Objective To understand websites of public hospitals in China.Methods Website search and appraisal were called into play to analyze the percentage and present conditions of websites built by public hospitals in Shanghai,Hubei Province and Gansu Province.Rusults The study found websites in less than 55％ of the public hospitals in these three areas.Those websites in operation provide instant information on hospitals and medical services,yet their online service functions are less satisfactory and website levels vary sharply.Conclusion The authors recommend the Chinese government encourage public hospitals to build websites and enhance their online services.

Objectives To analyze the deployment of medical equipment and its impacts on medical services of hospitals.Methods Existing data collection,a survey of public hospitals and a chart review of acute myocardial infarction(AMI)inpatients were used to collect related data.Gini coefficients,Chi-square and multivariate model were used to analyze deployment of medical equipment and its impacts on medical services.Results The number of CTs and that of CTs per million population in Pudong new area were higher than those of MRIs and DSAs,and the distribution of CTs among districts in Shanghai was relatively equal(Gini coefficient was 0.20).But lack of DSAs in some public general hospitals had affected the AMI inpatient care.Conclusions Public hospitals and governments in China should keep at a balance the demand of medical services,deployment level of medical equipment,and financial affordability for the society,governments and hospitals.

Objective To survey bacterium pollution state on the surface of medical equipment maintenance tools,and thenobserve the disinfection effect of ozone.Methods Totally 30 medical equipment maintenance tools including screwdriver,hexagona wrench and multimeter from certain hospital were placed in ozone disinfection cabinet,and then disinfected by ozoneup to 5 minutes.Samples on the surface of tools were collected by cotton swabs before and after disinfection,cultured for 48hours in 37 ℃,and then the bacterial colony counts were measured and analyzed,and pathogenicity bacteria were identified.The pollution couditions on kinds of tools were compared.Results The surface of the tools was polluted severely,bacterialcolony counts of which before disinfection reached (132.68±37.02) cfu/cm2,and decreased to (6.44±1.08) cfu/cm2 after 5-minutes' disinfecting.There was statistically significant difference in the bacterial counts before and after the disinfection (P＜0.01),and the inactivation ratio was up to 95.15％.Pathogenicity bacteria such as staphylococcus aureus and escherichia coliwere detected before the disinfection,and killed after that.The bacteria counts were significantly different in the three kindsof tools,and the screwdriver gained the highest count while the multimeter had the lowest one.Conclusion The surface ofmedical equipment maintenance tools is polluted by bacteria severely,including some pathogenicity bacteria,and should be disinfected regularly.Ozone can kill bacteria rapidly,and the tools can achieve sanitary standard after 5-minutes' ozone disinfecting.

Objective To compare the serum estradiol level of gouty patients with healthy controls and to investigate whether estradiol upregulatesthe expression of the uric acid transporter ATP-binding cassette superfamily member 2 (ABCG2) of human renal tubular epithelial cells (HK-2)..Methods Serum of 16 male gout patients and 16 male healthy controls and their estradiol level were assessed with ELISA.The HK-2 cells wer cultured with different concentrations of estradiol for 24 hours or 48 hours.mRNA expression of ABCG2 was assessed by quantitative polymerase chain reaction (qPCR).HK-2 cells were cultured with estradiol or estradiol and inhibitor of PI3K/Akt pathway LY294002.mRNA expression of ABCG2 was assessed by qPCR,while the Akt,p-Ser473-Akt,p-Thr308-Akt and ABCG2 expression were investigated by Western blot.Data was analyzed using either the one-way analysis of variance or the t test.Results The level of serum uric acid in gout patients was [(547±18) μmol/L],which was significantly higher than that of healthy controls [(344±12) μmol/L),t=-5.395,P＜0.01].The level of estradiol in gout patients was (45±6) μmol/L,which was significantly lower than that of healthy controls [(100±8) μmol/L,t=9.375,P＜0.01].The mRNA expression of ABCG2 of 10-4 mol/L estradiol group was elevated after 24 hours or 48 hours (t=3.168,t=3.990;P＜0.01).In the group of co-stimulation withestradiol and LY294002,the ABCG2,p-Ser473-Akt and p-Thr308-Akt expression were down regulated compared to the estradiol group.Conclusion There is a significant correlation between serum estradiol and uric acid.Estradiol inducesthe expression of ABCG2 of HK-2 cells by activating PI3K/Akt pathway.

