The manuscript introduced the overview, training objectives, policy advantages, training process,curriculum, examination of the Australian College in Rural and Remote Medicine and further contrasted that with China's domestics.The authors held that Australia's training is better targeted due to its colleges tailored to this end;the training duration for general practitioners of rural and remote areas is longer,and the training schedule is reasonable;the curriculum design and training content are more targeted;and the homogeneous training is better achieved as its examination is run by the college in a standardized manner.The authors therefore hold that China should develop detailed regulations for general practitioners from rural and remote areas and explore the feasibility of setting up second-level disciplines institutes for internal medicine, surgery, gynecology and obstetrics, pediatrics and general at national and provincial level.

Objective To investigate the tissue stimulation of copper ions to the smooth muscle of murine terminal rectum.Methods In this study copper needle used for electrochemical therapeutic equipment was punctured into submucosal smooth muscle tissue of terminal rectum above the dentate line in 65 male rats.Rats were then divided into 5 groups (10 rats in each group) at random and sacrificed at 1, 3, 4, 6, 8 weeks after respectively, samples were sent for observation of macroscopic and microscopic tissue reaction.Results Rats had no abnormal histological change in the puncture points grossly. Undor microscope, mild edema was detected in the submucosal layer in 1 week group. Remarkable infiltration of inflammatory cells and lymphocytes subsided 3 weeks after, and disappeared five weeks after.Smooth muscle was normal microscopically in all groups.In contrast, platinum and steel needles caused infiltration of plasma cells and neutrophils, ulcers and small abscess formation in around puncture points.Conclusion Inflammatory reaction was induced after puncturing of copper needle into the tissues and the tissue reaction disappeared after 5 Ws.In contrast with platinum and steel needles, copper needle was non-traumatic to the smooth muscle tissue.

Objective To explore the relationship of methylenetetrahydrofolate reductase (MTHFR)gene C677T,factor V(FV)gene G1691A and prothrombin(PT)gene G20210A polymorphisms to unexplained recurrent early spontaneous abortion(URESA).Methods One hundred and twelve patients with URESA and 100 women with at least 1 normal pregnancy and without any miscarriage were analyzed for MTHFR,FV and PT gene polymorphisms by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).Results MTHFR gene T/T genotype and T allele frequencies were increased in URESA patients[38.4%(43/112)and 59.8%(134/224)]versus controls[18.0%(18/100)and 43%(43/100),P

Humans ; Siblings ; Forensic Medicine ; Forensic Genetics

The study aims to investigate the associations of SUMO4 polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients. Blood samples and clinical data were collected from 132 renal transplant recipients with tacrolimus treatment. CYP3A5*3 genotypes were detected by PCR-RFLP, and SUMO4 (rs237024, rs237025) genotypes were detected by Sequenom® MassARRAY system. SUMO4 rs237024 and rs237025 genotypes were in complete linkage disequilibrium (D' = 1). The dose-adjusted concentration of tacrolimus in SUMO4 rs237024A-rs237025A (GA-GA +AA-AA) carriers was considerably higher than that in GG-GG carriers (P < 0.05). After stratification by CYP3A5*3 genotypes, SUMO4 rs237024A-rs237025A carriers (GA-GA+AA-AA) had a higher dose-adjusted tacrolimus concentration than that in GG carriers in CYP3A5 expresser (P < 0.05). The results illustrated that SUMO4 rs237024 and rs237025 polymorphisms were associated with tacrolimus concentrations, and the test of these genotypes may be useful for individualized medicine of tacrolimus.
Asian Continental Ancestry Group ; genetics ; Cytochrome P-450 CYP3A ; genetics ; Genotype ; Humans ; Immunosuppressive Agents ; blood ; therapeutic use ; Kidney ; Kidney Transplantation ; Linkage Disequilibrium ; Polymorphism, Single Nucleotide ; Small Ubiquitin-Related Modifier Proteins ; genetics ; Tacrolimus ; blood ; therapeutic use

Nanotechnology has shown obvious advantages in the field of medical treatment and diagnosis. Through the encapsulation of nano carriers, drugs not only enhance the therapeutic effect and reduce toxic and side effects, but also become intelligent responsive targeted drug systems through the modification on the surface of nano carriers. However, due to the obstacles in relevant basic research, production conditions, cost, clinical trials, and the lack of pharmacokinetic research on various drug loading systems, few nano systems have been used in therapy. In order to solve the above problems, this paper reviewed and analyzed the research progress of nano carriers in drug delivery, including their auxiliary role and characteristics, types and functions, pharmacokinetics, application prospects and challenges.

