Objective To investigate the anti-inflammatory effect of C1q/ tumor necrosis factor (TNF)-related protein 9 (CTRP9) in RAW264.7 mouse macrophage cells treated with oxidized low density lipoprotein (oxLDL),and to explore its mechanism.Methods RAW264.7 mouse macrophage cells were divided into three groups:the control group,the oxLDL group (treated with oxLDl) and the gCTRP9-oxLDL group (pretreated with recombinant globular domain of CTRP9 and stimulated by oxLDL).Foam cells were detected by oil red O staining.Western blot was used to detect the expressions of pro-inflammatory cytokines tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein 1 (MCP-1).In addition,the expression levels of NF-κB p65 in cytoplasm and nucleus proteins extraction were both determined.Results The relative levels of MCP-1 and NF-κB were increased in the oxLDL group as compared with the control group (1.66±0.09 vs.1.03±0.10,0.52±0.11 vs.1.03±0.06,both P＜0.05).The expression levels of TNF-α and MCP-1 were decreased in gCTRP9+oxLDL group as compared with the oxLDL group (both P＜0.05).The expression level of NF κB p65 in nucleus 2 and 8 h after treatment was lower in the gCTRP9+oxLDL group than in the oxLDL group (1.03±0.06 vs.0.17±0.10,0.31±0.03,both P＜0.05).Conclusions oxLDL may induce the expressions of inflammatory cytokines of TNF α and MCP-1 in macrophage ceils.gCTRP9 pretreatment could reduce the oxLDL-induced pro inflammatory effect and nuclear factor κB translocation may be involved in this process,which suggests that gCTRP9 may play a protective role in anti inflammatory and anti-atherosclerosis.

In order to solve the problem of selection and in vivo delivery problem in siRNA treatment, hepatitis B virus (HBV) HBx gene which could be targeted by siRNA was studied. The siRNA expression plasmid which specific inhibits HBx expression was obtained by in vitro selection via a dual-luciferase plasmid including HBx-Fluc fusion protein expression domain. The selected siRNA expression plasmid was then encapsulated in PEG-modified cationic liposome, which was devoted into pharmacodynamic studies at both cellular and animal level. The results illustrated that the cationic liposome which encapsulated siRNA expression plasmid could effectively inhibit HBx gene expression both in vitro and in vivo.

Objective To evaluate the clinical effect of endoscopic retrograde biliary drainage (ERBD) and endoscopic naso-biliary drainage (ENBD) on hilar cholangiocarcinoma (HACC).Methods The clinical data of 87 patients with HACC,who underwent ERBD and ENBD form January 2010 to January 2016,were retrospectively analyzed.The incidence of postoperative severe cholangitis,biliary obstruction again within 4 weeks,reduction of total bilirubin and survival time were studied.Results There were significant differences between ERBD group and ENBD group on the incidence of severe cholangitis[29.2％ (14/48) VS 10.3％ (4/39),x2 =4.689,P=0.030] and bile duct obstruction in 4 weeks after operation [47.9％ (23/48) VS 23.1％ (9/39),x2=5.710,P =0.017].The total bilirubin within 2 weeks and 4 weeks postoperatively was significantly reduced compared with that before operation (P＜0.05).There was no statistical difference in descend range of total bilirubin between the two groups.There was significant difference between ERBD group and ENBD group in the median survival time [14 weeks (range,0-60 weeks) VS 34 weeks (range,2-96 weeks),x2 =10.101,P=0.010].Conclusion Compared to ERBD,ENBD has certain advantages on palliative care for HACC.

Objective:To investigate the current status of endoscopy department of county hospitals in China, and to improve the construction quality of the endoscopy department of county hospitals.Methods:County hospitals from 20 provinces, autonomous regions and municipalities in 2019 were investigated in this study through an online survey. Questions were about the department scale, basic information of the endoscopy center, clinical diagnosis and treatment ability, teaching and academic ability.Results:A total of 114 county hospitals were included. The department of gastroenterology in county hospitals owned 38.9 beds, 8.6 doctors and 6.4 nurses on average in 2019. The mean host and endoscope were 3.1 and 11.0 respectively in each center. The mean outpatient, discharge and endoscopy procedure were 22 thousand , 2.3 thousand and 7.8 thousand respectively. The referral rate of 53 (46.5%) hospitals to higher-level hospitals was less than 3%. In terms of teaching and academy, 5 (4.4%) in 114 hospitals had endoscopist training bases of Chinese Medical Association. Fifty-two (45.6%) county hospitals hosted academic conferences at the city level and above, 21 (18.4%) published SCI papers and 67 (58.8%) published papers in key Chinese journals.Conclusion:Endoscopy centers of most county hospitals are well constructed with comprehensive facilities, qualified medical ability, management, and a research team, which meets the recommendation level of service.

