Objective To investigate spatial distribution and temporal trend of main water-soluble inorganic ions in PM_2.5 of Wuhan. Methods PM_2.5 samples were simultaneously collected at 5 sites in Wuhan from January 2017 to December 2017 (7 consecutive days per month). The main water-soluble ions in PM_2.5 were determined by weighing method and ion chromatography. The seasonal variations and spatial distribution differences were analyzed. Results The results showed that the mass concentration of PM_2.5 in Wuhan changed in different seasons. It was highest in winter, followed by spring and autumn, and lowest in summer. There were obvious seasonal changes in the mass concentrations and proportions of distinct ions. The concentrations of the four detected water-soluble inorganic ions were highest in winter. SO₄^2- had highest concentration and proportion, followed by NO₃^- and NH₄⁺, and Cl- was the lowest. In terms of spatial distribution, the total ion concentration and proportion was the largest in Wuchang and the lowest in Dongxihu. Conclusion The seasonal variation of main water-soluble inorganic ions in PM_2.5 was obvious, and the spatial distribution was also different in Wuhan.

Objective To analyze the causes, characteristics and solutions of medical complaints against five tertiary general hospitals in Shandong province, and provide references for the hospitals to improve their quality of care and to build a harmonious relationship between doctors and patients. Methods A retrospective analysis method was used to analyze the causes, solutions and subjects of 1 049 medical complaints against five tertiary general hospitals in Shandong province from 2012 to 2015. Results Among the departments complained, orthopedics(165 cases, 15.7% ), and obstetrics and gynecology(136 cases, 13.0% )topped the rest. The causes of complaints mainly focued on the quality and effect of surgery(355 cases, 33.8% ), diagnosis and treatment(269 cases, 25.6% ), and service attitude(204 cases, 19.4% ). For outpatient/emergency departments, the patients mostly complained on " service attitude" (125 cases, 36.1% ), while the causes of complaints by inpatients were mainly " quality of surgery and effects" (332 cases, 44.8% ). In terms of the dispute solution pathways, consultation between doctors and patients became the most useful one(353 cases, 84.5%), and the third-party mediation approach(56 cases, 13.4% )also played an important role. Conclusions The hospitals should comprehensively strengthen their medical quality management, improve the quality of " service contact" and patient satisfaction. They are also recommended to establish a perfect complaint handling mechanism for higher patient satisfaction. The government should set up specialized courts for medical disputes and improve the efficiency of judicial solution of such disputes.

Objective To provide reference for service optimization of information suppliers and doctors through analyzing the residents'value cognition and utilization of online health information.Methods Questionnaires were distributed in June 2016 to 1 460 residents aged 18 or above and having experienced medical visits themselves or accompanying others in one year. They were surveyed to learn their health information cognition and utilization behavior. The data so acquired were subject to constituent ratio and Chi square test analysis. Results In terms of their use of online health information, 58.5% of the respondents would consult relevant information before medical visits, 64.3% would verify the doctor's diagnosis online following such visits. In case of any inconsistences, 28.2% of them would seek second opinion at another hospital. Statistical differences were discovered in the cognitive difference of residents of different sexes on "internet health information inquiry can relieve tension" , and in the utilization difference of residents of different ages and educational on " whether to consult online health information before medical visits" ( P<0.05). Conclusions The residents'value cognition of online health information is rational in general, but there are also some cognitive behaviors worthy of notice. Information conflicts may incur doctor-patient conflicts and repetitive medical visits. Stakeholders should ensure the professionalism and quality of the information providers. The doctors should master the communication skills and pay attention to the potential impact of online health information.