This study aims to investigate the function of two SNPs (rs8904C > T and rs696G >A) in 3' untranslated region (3'UTR) of NFKBIA gene by constructing luciferase reporter gene. A patient's genomic DNA with rs8904 CC and rs696 GA genotype was used as the PCR template. Full-length 3'UTR of NFKBIA gene was amplified by different primers. After sequencing validation, these fragments were inserted to the luciferase reporter vector, pGL3-promoter to construct recombinant plasmids containing four kinds of haplotypes, pGL3-rs8904C/rs696G, pGL3-rs8904C/rs696A, pGL3-rs8904T/rs696G and pGL3-rs8904T/rs696A. Then these plasmids were transfected into LS174T cells and the luciferase activity was detected. Compared with pGL3-vector transfected cells (negative control), the luciferase activity of the four kinds of recombinant plasmids was significantly decreased (P < 0.001). For rs696G > A, the luciferase activity of the recombinant plasmids containing A allele (pGL3-rs8904C/rs696A and pGL3-rs8904T/rs696A) was about 45.1% (P < 0.05) and 56.1% (P < 0.001) lower than those containing G allele (pGL3-rs8904C/rs696G and pGL3-rs8904T/rs696G), respectively. For rs8904C > T, there were no significant differences in the luciferase activity between the recombinant plasmids containing T allele and those with C allele. Together, the luciferase reporter gene vectors containing SNPs in NFKBIA gene 3'UTR were constructed successfully and rs696G > A could decrease the luciferase activity while rs8904C >T didn't have much effect on the luciferase activity.
3' Untranslated Regions ; Genes, Reporter ; Genetic Vectors ; Humans ; I-kappa B Proteins ; genetics ; Luciferases ; NF-KappaB Inhibitor alpha ; Plasmids ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Transfection

Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Glycogen Synthase Kinase 3 ; physiology ; Glycogen Synthase Kinase 3 beta ; Humans ; Insulin-Like Growth Factor I ; pharmacology ; Interleukin-6 ; physiology ; Multiple Myeloma ; pathology ; Phosphatidylinositol 3-Kinases ; physiology ; Proto-Oncogene Proteins c-akt ; physiology ; Signal Transduction ; drug effects

China implemented the public hospital reform in 2012.This study utilized bootstrapping data envelopment analysis (DEA) to evaluate the technical efficiency (TE) and productivity of county public hospitals in Eastern,Central,and Western China after the 2012 public hospital reform.Data from 127 county public hospitals (39,45,and 43 in Eastern,Central,and Western China,respectively) were collected during 2012-2015.Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist.The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal-Wallis H test and Mann-Whitney U test.The average bias-corrected TE values for the four-year period were 0.6442,0.5785,0.6099,and 0.6094 in Eastern,Central,and Western China,and the entire country respectively,with average non-technical efficiency,low pure technical efficiency (PTE),and high scale efficiency found.Productivity increased by 8.12％,0.25％,12.11％,and 11.58％ in China and its three regions during 2012-2015,and such increase in productivity resulted from progressive technological changes by 16.42％,6.32％,21.08％,and 21.42％,respectively.The TE and PTE of the county hospitals significantly differed among the three regions of China.Eastern and Western China showed significantly higher TE and PTE than Central China.More than 60％ of county public hospitals in China and its three areas operated at decreasing return scales.There was a considerable space for TE improvement in county hospitals in China and its three regions.During 2012-2015,the hospitals experienced progressive productivity;however,the PTE changed adversely.Moreover,Central China continuously achieved a significantly lower efficiency score than Eastern and Westem China.Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China,especially in Central China.

Objective Identify the mechanism of induced atrial arrhythmias after pulmonary vein isolation (PVI) in patients with paroxysmal atrial ifbrillation(PAF), and investigate its long-term prognosis. Methods All patients with PAF undergoing PVI and induction test afterwards between Feburary 2010 and October 2010 were included. The induction protocol was rapid pacing initiated at cycle length of 250 ms with progressive shortening in a decrement of 10 ms down to 180 ms or refractoriness. Isoproterenol of 2-4μg/min was administrated as well. Inducibility was deifned as induction of atrial arrhythmia lasting >1 min. The mechanism of induced tachycardia was identiifed by activation mapping and entrainment mapping under the guidance of CARTO system. All patients were followed up by 36 months. Results Forty-nine atrial tachycardia were induced in 39 (19.7%) patients, including 35 organized atrial tachycardia (OAT) and 14 atrial ifbrillation (AF). The LA diameter was signiifcantly larger in inducible group than non-inducible group (39.5±6.6 mm vs. 36.7±5.2 mm, P=0.004). Macroreentry was the most common mechanism in induced OATs (28, 80.0%), and mitral isthmus was the most common critical site (20, 40.8%), followed by cavo-tricuspid isthmus (12, 24.5%), PV (6, 12.2%), LA septum (4, 8.2%), superior vena cava (3, 6.1%) and LA roof (1, 2.0%). Conclusions The most common mechanism of induced tachycardia by IV isoproterenol and rapid pacing is MI and CTI dependent after PVI in PAF patients, which can be succssefully eliminated by liner ablation, not increasing long-term recurrence rate.