The paper describes the short and medium term (within 2 to 5 years) priorities that any region in China right now faces in working out and implementing its regional health planning, viz. the coordinated development strategy of medicine and health, medical security and social economy. The authors hold that to achieve the coordinated growth of the health cause and society, it is imperative to overcome in the short run logically related obstacles in four aspects: ineffective solution to the apparent problems followed with interest by both the social and health sectors and lack of effective operating conditions accompanying medical insurance reform, both resulting in the lack of a driving force in the reform within hospitals; difficulty in achieving breakthroughts in the development of the health cause; and the probability of a regional health planning becoming a mere formality because of the above factors. In addition, the fact that reform of medical and health institutions in their setup and ownership of property rights lags behind macroscopic social economic reform obscures the explanation of and solution to the above problems. Based on the research results, the paper sets forth the priorities in short and medium term planning.

Objective To study effect of TCM-based syndrome differentiation combined with diet nursing and point massage on insomnia.Methods Five hundred and twelve patients with insomnia were randomized into control group(n=85)and intervention group (n=67).The patients in both groups received treatment by TCM-based syndrome differentiation.Besides,the control group was given conventional nursing while those in the intervention group received diet nursing and point massage.The two groups were compared in three months in terms of sleep quality and curative effect.Results In comparisons of sleep quality index,the two groups both had statistically significant improvements respectively(both P<0.05).In terms of time to sleep, duration of sleep an sleep efficacy and Pittsburg sleep quality index,the intervention group scored significantly lower than the control group(all P<0.05).In terms of curative effect,the intervention group was significantly higher than the control group(P<0.05).Conclusion The method of TCM-based syndrome differentiation combined with diet nursing and point massage is effective in improving the sleep quality of those with insomnia.

Objective:Nuclear apoptosis-inducing factor 1(NAIF1) is a novel apoptosis gene cloned in laboratory. To analyze the binding proteins of NAIF1 by pulldown method, the fusion expression vector of truncated human nuclear apoptosis-inducing factor 1〔NAIF1(73-327)〕 was constructed, were expressed and purified the recombinant GST-NAIF1(73-327) fusion protein in E.coli.Methods:The cDNA encoding human NAIF1(73-327) was amplified by PCR and cloned into pGEX-KG vector. The GST-NAIF1(73-327) fusion protein was expressed in E.coli and purified by affinity chromatography. The purified protein was detected by SDS-PAGE, Western blot and ESI-Q-TOF-MS/MS.Results:A prokaryotic expression vector of GST-NAIF1(73-327) was constructed and the GST-NAIF1(73-327) fusion protein was expressed in E.coli at high level. SDS-PAGE analyses indicated that the purified protein was about 53 kD. Western blot and MS/MS analyses verified the recombinant fusion protein.Conclusion:An efficient method for obtaining recombinant GST-NAIF1(73-327) fusion protein had been established and it could be used for further studies on the structure and function of NAIF1.

Objective:To set up an effective and simple purification method to obtain highly purified prokaryotic protein of PDCD5 and study its stability. Methods:Recombinant PDCD5 protein expressed in E. coli was accumulated as an inclusion body. After washing, the inclusion body was denatured, renatured, digested with thrombine and then purified by two steps of chromatography. The purity of the products was analyzed by capillary electrophoresis and the stability was identified by SDS-PAGE. Results:Capillary electrophoresis showed that the purity of protein was 100%, and molecular weight was 15 800 with pI 5.9. Further bioactivity assay indicated that the purified PDCD5 could enhance the apoptosis of HL 60 cells withdrawing cytokine, which was in a dose dependent manner. Stability analysis showed that the PDCD5 protein was sensitive to temperature and easy to degrade at 4 ℃ and 25 ℃. However, it was relatively stable at -20 ℃ or lyophilized. Conclusion:Highly purified and stable recombinant PDCD5 protein was obtained, which lays a foundation for the functional study and application investigation of PDCD5 .

Objective: To explore the occurrence of cognitive impairment in Chinese heart failure (HF) patients and it's impact on prognosis. Methods: In this prospective observational study, a total of 990 HF patients were enrolled from 24 hospitals in China during December 2012 to November 2014. All patients were administrated with the interview-format Montreal Cognitive Assessment (MoCA), according to which they were divided into MoCA<26 (with cognitive impairment) group and MoCA≥26 (without cognitive impairment) group. Baseline data were collected and a 1-year follow up was carried out. Univariate and multivariate logistic or Cox regression were performed for 1-year outcomes. Results: Cognitive impairment was evidenced in 628 patients (63.4%) and they were more likely to be older, female, and with higher proportion of New York Heart Association(NYHA) class Ⅲ-Ⅳ, chronic obstructive pulmonary disease (COPD), ischemic heart disease, while body mass index (BMI), education level, and medical insurance rate were lower (all P<0.05) as compared to patients in MoCA≥26 group. The rate of percutaneous intervention, device implantation, cardiac surgery and evidence-based medications were significantly lower in MoCA<26 group than in MoCA≥26 group (all P<0.05). During the 1-year follow up, patients in the MoCA<26 group had higher all-cause mortality (10.2%(64/628) vs. 2.2%(8/362), P<0.01), cardiovascular mortality (5.9%(37/628) vs. 0.8%(3/362), P<0.01) and major adverse cardiac and cerebrovascular events (MACCE) (9.6%(60/628) vs. 2.5%(8/362), P<0.01) than patients in the MoCA≥26 group. In univariate regression, MoCA<26 was associated with increased all-cause mortality (HR(95%CI):4.739(2.272-9.885), P<0.01), cardiovascular mortality (HR(95%CI):7.258(2.237-23.548), P=0.001) and MACCE (OR(95%CI):4.143(2.031-8.453), P<0.01). After adjustment by multivariate regression, MoCA<26 was indicated as an independent risk factor for all-cause mortality (HR(95%CI): 6.387(2.533-16.104), P<0.01), cardiovascular mortality (HR(95%CI): 10.848(2.586-45.506), P=0.001) and MACCE (OR(95%CI): 4.081(1.299-12.816), P=0.016), while not for re-hospitalization for HF (OR(95%CI):1.010(0.700-1.457), P=0.957). Conclusions Cognitive impairment is common in HF patients,and it is an independent prognostic factor for 1-year outcomes. Routine cognitive function assessment and active intervention are thus recommended for HF patients.