Objective To investigate the clinicopathological features, postoperative survival and prognostic influencing factors of male patients with hepatocellular carcinoma (HCC). Methods The clinicopathological features and the follow-up data of 155 male HCC patients who received hepatectomy from Jan. 1995 to Dec. 2002 were retrospectively analyzed and the prognostic influencing factors were defined by uni-and multi-variate analysis. Results Compared with 24 female patients at the same period, males were about six-year older and both of their hepatitis B surface antigen (HBsAg) and liver cirrhosis positive rates were higher (P

Objective To evaluate changes in morphology of the cesarean scar and uterus between one and two years after cesarean section using high-resolution, three dimensional T2-weighted sampling perfection with application optimized contrast using different flip angle evolutions Magnetic Resonance Imaging (3D T2w SPACE MRI). Methods This prospective study was performed to investigate morphological changes in the cesarean scars and uterus from one to two years after cesarean section using high-resolution, 3D T2w SPACE MRI. The healthy volunteers having no childbearing history were recruited as the controls. All data were measured by two experienced radiologists. All data with normal distribution between the one-year and two-year groups were compared using a paired-sample t test or independent t test. Results Finally, 46 women took a pelvic MR examination one year after cesarean section, and a subset of 15 completed the same examination again after two years of cesarean section. Both the uterine length and the anterior wall thickness after two years of cesarean section (5.75 ± 0.46 and 1.45 ± 0.35 cm) were significantly greater than those measured at one year (5.33 ± 0.59 and 1.25 ± 0.27 cm) (t = -2.363 and -2.175, P= 0.033 and 0.048). No significant difference was shown in myometrial thickness two years after cesarean section (1.45 ± 0.35 cm) with respect to the control group (1.58 ± 0.21 cm, P = 0.170). Nine women who underwent MRI twice were considered to have scar diverticula one year after cesarean section, and still had diverticula two years after cesarean section. The thickness, height, and width of the uterine scar showed no significant change from one to two years (all P > 0.05). Conclusions 3D T2w SPACE MRI provides overall morphologic details and shows dynamic changes in the scar and the uterus between one and two years after cesarean section. Scar morphology after cesarean section reached relatively stable one year after cesarean section, and uterine morphology was closer to normal two years after cesarean section.

Although bulk endocytosis has been found in a number of neuronal and endocrine cells, the molecular mechanism and physiological function of bulk endocytosis remain elusive. In pancreatic beta cells, we have observed bulk-like endocytosis evoked both by flash photolysis and trains of depolarization. Bulk-like endocytosis is a clathrin-independent process that is facilitated by enhanced extracellular Ca(2+) entry and suppressed by the inhibition of dynamin function. Moreover, defects in bulk-like endocytosis are accompanied by hyperinsulinemia in primary beta cells dissociated from diabetic KKAy mice, which suggests that bulk-like endocytosis plays an important role in maintaining the exo-endocytosis balance and beta cell secretory capability.
Animals ; Calcium ; metabolism ; Cytoplasmic Granules ; metabolism ; Diabetes Mellitus ; metabolism ; pathology ; Disease Models, Animal ; Dynamins ; metabolism ; Electric Capacitance ; Endocytosis ; physiology ; Insulin ; metabolism ; Insulin-Secreting Cells ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred C57BL ; Patch-Clamp Techniques ; Photolysis ; Primary Cell Culture

