Objective To investigate the ratio of apoptosis to proliferating cell nuclear antigen(PCNA) in gastric carcinoma(GC) and elucidate the possible role of apoptosis and proliferation in the development of GC.Methods Apoptosis and PCNA were examined in 24 cases with gastric carcinoma and in 24 cases of the surrounding non-cancerous tissue embedded in paraffin by TUNEL and immunohistochemical staining technique respectively.Results The study indicated that the proliferation labeling indices(PIs) in GC(51 2) was significantly higher than that in the surrounding non-cancerous tissue(27 4),and the apoptotic indices(AIs) in GC(3 1) was significantly lower than that in the surrounding non-cancerous tissue(5 4)(P

Objective: To investigate the current status of prevention and control of occupational hazards in a city in 2017, to understand the capability to prevent and control occupational hazards and the level of occupational health supervision and management, and to propose measures to urge employers to assume the main responsibility for the prevention and control of occupational diseases. Methods: An analysis of the main factors influencing the prevention and control of occupational hazards in the city was performed to screen out six semi-quantitative assessment indicators (including the training of the main responsible persons and occupational health management personnel in companies) and four qualitative assessment indicators (including the coverage of supervision and inspection of occupational hazards performed by the district safety supervision department) , which could be used to measure the prevention and control effects of regional occupational hazards. Each indicator was scored. The typical investigation method was used to do data review and on-site inspection of 170 companies, 17 district-level occupational health supervision departments, and 16 sub-district (township) occupational health supervision departments in the city from October to December, 2017. The prevention and control of occupational diseases in each district was scored, and the completion rate and completion situation of each indicator in the city were analyzed. Results: The mean score of prevention and control of occupational hazards in the city was 84.9. The scores of two districts were relatively high, being 88.9 and 88.7, respectively; the scores of 9 (52.9%) districts were higher than 85. The pass rate of training for the main responsible persons and occupational health management personnel in companies in the city was 95.9%, the pass rate of occupational health training for workers was 84.7%, the pass rate of occupational health examination for workers was 96.5%, the pass rate for the inspection of occupational hazardous factors in workplaces was 95.3%, the pass rate for notifying occupational hazards in workplaces is 95.9%, and the pass rate for applying the warning signs of occupational hazards in workplaces was 76.5%. Conclusion The awareness of the importance of prevention and control of occupational hazards in all districts of the city has been increased, but the effectiveness of occupational health training for workers needs to be strengthened. The supply and demand of occupational health technical services are still not matched, and the ways and methods of occupational health supervision and inspection need to be improved.

Objective To establish and validate a model that can predict the risk of death dur-ing hospitalization in elderly patients with sepsis.Methods A total of 238 hospitalized patients with sepsis in the Intensive Care Unit of the First Hospital Affiliated to Harbin Medical University from Jan-uary 2019 to December 2022 were retrospectively included,and they were divided into death group with 68 cases(28.57％)and survival group with 170 cases(71.43％)according to the prognosis during hospitalization as the primary outcome indicator.Multivariate Logistic regression was used to screen the independent risk factors for death during hospitalization in sepsis patients,and a model for predicting the risk of death during hospitalization in sepsis patients was established based on these fac-tors.The performance of the prediction model was evaluated by the receiver operating characteristic(ROC)curve,and the results were expressed by the area under the curve(AUC);external valida-tion was performed based on the clinical data of 176 sepsis patients from January 2016 to December 2018.Results Univariate analysis showed that when compared with the survival group,the death group had higher ratios of patients aged over 70 years,ratio of injury(AKI)in stage Ⅲ,higher lev-els of red cell distribution width(RDW),fibrinogen,lactate,blood creatinine,the National Early Warning Score(NEWS)and the quick Sequential Organ Failure Assessment(qSOFA)score,but lower levels of oxygenation index and albumin,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that age over 70 years old(OR=1.426,95％CI,1.055 to 1.928),lactate＞6 mmol/L(OR=1.436,95％CI,1.105 to 1.867),RDW＞16％(OR=1.354,95％CI,1.080 to 1.698),AKI in stage Ⅲ(OR=1.982,95％CI,1.407 to 2.791),and qSOFA score＞2 points(OR=1.853,95％CI,1.255 to 2.738)were the independ-ent risk factors for death during hospitalization in patients with sepsis(P＜0.05).Based on the re-gression analysis results,a risk equation for death in patients with sepsis was established,and con-sistency index(Cindex)=-1.694+0.355 x age+0.303 x RDW+0.362 x lactate+0.684 x AKI in stage Ⅲ+0.617 x qSOFA score.The ROC curve showed that the AUC of Cindex for predicting death during hospitalization in patients with sepsis was 0.882(95％CI,0.834 to 0.929)with a sensitivity of 83.82％and a specificity of 77.06％by internal validation,and 0.823(95％CI,0.757 to 0.889)with a sensitivity of 74.13％and a specificity of 81.36％by external validation.Conclusion Age,lactate,RDW,AKI staging and qSOFA score are correlated with the risk of death in elderly patients with sepsis,and the model constructed based on these parameters may help predict the risk of all-cause death during hospitalization in elderly patients with sepsis.

