Objective To construct an expression vector directed by hU_(6)snRNA promoter for synthesizing small RNA and to identify its functional activity in the gastric carcinoma cells——SGC-7901.Methods Using human genomic DNA as template,U_(6) snRNA promoter was obtained by PCR method,and then cloned into PUC19 vector to produce the recombinant plasmid PUC-hU_6-extra,which was sequenced and then transfected into gastric carcinoma cell——SGC-7901 with liposome.The effect of expression directed by U_6 promoter was detected by RT-PCR method,and the cell proliferation curve analysis was performed by stained dye.Results The hU_6 snRNA promoter with the first 27 nucleotides followed were successfully cloned into PUC19 plasmid.The recombinant vector could efficiently transcribe small RNA molecules and exerted no effect on cell proliferation in SGC-7901 cells in vitro.Conclusion We have successfully constructed the recombinant PUC-hU_6-extra plasmid vector that can efficiently transcribe small RNA molecules directed by hU_6 snRNA promoter in the gastric carcinoma cells——SGC-7901.

Objective To investigate the effect of brain natriuretic peptide (BNP) on serum angiotensin-converting enzyme (ACE) 2 levels in acute heart failure patients with reduced ejection fraction (HFrEF). Methods A total of 106 patients with acute HFrEF were selected, and were divided randomly into control group and trial group. The control group was under routine treatment, while the trial group was under routine treatment combined with lyophiluzed recombinant human BNP for 24-hour. Cardiac functional parameters were measured by echocardiography both at the enrollment and the end of 7-day treatment. Serum levels of ACE2 and N-terminal pro-BNP (NT-proBNP) were determined using commercially available ELISA kits at the enrollment, the end of 24-hour treatment, and the end of 7-day treatment,respectively. Results A total of 103 patients with acute HFrEF were enrolled (control group=51, trial group=52). There were no significant differences in the use of drugs (e.g., aspirin) and serum biochemical indices (e.g. cardiac troponin I, creatinine) before treatment between these two groups. Compared to systolic blood pressure (SBP) at admission, SBP on the second day after treatment were significantly decreased in two groups (P<0.05). Compared to left ventricular ejection fraction (LVEF) at admission, LVEF values were significantly elevated on the seventh day after treatment in two groups ( P<0.05). There were no significant differences in SBP, diastolic blood pressure (DBP), and LVEF at admission between these two groups (P>0.05);there were also no significant differences in DBP on the second day after treatment, and LVEF on the seventh day after treatment (P>0.05), while SBP was significantly higher on the second day after treatment in control group than that of trial group (P < 0.05). Serum levels of NT-proBNP were decreased with the prolongation of time in two groups. Serum levels of ACE2 were decreased with the prolongation of time in control group, while were increased initially following decreased (which were still higher on the seventh day after treatment than that at admission) with the prolongation of time in trial group. Serum levels of NT-proBNP were higher after 2 days treatment or 7 days of treatment in control group than those of trial group, while serum levels of ACE2 were decreased after 2 days of treatment or 7 days of treatment in control group than those of trial group (P<0.05). Conclusion Patients with acute HFrEF may benefit from BNP by increasing serum ACE2 levels.

Objective:To detect the expression of Shank1 protein in renal cell carcinoma (RCC), to investigate its difference between the tumor and carcinoma adjacent tissue, and to analyze its correlation with RCC clinicopathological characteristics and prognosis. Methods:The renal carcinoma and carcinoma adjacent tissues of 120 patients were selected from Cangzhou Central Hospital and Ji'nan Central Hospital from May 2008 to December 2014. The expression level of Shank1 was determined by immunohistochemistry and Western blot. Statistical analysis was performed to determine the relationship between the expression of Shank1 and the clinicopathological features of RCC patients. Results:Results of immunohistochemistry showed that the expression level of Shank1 in renal cancer tissue was significantly higher than that in carcinoma adjacent tissue, and the difference was statistically significant (P<0.05). Western blot results showed that the expression level of Shank1 protein in renal cancer tissue was also significantly higher than in carcinoma adjacent tissue. Correlation analysis found that the high expression level of Shank1 in renal cancer tissue was not significantly related to gender, age, tumor size, and TNM stage, but was significantly associated with the histological differentiation of RCC (P<0.05). Conclusion:Shank1 is abnormal y expressed in RCC renal cancer tissues and is correlated with the histological differentiation of RCC.

