OBJECTIVE:To investigate the inhibitory effect of astragalus polysaccharide(APS)on the proliferation of human neuroblastoma SH-SY5Y cells. METHODS:After the cells were cultured with 0(blank control),25,50 and 100 mg/ml APS for 6,12 and 24 h,MTT method was used to determine cell viability and calculate inhibition rate. Following cell cultured with 0 (blank control),25,50 and 100 mg/ml APS for 24 h,Hoechst 33258 fluorescent staining was performed,and then cell nucleus morphology was observed under the fluorescence microscope;flow cytometer was used to detect the distribution of cell cycles and apoptosis;western blot was employed to determine the expression of extracellular regulated protein kinases (ERK) 1/2 protein in cells. Enzyme linked immunosorbent assay (ELISA) was conducted to determine the contents of interleukin 2 (IL-2),IL-6 and IL-12 in the cells. RESULTS:Compared to the blank control,those cultured with 100 mg/ml APS for 6 h,50 and 100 mg/ml APS for 12 h and 25,50 and 100 mg/ml APS for 24 h demonstrated higher inhibition rate. After the cells were cultured with 50 and 100 mg/ml APS for 24 h,those in G0/G1 phase increased and those in G2/M and S phases decreased,and the contents of IL-2 and IL-6 increased. After cells were cultured with 25,50 and 100 mg/ml APS for 24 h,the apoptosis rate was higher,densely hyperchromat-ic fragments in cell nuclei and apoptotic bodies appeared,the phosphorylation level of ERK1/2 protein in the cells was lower,and the content of IL-12 was higher. There was statistically significance (P<0.01 or P<0.05). CONCLUSIONS:APS can inhibit the proliferation of SH-SY5Y cells by arresting cell cycle and inducing cell apoptosis through a mechanism which may be correlated to the decrease in the phosphorylation of ERK1/2 and increase in cytokine.

This study aimed to develop the calculation method of pre-hospital emergency physician allocation gap and apply it to Shanghai.In order to reduce the ambulance dispatch lag frequency, through the analysis of its da-ta in the Shanghai urban area, the research group obtained the gap and extended the data to Shanghai city.The peak method establishes the association between pre-hospital emergency physician increment and the ambulance dispatch lag decrement.Based on descriptive statistics, the peak method by which the Shanghai ambulance dispatch lag data were analyzed uses the SAS programming software.This method of using programming software provides it with good reliability and validity.After an increase of 40 duty vehicles (381 pre-hospital emergency physicians), the ambu-lance dispatch lag ratio would drop from 25.61 percent to 0.22.Therefore, the association between the pre-hospital emergency physician increment and the ambulance dispatch lag decrement was established and can provide a scientif-ic evidence for the policy formulation.

It is difficult to diagnose and treat local recurrence of the rectal cancer after operation. The early diagnosis is crucial for the recurrence of rectal cancer after operation. MSCT perfusion imaging is valuable in the diagnosis of recurrence of rectal cancer after operation. The application of MSCT perfusion imaging following rectal cancer operation was reviewed in this article.

Objective:To investigate the occurrence and characteristics of post-traumatic stress disorder (PTSD) in medical school undergraduates, in order to provide reference to promote their mental health.Methods:Adopting stratified and cluster sampling method, 883 undergraduates from Xi ′an Medical College were selected and surveyed on March 9-16, 2020 by general condition questionnaire, PTSD Checklist-Civilian Version (PCL-C) and Simplified Coping Style Questionnaire (SCSQ). Results:The total score of PCL-C was (24.34 ± 8.12) points, (7.19 ± 2.61) points for re-experiencing symptoms, (9.87 ± 3.49) points for avoidance symptoms, and (7.28 ± 2.85) points for arousal symptoms. The incidence of PTSD was 8.2% (72/883). The scores of PTSD symptoms were higher in grade four students and whose coping tendency was negative, (26.37 ± 9.26) and (26.49 ± 9.48), respectively ( F value was 3.065, P<0.05; t value was -9.357, P<0.001). Positive coping scores were negatively correlated to PTSD symptoms ( r value was -0.130, P<0.001), while negative coping scores were positively correlated to PTSD ( r value was 0.244, P<0.001). Medical students with strong professional attitude had lower PTSD scores (23.23 ± 6.92)( F value was 21.650, P<0.001) and lower negative coping scores (8.21 ± 4.65) ( F value was 6.567, P<0.001). Conclusions:The incidence of PTSD was 8.2% in medical school undergraduates, whose severity was related to grade and coping tendency. Appropriate crisis intervention should be taken among medical students to improve their positive coping style, strengthen their professional identification and promote their mental health.