OBJECTIVE: To develop a model based on the clinical variables for evaluating the risk of distant metastasis in patients with advanced nasopharyngeal carcinoma (NPC). METHODS: From September,2007 to June,2015,a total of 238 consecutive patients with biopsy-proven NPC in stage Ⅲ-Ⅳ(M0) based on the AJCC TNM staging manual were enrolled in this study,including 106 male and 34 female patients with a median age of 45 years (range 18-68 years).In this cohort,126 patients received concurrent chemoradiotherapy,and 24 received chemotherapy and radiotherapy,and 40 had induction chemotherapy.We used the least absolute shrinkage and selection operator (LASSO) method to select the most significant features for establishing the model for assessing the risks of distant metastasis. RESULTS: Among the 18 clinical variables tested,5 were significantly associated with distant metastasis in advanced NPC,including plasma Epstein-Barr virus (EBV) DNA,neutrophil/lymphocytes (NLR),VCA-IgA,concurrent chemoradiotherapy,and induction chemotherapy.Based on these 5 clinical variables,we established the following model:risk score=1.73×EBV DNA+0.54×NLR+0.38×VCA-IgA-0.95×concurrent chemoradiotherapy-2.37×induction chemotherapy+0.51.The cutoff point of this model was-0.62,which classified the patients into high-risk and low-risk groups for distant metastasis.This model showed a good performance in predicting distant metastasis in patients with advanced NPC (<0.01). CONCLUSIONS The model we established herein can be used for evaluating the risks of distant metastasis in patients with advanced NPC and provides assistance in the clinical decision-making on individualized treatment strategy.
Adult ; Aged ; Chemoradiotherapy ; Female ; Herpesvirus 4, Human ; genetics ; Humans ; Induction Chemotherapy ; Male ; Middle Aged ; Models, Statistical ; Multivariate Analysis ; Nasopharyngeal Carcinoma ; secondary ; therapy ; virology ; Nasopharyngeal Neoplasms ; pathology ; therapy ; virology ; Neoplasm Staging ; Prognosis ; Young Adult

Leukocyte differentiation antigens (LDAs) play important roles in the immune system, by serving as surface markers and participating in multiple biological activities, such as recognizing pathogens, mediating membrane signals, interacting with other cells or systems, and regulating cell differentiation and activation. Data mining is a powerful tool used to identify novel LDAs from whole genome. LRRC25 (leucine rich repeat-containing 25) was predicted to have a role in the function of myeloid cells by a large-scale "omics" data analysis. Further experimental validation showed that LRRC25 is highly expressed in primary myeloid cells, such as granulocytes and monocytes, and lowly/intermediately expressed in B cells, but not in T cells and almost all NK cells. It was down-regulated in multiple acute myeloid leukemia (AML) cell lines and bone marrow cells of AML patients and up-regulated after all-trans retinoic acid (ATRA)-mediated granulocytic differentiation in AML cell lines and acute promyelocytic leukemia (APL; AML-M3, FAB classification) cells. Localization analysis showed that LRRC25 is a type I transmembrane molecule. Although ectopic LRRC25 did not promote spontaneous differentiation of NB4 cells, knockdown of LRRC25 by siRNA or shRNA and knockout of LRRC25 by the CRISPR-Cas9 system attenuated ATRA-induced terminal granulocytic differentiation, and restoration of LRRC25 in knockout cells could rescue ATRA-induced granulocytic differentiation. Therefore, LRRC25, a potential leukocyte differentiation antigen, is a key regulator of ATRA-induced granulocytic differentiation.
Antigens, Differentiation ; immunology ; metabolism ; Cell Differentiation ; drug effects ; Cell Line, Tumor ; Granulocytes ; cytology ; drug effects ; immunology ; metabolism ; Humans ; Leukocytes ; cytology ; drug effects ; immunology ; metabolism ; Membrane Proteins ; antagonists & inhibitors ; immunology ; metabolism ; RNA, Small Interfering ; pharmacology ; Tretinoin ; pharmacology