Objective An exploration of the molecular mechanism of microRNA-146a(miR-146)inter-vention in Sepsis-induced cardiomyopathy(SIC)using P38MAPK/NF-κB.Methods SD rats were divided into four groups by the random number table method:the normal control group,the SIC model group,the miR-146a agonist group,and the miR-146a inhibitor group.Rats in the normal control group and SIC model group were injected intraperitoneally with 0.2 μL/g saline,rats in the miR-146a agonist group were injected intraperitoneally with 0.2 μL/g miR-146a agonist,rats in the miR-146a inhibitor group were injected intraperitoneally with 0.2 μL/g miR-146a inhibitor;24 h later,rats in the SIC model group,miR-146a agonist group,and miR-146a inhibitor group were injected intraperitoneally with lipopolysaccharide(LPS)to prepare the SIC rat model,and the normal control group was injected with an equal amount of saline.Histopathological morphology was observed by HE staining;apoptosis rate of cardiomyocytes was detected by TUNEL;cardiac troponin I(cTnI)and B-type brain natriuretic peptide(BNP)contents were detected by ELISA;creatine kinase cardiac muscle binding(CK-MB)and myoglobin(Mb)contents were detected by chemiluminescence;p38 mitogen activation in rat myocardial tissue was detected by Western blot protein kinase(p38MAPK),nuclear factor-kB(NF-κB),tumor necrosis factor-α(TNF-α)and intercellular adhesion molecule-1(ICAM-1)by Western-Blot;miR-146a,TNF-α,interleukin-1α(IL-1α)and interleukin-1β(IL-1β)mRNA by reverse transcription quantitative(RT-q)PCR.Results Myocardial cells in the normal control group were uniform in size,neatly arranged,with distinct transverse lines,and had normal structure;myocardial cells in the SIC model group and miR-146a inhibitor group were disordered,with myocardial fibers fragmented and expanded at intervals.Myocardial structural damage was minimized in the miR-146a agonist group compared to the SIC model group.Compared with the normal control group,the apoptosis rate,serum cTnI,BNP,CK-MB,Mb levels,myocardial tissue p-p38 MAPK,p-NF-κB p65,TNF-α,ICAM-1 protein expression levels,TNF-α,IL-1α,miR-146a mRNA levels were significantly higher in the SIC model group,miR-146a agonist group and miR-146a inhibitor group,IL-1β mRNA levels were significantly increased and miR-146a mRNA levels were decreased.Compared with the SIC model group,the apoptosis rate,serum cTnI,BNP,CK-MB,Mb levels,myocardial tissue p-p38 MAPK,p-NF-κB p65,TNF-α,ICAM-1 protein expression in the miR-146a agonist group of rats levels,TNF-α,IL-1α,IL-1β mRNA levels were significantly reduced,and miR-146a mRNA levels were increased.Conclusion miR-146a has the ability to modulate the p38 MAPK/NF-κB signaling axis and the release of inflammatory factors.High miR-146a expression has some negative influence on the inflammatory response,reducing the onset and development of the inflammatory response while improving it.It can offer SIC early interven-tion therapy with a pre-study mechanism and theoretical support.

Objective To analyze the changes of mortality and potential years of life lost （PYLL） due to chronic obstructive pulmonary disease （COPD） among residents in Baoshan District， Shanghai from 2010 to 2019 and provide strategies and basis for COPD prevention and treatment in the future. Methods Based on the cause-of-death surveillance system in Baoshan District of Shanghai from 2010 to 2019， Microsoft Excel 2010， SPSS 22.0 and Joinpoint Trend Analysis Software were used to sort out and analyze the data over the years and calculate the crude mortality， standardized mortality， age-specific mortality， PYLL， annual percent change （APC）， etc. Results From 2010 to 2019， the average annual mortality of COPD was 48.08/100 000， and the standardized mortality rate was 39.95/100 000， accounting for 5.82% of the total deaths in the same period， and COPD ranked as the third leading cause of death in Baoshan District. During the 10 years， the crude and standardized mortality of male COPD patients were generally higher than those of female patients （ P <0.01）. However， the crude mortality and standardized mortality of COPD showed a decreasing trend with the increase of years （ P <0.001）， and an increasing trend with the increase of age， of which the proportion of patients aged 75 and above was the highest， accounting for 85.71% of all age groups. The PYLL caused by COPD deaths was 2 352.5 years， including 1 977.5 years for men and 375.0 years for women. The number of years of life lost per 10 000 people due to COPD in males （4.18 years） was much longer than that in females （0.82 years）. Conclusion From 2010 to 2019， the standardized mortality of chronic obstructive pulmonary disease among residents in Baoshan District， Shanghai has shown a significant decline. However， due to the heavy burden brought by COPD， which has an especially profound impact on the health of elderly and male residents， COPD should be regarded as one of the key diseases in the prevention and control of chronic diseases in public health services， and effective preventive measures should be taken.