Objective To analyze the diagnostic value of serum tumor markers in bone metastasis of non-small cell lung cancer (NSCLC).Methods The clinical data and follow-up data of 160 patients with NSCLC from March 2013 to September 2015 in Tangshan People's Hospital were retrospectively analyzed.According to the status of bone metastasis,the patients were divided into the observation group with bone metastasis (n =114) and the control group without bone metastasis (n =46).The positive rates and concentrations of 4 tumor markers including carcinoembryonic antigen (CEA),carbohydrate antigen CA125,CA19-9 and Ferritin were analyzed and compared.And their sensitivities and specificities to the diagnosis of NSCLC bone metastasis were analyzed.The Youden index was calculated to capture the performance of the diagnostic test.Results The concentrations of CEA,CA125,CA19-9 and Ferritin in the observation group were (19.74 ±6.71) μg/L,(45.62 ± 19.53) kU/L,(35.89 ± 15.66) kU/L and (334.02 ± 79.43) μg/L respectively,which were higher than those in the control group [(2.36 ± 0.92) μg/L,(14.37 ± 5.43) kU/L,(15.31 ±7.22) kU/L,(122.58 ± 69.46) μg/L],and the differences were statistically significant (t =7.200,P ＜0.001;t=7.180,P＜0.001;t =6.032,P ＜0.001;t=11.152,P＜0.001).The positive rates of CEA,CA125,CA19-9 and Ferritin in the observation group were 78.95％,68.42％,52.63％ and 73.68％ respectively,which were higher than those in the control group (8.70％,4.35％,4.35％ and 13.04％),and the differences were statistically significant (x2 =66.746,P ＜ 0.001;x2=53.822 P ＜ 0.001;x2 =32.193,P ＜0.001;x2 =48.975,P ＜ 0.001).The sensitivities of CEA,CA125,CA19-9 and Ferritin were 78.94％,68.42％,52.63％ and 73.68％ respectively,and the specificities of them were 91.30％,95.65％,95.65％ and 86.96％ respectively.The Youden indexes were 70.24％,64.07％,48.28％ and 60.64％ respectively.The sensitivity and specificity of multi-factorial combination were 99.17％ and 72.63％,and the Youden index was 71.80％.Conclusion Four tumor markers including CEA,CA125,CA19-9 and Ferritin were correlated with NSCLC,and combined detection has better performance of dignosis than single factor.

Objective:The paper aims at developing a method of defining and visualizing the scope of the basic medical insurance pharmacy service, and provides a new way of thinking for the designated pharmacy planning. Methods:Collecting the basic data and information on administrative divisions in the planning area taking equity and efficiency as the guidance, using ArcGIS and its function modules to define and visualize the scope of the medical in-surance pharmacy service. The procedure of issue focus, method improvement, data simulation, expert consultation, methodology perfecting were followed to define and visualize the scope. Results:Forming a whole set of operative pro-cedures of defining and visualizing the scope of the medical insurance pharmacy service based on medical resources allocation standard, and the operation commands and procedures in ArcGIS were clarified. Conclusion:Operating ac-cording to the appropriate method steps, the following can be achieved:(1) The adjacent scope of medical insurance pharmacy service are adjacent to each other but do not overlap or cross;(2) Spatial relations can be clearly and ef-fectively expressed;(3) The shape is flat and regular;(4) The data collected at different times can be comparable in space, providing good prerequisites for medical insurance designated pharmacy planning.

