Objective: To analyze the problems of large medical equipment allocation in our country, put forward the method and basis of scientific configuration. Methods: The current situation of large medical equipment allocation was analyzed by the methods of literature, statistics and analysis, in order to understand the operating costs and benefits and provide a scientific configuration tool when bringing in medical technology. Results: The configuration of large medical equipment has some problems, such as the uneven distribution of medical resources, equipment shortage, blind purchase of high-end equipment, low localization rate and so on. These problems will directly lead to the unreasonable allocation and the waste of medical resources. Conclusion:The configuration of large medical equipment must comply with the relevant provisions of the state by the HTA and other scientific methods, so as to improve the level of investment decision-making. It will make the use of medical resources efficiently and reasonably.

Objective To investigate the expressions of SOCS3 and IL‐6 in triple‐negative breast cancer(TNBC)and their clinical significance.Methods The expressions of SOCS3 and IL‐6 in TNBC and normal breast cells were detected by Western blot and fluorescence quantitative PCR.Immunohistochemical staining was used to detect their expressions in 84 TNBCs ,33 breast fibromas and 11 normal breast tissues. The correlation of their expressions in TNBC and the relationship between their expressions and clinical pathological parameters were analyzed as well.Results SOCS3 was not expressed or down‐expressed in TNBC cell lines while IL‐6 was over‐expressed. The positive rate of SOCS3 protein was 32.1% in TNBCs ,63.6% in breast fi‐bromas(P<0.01)and 72.7% in normal breast tissues (P< 0.01);and that of IL‐6 protein was 72.6% in TNBCs ,30.3% in breast fibromas(P< 0.01)and 27.3% in normal breast tissues (P< 0.01).Moreover ,a significant negative correlation was found between the expression of SOCS3 and that of IL‐6 in TNBC(rs = -0.590 ,P<0.01). The expressions of SOCS3 and IL‐6 were markedly associated with tumor size ,lymph node metastasis ,clinical stages and expressions of Ki‐67 and p53(P<0.05) , but not with age ,histological grades or menopausal status(P>0.05).Conclusion The expressions of SOCS3 and IL‐6 are asso‐ciated with the development of TNBC ,suggesting that SOCS3 and IL‐6 can serve as biological markers for evaluating the prog‐nosis ,and therapeutic targets of T NBC.

Objective To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) transplantation on angiogenesis and functional recovery after focal cerebral ischemia in rats.Methods BMSCs were isolated and cultured using the whole bone marrow adherent method,and conducted phenotypic identification using flow cytometry analysis of surface positive antigen of CD29,CD90 and the negative antigen of CD34,CD45.Rats were subjected to middle cerebral artery occlusion (MCAO) for 90 minutes,and divided into three groups randomly,the sham group,model group and BMSCs group.24 hours after cerebral ischemia,rats were injected with 1 ml BMSCs solution (1 × 106 cells/ml) or PBS via the tail vein.The modified neurological severity score(mNSS) test,the corner test and the adhesive tape test were used to evaluate sensorimotor function on the 1,7,14 and 28 days after ischemia.Infarcted volume was detected by toluidine blue staining,and the numbers of vWF positive microvessels and vascular endothelial growth factor (VEGF) positive cells in the ischemic boundary were determined by immunofluorescence.Results By flow cytometric analysis,the cell phenotype of passage 3 BMSCs showed that CD29,CD90,CD34 and CD45 were 98.3％,97.4％,0.2％ and 4.8％,respectively.Compared with the model group,BMSCs significantly reduced the score of mNSS(P＜0.01),the number of right turn of corner test(P＜0.05),latency of removal adhesive tape(P＜0.05) and the infarcted volume (P＜0.01).The numbers of vWF positive vesscls and the VEGF positive cells were (42.97±8.64)/mm2 and (54.83± 10.66)/mm2 at the boundary zone in model group 14 days after ischemia,respectively.BMSCs significantly increased the numbers of vWF positive vessels ((69.43± 7.29)/mm2) and VEGF positive cells ((78.70±6.16)/mm2,P＜0.01).Conclusion BMSCs can improve the functions of cerebral lesions after cerebral ischemia,which may be associated with the enhanced angiogenesis and VEGF expression in the ischemic boundary.

