Objective To learn the current deployment and problems of medical equipment at 44 hospitals directly under or managed by the NHFPC,studying the correlation between the number of equipment deployment,and amount of outpatients/inpatients and inpatient surgeries for recommendations on scientific and rational deployment of medical equipment.Methods Literature review,expert consultation and questionnaire survey methods were used to study the use and problems in hospital equipment deployment.EpiData was used to build a database,and the means,standard variations and constituent ratios were applied for descriptive analysis of medical equipment deployment of the hospital departments.The data of hospital equipment usage and staffing,hospital beds,and service volume were subject to correlation analysis.Results 24 of the 44 hospitals were deployed with class-A medical equipment,covering eight types and 43 devices;the 44 hospitals were deployed with 441 class-B equipment of five types;the equipment types in great demand at such hospitals were MRI (77.27%),CT (70.45%),bioanalysis devices (68.18%),conventional radiation devices (52.27%),and conventional equipments (54.55%).The survey found a positive correlation ( P <0.05 ) between the equipments,and the amount of outpatients/inpatients and inpatient surgeries.Conclusions Hospitals should further establish and improve their deployment management system,rationalize their deployment procedures,and use scientific and rational deployment.Such approaches as equipment sharing,centralized management and performance appraisal could be called into play to improve equipment efficiency.

Objective To observe the effect of recombinant human granulocyte/macrophage colonystimulating factor (rhGM-CSF) combined with nano-silver as a treatment on deep burn degreen Ⅱ about inflammation .Methods The burn model was built with Wistar rats .They were randomly divided into four groups ,petrolatum treatment (group A ,n= 30) ,nano-silver treatment (group B ,n=30) ,rhGM-CSF treatment(group C ,n=30) ,and rhGM-CSF combined with nano-silver treatment(group D ,n=30) . observation the inflammatory reaction ,and culture bacteria on wound of the four groups at 1st ,4th ,7th ,10th ,14th ,21th day after treatment were made .The level of IL-2 and IL-8 were measured in serums with ELISA .Results The inflammatory reaction:group A>group B>group C>group D ;Bacterias were observed in group A ,group B/C and group D at 4th ,10th ,14th day respectively af-ter treatment .The number of bacterial growed in group D was less than in group A ,group B and group C .The numbers of bacterial growed in group B and group C were less than in group A .And after 10 ,14 ,21 days treatment ,there was significantly statistical difference(P<0 .05) .There was difference among groups in the levele of IL-2 and IL-8 ,which were the lowest in group D and the highest in group A .The level of IL-2 has no significantly statistical difference between every groupat 1st day and between B and C group at 4th day(P>0 .05) .After other days treatment ,there was significantly statistical difference(P<0 .05) .There was signifi-cantly statistical difference in every group at each day of the IL-8 levele except A and B group ,B and C group ,C and D group at 1st day (P<0 .05) .Conclusion rhGM-CSF combined with nano-silver treatment could alleviate inflammatory reaction ,and be better than rhGM-CSF or nano-silver alone .

Objective Thymidine phosphorylase (TP) cDNA was transfected into colorectal cancer cell lines LOVO with the lentiviral vector,the anticancer effeciency of 5'-deoxy-5-fluorouridine (5'-DFUR)and 5-fluorouracil (5-FU) on LOVO cells were evaluated.Methods TP cDNA were transfected into LOVO cell line with the lentiviral vector pLenti6.3_MCS_IRES2-EGFP,and the transfection efficiency was analyzed by flow cytometer and immunohistochemistry.Cells were divided into six groups:LOVO,LOVO-TP,LOVO-control,LOVO + INF-α2a,LOVO-TP + INF-α2a,LOVO-control + INF-α2a.TP protein expression and the relative quantitative analysis for TP mRNA in transfections cells were detected by Western blot and RT-PCR respectively.Volumes of converted 5-FU from either in the medium containing different concentration of 5'-DFUR,in which all cells were cultured,or in cells lysate,were detected by high performance liquid chromatography (HPLC).Results The transfection efficiency of TP cDNA in LOVO cells was 95％.The Mean gray value of TP protein expression in LOVO-TP and LOVO-TP + INF-α2a were 198.15 folds and 243.22 folds higher than LOVO cell,respectively (P ＜ 0.01).The RQ values of TP mRNA expression in LOVO-TP and LOVO-TP + INF-α2a were also 18.56 folds and 59.61 folds higher than wild LOVO cell,respectively (P ＜ 0.01).The IC50 values of 5'-DFUR on LOVO-TP and LOVO-TP + INF-α2a were 1 660 μ mol/L and 813 μ mol/L,respectively,significantly lower than 4 462.59 μ mol/L in wild LOVO (P ＜ O.01).The 5-FU volumes detected from media contained series concentration of 5'-DFUR for culturing LOVO-TP and LOVO-TP + INF-α2a were 2.0-5.3 folds,and 2.9-10.4 folds more than wild LOVO,respectively (P ＜ 0.01).Conclusions Transfected TP cDNA into colorectal cancer cell line LOVO with lentiviral vector increases the expression of TP mRNA and TP protein and the amount of 5-FU converted from 5'-DFUR,enhancing its anticancer effect.