OBJECTIVETo investigate the mechanisms of lysophosphatidic acid (LPA) in stimulating invasion and metastatic colonization of ovarian cancer cells.

METHODSThe metastatic ability in vivo of ovarian cancer SK-OV3, HEY, OVCAR3, and IGROV1 cells was determined in tumor-bearing nude mouse models. Matrigel assay was used to detect the changes of response in vitro of ovarian cancer cells to LPA after Rac(-) or Rac(+) adenovirus treatment. LPA-induced Rho GTPase activation was detected by GST-fusion protein binding assay.

RESULTSThe peritoneal metastatic colonization assay showed overt metastatic colonization in mice receiving SK-OV3 and HEY cell inoculation, indicating that they are invasive cells. Metastatic colonization was not detected in animals receiving OVCAR3 and IGROV1 cells, indicating that these cells are non-invasive cells. In the matrigel invasion assay, exposure to LPA led to a notably greater migratory response in metastatic SK-OV3 and HEY cells (Optical density: SK-OV3 cells: 0.594±0.023 vs. 1.697±0.049, P<0.01; HEY cells: 0.804±0.070 vs. 1.851±0.095, P<0.01). But LPA did little in the non-metastatic OVCAR3 and IGROV1 cells (Optical density A: OVCAR3 cells: 0.336±0.017 vs. 0.374±0.007, P>0.05; IGROV1 cells: 0.491±0.036 vs. 0.479±0.061, P>0.05). LPA migratory responses of ovarian cancer cells were closely related to their metastatic colonization capabilities (r = 0.983, P<0.05). Rac(-) blocked the LPA response of invasive SK-OV3 and HEY cells (LPA-induced fold increase of cell migration: SK-OV3 cells: 2.988±0.095 vs. 0.997±0.100,P=0.01; HEY cells: 2.404±0.059 vs. 0.901±0.072, P=0.01). But Rac(+) confered the non-invasive cells with LPA response and invasion capability (LPA-induced fold increase of cell migration: OVCAR3 cells: 1.072±0.080 vs. 1.898±0.078, P<0.01; IGROV1 cells: 1.002±0.044 vs. 2.141±0.057, P<0.05). Among Rho GTPases, only Rac activation was different between ovarian cancer cell lines with different metastatic capability after LPA stimulation: Cdc42 could not be activated in both the invasive and non-invasive cell lines. RhoA could be activated in both the invasive and non-invasive cell lines. Rac could be activated by LPA in the invasive ovarian cancer cell lines. However, Rac could not be activated in the non-invasive cell lines.

CONCLUSIONLysophosphatidic acid stimulates invasion and metastasis of ovarian cancer cells through Rac activation.

Animals ; Cell Movement ; Female ; Humans ; Lysophospholipids ; metabolism ; Mice ; Ovarian Neoplasms ; metabolism ; Tumor Cells, Cultured ; rho GTP-Binding Proteins ; rhoA GTP-Binding Protein

