Objective:To systematically evaluate the influence of the implementation of essential drug policy ( EDP) on prescrip-tion use rate of antibiotics in primary hospitals. Methods:Based on CNKI, Wanfang and VIP of China journal databases, all litera-tures were adopted including the data of the prescription use rate of antibiotics in primary hospitals. RevMan5. 3 and Stata 12. 0 soft-ware were used to conduct the Meta analysis. Results:Totally 43 literatures were included in the study according to the evaluation se-lection criteria. After the implementation of EDP, the prescription use rate of antibiotics in primary hospitals was decreased, and com-pared with that before the implementation of EDP, the risk difference value was significant [RD= -0. 03,95%CI( -0. 04,-0. 03), P<0. 000 01], while the use rate was still high (46. 16%). The result of Egger’s test indicated the publication bias of the 43 litera-tures was not significant (P=0. 571). However, there was high heterogeneity(I2 =94%,P<0. 000 01)among the different studies. Based on the classification of hospital type and different areas, the results of sub-group analysis showed the differences of study methods in the literatures and regional implementation measures of EDP contributed to the high heterogeneity among the different studies. Con-clusion:In order to reduce the heterogeneity of studies, a unified evaluation criteria for the research quality of the cross-section survey should be established. And special policies related to EDP should be taken to effectively decrease the use rate of antibiotics in primary hospitals.

Objective To investigate the clinical effects of autologous tumor immune cells (DC-CIK)assisted interventional therapy in the treatment of advanced primary liver cancer.Methods Totally 76 patients with advanced primary liver cancer were divided into 2 groups with 38 cases in each group by random number table method.The control group were merely treated with interventional therapy while the ob-servation group were treated with autologous DC-CIK cell assisted interventional therapy.The short-term curative effect,adverse reactions,liver function indexes before and after treatment,alpha fetal protein (AFP)and changes of immune function were compared between the 2 groups. Results There was no statistically significant difference in short-term curative effect and incidence of adverse reactions between the 2 groups (P >0.05).After treatment,the levels of AST,ALT and AFP in the observation group [(30.4 ±6.0)u/L,(45.2 ±3.8)u/L,(168.5 ± 49.3)mg/L]were significantly lower than those in the control group [(65.1 ±6.3)u/L,(61.8 ±5.3)u/L,(315.2 ±39.5)mg/L],and the differences were statistically significant (P <0.05).After treatment,CD3 +,CD4 + and CD4 +/CD8 + in the observation group were significantly higher than those in the control group (P <0.05).Conclusion Autologous DC-CIK cell assisted interventional therapy can sig-nificantly improve the liver function of patients with advanced primary liver cancer,and it can reduce the level of tumor marker AFP and sig-nificantly improve the immune function of patients.

Objective To investigate the effect of diabetes on the expression of the glucose transporter (GLUT-1) in blood brain barrier (BBB) endothelial cell at different time points. Methods Forty male SD rats were randomly divided into normal control and diabetic group. Diabetic model of SD rats was established by intravenous streptozotocin(50 mg/kg) injection. Ten rats in each group were sacrificed on the 2nd month and 10th month respectively. The rat' s prefrontal cortex was removed to observe the expression of GLUT-1 in BBB EC with immunohistochemical(IHC) staining. Results By IHC method, the number of GLUT-1 positive microvessels was significantly decreased in diabetic group in the 2nd month (4. 3 ± 0. 9) compared with that of control group (6.4 ± 1.7, t = 7. 586, P < 0. 01 ) ; the number of GLUT-1 positive microvessels was significantly increased in the diabetic group in the 10th month (8.4 ± 1.4) compared with that of control group (5. 8 ± 1.7, t = 15.922,P < 0. 01 ). Conclusions Short-term diabetes GLUT-1 expression in BBB EC is downregulated in early stage, while it is upregulated in advanced stage.