Objective To investigate the expression of a proliferation-inducing ligand (APRIL) in urothelial carcinoma tissue and its clinical significance. Methods We investigated the expression of APRIL mR-NA in urothelial carcinoma tissue of 33 patients in urothelial carcinoma in Cangzhou Central Hospital from July 2013 to March 2015, Among of them, 23 cases of adjacent pericancerous tissues were detected by qRT-PCR. Immunohistochemistry and western blot were used to detect the APRIL protein expression level in urothelial carci-noma tissue and adjacent pericancerous tissues. We analyzed the relationship between APRIL expression and clinical pathology in patients with urothelial carcinoma by statistical methods. Results The qRT-PCR revealed that the expression of APRIL in urothelial carcinoma tissue was significantly higher than that in the adjacent peri-cancerous tissues (P < 0.05). Immunohistochemistry and western blot showed that the expression of APRIL in urothelial carcinoma tissue was higher than that in the adjacent pericancerous tissues. Correlation analysis found that the high expression of APRIL in urothelial carcinoma tissue was not significantly related to gender , age , size of tumor, lymph node metastasizing or not, and clinical stages (P > 0.05). Conclusion The APRIL is a high abnormal expression in urothelial carcinoma tissues , and maybe related to the occurrence and development of urothelial carcinoma.

OBJECTIVE:To study the safety and efficacy of Neuroform self-expanding stent for symptomatic intracranial artery stenosis.METHODS:A total of 37 patients with symptomatic intracranial artery stenosis received treatment at the Department of Neurosurgery,Affiliated Hospital of Behua University and Xuanwu Hospital were selected,who were ineffective to anticoagulation and antiplatelet treatment,including 24 males and 13 females,aged from 49 to 72 years,mean aged 64 years.All patients were received Neuroform self-expanding stent following angiography.RESULTS:All patients underwent PTAS with mean preoperative stenosis were reduced from 64% to 24% after percutaneous transluminal angioplasty (PTAS).The technically successful rate was 100%.All the patients were received a 6-22 month follow-up (average 13 months).The average artery stents was retrieved by 50%-90% after stent deployment.There was no arterial dissection,acute occlusion of the target artery or symptomatic distal emboli.Within the follow-up period,1 patient endured asymptomatical artery full occlusion.Two stents were implanted simultaneously in 3 patients,1 of them suffered bilateral vertebral artery stenosis,and 2 had right vertebral arterial and basilar artery stenosis.One patient suffered acute in-stent thrombosis and recovered after thrombolytic therapy.No pathogenetic condition was aggravated in the follow-up.CONCLUSION:The application of Neuroform self-expanding stent can alleviate the ischemic symptoms of patients with vertebrobasilar stenosis and elevate the operative safety and effectiveness.However,further study is needed to evaluate the long-term therapeutic effect.

Objective To propose an optimal therapeutic scheme, finite element analysis was used to evaluate the biome?chanical status of femoral head under daily activities. Methods Non?necrotic femoral head volunteers (11 people) and necrotic femoral head patients (7 cases) were included in this study. All these participants were divided into two groups:control group and abnormal group. The DICOM imaging files of each participant were imported into ScanIP software to form a mask showing the prox?imal femurs. Then the finite element models of proximal femurs were progressively reconstructed. The generated models were im?ported into Abaqus, and the forces were added on these models to simulate daily activities, including standing, sitting, upstairs, and squatting etc. The loads and boundary conditions of digital daily activities simulation were collected from Orthoload database. All of the femoral finite element models were progressed in Abaqus under above activity conditions. After the models were pro?cessed, stress concentrating region was defined in each models respectively, which expressed the main bearing structure in each model based on the result of finite element analysis. At last, the elastic modulus (E?modulus) and strain of the stress concentrating region in each femoral model were extracted and calculated. Results There was no significant difference in age, weight, and height between these two groups. In control group, no significant differences of E?modulus (7 125±745 MPa on left, and 7 112±751 MPa on right) and strain (micro?strain:952 on left, and 954 on right)were found between their bilateral proximal femurs;however in abnormal group, the patients' E?modulus (5 798±1036 MPa on normal side, and 6 667±888 MPa on necrotic side) and strain (mi?cro?strain:1 261 on normal side, and 987 on necrotic side) of necrotic side were significantly lower than normal side. As to all the daily activities which were considered in this study, in abnormal group, the E?modulus among each postures of abnormal side were significantly lower than the E?modules of healthy side;the micro?strain in downstairs was also significantly lower than other pos?tures. Conclusion Daily activities with different intensity could generate different mechanical effects on femoral head, espe?cially on necrotic femoral head. The higher intensity of posture, the greater damage would be found in necrotic femoral head.