Objective To explore the diagnostic value of CEUS for thyroid TI-RADS 3,4 nodules.Methods The CEUS performence of 95 patients with thyroid TI-RADS 3,4 nodules (all were confirmed by surgery pathology) diagosed by conventional ultrasound were reviewed retrospectively,and the value of CEUS in the revision and differential diagnosis of thyroid TI-RADS 3,4 nodules were analyzed.Results Compared with pathological pattern,conventional ultrasound TI-RADS classifications in assessing the property of thyroid nodule had no statistical differences (χ2 =3.56,P =0.06).For thyroid TI-RADS 3,4 nodules,compared with conventional ultrasound TI-RADS classifications,the diagnosis accuracy of CEUS score and revised CEUS TI-RADS classifications showed significant differeces respectively (P=0.03,＜0.01) for thyroid papillary carcinoma greater than 1 cm.But no statistical difference were found respectively (P=0.25,1.00) for thyroid papillary carcinoma smaller than 1 cm.According to the ROC curve analysis,the area under the curve of traditional ultrasound TI-RADS classifications,CEUS score and revised CEUS TI-RADS classifications were 0.64,0.75,0.81 respectively,cut-off value was TI-RADS 4a,1 score,TI-RADS 4a respectively,the sensitivity and specificity of evaluating benign and malignant nodules was 45.3％ and 80.0％,69.3％ and 65.0％,82.7％ and 60.0％,respectively.The area under the ROC curve were statistical difference between CEUS score,revised CEUS TI-RADS classifications and conventional ultrasound TI-RADS classifications (both P＜0.05),while CEUS score and revised CEUS TI-RADS classifications without statistical difference.Conclusion CEUS had the revised and improved identification value for thyroid TI-RADS 3,4 nodules.

Objective:To observe the expression of microRNA (miRNA, miR) -7850 in renal cancer tissues, and to explore the effect of miR-7850 on the proliferation and migration of renal cancer cells and on the regulation of serine proteinase inhibitor B3 (SERPINB3) gene expression.Methods:Real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-7850 in renal cancer tissues and renal cancer cell lines. The renal cell carcinoma cell line with the lowest expression of miR-7850 was selected, and the negative control sequence (miR-NC) and miR-7850 mimics were transfected into renal cell carcinoma cells by Lipofectamine 2000 transfection reagent, respectively, which were defined as miR-NC group and miR-7850 group. qRT-PCR was used to detect the expression of miR-7850 in transfected renal cancer cells. The cell proliferation and migration ability after transfection were detected by cell counting kit-8 (CCK-8) method and transwell experiment. Bioinformatics prediction and dual luciferase reporter gene experiments were used to verify the target gene of miR-7850. qRT-PCR and Western blot were used to detect the expression of target genes in renal cancer cells after transfection.Results:Compared with adjacent tissues (5.95±0.44), the expression of miR-7850 in kidney cancer tissues (1.19±0.33) was lower ( P<0.01). Compared with immortalized proximal renal tubular epithelial cells (1.01±0.07), the expression of miR-7850 was lower in renal cancer cell lines ( P<0.05), and the lowest in A498 cells (0.13±0.01) ( P<0.01). The expression of miR-7850 in the miR-7850 group (7.46±0.93) was significantly higher than that in the miR-NC group (1.01±0.08) ( P<0.01), indicating successful transfection. Compared with the miR-NC group, the cell proliferation ability of the miR-7850 group was significantly reduced ( P<0.05). The number of migrating cells in miR-NC group and miR-7850 group were (139.50±12.31) and (75.09±16.05) cells, respectively, and the cell migration ability in miR-7850 group decreased significantly ( P<0.01). Bioinformatics technology shows that the target gene of miR-7850 was SERPINB3. The dual luciferase reporter gene experiment confirmed that miR-7850 can target the SERPINB3 gene ( P<0.05). Compared with the miR-NC group, the expression of SERPINB3 in cells of miR-7850 group was significantly reduced ( P<0.05), as well as the CDK4, CyclinD, Snail and Vimentin. Conclusions:miR-7850 is lowly expressed in renal cancer tissues and cell lines. miR-7850 can inhibit the proliferation and migration of renal cancer A498 cells, which may be related to its inhibition of SERPINB3 gene expression.