Objective:To evaluate the safety and effectiveness of capsule endoscopy for the diagnosis of intestinal diseases in children.Methods:Clinical data of 113 pediatric patients who received capsule endoscopy in Xi'an Children's Hospital from October 2018 to September 2020 were retrospectively analyzed. The completion rate, passage time of stomach and small intestine, lesion detection rate, adverse reactions and complications of capsule endoscopy were analyzed.Results:Among 113 pediatric patients, 78 (69.03%) were male and 35 (30.97%) were female. The age was (99.8±44.7) months (9-195 months), and 31 (27.43%) were under 7 years old. The minimum weight was 9 kg and the minimum height was 70 cm. Eighty-seven pediatric patients (76.99%) swallowed capsules orally (the oral group) with the minimum age of 4 years and 3 months. Capsules were implanted in 26 pediatric patients (23.01%) under gastroscopy (the gastroscopic group), with the maximum age of 9 years and 2 months. Unexplained abdominal pain (47.79%) and unexplained gastrointestinal bleeding (31.89%) were common in the pediatric patients. The completion rate of capsule endoscopy was 97.35% (110/113), and the detection rate of lesions in small intestine was 31.81% (35/110). The passage time of small intestine in the gastroscopic group was significantly longer than that of the oral group (461.04±129.27 min VS 288.23±107.84 min, t=5.646, P<0.01). There was no significant difference in the passage time of stomach or small intestine among different genders, different ages or different endoscopic examination results ( P>0.05). The positive results of capsule were not correlated with the method of ingestion ( P=0.401, OR=2.562, 95% CI:0.284-23.077), gender ( P=0.154, OR=2.352, 95% CI:0.726-7.616), age ( P=0.949, OR=1.007, 95% CI:0.816-1.242), examination reason ( P=0.246) or small intestine passage time ( P=0.219, OR=1.003, 95% CI:0.998-1.008). No complications such as capsule retention occurred in any pediatric patient. Conclusion:Capsule endoscopy in children is noninvasive, rapid and simple, which can improve the diagnostic rate of small intestinal diseases in children, and can be further promoted in pediatric patients.

Objective:To investigate the effect of air sterilization station on air quality control of digestive endoscopy center through a national multi-center dynamic monitoring research.Methods:This study was conducted jointly with 15 digestive endoscopy centers in different regions of China. Each center selected 2 endoscopy rooms using level 4 and level 3 digestive endoscopy techniques, one with an air sterilization station (the experimental group) and the other without the device (the control group). The concentrations of PM 5 and PM 0.5 in the rooms before and after the use of air sterilization station were detected and compared. Results:The air quality of all research units failed to reach the standard air cleanliness level 8 without using air sterilization station. After using the air sterilization station, the PM 5 concentration and PM 0.5 concentration of the experimental group in each center under dynamic conditions were lower than those of the control group, and the difference was significant ( P<0.05). The PM 5 concentration and PM 0.5 concentration in the experimental group at each center showed a decreasing trend with start-up time, with significant difference at different start-up times ( P<0.05). The PM 5 concentration could reach the air cleanliness level 8 standard 15.7 minutes after the air sterilization station started, and the PM 0.5 concentration could reach the air cleanliness level 8 standard 25.0 minutes after the air sterilization station started. Conclusion:In the dynamic environment of the digestive endoscopy center, the air sterilization station can significantly improve the air quality in the endoscopy rooms, which is worth promoting in endoscopy rooms of medical institutions of all levels.

ObjectiveTo analyze the quality and status of technical service items of radiation health technical service institutions (RHTSI) in China. Methods A total of 608 and 622 RHTSIs with radiation health technical service qualifications from 31 provinces, autonomous regions, and municipalities in the years of 2021 and 2022 were selected as the research subjects. The data of quality monitoring of radiological health technology services, comparison of radiological health testing capabilities, and investigation of the current status of technical support institutions were collected to analyze the status of technical service items which was conducted by RHTSIs from 2021 to 2022. Results A total of 622 RHTSIs in China obtained technical service institution qualifications in 2022, an increase of 14 from 608 in 2021. While a total of 404 of 622 RHTSIs conducted radiological health technology services, a decrease of 11.4% from 456 in 2021. A total of 241 804 technical service items were conducted in 2022, an increase of 39.7% from 173 064 in 2021. The median number of technical service items by non-health system RHTSIs was higher than that of the health system RHTSIs in 2021 and 2022, (203 vs 40 items, 215 vs 55 items, all P<0.01). The number of technical service institutions and technical service items conducted in different regions from high to low were the eastern, central, and western regions in 2021. The number of technical service institutions in different regions was highest in the eastern region, followed by the central and western regions, while the number of technical service items from high to low were the eastern, western, and central regions in 2022. The number of provincial, municipal, and county-level health system RHTSIs decreased by 6.5%, 26.3%, and 27.3%, respectively, in 2022 compared with 2021. The number of technical service items conducted by provincial health system RHTSIs increased by 48.6%, while those conducted by municipal and county-level health system RHTSIs decreased by 13.8% and 21.3%, respectively. Conclusion Although the number of RHTSI conducting technical services decreases in 2022 compared with 2021, the number of technical service items conducted increases. Non-medical RHTSI undertake the majority of technical service items. Within the medical institutes, the number of technical service items conducted by provincial RHTSI is higher than that of municipal and county-level RHTSI.

