). After the treatment, there were no significant changes in WBC, Plt and Hb in the two groups (P>0. 05), while WBC and Plt in the study group were higher than those in the control group (P<0. 05). The incidence of adverse reactions in the study group was lower than that in the control group (P<0. 05). Conclusion:Calf spleen extractive injection combined with chemotherapy not only can increase the immune func-tion, but also alleviate myelosuppression and gastrointestinal toxicity in the treatment of postoperative colorectal carcinoma patients.

OBJECTIVE:To establish the method for pharmacokinetic study of luteolin and cynaroside in rats and to determine pharmacokinetic parameters. METHODS:16 SD rats were randomly divided into luteolin group (sublingual iv,1.34 mg/kg) and cynaroside group(sublingual iv,0.64 mg/kg). 0.5 ml blood were collected before administration and 0,15,30 min and 1,2,3,4,6, 8,12,24,48 h after administration respectively to prepare plasma. UPLC-TQ-MS was adopted to determine plasma concentration, and pharmacokinetic parameters were calculated. A CORTECSTM UPLC? C18(100 mm×2.1 mm,1.6 μm)column was used with mobile phase consisted of acetonitrile-water (containing 0.1% formic acid) at a flow rate of 0.4 ml/min,the column temperature was set at 40 ℃,and quercetin was used as internal standard. RESULTS:The linear range of luteolin and cynaroside were 2.5-500 ng/ml (r=0.998 2) and 10-2 500 ng/ml (r=0.993 5). The lowest quantitation limits were 1 and 2.5 ng/ml,and extraction were 70.75%-87.72% and 75.40%-91.18%(n=6);RSD of inter-day and intra-day were all lower than 10%(n=3). Pharmacokinetic parameters as t1/2 were (1.88 ± 0.32) and (1.57 ± 0.08) h;CL were (0.77 ± 0.18) and (0.06 ± 0.01) L/(h·kg);AUC0-6 h were (189.60±40.04)and(1 093.14±187.36)ng·h/ml;AUC0-∞ were(195.18±38.37)and(1 097.11±188.07)ng·h/ml. CONCLU-SIONS:The method can be used for pharmacokinetic study of luteolin and cynaroside in rats,and the pharmacokinetics of them in rats are in line with two-compartment model.

20 mm),these three imaging techniques(HAP-MDCT,Lipiodol CT and DSA)had the same sensitivity,for 10~20 mm hepatic nodules,the detecting rate was no significant difference among them,while,for

OBJECTIVE:To compare the contents of hesperidin in raw Fructus Aurantii Immaturus and its processed products.METHODS:HPLC was used for the quantitative analysis of raw Fructus Aurantii Immaturus and its processed products.RESULTS:The content of hesperidin in vinegar-fried Fructus Aurantii Immaturus was the highest and that in the bran-fried Fructus Aurantii Immaturus was the lowest.CONCLUSION:It is suggested that there exist significant differences in intrinsic quality among various processed products of Fructus Aurantii Immaturus.

Medical integration is an inevitable trend of medical development and medical educa-tion reform nowadays. Under the guidance of integration,medical colleges at home and abroad develop a series of exploration and practice of medical education reform. According to difficulties and problems of medical education reform,this article put forward:changing ideas to adapt to the transformation of medi-cal model,combining medical education reform and new medical reform,playing the main role of educa-tion administration department in the reform of medical course system,strengthening multi-dimensional integration of medical science.

Objective To investigate the effect of curcumin on chronic pancreatitis in rat.Methods Eighteen one-month old male SD rats were randomly divided into control group,ANP group and curcumin group with 6 rats in each group.After fed by 25％ alcohol for twelve weeks,the rats in ANP group were intraperitoneally injected with lipopolysaccharides ( LPS,2 mg/kg body weight) once a week for 4 weeks.The rats in curcumin group were fed with curcumin when they were intraperitoneally injected with lipopolysaccharides.Seventeen weeks later,the rats were sacrificed.Serum glucose was measured,pancreatic morphology was routinely examined,collagen deposition was determined by Masson stain,and the amylase and lipase in pancreatic tissue were evaluated,TGF-β1 mRNA was determined by using RT-PCR.Results The pathological score of control group,ANP group and curcumin group was 1.17 ±0.41,7.33 ±2.58 and 3.50 ± 1.05,and the score in curcumin group was lower than that of ANP group (P ＜ 0.01 ),but which was higher than that in control group (P ＜ 0.05 ).There was no difference in the serum glucose among the groups.The levels of amylase and lipase in pancreatic tissue were (7348 ± 102 ),( 14135 ± 1272) U/g,which were significantly higher than those in ANP group[( 5428 ± 547 ) and (9123 ± 1250 ) U/g,P ＜ 0.05].The expressions of TGF β1 mRNA in control group,ANP group and curcumin group were 0.618 ± 0.019,0.818 ±0.012,0.745 ±0.088,and the values in ANP group were significantly higher than those in control group and curcumin group (P ＜ 0.01 ).Conclusions On the basis of long term ethanol intake,repeatedly intraperitoneal injection of LPS can induce chronic pancreatitis,and curcumin has anti-fibrosis effect possibly by its inhibitory effect on the expression of TGF-β1.

Objective:To establish an ultra performance liquid chromatography-tandem quadrupole mass spectrometry method for the determination of warfarin and its metabolite 7-hydroxywarfarin in human plasma. Methods: An ACQUITY UPLC? BEH C18 (50 mm × 2. 1 mm, 1. 7 μm) column was used as the stationary phase at 40℃. The mobile phase consisted of acetonitrile and water (con-taining 0. 1% formic acid) with gradient elution at a flow rate of 0. 4 ml·min-1 . Warfarin-d5 was used as the internal standard. The analytes were detected on a triple-quadrupole mass spectrometer equipped with an ESI interface in a positive mode. Results:The reten-tion time of warfarin and 7-hydroxywarfarin was 1. 8 min and 1. 5 min, respectively. Excellent linear calibration curve of warfarin and 7-hydroxywarfarin was obtained within the concentration range of 25-2 000 ng · ml-1 ( r =0. 999 3 ) and 5-500 ng · ml-1 ( r =0. 999 6), respectively. The lower limit of quantification of warfarin and 7-hydroxywarfarin was 5 ng·ml-1 and 2. 5 ng·ml-1 with the average recovery of 96. 9%-105. 3% and 97. 1% -103. 3%, respectively. The intra-and inter-day standard deviations were both less than 10%. Conclusion: The method is accurate and simple, and suitable for the determination of warfarin and its metabolite 7-hydroxywarfarin in human plasma.