OBJECTIVE: Sort out and analyze the current status and existing problems of the pilot work of the medical device marketing authorization holder system to provide reference opinions for the full implementation of the medical device marketing authorization holder system. METHODS: Use literature analysis, comparative analysis and field research to comprehensively analyze the status, advantages and risks of commissioned production under the medical device marketing authorization holder system. RESULTS: The commissioned production under the medical device marketing authorization holder system brings dividends and also brings risks. CONCLUSIONS We should consider improving the medical device marketing authorization holder system from marketing authorization holder, the entrusted manufacturer, and the regulatory authority, and strengthen the quality supervision of the entrusted production of products.
China ; Marketing

Objective To establish and validate a model that can predict the risk of death dur-ing hospitalization in elderly patients with sepsis.Methods A total of 238 hospitalized patients with sepsis in the Intensive Care Unit of the First Hospital Affiliated to Harbin Medical University from Jan-uary 2019 to December 2022 were retrospectively included,and they were divided into death group with 68 cases(28.57％)and survival group with 170 cases(71.43％)according to the prognosis during hospitalization as the primary outcome indicator.Multivariate Logistic regression was used to screen the independent risk factors for death during hospitalization in sepsis patients,and a model for predicting the risk of death during hospitalization in sepsis patients was established based on these fac-tors.The performance of the prediction model was evaluated by the receiver operating characteristic(ROC)curve,and the results were expressed by the area under the curve(AUC);external valida-tion was performed based on the clinical data of 176 sepsis patients from January 2016 to December 2018.Results Univariate analysis showed that when compared with the survival group,the death group had higher ratios of patients aged over 70 years,ratio of injury(AKI)in stage Ⅲ,higher lev-els of red cell distribution width(RDW),fibrinogen,lactate,blood creatinine,the National Early Warning Score(NEWS)and the quick Sequential Organ Failure Assessment(qSOFA)score,but lower levels of oxygenation index and albumin,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that age over 70 years old(OR=1.426,95％CI,1.055 to 1.928),lactate＞6 mmol/L(OR=1.436,95％CI,1.105 to 1.867),RDW＞16％(OR=1.354,95％CI,1.080 to 1.698),AKI in stage Ⅲ(OR=1.982,95％CI,1.407 to 2.791),and qSOFA score＞2 points(OR=1.853,95％CI,1.255 to 2.738)were the independ-ent risk factors for death during hospitalization in patients with sepsis(P＜0.05).Based on the re-gression analysis results,a risk equation for death in patients with sepsis was established,and con-sistency index(Cindex)=-1.694+0.355 x age+0.303 x RDW+0.362 x lactate+0.684 x AKI in stage Ⅲ+0.617 x qSOFA score.The ROC curve showed that the AUC of Cindex for predicting death during hospitalization in patients with sepsis was 0.882(95％CI,0.834 to 0.929)with a sensitivity of 83.82％and a specificity of 77.06％by internal validation,and 0.823(95％CI,0.757 to 0.889)with a sensitivity of 74.13％and a specificity of 81.36％by external validation.Conclusion Age,lactate,RDW,AKI staging and qSOFA score are correlated with the risk of death in elderly patients with sepsis,and the model constructed based on these parameters may help predict the risk of all-cause death during hospitalization in elderly patients with sepsis.

Pulmonary hypertension (PH) is an insidious pulmonary vasculopathy with high mortality and morbidity and its underlying pathogenesis is still poorly delineated. The hyperproliferation and apoptosis resistance of pulmonary artery smooth muscle cells (PASMCs) contributes to pulmonary vascular remodeling in pulmonary hypertension, which is closely linked to the downregulation of fork-head box transcriptional factor O1 (FoxO1) and apoptotic protein caspase 3 (Cas-3). Here, PA-targeted co-delivery of a FoxO1 stimulus (paclitaxel, PTX) and Cas-3 was exploited to alleviate monocrotaline-induced pulmonary hypertension. The co-delivery system is prepared by loading the active protein on paclitaxel-crystal nanoparticles, followed by a glucuronic acid coating to target the glucose transporter-1 on the PASMCs. The co-loaded system (170 nm) circulates in the blood over time, accumulates in the lung, effectively targets the PAs, and profoundly regresses the remodeling of pulmonary arteries and improves hemodynamics, leading to a decrease in pulmonary arterial pressure and Fulton's index. Our mechanistic studies suggest that the targeted co-delivery system alleviates experimental pulmonary hypertension primarily via the regression of PASMC proliferation by inhibiting cell cycle progression and promoting apoptosis. Taken together, this targeted co-delivery approach offers a promising avenue to target PAs and cure the intractable vasculopathy in pulmonary hypertension.