Objective To analyze the molecular biological characteristics of Streptococcus pyogenes (GAS) causing children tonsillitis in Yangfangdian community Haidian district,Beijing between 2011 and 2013.Methods From Apr.2011 to Apr.2013,there were 94 children with tonsillitis treated in outpatient of Beijing Shijitan Hospital Affiliated to Capital Medical University,and 17 strains GAS were isolated from these pediatrician outpatients.Their encoding mature M protein gene (emm gene),7 pairs of alleles housekeeping gene (gki,gtr,murI,mutS,recP,xpt and yqiL),superantigen speA and speC genes,macrolide-resistance genes ermB,mefA and ermRT were amplified by polymerase chain reaction (PCR).The PCR amplified products of emm gene and 7 pairs of alleles housekeeping gene were sequenced.The emm gene sequences were stored in the Centers for Disease Control and Prevention database.The emm types of GAS were identified.The 7 pairs of alleles housekeeping gene sequences of GAS were sent to the multilocus sequence typing (MLST) website for their iso-allelic sequences to identify their sequence types (ST).The PCR amplified products of superantigen gene speA and speC,macrolide-resistance genes ermB,mefA and ermRT were performed with agar gel electrophoresis.The corresponding qualitative results were obtained.Results Five emm-types were discovered:emm12.0 (76.4％),emm1.0 (5.9％),emm89.0 (5.9％),emm75.0 (5.9％) and emm22.0 (5.9％) ;emm12.0 and its subtype strains had the same allelic profiles which belonged to ST36 type; emm1.0 strain belonged to ST28 ; emm89.0 strain belonged to ST101 ; emm75.0 strain belonged to ST49 ; emm22.0 strain belonged to ST46 ; 94.1％ (16/17) strains carried macrolide-resistance gene ermB.None carried macrolide-resistance genes mefA and ermRT.None carried superantigen speA gene.100.0％ (17/17 cases) carried superantigen speC gene.Conclusions emm12.0 (ST36) strain was the most common type of GAS causing the children tonsillitis in Yangfangdian community Haidian District,Beijing between 2011 and 2013.These strains mainly carry macrolide-resistance ermB and superantigen speC gene.

We aimed to explore what kind of endocrine treatments are optimal for hormone receptorpositive and human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer in some specific clinical situations. We searched randomized controlled trials in Embase, Medline, the Cochrane library, and PubMed from inception to April 1, 2020 and performed a network meta-analysis based on a Bayesian fixed-effects model. Progression-free survival (PFS) with hazard ratios and corresponding 95% confidence interval was defined as the primary endpoint, while overall survival (OS), objective response rate (ORR), clinical benefit rate and serious adverse events were used as secondary endpoints. A total of 35 studies involving 12,285 patients and 24 treatment options were included. In general, most co-treatment options prolonged PFS compared to single-agent therapy, of which aromatase inhibitor (AI) plus everolimus and fulvestrant plus palbociclib were probably the most effective agents, and the latter had the best safety record. However, despite the superior efficacy of fulvestrant plus capecitabine for PFS and OS, palpable toxic effects have been demonstrated for this treatment, so its application must be scrupulously considered. The results of subgroup analysis indicated that fulvestrant combined with palbociclib improved prognosis for phosphatidylinositol 3-kinase (PI3K)-mutated patients, PI3K-unmutated patients, patients with endocrine therapy resistance, and visceral metastatic patients, while no obvious improvement was detected in OS. Moreover, the efficacy of fulvestrant plus cyclin-dependent kinase 4/6 (CDK4/6) inhibitors was slightly better than that of AI plus CDK4/6 inhibitors, while AI plus everolimus was more efficacious than fulvestrant combined with everolimus in terms of PFS, OS, and ORR. In conclusion, our results provide moderate evidence that fulvestrant plus palbociclib and AI plus everolimus were the most effective treatments, while the efficacy and safety of fulvestrant plus palbociclib was obviously superior in some specific clinical situations.