Objective To investigate the difference of endothelial cell (EC) in ultrastructure,markers and permeability between blood-brain barrier (BBB) and blood-nerve barrier (BNB).MethodsThe rat brain cortex and sciatic nerve were removed.Ultrastructure of endothelial cell was observed with electron microscopy.Employing immunohistochemical (IHC)staining,the relative distribution was determined for the OX-26,endothelial barrier antigen (EBA)and extravasated fibrinogen around microvessels.ResultsMicrovessels both in BBB and in BNB did share the same tight junctions.However,BNB had a significantly larger number of vesicles than that of BBB.Microvessels in BNB did not express the OX-26 and EBA,but staining weakly positive for fibrinogen,while microvessels in BBB showed strong positive for OX-26 and EBA,perivascular staining of fibrinogen had not been seen.ConclusionTight junctions were present in both BBB and BNB endothelial cell,but there was a significant difference between them in the number of the pinocytotic vesicles,markers expression and permeability.

Objective To construct and express a prokaryotic expression vector carrying the gene of FimH 1-156 that comprises human lysosome membrane protein 2 P41-49 gene ,and to express and purify the fusion protein .Methods FimH1-156 gene was cloned from plasmid pPKL241 by PCR ,and inserted into vector pET-28a(+ ) to obtain prokaryotic expression plasmid pET-28a-FimH . After transforming Escherichia coli BL21(DE3) with pET-28a-FimH ,fusion protein FimH1-156 was expressed under induction .The target fusion protein was purified ,and its antigenicity was detected through Western blot .Results The expressed recombinant pro-tein was purified ,the expression of protein was the highest when IPTG was 1 mmol/L and 4h after induction ,it was expressed as include body form ,and the expressed protein was identified to react with monoclonal antibodies 6 × His by Western blotting .Conclu-sion We cloned FimH1-156 fusion protein expressed genes successfully ,constructed prokaryotic expression vector ,and won the in-clusion body purification of FimH1-156 fusion protein .

Background: Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients. Methods: A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics. Results: Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower.Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP.The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer. Conclusion Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

Objective:To explore the correlation between the expression of signaling lymphocyte activation molecule family 6 (SLAMF6) on peripheral blood CD8 +T cells and perforin and granzyme B and the clinical significance in patients with newly diagnosed severe aplastic anemia(SAA). Methods:The indicators of blood routine and bone marrow and peripheral blood samples of 32 newly diagnosed SAA patients admitted to Henan Provincial People′s Hospital from January 2016 to June 2019 were collected for retrospective analysis. Flow cytometry was used to detect the expression of SLAMF6, perforin and granzyme B on samples CD8 +T cell before therapy and 6 months after therapy (11 cases received transplantation, 21 cases received immunosuppressive therapy [IST]). Spearman correlation analysis was performed to determine the association between clinical indicators and laboratory test results. The expression of SLAMF6, perforin and granzyme B was also detected in 10 healthy people (normal group) and 13 myelodysplastic syndromes/paroxysmal nocturnal hemoglobinuria (MDS/PNH) patients (MDS/PNH group). Results:(1) At diagnosis: the expression of SLAMF6 was significantly lower in the SAA group than that in the normal group and the MDS/PNH group ([56.40±6.37]% vs [84.34±5.81]% and [82.24±4.98]% (both P<0.001]). The expression of perforin was significantly higher in the SAA group (32.73±8.46) than that in the normal control group (23.75%±5.10%), and the MDS/PNH group (26.12%±5.53%) (both P<0.05). The expression of granzyme B was also significantly higher in the SAA group (36.23%±7.94%) than that in the normal control group (21.67%±5.05%) and the MDS/PNH group (21.79%±5.10%) (both P<0.001). The expression of SLAMF6 was positively correlated with the hemoglobin ( r=0.804), and reticulocyte absolute values ( r=0.656) in peripheral blood, percentage of granulocytes ( r=0.643) and erythrocytes ( r=0.622) in bone marrow of SAA patients (all P<0.05). Expression of SLAMF6 was negatively correlated with perforin ( r=-0.792) and granzyme B ( r=-0.908) on CD8 +T cells in patients with SAA (both P<0.001). (2) After treatment: the expression of SLAMF6 in peripheral blood CD8 +T cells of 30 surviving patients was higher than pre-treatment ([79.19±12.69]% vs [56.40±6.37]%, P<0.001). The expressions of perforin and granzyme B were lower than pre-treatment level (both P<0.05). The expression of SLAMF6 on CD8 +T cells in 11 transplanted patients was higher than before transplantation ([86.54±3.75]% vs [56.40±7.35]%, P<0.001). The expressions of perforin and granzyme B were lower than before transplantation (both P<0.05). The expression of SLAMF6 on CD8 +T cells in 12 IST-respond patients was higher than that before treatment, while the perforin and granzyme B levels were lower than pre-treatment (all P<0.05). The post-treatment expressions of SLAMF6, perforin and granzyme B were similar as before treatment levels in 7 IST-unrespond patients (all P>0.05). Conclusion:SLAMF6 is significantly down-regulated on CD8 +T cells in newly diagnosed SAA, negatively correlated with the effective factors of CD8 +T cells, which might participate in the immune regulatory of CD8 +T cells as a negative regulatory factor in patients with SAA. The SLAMF6 is significantly up-regulated after hematopoietic recovery, while there is no significant change in treatment-unrespond patients, which could thus serve as an useful diagnostic and therapeutic index of patients with SAA.

Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.

A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics.

Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower. Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP. The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer.

Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.

A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics.

Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower. Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP. The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer.

Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

OBJECTIVETo analyze and compare burden of disease caused by malignant tumor in China, 1990 and 2010.

METHODSThe indicators including prevalence, death, years of life lost (YLL), years lived with disability (YLD), and disability adjusted of life years (DALY) of malignant tumor from the results of Global Burden of Disease (GBD) 2010 were used to calculate the standardized prevalence rate, mortality rate, YLL rate, YLD rate and DALY rate with the 2010 national census data. The research described the prevalence, death, and burden of disease caused by malignant tumor and analyze the trend of these indicators in 1990 and 2010 in China.

RESULTSIn China from 1990 to 2010, the standardized prevalence rate of malignant tumor increased from 529.76/100 000 to 749.57/100 000 (increased by 41.49%); the standardized mortality rate decreased from 196.57/100 000 to 169.88/100 000 (decreased by 13.58%); the standardized DALY rate decreased from 5 206.56/100 000 to 4 150.86/100 000. In 2010, the top five standardized DALY rate of malignant tumor were lung cancer, liver cancer, gastric cancer, esophageal cancer, and colorectal cancer. Their standardized DALY rate were 892.21/100 000, 787.40/100 000, 521.36/100 000, 303.95/100 000, and 269.94/100 000, respectively. In all kind of malignant tumors, the burden of disease of lung cancer had the fastest-growing rate. The standardized mortality rate of lung cancer increased from 34.78/100 000 in 1990 to 41.09/100 000 in 2010; the standardized DALY rate increased from 830.77/100 000 in 1990 to 892.21/100 000 in 2010. The burden of disease of gastric cancer had the fastest-falling rate. The standardized mortality rate of gastric cancer decreased from 39.65/100 000 in 1990 to 23.79/100 000 in 2010; the standardized DALY rate decreased from 968.96/100 000 in 1990 to 521.36/100 000 in 2010.

CONCLUSIONThe burden of disease caused by malignant tumor in China remained at high levels in 2010. The top five burden of disease of malignant tumor were lung cancer, liver cancer, gastric cancer, esophageal cancer, and colorectal cancer. The burden of disease of lung cancer had the fastest-growing rate and gastric cancer had the fastest-falling rate from 1990 to 2010 in China. Prevention and control of malignant tumor was still difficult.

China ; Colorectal Neoplasms ; Cost of Illness ; Esophageal Neoplasms ; Humans ; Liver Neoplasms ; Lung Neoplasms ; Mortality ; Neoplasms ; Prevalence ; Quality-Adjusted Life Years ; Stomach Neoplasms