Objective To understand the efficacy of antiretroviral therapy for people living with HIV/AIDS and influencing factors;and provide evidence to improve the treatment of HIV infection and AIDS for the better life of the patients.Methods A cross sectional study was conducted in designated AIDS hospitals in Harbin.A questionnaire was used to collect the information of the patients receiving treatment in these hospitals.The statistical analysis was done with software SAS 9.2 and Excel 2010.Univariate analysis was performed with t test and multivariate analysis was performed with ordinal logistic regression model.Wilcoxon ranks sum test was conducted to compare the CD4+ T lymphocyte counts.Results The number of the patients receiving antiretroviral therapy was in increase in recent years.The HIV infection route was mainly homosexual contact.The CD4 +T lymphocyte count of the patients increased at different levels after ≥6 months treatment (P＜0.01).Household income (P＜0.05),adherence to treatment plan or not (P＜0.05),social relationship (P＜ 0.05),concern of economic cost (P＜0.01) medication compliance (P＜0.01) and initial level of CD4 + T lymphocyte (P＜0.01) were the influencing factors for antiretroviral therapy efficacy.Conclusion In designated hospitals in Harbin,the number of the patients receiving HIV antiretroviral therapy kept to increase and the efficacy of the treatment was obvious.

Multi-campus operation is an important and effective means for high-quality development of public hospitals and balanced layout of high-quality medical resources. By way of literature review, the study identified problems encountered in the construction of multi-campus hospitals in China, with a tertiary general hospital cited as a case example. The authors introduced its multi-campus development practice from such aspects as campus discipline layout, homogeneous operation, performance assessment, management mode and cultural construction, along with suggestions for such practice in China.

The 2nd round of the third-party evaluation of the National Healthcare Improvement Initiative was made during Dec 2016 and Jan 2017.The methods, organization and implementation of the survey and the technical roadmap were the same as those of the 1st round of evaluation.The total number of respondents was 94 218,including 19 773 doctors,24 315 nurses,29 105 outpatients and 21 025 inpatients. 142 typical cases were collected from sample hospitals.The key findings showed that, the National Healthcare Improvement Initiative has been implemented quite well in the 2nd year, achievements and challenges exist side by side.The overall satisfaction rate of both outpatients and inpatients was good, both were about 90%.Further improvement is expected.Hospital staff have been actively involved in this Initiative,but they are not satisfied with their working environments and compensations.

Objective To explore the influencing factors of outpatients′satisfaction in different types of hospitals,and to generate evidence for further healthcare improvement in different types of hospitals. Methods Based on the inpatient satisfaction survey results of the third party evaluation of the National Healthcare Improvement Initiative in 136 public tertiary hospitals,we divided the outpatients in four groups according to the hospital types as general, traditional Chinese medicine, maternal and child and specialty hospitals.SPSS 22.0 and SAS 9.4 were used to conduct the Pearson Chi-square test, variance analysis, Bonferroni test for univariate analysis, and multiple stepwise logistic regression analysis of the influencing factors of outpatients′satisfaction in different types of hospitals.Results A total of 29 105 complete questionnaires were collected from the outpatients.There were statistically significant differences between the overall outpatient satisfactions of different types of hospitals(P <0.01).Hospital experience was the common most significant positive factors affecting the overall satisfaction of outpatients in all types of hospitals(P<0.01,OR=4.10,4.39,3.83,4.36).Waiting time for consultation was the common most significant negative influencing factor of the overall outpatient satisfaction of all types of hospitals(P<0.01, OR=0.99).Conclusions In the next round of healthcare improvements, all types of hospitals should focus on shortening outpatient waiting time.In a short run, hospitals can address this issue through more appropriate allocation of resources within hospitals.In a longer run, there is a need to rationalize the allocation of multiple resources within the overall health service delivery system.It is necessary to strengthen patient centered humane care,and to meet diverse healthcare needs.Western areas are called for enhanced investment and strengthened healthcare improvements.