Objective To investigate the distribution of divalent metal transporter 1 (DMT1) in the cerebellum of APP/PS1 transgenic mouse. Methods Immunohistochemistry, immunofluorescence, and confocal laser scanning microscopy were used to analyze the relationship between DMTl and amyloid beta (Aβ) and their distribution in senile plaques. Western blotting was used to analyze DMT1 protein level in the APP/PS1 transgenic mouse cerebellum. Results DMTl and Aβ were mainly located in the amyloid plaques, which were predominately located in the molecular layer of the cerebellar cortex of the transgenic mouse. Only a few plaques could be seen in the Purkinje cell layer and granular layer. Confocal laser microscopy revealed the DMTl and Aβ were co-localized in senile plaques. Conclusion The abundant expression of DMTl protein suggests that DMTl and the divalent metal ions that it transports might be involved in the formation of Aβ senile plaques and other pathological processes in the cerebellum in Alzheimer' s disease.

Objective:To explore the "Internet + nursing service" model based on the nurse-patient safety needs, and provide reference for development of "Internet + nursing service".Methods:The First Affiliated Hospital of Sun Yatsen University established a "Internet+ nursing service" management team in December 2019, developed an information platform, formulated and implemented a specific plan of the "Internet+ nursing service" model, including service objects, service projects and service modes. After the smooth operation of this model, the statistics of the nursing service projects and service times that had been carried out from September 2020 to March 2021, as well as the satisfaction of 21 patients who received nursing services would be counted.Results:From September 2020 to March 2021, 21 patients were provided with 55 on-site nursing services, and 151 operations in 16 projects were completed. No nursing-related adverse events occurred. The patients gave all five-star evaluations to the door-to-door service, the satisfaction score was 5 points, and the overall evaluation was 99.88 points.Conclusions:The pilot work of "Internet + nursing service" based on the nurse-patient safety needs has met the care needs of discharged patients and the safety needs of door-to-door services, guarantee the safety of nurses' door-to-door service effectively. And it provides reference for the development and improvement of "Internet + nursing service" related safety work in tertiary A-level hospitals.

Objective:To evaluate the optimized effect of erector spinae plane block (ESPB) combined with general anesthesia when used for the patients undergoing laparoscopic pancreaticoduodenectomy.Methods:Sixty-eight American Society of Anesthesiologists physical status Ⅱ orⅢ patients of both sexes, aged 18-64 yr, with body mass index of 18-24 kg/m 2, scheduled for elective laparoscopic pancreaticoduodenectomy, were divided into general anesthesia group (group G, n=34) and ESPB combined with general anesthesia group (group EG, n=34) using a random number table method.In group E, ultrasound-guided ESPB was performed before induction with general anesthesia, and 0.375% ropivacaine 20 ml was injected into both sides.Total intravenous anesthesia was applied in both groups.Patient-controlled intravenous analgesia (PCIA) with sufentanil 1.5 g/kg in 100 ml of normal saline was performed after surgery.The PCIA pump was set up to deliver a 2 ml bolus dose with a 5-min lockout interval and background infusion at 3 ml/h.Analgesia was performed until 24 h after operation, and the visual analogue scale score at rest was maintained at ≤4.Sufentanil 0.1 g/kg was intravenously injected as rescue analgesic when visual analogue scale score >4.The extubation time and occurrence of intraoperative cardiovascular events were recorded.The amount of sufentanil used during operation and within 24 h after operation was recorded.The time to first pressing the analgesia pump after operation and effective pressing times of PCA within 24 h after operation were recorded.Time to first flatus, first ambulation time and length of postoperative hospital stay were recorded.The development of postoperative adverse reactions such as nausea and vomiting, irritability and respiratory depression within 24 h after operation was recorded. Results:Compared with group G, the incidence of intraoperative hypertension and tachycardia was significantly decreased, the extubation time was shortened, the consumption of sufentanil during operation and within 24 h after operation was reduced, the time to first pressing the analgesia pump was prolonged, the effective pressing times of PCA within 24 h after operation were reduced, time to first flatus, first ambulation time and length of postoperative hospital stay were shortened, and the incidence of nausea and vomiting, irritability and respiratory depression within 24 h after operation was decreased in group EG ( P<0.05). Conclusion:The combination of ESPB and general anesthesia is helpful in achieving an anesthesia mode of lower opioid consumption and more helpful for inhibition of postoperative pain responses and for early postoperative recovery than general anesthesia alone when used for the patients undergoing laparoscopic pancreaticoduodenectomy.

