Objective:The main objective of this study is to analyze the development trend of China's private healthcare providers since the issue of Document No. 58 by the General Office of the State Council in the year 2010. It intends to evaluate the effectiveness of the policy on encouragement and guidance to private healthcare. Methods:(1) Using the statistical data collected from national and provincial healthcare yearbook, we made a comparative a-nalysis on seven indicators regarding the development of private healthcare providers, including the number of health-care providers, the number of beds, the number of healthcare professionals, annual outpatient diagnose-and-treat per-son-times, annual inpatient hospitalization person-times, bed utilization rate and average length of stay for two periods of time (i. e. 2006—2010 and 2011—2015). (2) A field study was conducted to six selected provinces. In these provinces, essential information of the related policy was collected, held stakeholder interviews and focus group dis-cussions among hospital management team and medical workers and visits to several typical private providers were made to understand the policy effectiveness and existing problems. The study also tried to find the key factors for a successful private healthcare provider in China. Results:(1) The results show that since the issue of Document No. 58 in the year 2010 , the number of China's private healthcare providers has greatly increased while the scale and service capabilities of private providers still need to be improved. (2) As per the results again, a great difference ex-ists between provinces in terms of private healthcare provider development during 2010 to 2015 . Conclusion:A posi-tive impact of government regulation on the development of private healthcare providers was noticed. However, China's private healthcare providers are still facing many invisible obstacles and challenges. The government needs to put more focus on building a cross-department coordination and supporting regulation system to advance the sustain-able development of private healthcare providers. Moreover, the government needs to cautiously promote the Public-Private-Partnership ( PPP) to improve the effective allocation of resources in the healthcare market and provide essen-tial support to private healthcare providers in solving the problems they meet during their development process.

Objective To investigate the effects of T. gondii soluble tachyzoite antigen (STAgs) on the survival time of mouse heart allograft and the possible mechanism. Methods The STAgs were prepared by pulverizing T. gondii tachyzoite with ultrasound on ice. Cervical heterotopic heart transplantations were done by using Balb/c mice as donors, and C57BL/6 mice as recipients.The recipients were classified randomly into three groups: syngeneic group, acute rejection group and STAgs-treated group. The recipients in acute rejection group and STAgs-treated group were injected subcutaneously with 0. 1 ml PBS and 0. 1 ml (5 μg) STAgs at the 4th day before transplantation respectively, and those in syngeneic group were not subjected to any treatment. The grafts were observed daily by cervical palpation, and the total cessation of cardiac contraction was defined as the endpoint. The heart allografts were harvested at the 7th day after transplantation for pathological examination and immunohistochemical staining for CD4+ T, CD8+ T. Results The recipients in syngeneic group were all alive at the 100th day after transplantation. The average survival time in acute rejection group and STAgs-treated group was (6.7± 0.5) days and (70.8± 3.5) days,respectively (P＜0.05). HE staining showed that the rejection on the 7th day after transplantation in syngeneic group, acute rejection group and STAgs-treated group was fallen into 0 degree, Ⅲ-Ⅳ degree and 0- Ⅰ degree, respectively. Immunohistochemical staining revealed that the CD4+ T and CD8+T were markedly down-regulated in STAgs-treated group as compared with those in acute rejection group. Conclusion T. gondii STAgs can significantly prolong the survival time of mouse heart allograft and inhibit the rejection probably by changing the ratio of TH1/TH2, or inhibiting the effect of dendritic cells by inducing the lipoxin A4.

Objective　To investigate the changes and clinical significance of serum caspase-cleaved cytokeratin-18 (CCCK-18) and complement 1q tumor necrosis factor-related protein 3 (CTRP3) levels in patients with acute ischemic stroke (AIS).Methods　A total of 163 AIS patients were selected as the AIS group.According to the National Institutes of Health Stroke Scale (NIHSS),the patients were divided into the mild defect group (49 cases),moderate defect group (76 cases),severe defect group (38 cases),after 3 months of treatment,patients were divided into poor prognosis group (66 cases) and good prognosis group (97 cases) according to the modified Rankin scale (mRS),in addition,72 healthy individuals who had physical examination during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to determine serum CCCK-18 and CTRP3 levels.Results　The serum CCCK-18 level in the AIS group was significantly higher than that in the control group,and the CTRP3 level was significantly lower than that in the control group (P＜0.05).The serum CCCK-18 level in the mild,moderate,and severe defect groups gradually increased,and the CTRP3 level gradually decreased (P＜0.05).The serum CCCK-18 level was positively correlated with NIHSS score,and CTRP3 level was negatively correlated with NIHSS score (P＜0.05).Multivariate logistic regression analysis showed that large area infarction,high NIHSS score,high CCCK-18 level were an independent risk factor for poor prognosis in AIS patients,and high CTRP3 level was an independent protective factor (P＜0.05).The ROC curve showed that the AUC of CCCK-18 combined CTRP3 predicting poor prognosis of AIS patients was significantly greater than that of CCCK-18,CTRP3 alone predicted(P＜0.05),the sensitivity and specificity were 86.36% and 81.44%.Conclusion　The serum CCCK-18 level in AIS patients is up-regulated,and the CTRP3 level is down-regulated,which is related to the severity of the disease and poor prognosis.Combined detection of the two can improve the predictive value of poor prognosis.

Objective: To investigate the infection status and genotype distribution of cervical human papillomavirus (HPV) in women of different ethnic groups and different ages in Yili, Xinjiang Uygur Autonomous Region (Xinjiang). Methods: By using the convenient sampling method, 54 760 women from November 2015 to May 2017 seeking for service in gynecological clinics in a general hospital in Yili, Xinjiang, were selected as the research subjects, and 3 445 samples of cervical mucous exfoliative cells were collected, and the social information of their ethnic and age was collected at the same time. The inclusion criteria were those with sexual life, cervical integrity, and ethnic groups for Han or Uygur or Kazak. PCR-reverse dot blot hybridization was used to detect HPV genotyping in exfoliated cells, and chi-square test was used to compare the difference of HPV positive rate among different ethnic groups. Then, according to ethnicity and age, the differences in positive rates of different ages and ethnic groups were compared in each layer. Results: The positive rate of HPV was 25.6% (882 cases), of which the Han, Uygur and Kazakh were 27.9% (564 cases), 22.9% (196 cases) and 21.6% (122 cases), and the difference was statistically significant (χ²=13.80, P=0.001). The most prevalent high-risk genotypes of Han women were HPV16/52/58, accounting for 24.8% (140 cases), 17.7% (100 cases) and 9.8% (55 cases), respectively. The most prevalent high-risk genotypes of Uygur women were HPV16/52/53, accounting for 34.2% (67 cases), 12.8% (25 cases), 9.2% (18 cases), respectively. The most prevalent high-risk genotypes of Kazak were HPV16/52/53, accounting for 37.7% (46 cases), 17.2% (21 cases), 12.3% (15 cases), respectively. The highest rate of HPV in Uygur patients aged ≥61 years was 41.5% (22 cases), and the lowest in group 36-40 years old, 15.9% (21 cases), the difference between different age groups was statistically significant (χ²=35.01, P<0.001). Conclusion The positive rate of HPV infection among Han, Uygur and Kazak in Yili Prefecture of Xinjiang was different, and the HPV positive genotype differs among different ethnic groups.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.