An analysis of the readmission service in rural townships and counties.Based on the concept of health integration,the authors proposed the service integration among hierarchical institutions in alignment with hierarchical medical system,and the autonomous service integration among differentiated hierarchical institutions.The purpose is elevation of quality of care in rural areas and better capital usage efficiency in NRCMS.

Objective:To construct a recombinant adenoviral vector carrying the specific siRNA of Survivin gene,and to observe its effect on the expression of Survivin gene and on the radiosensitivity of cancer cells in tumor-bearing mice.Methods:The specific siRNA of Survivin gene was designed and synthesized,and a recombinant adenovirus AdEGFP-siRNA was subsequently constructed.SMMC 7721 xenograft models were established with nude mice and were divided into the following 5 groups:siRNA+radiotherapy and siRNA groups(intratumoral injection of AdEGFP-siRNA),siRNA(-)group(injected every other day with AdEGFP-siRNA[-],2?108 pfu/100 ?l per time,total 5 times),pure radiotherapy group and blank control groups(injected with the same volume of normal saline).On day 10,12,14,and 16,the mice in siRNA+radiotherapy and pure radiotherapy groups were given 5 Gy/time radiotherapy.The tumor volumes were measured regularly.The expression of Survivin in tumor tissues was determined immunohistochemically.Results:Adenovirus AdEGFP-siRNA harboring the specific siRNA of Survivin gene and enhanced green fluorescent protein gene(EGFP)was successfully recombined.The growth of SMMC 7721 xenografts in nude mice was inhibited after injecting AdEGFP-siRNA,with the inhibition rate being 56.2%.The inhibition rate in AdEGFP-siRNA therapy + radiotherapy increased to 82.6%.Immunohistochemistry study showed that the specific siRNA markedly silenced the expression of Survivin gene in hepatocarcinoma cells.Conclusion:The specific siRNA can markedly silence Survivin gene and subsequently inhibit the growth of cancer;meanwhile,it can also increase the radiosensitivity of cancer cells so as to improve the treatment effect.

The Tongmai Yangxin pill (TMYX) has potential clinical effects on no-reflow (NR); however, the effective substances and mechanisms by which this occurs remain unclear. This study evaluates the cardioprotective effects and molecular mechanisms of TMYX against NR. We used a myocardial NR rat model (2 h after myocardial ischemia and 2 h after reperfusion) to confirm the effect and mechanism of action of TMYX in alleviating NR. In vitro studies in isolated coronary microvasculature of NR rats and in silico network pharmacology analyses were performed to reveal the underlying mechanisms of TMYX and determine the main components, targets, and pathways of TMYX, respectively. The experiment was approved by the Ethics Committee of Hunan University of Chinese Medicine (LLBH-202212160001). TMYX showed therapeutic effects on NR by improving cardiac structure and function, reducing NR, ischemic areas, and cardiomyocyte injury, and decreasing the content of cardiac troponin I (cTnI). Moreover, the mechanism of TMYX predicted by network pharmacology is related to the hypoxia inducible factor-1 (HIF-1), nuclear factor kappa-B (NF-κB), and tumor necrosis factor (TNF) signaling pathways. TMYX increased the expression of G protein-coupled estrogen receptor (GPER), phospho-extracellular signal-regulated kinase (p-ERK), and HIF-1α. In vitro, TMYX enhanced the diastolic function of coronary microvascular cells; however, this effect was inhibited by GPER inhibitor (G-15), eNOS inhibitor (L-NAME), and sGC inhibitor (ODQ). This study integrates pharmacology and experimental evaluation to reveal that TMYX activates HIF-1α/eNOS signaling pathway by upregulating GPER to relax coronary microvessels, thereby significantly alleviating NR.