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 fully understand the maternal and neonatal outcomes in pregnant women with COVID-19 and explore the evidence of intrauterine vertical transmission of 2019-nCoV by analyzing clinical and laboratory information in peer-reviewed publications on COVID-19 in pregnant women.Methods:PubMed, Embase, China National Knowledge Infrastructure, China Academic Journals, and Wanfang Databases were searched to retrieve articles on COVID-19 in pregnancy published from December 1, 2019, to April 9, 2020. In addition, the World Health Organization COVID-19 Database and the reference lists in each included article were also searched. All included cases were positive for 2019-nCoV nucleic acid with maternal and neonatal outcomes regardless of delivery or not. Clinical manifestations, perinatal and neonatal outcomes were analyzed systematically.Results:This study reviewed 29 publications involving 146 pregnant women who tested positive for 2019-nCoV nucleic acid and their 116 newborns (including two twins). Five cases of severe COVID-19 and three cases of unidentified type that were admitted to ICU for treatment were severe symptoms, accounting for 5.5% (8/146) of all cases. Totally, 69.9% (102/146) of the women underwent cesarean section and 8.2% (12/146) gave birth vaginally. Thirty (20.5%) women continued their pregnancies. One case (0.7%, 1/146) terminated the pregnancy at 26 weeks of gestation due to bidirectional affective disorder and one (0.7%, 1/146) received artificial abortion at 6 weeks of gestation. Fever (58.2%, 85/146) and cough (32.9%, 48/146) were the most common symptoms. However, 15.8% (23/146) of the pregnant women were asymptomatic on admission and symptoms appeared or became worse after delivery in 20.5% (30/146). Lymphocytopenia (49.6%, 56/113) and elevated C-reactive protein (58.4%, 66/113) were the main laboratory findings. The most common computed tomography (CT) finding was bilateral multiple patchy ground-glass opacity in lungs (79.7%, 94/118). The outcomes of 92.2% (107/116) of the newborns were good, and the rest 7.8% (9/116) showed different abnormalities of varying degrees. Among the nine newborns, six showed different degrees of dyspnea, cyanosis and vomiting including one died of multiple organ failure and disseminated intravascular coagulation; one tested positive for viral nucleic acid 36 hours after birth; one was stillbirth due to unknown reason, but intrauterine vertical transmission was excluded; one neonatal death in a critically ill mother undergoing cesarean delivery.Conclusions:Pregnant women are less likely to progress to severe COVID-19 and mostly have a good outcome. Despite reports of adverse neonatal outcomes, evidence of intrauterine vertical transmission of 2019-nCoV remains insufficient.

Objective: To investigate the hearing loss and speech disorders in the elderly, to analyze the risk factors of the elderly deafness, as well as to provide reference for the clinical research of the elderly deafness. Methods: From March 2016 to March 2018, 913 elderly people, who were tested for hearing and speech disorders, were examined by a unified questionnaire to investigate the demographic data of the subjects and the related factors of deafness, and the hearing and speech recognition tests were carried out. According to the hearing loss, the hearing impaired group was divided into the hearing impaired group (500, 1 000, 2 000 and 4 000 Hz, the average hearing threshold>25 dBHL) and the non hearing impaired group (the average hearing threshold of the four frequencies ≤25 dBHL), and then the single factor analysis and the unconditional Logistic regression analysis were used. Finally, the risk factors of senile deafness were analyzed. Results: Of the 913 elderly subjects in the survey, 389 (42.61%, 389/913) had no hearing impaired, 345 (37.79%, 345/913) were mild hearing impaired, and 149 (16.32%, 149/913) had moderate hearing loss. Twenty-six patients were severe hearing loss (2.85%, 26/913); 4 patients had severe hearing loss (0.44%, 4/913). Among the 524 hearing-impaired elderly, there were 244 speech-recognition disorders (46.56%, 244/524), of whom 106 were mild hearing-impaired, accounting for 30.72% (106/345), 108 were moderate hearing loss, accounting for 72.48% (108/149), 26 were severe hearing loss, accounting for 100% (26/26), and 4 were the profound hearing loss, accounting for 100% (4/4). Statistical analysis showed that the age, job status, history of hypertension, history of hyperglycemia, and smoking history were independent risk factors for senile hearing loss (P<0.05). Conclusions High incidences of hearing and speech recognition obstacle are found in health examination for the elderly patients. Noise exposure, age, history of hypertension, high blood sugar, and smoking history are high-risk factors for senile deafness, therefore, prevention and rehabilitation programs are urgent to be developed.