Objective To retrospectively analyze the engraftment, transplant-related complications and survival after unrelated cord blood transplantation (UCBT) in patients with hematologic malignancies. Methods Fifty consecutive patients with hematological malignancies (median age, 19 years; median weight, 53 kg) were treated with UCBT in single center from April 2000 to August 2009. Thirty-nine patients were high-risk or refractory. Double UCB grafts were used for 26 patients, while single UCB graft for 24 patients. Myeloablative conditioning was given to 45 cases and non-myeloablative regimens to 5 cases. All patients were given a combination of cyclosporin A (CsA) and mycophenolate mofetil (MMF) for graft-versus-host disease (GVHD) prophylaxis. Results The median total nucleated cell (TNC) dose was 4.0 (range, 1.95-16.24)×10~7 TNC/ kginfused, and CD34~+ cell dose was 2.74(range, 0.67-29.28)×10~5/kginfused. Forty-two of 50 patients acquired engraftment with implantation rate being 86%. The median time to engraftment (absolute neutrophil count>500/mm~3 and platelets 20 000/L) was 19 and 34 days. The cumulative incidence of neutrophil engraftment by day 42 was 86.3%(95% confidence interval [CI] 0.769-0.957); the cumulative incidence of platelets engraftment by day 120 was 72.3% (95% CI 0.620-0.821). Twenty cases developed acute GVHD, and the incidence of acute GVHD of grades Ⅲ/Ⅳ by day 100 was 7.1%. The incidence of chronic GVHD within 2 years was 17.4%. During a median follow-up period of 22 months (range 4-116), Overall 6-month, 1-year and 2-year survival rate was 66.2%(95% CI 0.590-0.734), 57.4%(95% CI 0.496-0.652), 54.2%(95% CI 0.462-0.622), respectively. For the patients with non-advanced hemotologic malignancies, 6-month, 1-year and 2-year survival rate was 73.2% (95% CI 0.659-0.805), 66.1% (95% CI 0.579-0.743), and 62.2% (95% CI 0.542-0.682) respectively. Five cases relapsed. The cumulative incidence of relapse within 2 years was 16.2% (95% CI 0.099-0.225). Twenty-one cases died mainly due to infection. Conclusion UCBT could be safely and effectively used for adult patients with hematologic malignancies.

Objective To investigate the immunological effects of thymoglobulin (RATG) on human CD4+and CD8+cells for costimulatory molecule gene expression and the production ofimmune-regulatory cytokines. Methods CD4+and CI8+T cells were isolated and purified fromnormal human peripheral blood mononuclear cells (PBMC) followed by incubation with RATG at37℃. Cells and culture supematants were collected at 24, 48, and 72 h after incubation, and analyzedby real-time quantitative polymerase chain reaction (RT-PCR) for CTLA-4, CD154, forkhead box P3(Foxp3), OX40, IFN-γ, IL-2, IL-10 and CD25 gene expression, and multiplex cytokine detectionassay for IFN-y, IL-2, IL-10, and IL-4 production. Untreated and rabbit isotype Ig-treated cells wereused as negative controls. Results RT-PCR demonstrated that RATG pre-treated CI+and CD8+cells upregulated the expression of CTLA-4, OX40, Foxp3, CD25, IFN-γ, IL-10 and IL-2 genes, anda dramatic increase of supernatant IFN-γ, IL-10, IL-2 and IL-4 was revealed 24 h after treatment asdetermined by multiplex cytokine detection assay when compared with negative controls. Theupre gulation of CTLA-4, Foxp3, OX40, IL-10 and CD25 was reduced, and a down-regulation ofCD154 and IL-2 gene expression was revealed 48 h after treatment. Cells, treated with RATG for 72h, demonstrated up-regulation of CTLA-4, Foxp3, OX40, IFN-y and CD25 gene expression, and theexpression of IL-2 and IL-10 genes was down-regulated. Additionally, supernatant IFN-γ, IL-2,IL-10 and IL-4 levels were decreased. Conclusion RATG stimulates CI4/CD8 T cells to up-regulatecostimulatory molecules and release immune regulation associated cytokines IF'N-γ, IL-2, IL-10in vitro. These results suggest that the unique effect of RATG on CD4+CD8+T cells may be animportant mechanism for its action in inducing immunoregulation, immunosuppression and transplanttolerance.