Objective To provide reference for bettering online health information supply and meeting residents' health needs by analyzing residents' access to and utilization rate of online health information. Methods 1 460 residents aged 18 years or above and having experienced medical visits themselves or accompanying others in one year were surveyed in June 2016. The survey covered their access to online health information and the utilization rate. χ2test, variance analysis, and important quadrant derivation model were used in the data analysis. Results 84.5% of the respondents used mobile phones as the most popular tool for accessing health information on the Internet, with more women than men. The importance quadrant analysis found that the residents have the highest utilization rate (72.6% ) of search engines, yet the reliability scoring of such engines was the lowest ( 62.8 ). Professional medical health websites scored the highest in reliability (81.8), yet the lowest utilization rate (2.1% ). Conclusions Search engines require stronger scrutiny to improve their information quality. Professional health and medical institutions'websites are encouraged to step up health information promotions, and health management Apps should be regulated in their development, to create convenient and reliable online health information platforms.

【Objective】 To study the CD4 T cell epitopes in Core and NS3 protein of genotype 1(GT1) and 6(GT6) of hepatitis C virus(HCV). 【Methods】 A total of 298 overlapping peptides(16-mer) spanning Core and NS3 protein of GT1 and GT6 HCV were synthesized. Peripheral blood mononuclear cells(PBMCs) from 17 HCV+ and 7 healthy blood donors were stimulated by peptide pools, followed by evaluating T cell response by IFN-γ ELISPOT, by which 21 peptides with positive results were found. These peptides were further applied to individually stimulate 20 HCV+ and 18 healthy PBMCs. The differences of responsive frequencies to the 21 positive peptides between the two study groups were compared. 【Results】 Pooled and individual peptide stimulation tests showed that HCV+ PBMCs were responsive to the stimulation of 5 peptides(GT1 NS31273-1288 and NS31315-1330; GT6 NS31033-1048, NS31087-1102 and NS31351-1366), with a responsive frequency ranging 18.9%-27.0%. In contrast, healthy PBMCs were not or low responsive(0%-4.0%) to these five peptides. The responsive frequencies were statistically different between the two groups(P<0.05). No reported epitopes in IEDB were found identical with these 5 peptides via sequence alignment. 【Conclusion】 Our study identified novel CD4 T cell epitopes in NS3 protein of GT1 and GT6 HCV, which has potential application value for the research and development of HCV vaccine.

【Objective】 To investigate the correlation of peripheral myeloid-derived suppressor cells (MDSC) with hepatitis c virus (HCV) infection. 【Methods】 109 voluntary blood donors who donated blood during February 2018 to September 2020 at Guangzhou Blood Center were recruited in this study. They were assigned to chronic hepatitis c (CHC) group (n=48), spontaneous clearance (SC) group (n=29) and healthy donors (control) group (n=32) according to the results of anti-HCV and HCV RNA tests. Blood samples were drawn from the participants and peripheral blood mononuclear cells (PBMC) were freshly isolated, followed by staining with fluorescently-labeled antibody against cell surface markers of MDSC, which were then applied to the detection of monocytic- (M) and polymorphonuclear (PMN)-MDSC by flow cytometry. Parameters for liver function including alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), total bilirubin (TBIL) and direct bilirubin (DBIL) were also measured. One-way ANOVA tests were applied to compare the differences of M- and PMN-MDSC and liver function between three study groups. For pairwise comparisons, P values were adjusted for multiple comparisons by Bonferroni correction (Pc). 【Results】 The frequencies of M-MDSC (%) in CHC, SC and HC were 1.39±0.86, 0.85±0.63 and 0.57±0.23, respectively (P<0.01). Specifically, CHC presented significantly higher level of M-MDSC than SC (Pc<0.01) and control (Pc<0.05). There was no significant difference in the frequencies of PMN-MDSC among the three study groups (0.81±0.54 vs 0.65±0.40 vs 0.62±0.29, P>0.05). In addition, AST (34.4±19.2 vs 23.0±7.78 U/L) and GGT (40.8±31.4 vs 22.3±7.40 U/L) level were higher in CHC compared with control (Pc<0.05 and Pc<0.01, respectively). 【Conclusion】 The level of peripheral M-MDSC was significantly elevated in chronic HCV infected donors, which would related to the progression of chronicity after HCV infection.