Objective To clone and identify human genes transactivated by homo sapiens HCV FTP2 by constructing a cDNA subtractive library with suppression subtractive hybridization tech- nique.Methods Suppression subtractive hybridization(SSH)and bioinformatics techniques were used for screening and cloning of the target genes transactivated by HCV FTP2.The mRNA was iso- lated from HepG2 cells transfected pcDNA3.1(-)-HCV FTP2 and pcDNA3.1(-)empty vector re- spectively,and SSH method was employed to analyze the differentially expressed DNA sequence be- tween the two groups.After digestion with restriction enzyme Rsa I,small-size cDNAs were ob- tained.Then tester cDNA was divided into two groups and ligated to the specific adaptor I and adap- tor 2 respectively.After tester cDNA was hybridized with driver cDNA twice and underwent two times of nested PCR and then was subcloned into T/A plasmid vectors to set up the subtractive library. Amplification of the library was carried out with E.coli strain DH5?.Futhermore,the cDNA was se- quenced and analyzed in GenBank with Blast search after PCR.Results The subtractive library of genes transactivated by HCV FTP2 was constructed successfully.The amplified library contains 71 positive clones.Colony PCR shows that 56 clones contain 200～1000 hp inserts.Sequence analysis was performed in 24 clones randomly,and the full length sequences were obtained with bioinformatics method.Altogether 20 coding sequences in total were obtained,consisting of 19 known and 1 un- known.Conclusion The obtained sequences may be target genes transactivated by HCV FTP2,and some genes coding proteins involved in cell cycle regulation,metabolism and cell apoptosis.

Objective To screen promoter binding protein of cyclin B2 by using human liver cDNA library, and investigate the expression and regulation mechanism of cyclin B2 gene. Methods By using cyclin B2 biotinylated promoter DNA as the selective molecule, the T7select human liver cDNA library was biopanned and positive clones were selected. After screening, positive plaques were performed to amplify for inserted DNA fragment, and the DNA fragment was cloned into pGEM-Teasy vector. Results Sequence analysis was performed in 20 positive plaques, and the full length sequences were obtained with bioinformatics method and searched for homologous DNA sequence from GenBank, altogether 6 coding sequences were obtained, all of which were known ones. Conclusion Cyclin B2 promoter binding proteins were screened. The results will be useful for further study the expression and regulation mechanism of cyclin B2.

Objective To analyze the effects of dominant hand position on the quality of external chest compression for cardiopulmonary resuscitation (CPR) by the employment of the high-fidelity real-time feedback manikin system.Methods A total of 228 medical students of Wuhan University were enrolled in 2013 after standard CPR training courses.Participants were brought to a simulation scenario in which an adult happened to have heart arrest out of a hospital.Each studeut was asked to do five cycles of conventional CPR.In accordance with the dominant hand and the actual compressing hand position,the students were divided into dominant hand (DH) group and non-dominant hand (NH) group.Comparisons of chest compression rate,chest compression depth and chest recoil between two groups were carried out,respectively.The data were analyzed by the software of SPSS 13.0.Results There was no significant difference in overall chest compression rate between two groups (P ＞ 0.05) while the frequency distributions of chest compression rate showed differences (P ＜0.01),and chest compression rates above 100 cycle per min in DH group were higher than that in NH group (97％ vs.92％,P =0.002).There was significant differences in chest compression depth between two groups (DH 44±8 mm vs.NH 43±8mm,P=0.001).In NH group,the depth in cycle 5 (41 ±8) mm is obviously less than that in cycle 1 (44 ±7) mm,cycle 2 (43 ±7) mm and cycle 3 (43 ±8) mm.Totally,there was no differences in chest recoils between two groups [NH (98 ±8)％ vs.DH (97 ± 10)％,P =0.13],but full chest recoils were seen more in NH group (85％ vs.79％,P ＜ 0.05).Conclusions The dominant hand position can improve the quality of CPR resulted from the higher compression rate,deeper compression depth as well as delayed fatigue.

Objectives To understand essential basis data availability for implementation of cost accounting in TCM hospitals. Methods Costs of a total of 1588 TCM hospitals were investigated by conducting the baseline survey via questionnaires in 2013. Results Departmental basic data (including ratio of office staff and entire staff, ratio of outpatient and inpatient departments in clinical department), and construction data for housing were well accessible, while utility fee and internal service data were not. Conclusion ①Public TCM hospitals need to improve and specify the basic cost data. ②Differences exit among different types and levels of hospitals in the availability of data. ③There are still difficulties in carrying out cost accounting in public TCM hospitals, which needs strong supports from all relevant departments.

Objective To examine the availability of emergency medical services(EMS) for patients with acute stroke and to investigate influential factors affecting the preference of patients'to EMS.Methods Consecutive information of patients with acute stroke who presented to the emergency department of Zhongnan Hospital of Wuhan University from June 1, 2014 to December 31, 2015 were analyzed.Gender, age of patients, transport modality, risk factors in cerebrovascular diseases, initial symptoms, stroke types, onset and admission time were included to make analysis in retrospective study.The participants were divided into two groups based on the preference of patients, namely EMS group and self-transport group.Wilcoxon rank sum test or Chi-squared test was used to statistical analysis as appropriate.A multiple binary logistic regression was used to determine the relationship between various patient-related factors with probability whether patients chose EMS or not.Results Among the 240 patients, only 29.2%of them asked for the EMS at the onset of symptoms (EMS group, n=70), and the rest patients called for other services(self-transport group, n=170).Logistic regression analysis revealed that the patients with the symptom of altered consciousness or convulsion (95%CI:0.107-0.403,OR=0.208,P<0.01) were more likely to use EMS.The time consumed from onset to visit of patients with acute stroke to emergency physician was significantly shorter in EMS group (M, 60 min vs.180 min,P<0.01).Conclusion The symptom of altered consciousness or convulsion was the independent factor to determine whether patients with acute stroke preferred EMS or not.

