Objective To analyze the utilization of community health services(CHS) and influencing factors in Shenzhen. Methods Surveys were conducted by means of cluster random sampling and utilization of CHS for health promotion, utilization of single services and integrated utilization were analyzed using descriptive methods. Results The rate of integrated utilization was 35.90% and the most utilized single services were patient care and drug purchase, with general physical checkup, health guidance and disease prevention coming next. Conclusion Factors such as the layout, convenience and knowledge of CHS are conducive to enhancing the rate of CHS utilization whereas factors such as residence in a special economic zone, student status, and higher educational backgrounds have a negative influence on CHS utilization.

Migrant workers incur the challenges of linkage and compatibility of medical insurance systems for their migration across regions and change of identities. To identify a medical insurance system adaptable to their needs, the paper recommends the following: Take their medical insurance into the national account of medical insurance; build a linkage mechanism between cities and villages, and that between cities as well; make the medical insurance system more compatible and portable, in order to safeguard their right of health.

Objective: To investigate the effect of four kinds of inactivation methods on the activity of soybean agglutinin (SBA). Methods: Dry-heat, humid-heat, acid-alkali and metal ion were employed to evaluate their effects on the activity of SBA, which were quantified by hemagglutination. Results: Dry-heat below 120℃ did not obviously decrease the activity of SBA, while humid-heat (95℃ for 30 min,100℃ for 20 min or 105℃ for 10 min) completely inactivated the SBA. The activity of SBA significantly decreased when soybean protein was extracted under pH 1.0-4.5 or pH 9-13. Quadrivalent and trivalent metal ions markedly inhibited the activity of SBA. Conclusion: SBA can be inactivated effectively by humid-heat, acid-alkali or metal ion. Further study is needed to clarify whether there are synergistic effects between these treatments.

Objective To investigate the clinical significance in diagnosis and prognostic judgments of acute myelocytic leukemia with combined detection of morphology ,peripheral blood and immune typing of bone marrow cells .Methods Microscopic examina‐tion of bone marrow cell morphology ,automatic blood cell analyzer detection of peripheral blood parameter and flow cytometry anal‐ysis of immune markers of leukemia cells ,all these datas were analyzed statistically .Results Peripheral blood cell analysis showed that instruments may indicate the presence of abnormal or naive cells in about 85% patients ,different kinds of leukemia had signifi‐cant difference in total leukocyte count (majority higher in M1 - 2 ,M5 ;majority lower in M3) ;while anemia and thrombocytopenia were observed in most patients ,but the degree was different ;M1 - 2 and M5 can not be identified by classification of leukocyte by automatic blood cell analyzer ,CD7 ,CD10 and CD2 can cross express in myeloid leukemia ,which have a prompt effect with treatment and prognosis .Conclusion Detection of peripheral blood parameters has an important role in early screening ,differential diagnosis and prognosis judgment of leukemia ,immunological markers detection is the powerful supplement and support for leukemia diagno‐sis and typing ,sensitive markers have close contact with prognosis ,which significantly improves the effect of the diagnosis and treatment of leukemia .

Objective Exploring theoretical teaching model of chronic diseases management of preventive medicine undergraduates,to provide feasible suggestions to improve the theoretical teaching of the chronic disease management ability of preventive medicine specialty in China so that graduates can better adapt to chronic diseases management work.Methods On the basis of reading a large number of relevant literature both at home and abroad,the research team designed questionnaires,and conducted a questionnaire survey on 190 respondents who engaged in chronic diseases management or teaching in central China.The content includes the understanding of the importance of training chronic disease management ability in undergraduate education of preventive medicine and the constitution and training mode of undergraduates' chronic disease management ability.EpiData 3.1 software was used to input survey data,SPSS 23.0 software was used for statistical description analysis,and the usage ratio and component ratio were used for statistical description analysis.Results The survey found that more than 50％ of the respondents believed that training students with chronic disease management should focus on prevention,intervention services and health promotion ability,and chronic disease modules need to be added to undergraduate courses in preventive medicine.Conclusions preventive medicine undergraduates need to be improved,and medical colleges should change teaching model to increase undergraduates' ability of chronic diseases management.

Gallbladder Diseases ; Gallbladder Neoplasms ; Humans ; Polyps

[摘 要] 目的：构建靶向CD38和CD138分子抗原的双靶点嵌合抗原受体基因修饰T淋巴细胞（CD38/CD138 CAR-T细胞），探讨其对多发性骨髓瘤（MM）细胞的体外杀伤作用。方法：利用CAR-T细胞技术，基于MM细胞高表达CD38和CD138抗原，分别构建靶向CD38、CD138的CD38 CAR-T与CD138 CAR-T细胞，以及同时靶向CD38与CD138的CD38/CD138 CAR-T细胞，实验分为未处理T、CD38 CAR-T、CD138 CAR-T和CD38/CD138 CAR-T细胞组。采用流式细胞术检测CAR-T细胞的表型，利用LDH释放法检测各种CAR-T细胞对MM细胞RPMI8226和U266的体外杀伤作用。结果：成功构建CD38 CAR-T、CD138 CAR-T和CD38/CD138 CAR-T细胞。CD38/CD138 CAR-T细胞倾向于向记忆表型分化，表达较高水平的增殖分子（CD25）、激活分子（CD27）和较低水平的耗竭分子（PD-1、CTLA-4、TIM-3）（均P < 0.001），而且CD38/CD138 CAR-T细胞不易于耗竭和衰老，且表达较低水平的r-H2AX、p-p53、p21和p16蛋白（均P < 0.01）。在不同效靶比条件下，CD38/CD138 CAR-T细胞较CD38 CAR-T、CD138 CAR-T细胞对RPMI8226和U266细胞具有更强的杀伤作用（均P < 0.001）。结论：靶向CD38和CD138治疗MM的CD38/CD138 CAR-T 细胞在体外具有较优表型及较强的抗肿瘤功能。