Objective:To explore the histogenesis and differentiation of dermatofibroma (DF) and dermatofibrosarcoma protuberans (DFSP). Methods: Clinical information and microscopic characteristics of 26 cases of DF and 26 cases of DFSP were investigated. The immunohistochemical study was performed on microarray sections by a panel of antibodies including FactorⅩⅢa, HLA-DR, CD34, CD14, S-100, MSA, and Ki67. Probe was labeled by in vitro transcription. The mRNA expression levels of TGF-? and bFGF were investigated by in situ hybridization. Results: All cases showed positive for Factor ⅩⅢa,HLA-DR and CD34 to different extent. The medians of positive rates in DF were FactorⅩⅢa 90%, HLA-DR 70%, and CD34 5%, and in DFSP were FactorⅩⅢa 10%, HLA-DR 5%, and CD34 80%. CD14 was positive in 3 cases of DF and 1 case of DFSP. S-100 was positive in 6 cases of DFSP and 2 cases of DF. MSA was positive in 5 cases of DFSP and 3 cases of DF. In all cases, positive rate of Ki67 was less than 5%. The mRNA expression levels of TGF-? was elevated in DF in comparison with DFSP. Conclusion: Both DF and DFSP can differentiate to dendritic cells (DC) in different degree. Considering the character of microscopic features and immunohistochemical phenotype, cells of DF are much similar to mature DC, while those of DFSP much similar to immature dermal reserve cell (DRC). The differences of cell differentiation between DF and DFSP result in different prognosis. DF is a benign tumor, while DFSP a low grade malignant tumor. The different expression of FactorⅩⅢa and CD34 may be helpful to differential diagnosis of DF and DFSP.

Objective To investigate the therapy effects of bone marrow mesenchymal stem cells (MSCs) on renal recovery after ischemia-reperfusion injured. Methods Seventy-two Spargue-Dawley rats were randomly divided into 4 groups as normal control, sham operated control, I/R group(n=30) and the MSCs group. Rats were subjected to 45 min bilateral renal ischemial-reperfusion injury with microvascular clips, after 60 min of reperfusion they were injected in BrdU positive MSCs(1?106/mL)intravenously. The animals were sacrificed at 12 h, 3 d, 7 d, 14 d, and 42 d after reperfusion, and the bilateral kidney and blood samples were harvested. The blood urea nitrogen(BUN) and serum creatinine(Scr) were measured on automatic biochemistry analyzer. Renal morphologic changes were scored with Paller’s criterion on hematoxylin and eosin(H&E) stained sections. The apoptosis of tubular cells were examined by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL). PCNA positive tubular cells were detected immunohistochemically as proliferation index. And confocal microscopy were used to identified the distribution of BrdU positive MSCs. Results After 12 h, 3 d of reperfusion, the Scr value of MSCs group were signifcantly lower than I/R group(P

Objective To evaluate two methods measuring alveolar bone loss by micro computed tomography (micro-CT)based on periodontitis model in mice.Methods The silk ligatures were tied around the right maxillary second molars of mice to induce periodontitis model.The right half maxillaries of mice model were harvested for micro-CT analysis.Three dentists were recruited for the measurement with two different methods:Modified tomography (T) method and reconstruction (R) method.Accuracy and consistency of each method were estimated by standard deviation (SD).Results The SDs of R method managed by the same operator (measurement for 3 times) or different operators (3 operators) were 34.87μm and 35.67 μm respectively,while that of T method was 7.82 μm and 14.24 μm respectively.The SDs of T method were significantly lower than those of R method (both P＜0.05).Conclusion T method is more accurate and consistent than R method for evaluating alveolar bone loss in mice periodontitis model.

Objective To evaluate the value of IL-17 and IL-23 expression in response prediction of infliximab treatment in Crohn's disease (CD).Methods A total of 23 CD patients were enrolled in this study including 19 males and 4 females.Another 17 patients with colonic polyps were recruited as control group.The tissue expression of IL-17 and IL-23 in intestinal mucosa was measured by immunohistochemistry (IHC).In each specimen, IL-17 or IL-23 positive cells were counted and recorded in 10 random high power fields (HPFs).Results Infliximab was effective in sixteen patients (69.6％), while 7 patients (30.4％) did not response.The numbers of IL-17 or IL-23 positive cells were much more in responders than those in nonresponders.The median numbers of IL-17 positive cells were 26.7 (18.0, 38.6)/HPF in responders, 11.8 (7.0, 14.0)/HPF in nonresponders, 3.0 (2.0,4.0)/HPF in controls (P =0.004).The median numbers of IL-23 positive cells were 74.5(44.8, 128.6)/HPF in responders, 22.4(19.0, 38.8)/HPF in nonresponders, 3.0(2.0, 4.0)/HPF in controls (P =0.018).IL-17 or IL-23 positive mucosal cells were significantly decreased after infliximab treatment.Conclusion High expression of IL-17 and IL-23 in mucosa may predict the response to infliximab in CD patients.