Objective:To provide policy recommendations for Beijing public health departments to grasp the dy-namic allocation of healthcare resources and the advantage of medical functional dispersal, and making appropriate health policies to rationally adjust the allocation of health resources. Methods:To study the dynamic function of Bei-jing medical, this study uses the method of accounting of cases summary of the annual report on health finance through the descriptive analysis of the gross fixed capital formation in various regional government-run health facili-ties. Results:The results of this study show that the quality of medical health administrative resources was higher, but effectively dispersed in 2015. By contrast, the basic public health resources allocation was unbalanced. Conclu-sion:This study puts forward the corresponding health policy suggestions. On one hand, it is important to make fur-ther policy to encourage high quality medical resources to be effectively relieved and the regional planning should be done according to market demand by avoiding the blind construction at the early stages. On the other hand, much at-tention should be paid on the balanced development of the basic public health service ability and the coordinated de-velopment of administrative capacity in health, and supporting policies should be formulated, which should rationally allocate the public health resources for a better overall medical functional dispersal.

Objective To evaluate the value of energy spectrum CT with multimodal quantitative parameters in diagnosis of the metastatic lymph nodes of gastric adenocarcinoma compared with the conventional CT.Methods 37 patients with gastric adenocarcinoma diagnosed by gastroscopy underwent enhanced CT scan with gemstone spectral imaging mode.We positioned and marked the stomach lymph nodes on CT images and compared with postoperative pathologic results one to one.ROC was used to identify the critical quantitative index of energy spectrum CT in distinguishing the metastasis from benign lymph node,and to evaluate the diagnostic effect compared with CT features.Results The 40-80 keV single energy spectrum curve slope (λHU )and normalized iodine concentration (NIC)in metastasis group were lower than those in the benign one in the arterial phase with statistical differences (P <0.05 ),but without statistical differences in venous phase.The combination of arterialλHU and NIC showed significant advantages compared with CT features(P <0.01), with the sensitivity,specificity and accuracy of 84.3% vs 61.4 %,88.4% vs 81.3 % and 86.8% vs 73.6 %.Conclusion The energy spectrum CT can provide quantitative analysis for differential diagnosis of gastric cancer metastasis from benign lymph nodes,and significantly improve the diagnostic accuracy of lymph node metastasis of the cancer.

Objective To evaluate the efficiency and toxicities of Gemcitabine combined with S -1 cap-sule in the treatment of advanced esophageal cancer .Methods Twenty-nine patients with advanced esophageal cancer were treated with S-1 capsule 80 mg/m2 ,twice daily for 14 days and Gemcitabine (1 000 mg/m2 ) was in-travenously administrated on day 1 and 8.The chemotherapy was repeated every 21 days.After two consecutive treatment circles ,the short term efficacy ,adverse effects and follow -up condition were evaluated .Results One case showed complete remission (CR),11cases showed partial remission (PR),9 cases showed stable disease (SD),8 cases showed progressive disease(PD).The responsive rate(CR+PR)was 41.4%;the illness control rate(CR+PR+SD)was 72.4%.The major adverse events were myelosuppression ranging from grade Ⅰto Ⅲ, hand-foot syndrome,disgusting and the damage of liver function .Some patients displayed the damage of liver function.The median time to progress ( mTTP) was 6.9 months.The median 1-year survival rate was 64.3%. Conclusion The combination of Gemcitabine and S -1 capsule is an effective and well -tolerated method for the patients with advanced esophageal cancer .

Objective To explore the clinical features of lissencephaly and the detection ofLISI gene.MethodsThe characteristic of clinical features, laboratory examination and gene detection in one case of lissencephaly was retrospectively analyzed. Meanwhile, the related literatures were reviewed.ResultsA 5-month-old female child diagnosed with epilepsy 20 days ago was hospitalized for convulsive seizure more than 30 times in 3 days. The manifestations were eyes staring, and turning upward, cyanosis of lips and face, froth at the mouth, extremities rigidity and loss of consciousness, and the symptoms can spontaneously remitted in 2-3 minutes. Laboratory examination showed that peripheral blood white cell count was 13.67×109/L, hemoglobin 108 g/L, red blood cell count 3.90×1012/L, lymphocyte 10.26×109/L; maocardial enzyme and hepatic and renal function were normal; blood ammonia was 23 μmol/L and lactic acid 2.11 mmol/L. Long-range video EEG showed highly arrhythmia, and frequent partial epilepsy, and sometimes secondary generalized epilepsy. Head MRI showed lissencephaly. The child was treated with oral administration of Keppra 27 mg/(kg·day), Topiramate 6.5 mg/(kg·day), currently no seizure. The detection ofLIS1 gene found that heterozygous mutation of c.232delG, which lead to protein shift mutation (p.E78NfsX25). No mutation was found in her parents.ConclusionsChild with lissencephaly may combine with epilepsy which may cause by mutation inLIS1 gene. And there was no information about point mutation of c.232delG inLIS1 gene being reported at home and abroad so far.

Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’s operation group (n=22) and triple branches aortic arch stent-graft placement op?eration (triple-branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera?tive death in Sun’s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’s group [(50.9±6.9) mm vs. (55.0±7.5) mm,(28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame?ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv?al curve showed that five-year survival rate of Sun’s group was similar with that of triple-branched group (Log-rank χ2=0.095,P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’s group and triple-branched group (P>0.05). Conclusion Sun’s operation can significantly decrease patient’s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.