As a glucocorticoid drug with wide clinical application， triamcinolone acetonide can be administered by multiple routes， such as eye， nose， joint cavity， and skin， for the treatment of various local diseases such as arthritis， macular edema， rhinitis， and urticaria. As a drug with extremely low solubility in water， the dose form of triamcinolone acetonide is closely correlated with administration route and site. The dosage form of triamcinolone acetonide administered via injection（including joint cavity injection， vitreous injection， suprachoroidal injection， intramuscular injection） is mainly suspension， and the representative drugs include Kenalog-40®， Zilretta®， Triesence®， Xipere®， etc.； the dosage forms of nasal mucosal administration are mostly sprays， and the representative drug is Nasacort®； the dosage forms of oral mucosal administration are mostly patches， ointments and creams， and the representative drug is Oracort®； the dosage forms for transdermal administration are mostly ointments， creams and lotions， and the representative drugs include Trianex®， Teva-Triacomb®， etc. At present， the research on dosage forms of triamcinolone acetonide by various administration routes mainly focuses on the construction of delivery carriers， the addition of cosolvents or the use of new delivery tools.

BACKGROUND: Worldwide, the volume and availability of digestive endoscopy have undergone dramatic development in recent years, with increasing attention on quality assurance. We investigated the utilization and quality of digestive endoscopy in China from 2015 to 2019 and developed a quantitative quality evaluation tool for medical institutions. METHODS: We invited all tertiary/secondary hospitals in Chinese mainland to participate in the survey annually. The questionnaires included the personnel, annual volume, and quality indicators of endoscopy. An endoscopy quality index (EQI) was developed based on recorded quality indicators using principal component analysis to determine the relative weight. RESULTS: From 2015 to 2019, 806, 1412, 2644, 2468, and 2541 hospitals were respectively enrolled in this study. The average annual volume of endoscopy increased from 12,445 to 16,206 (1.30-fold) and from 2938 to 4255 (1.45-fold) in tertiary and secondary hospitals, respectively. The most obvious growth was observed in diagnostic colonoscopy (1.44-fold for all hospitals after standardization). The proportion of early cancer among all esophageal and gastric cancers during diagnostic esophagogastroduodenoscopy increased from 12.3% (55,210/448,861) to 17.7% (85,429/482,647) and from 11.4% (69,411/608,866) to 16.9% (107,192/634,235), respectively. The adenoma detection rate of diagnostic colonoscopy increased from 14.9% (2,118,123/14,215,592) to 19.3% (3,943,203/20,431,104). The EQI model included 12 quality indicators, incorporating 64.9% (7.792/12) of the total variance into one comprehensive index. According to the EQI measurements, the quality of endoscopy was higher in tertiary hospitals and hospitals in developed areas with higher volume or more endoscopists than that in other hospitals. CONCLUSIONS Digestive endoscopy in China has developed considerably in recent years in terms of both volume and quality. The EQI is a promising tool to quantify the quality of endoscopy at different hospitals.
Humans ; Colonoscopy/methods* ; Endoscopy, Gastrointestinal ; Endoscopy, Digestive System/methods* ; Surveys and Questionnaires ; Adenoma ; China

Objective To investigate the current situation of radiological health technical service institutions and their technical services in China, and to provide a basis for better utilizing radiological health technical service resources and strengthening institutions’ capability building. Methods From October to December 2021, we conducted quality monitoring, ability comparison, capability building surveys, and other investigations on radiation health technical services to collect information on the qualifications and technical services of radiation health service institutions. The data were pooled and analyzed using SPSS software. Results By the end of 2021, there were 608 radiological health technical service institutions across China, with 47.0% of them located in the eastern region, and the percentage of institutions in the health system (42.6%) was less than that in the non-health system (57.4%). Institutions of grade A offered 62.3% of technical services, while institutions of grade B provided 37.7% of technical services; technical services provided by the non-health system and the health system accounted for 84.2% and 15.8%, respectively; institutions in the health system at the province, prefecture, and county levels offered 37.1%, 50.6%, and 12.3% of technical services, respectively. Conclusion In recent years, the proportion of institutions in the non-health system has increased significantly, but the proportion of institutions in the health system with radiological health qualifications is small, and the development is uneven in the numbers of institutions, technical services, and professional and technical personnel in the eastern, central, and western regions and at the province, prefecture, and county levels in China. It is necessary to further encourage and support health system institutions in strengthening capability building and applying for radiological health qualifications, and to increase construction and investment in the western region and at the district/county levels, in order to improve the overall capability and level of radiological health technical services in the country.