Abstract OBJECTIVE Neuroblastoma(NB) is a prevailing pediatric extracranial solid tumor that accounts for 10%-15% of all childhood cancer-related fatalities. Despite significant strides made in NB therapy through multimodal approaches, the survival rate of high-risk NB patients remains at approximately 50%. Consequently, there is an urgent need to identify novel molecular targets for NB treatment. Recent studies have shown that MYCN oncogene amplification is present in about 25% of NB cases and is a crucial determinant of poor prognosis for high-risk NB patients. Since MYC family proteins, including MYCN, are inherently disordered proteins, MYCN lacks a defined ligand binding site along with a large protein-protein interaction surface. Current treatment approaches for MYCN-amplified NB patients do not include direct targeting of MYCN itself, since the absence of a “drugable” pocket renders it challenging. Notably, no direct MYC-targeting drugs are currently available. There is an existing association between Aurora A kinase(AURKA) and MYCN, whereby they form a complex to fortify MYCN stability. However, MYCN is inherently unstable, with a half-life of only 30 min, but AURKA intervenes by facilitating its stability through a direct protein-protein interaction, hence protecting it from proteasomal degradation. This interaction potentially augments tumor cell proliferation and invasiveness. Notably, AURKA has been verified as a transcriptional target of MYCN. The present study endeavors to employ computer-aided drug design technology to probe AURKA inhibitors discerned from a natural product library of traditional Chinese medicine(TCM), thereby identifying a novel drug for treating NB. METHODS Collected from the YaTCM database, a total of 47 696 natural compounds from TCM were subjected to preprocessing including protonation, deionization, hydrogenation, stereoisomerism, conformation generation, and energy minimization. Of these, 58 048 compounds were initially screened as potential ligands for the library. Utilizing “Lipinski Ro5” and “Verber Ro3” guidelines, 22 227 hit compounds were selected from the library that met the screening criteria. Initially, crystal structures of AURKA and its inhibitor AA35 were downloaded from the RCSB PDB database. The spatial coordinates of AA35 were set as the center of the binding pocket for AURKA, and a 10 Å * 10 Å * 10 Å space around the pocket was designated as the active space. A comprehensive drug screening platform integrating lead-likeness filtering, pharmacokinetic prediction, molecular docking, flexible docking, and molecular dynamics(MD) simulations were established to excavate potential aurora kinase A inhibitors from the TCM compound library, which were further validated by MD simulations. RESULTS A grand total of 6 220 Chinese herbal remedies had been meticulously curated within the YaTCM database. Out of these, an impressive 47 696 Chinese herbal monomers had undergone a rigorous series of flexible docking tests, resulting in the selection of the top ten molecules with the most favorable docking scores. The aforementioned molecules underwent AMDE parameter and toxicity predictions. It was discovered that with the exception of a few compounds such as Tryptophane, 3'-Methoxydaidzein, and Burttinol D(which might elicit liver toxicity), 3'-Methoxydaidzein and Pratensein(which might elicit kidney toxicity), and 3-Deoxysappanone B(which had moderate oral toxicity), as well as Tryptophane(with an oral bioavailability of less than 50%), five compounds including Compound X, (+)-Sesamin dicatechol, Tuberosin, Abrine, and Maackiain, displayed favorable pharmacokinetic parameters and low toxicity predictions. Moreover, all of these compounds exhibited a high binding affinity with the inhibitor active pocket of AURKA. In this study, Compound X, despite its cumbersome name, was referred to as “Compound X”. Upon focusing on Compound X as the subject of investigation, it was discovered that its phenolic framework could readily interact with the hydrophobic cavity constituted of hydrophobic amino acids, namely TYR199, VAL182, LEU178, LEU208, and VAL206. Notably, Compound X could partake in Pi-Pi interactions with TYR199 and create hydrogen bonds with HIS201, GLU175, and LYS166. Computational studies via MD simulations confirmed that Compound X could form a stable receptor-ligand complex with the receptor. Impressively, the inclusion of Compound X significantly reduced the stability of the AURKA-MYCN complex. CONCLUSION This study concludes that Compound X can be used as an AURKA inhibitor for the treatment of NB, which is a novel finding based on the combination of various virtual screening techniques from the natural product database of TCM.