ABSTRACT:Objective To observe whether N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP)can inhibit rat silicotic fibrosis by regulating stimulatory G proteinα(Gαs)/inhibitory G proteinα(Gαi)signal.Methods Male Wistar rats were randomly divided into three groups (n=1 0 ):control 1 6-w group,silicosis 1 6-w group,and Ac-SDKP pre-treatment group.The pathological changes of the lung tissue was observed by HE staining;the expressions ofα-smooth muscle actin (α-SMA),Collagen Ⅰ,fibronectin (Fn),Gαs,Gαi2 ,Gαi3 and cAMP were detected by Western blot.Immunofluorescence was performed on lung tissue sections to detect the coexpression ofα-SMA/Gαi3 . Results Within silicosis 16-w group,HE staining showed that the silicotic nodule volume increased,nodule fusion and the formation of interstitial fibrosis could be seen,and cell fibrous nodules were visible.Immunofluorescence staining showed the enhanced coexpression ofα-SMA/Gαi3 in fibrosis area.Compared with those in control group, the expressions ofα-SMA,Collagen Ⅰ,Fn,Gαi2 and Gαi3 significantly increased in silicosis 1 6-w group,but the expressions of Gαs and cAMP decreased.Compared with silicosis 1 6-w group,Ac-SDKP pre-treatment group had alleviated lung injury and decreased coexpression ofα-SMA/Gαi3 .The expressions ofα-SMA,Collagen Ⅰ,Fn,Gαi2 and Gαi3 protein significantly decreased in Ac-SDKP pre-treatment group,while the expressions of Gαs and cAMP increased obviously.Conclusion Ac-SDKP can regulate the expressions of Gαs and Gαi and promote the formation of cAMP,thus playing an effective role against silicotic fibrosis.

BACKGROUND:At present, there are many researches about repairing articular cartilage defects. In particular, the microfracture technique has been widely used. OBJECTIVE:To observe recovery of knee joint motor function and morphological changes in tissue repair during articular cartilage defects with different directions (coronal position and sagittal position). METHODS:Articular cartilage fracture models with 2 mm-thick medial femoral condyles of rabbit knee joint were established. According to incision directions, models were assigned to coronal and sagittal groups. At 5, 10 and 20 weeks after model induction, general observation was performed. Specimens were sliced into paraffin sections, and subjected to hematoxylin-eosin staining and col agen staining. Tissue repair at the articular cartilage defects was observed using optical microscope and immunohistochemical method. After model induction, range of motion of rabbit joints was regularly examined in the two groups.RESULTS AND CONCLUSION:A white line was seen across the femoral condyles at defects in the two groups. Articular surface at defect repair was at the level of in situ cartilage, and reached a bone union. Knee joint treated by operation did not affect function. Under light microscope, partial reconstruction of subchondral bone was seen in the two groups, mainly fibrocartilage repair. The level of bony remodeling was lower than tidal line of adjacent in situ cartilage. Immunohistochemical method exhibited that type I col agen staining gradual y reduced at defects of specimens, but type II col agen staining gradual y increased. These results suggested that there was no significant difference in the recovery of motor function of knee joint and the repair of articular cartilage with different directions (coronal and sagittal position).

Objective To investigate the effects of three laparoscopic bariatric operations on relieving type 2 diabetes in morbid obese patients. Methods From 2005 to 2009, 15 morbid obese patients with type 2 diabetes received bariatric operations in Shengjing Hospital including lapband operation (7 cases) , sleeve gastrectomy (7 cases) and gastric bypass(4 cases). All patients were followed up for more than 1 year. Results All patients recovered without major complications. Body weight decreased and BMI was respectively (27. 6 ± 2. 0) kg/m2, ( 26. 9 ± 1. 4) kg/m2 and (27. 5 ± 3. 0) kg/m21 year after operation. The excess BMI loss in three groups were (76. 4% ± 6. 8% ) , (83. 7% ± 4. 6% ), (85. 7% ±9. 5% ) 1 year after operation. On the other side, the fasting glucose levels and glycohemoglobin in gastric bypass group were much lower than that in other two groups. Conclusion All these operations were effective in controling the weights and fasting glucose levels, while the gastric bypass method is better than other two methods in weight and serum glucose control. Sleeve gastrectomy was better in weight and glucose control than lap band operation.