Objective:Since malignant fibrous histiocytoma (MFH) may be taken as an undifferentia-ted pleomorphic sarcoma (UPS), this study was conducted to reassess 33 previously diagnosed MFH cases in the past 10 years based on the latest WHO concept. And then to search for the clinicopathological features, probably tumorigenesis, and the line of differentiation of the remaining MFH/UPS cases.Methods: Thirty-three cases in tissue microarray were studied by immunohistochemistry with panels of neurogenic, myogenic, and lipogenic antibodies. Three expertise pathologists reevaluated the slides separately. Results: Among the 33 cases, 17 cases (51.5%) of MFH had their diagnoses changed, including 5 leiomyosarcomas, 3 malignant peripheral nerve sheath tumors, 1 fibrosarcoma, 1 inflammatory myofibrosarcoma, 1 giant cell tumor and 1 angiomatoid fibrous histiocytoma. The remaining 16 cases (48.5%) were finally diagnosed as MFH/UPS, among which patients were mainly old adults (median age: 63 years; range: 38 to 76 years). The median tumor size was 6.0 cm (range: 3.0 to 14.0 cm), 8 cases (50%) located in lower limb and 5 cases (31.3%) located in thigh. These tumors had marked cytological and nuclear pleomorphism. Immunohistochemistry showed that Vimentin was strongly positive in all 16 MFH/UPS (100%), Muscle-specific actin was variously positive in 8 cases (50%) and 1 case focally expressed Desmin. Eleven cases (68.8%) variously expressed CD68 (KP1) and 7 cases (43.8%) expressed CD68 (PG-M1), which were much higher than leiomyosarcoma, malignant peripheral nerve sheath tumor and liposarcoma with significant difference. Moreover, Ki67 expression rates were from 10% to 100%, including 14 cases more than 50% and 11 cases more than 70%. However, only 2 cases (12.5%) showed P53 positive. Conclusion: MFH/UPS often show marked histological pleomorphism, and the diagnosis must be made by exclusion of other definitive sarcomas, especially myogenic and neurogenic sarcoma. Only Vimentin was always expressed in MFH/UPS, while some of the tumors were positive for myogenic antigen and CD68. It was suggested that MFH/UPS might arise from primary mesenchymal cells, and some cases exhibited fibroblastic and/or myofibroblastic features. In addition, histiocytic phenotypic marker did have more expression in MFH/UPS than in other sarcomas. MFH/UPS still had certain clinicopathological characteristics.

AIM: To study the synergistic protective effect of picrosideII and NGF for the oxidative stress on PC12 cells induced by hydrogen peroxide (H2O2). METHODS: The fluorescent probe 6-carboxy-2',7'-dichlorodihydrofluorescein (CDCFH) was used to assess the intracellular reactiveoxygen species (ROS) level, and MTT assay, morphological observation as well aslactate dehydrogenase (LDH) leakage were conducted to measure cellular injury. RESULTS: The H2O2-induced cytotoxicity was significantly attenuated in the presence of picroside II (25 μg/mL) and NGF (2 ng/mL). Cultures with this combined treatment possessed decreased level of ROS while increased cell survival, as compared to that of picroside II or NGF alone-treated cells. Accordingly, it was concluded that their synergistic protective activities against oxidative stress in vitro were demonstrated in various aspects including reversing morphological changes, enhancingthe ability of cell proliferation and ROS scavenging. CONCLUSION: Such action supports the therapeutic potential of picroside II and NGF in treating nervous disorders based on their synergistic effect.

Objective To observe the changes of the quality of life in type 2 diabetes accompanying subclinical atherosclerosis and explore the effect of diabetic macrovascular complications in the quality of life.Methods One hundred and thiry-six type 2 diabetes were measured carotid intima media thickness (IMT) and then divided into AS group(n =51) and CON group(n =85).Two groups were examined with Special of Quality of Life for Diabetes Mellitus (DSQL).Plasma glucose,plasma insulin,glycosylated hemoglobin(HbA1c),high sensitivity C-Reactive Protein (hs-CRP) as well as insulin resistance index (HOMA-IR) and body mass index (BMI) were observed.Results The scores of DSQL and all domains had obvious difference between AS group and control group(P ＜0.05 orP ＜0.01) ;Relative to the control group the AS group was significantly increased BMI,HbA1c levels,hsCRP levels.The DSQL was associated with IMT,BMI,HbA1c,hsCRP,HOMA-IR.Conclusion The diabetic macrovascular compliations might result in impaired quality of life,which is associated with hyperglycemia,insulin resistance,inflammation,and central obesity.Psychotherapy and health education are very important for the improvement the DSQL in type 2 diabetic accompanying subclinical atherosclerosis.