In the face of the worldwide threat of severe acute respiratory syndrome (SARS) to human life, some of the most urgent challenges are to develop fast and accurate analytical methods for early diagnosis of this disease as well as to create a safe anti-viral vaccine for prevention. To these ends, we investigated the antigenicity of the spike protein (S protein), a major structural protein in the SARS-coronavirus (SARS-CoV). Based upon the theoretical analysis for hydrophobicity of the S protein, 18 peptides were synthesized. Using Enzyme-Linked Immunosorbent Assay (ELISA), these peptides were screened in the sera from SARS patients. According to these results, two fragments of the S gene were amplified by PCR and cloned into pET-32a. Both S fragments were expressed in the BL-21 strain and further purified with an affinity chromatography. These recombinant S fragments were confirmed to have positive cross-reactions with SARS sera, either by Western blot or by ELISA. Our results demonstrated that the potential epitope regions were located at Codons 469-882 in the S protein, and one epitope site was located at Codons 599-620. Identification of antigenic regions in the SARS-CoV S protein may be important for the functional studies of this virus or the development of clinical diagnosis.
Antigens, Viral ; immunology ; Chromatography, High Pressure Liquid ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Genetic Vectors ; Humans ; Mass Spectrometry ; Membrane Glycoproteins ; genetics ; immunology ; metabolism ; Molecular Weight ; Peptide Fragments ; chemistry ; Recombinant Proteins ; genetics ; immunology ; SARS Virus ; genetics ; immunology ; metabolism ; Spike Glycoprotein, Coronavirus ; Viral Envelope Proteins ; genetics ; immunology ; metabolism

Objective: To investigate the image quality of ultralow-dose CT (ULDCT) of the chest reconstructed using a cycle-consistent generative adversarial network (CycleGAN)-based deep learning method in the evaluation of pulmonary tuberculosis. Materials and Methods: Between June 2019 and November 2019, 103 patients (mean age, 40.8 ± 13.6 years; 61 men and 42 women) with pulmonary tuberculosis were prospectively enrolled to undergo standard-dose CT (120 kVp with automated exposure control), followed immediately by ULDCT (80 kVp and 10 mAs). The images of the two successive scans were used to train the CycleGAN framework for image-to-image translation. The denoising efficacy of the CycleGAN algorithm was compared with that of hybrid and model-based iterative reconstruction. Repeated-measures analysis of variance and Wilcoxon signedrank test were performed to compare the objective measurements and the subjective image quality scores, respectively. Results: With the optimized CycleGAN denoising model, using the ULDCT images as input, the peak signal-to-noise ratio and structural similarity index improved by 2.0 dB and 0.21, respectively. The CycleGAN-generated denoised ULDCT images typically provided satisfactory image quality for optimal visibility of anatomic structures and pathological findings, with a lower level of image noise (mean ± standard deviation [SD], 19.5 ± 3.0 Hounsfield unit [HU]) than that of the hybrid (66.3 ± 10.5 HU, p < 0.001) and a similar noise level to model-based iterative reconstruction (19.6 ± 2.6 HU, p > 0.908). The CycleGAN-generated images showed the highest contrast-to-noise ratios for the pulmonary lesions, followed by the model-based and hybrid iterative reconstruction. The mean effective radiation dose of ULDCT was 0.12 mSv with a mean 93.9% reduction compared to standard-dose CT. Conclusion The optimized CycleGAN technique may allow the synthesis of diagnostically acceptable images from ULDCT of the chest for the evaluation of pulmonary tuberculosis.