Objective:The purpose of this paper is to study the utilization condition of basic medical service of rural residents in Zhongxian Village,especially the vulnerable groups,and to provide evidence for making suggestions.Methods:The individual interview was created to investigate the rural residents of 24 families in Zhongxian Village.The second data of the third investigation of health care service in Chongqing was also used.Results:The low income and poor health care awareness are vital factors influenting the utilization of health care.Conclusions:In order to improve the health level of rural residents,we should improve the medical quality of working staffs,make more health care knowledge known to the rural residents and promote the establishment of medical and health security system in rural areas.

Objective To explore the clinical efficacy and complications of transoral endoscopic peroral endo﹣scopic myotomy (POEM) for achalasia (AC). Methods 38 patients with AC received POEM treatment from January 2013 to January 2013 in our digestive endoscopy center. Procedure-related complications and gastroesophageal re﹣flux were observed, and ECKARDT score and the lower esophageal sphincter pressure changes were analysed. Results All patients underwent POEM successfully. No serious POEM-related complications were observed, bleed﹣ing, gas related complications were treated successfully by conservative treatment. Postoperative follow-up time was 10.4 months (range 9 to 12 months), the symptoms of all the patients were alleviated, ECKARDT score average from preoperative 8.7 points dropped to postoperative 1.2 points (P<0.01), esophageal sphincter pressure decreased sig﹣nificantly, mean pressure dropped from preoperative (33.40 ± 11.80) mmHg to postoperative (13.50 ± 4.30) mmHg (P< 0.01) and gas related complications occurred in 6 cases (15.78 %), esophageal reflux occurred rate total was 23.68%(9/38). Conclusion POEM is safe and effective for the treatment of AC, and has better long-term effect.

BACKGROUND:Both high glucose and lipopolysaccharide have been proved to promote the apoptosis of human periodontal ligament fibroblasts (HPLFs), but their interactions on the HPLF apoptosis in vitro have not yet been reported. OBJECTIVE:To investigate the effect of different concentrations of lipopolysaccharide and high glucose on the proliferation, apoptosis and the expression levels of Bax and Bcl-2 in HPLFs in vitro. METHODS:The primarily cultured HPLFs were identified. The 5-8 generations of HPLFs were col ected and used in the subsequent experiment. The HPLFs were cultured in different concentrations of glucose (5.5 and 25 mmol/L) and lipopolysaccharide (0, 1 and 10 mg/L) for 24 and 48 hours, respectively. RESULTS AND CONCLUSION:Lipopolysaccharide (10 mg/L) could significantly inhibit the cel proliferation, promote the cel apoptosis, upregulate the expression levels of Bax and Bcl-2 mRNA and induce a significant decrease in Bcl-2/Bax ratio in the cel s cultured with 5.5 mmol/L glucose (P<0.05). The lipopolysaccharide-induced suppression of cel proliferation, cel apoptosis, the expressions of Bax and Bcl-2 mRNA as wel as decrease in Bcl-2/Bax ratio were significantly strengthened in the HPLFs treated with 25 mmol/L glucose (P<0.05). Analysis of variance found that high glucose and lipopolysaccharide had a significant interaction on the cel apoptosis (P<0.05). These results reveal that lipopolysaccharide-induced suppression of cel proliferation, cel apoptosis and the expressions of Bax and Bcl-2 mRNA are augmented in HPLFs cultured under high glucose condition, indicating lipopolysaccharide and high glucose interactively act in inducing cel apoptosis.

Objective To investigate the effect of nano-silver antibacterial dressing on infection control in the patients with diabetic foot. Methods 60 patients with diabetic foot who were treated in our hospital from January 2017 to January 2018 were selected as the study subjects. They were randomly divided into intervention group and control group, with 30 cases in each group. Both groups strictly controlled blood glucose levels. After debridement, the intervention group was given nano-silver antibacterial dressing. The control group was given vaseline dressing. The degree of wound pain, the severity of wound ulcer, and the area of ulcer were evaluated at the time of enrollment and 4 weeks after treatment. The ulcer healing time and the number of dressing changes were counted in both groups. Results After intervention, the Wagner grading of the two groups was significantly improved compared with that before treatment, and the difference was statistically significant (P<0.05); after treatment, the Wagner grading in the intervention group was significantly better than that in the control group, and the difference was statistically significant (P<0.05). After intervention, the ulcer area of the two groups was significantly lower than that before the intervention (P<0.05); the ulcer area in the intervention group was smaller than that in the control group after intervention (P<0.05). The VAS in the two groups after intervention was significantly lower than that before the intervention (P<0.05); the VAS in the intervention group was significantly lower than that in the control group after intervention (P<0.05). The ulcer healing time in the intervention group was significantly shorter than that in the control group, and the difference was statistically significant (P<0.05); the number of dressing changes was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion The application of nano-silver antibacterial dressing can promote the healing of ulcers, reduce the ulcer area, improve the Wagner grading and reduce the number of dressing changes.

Through several years of exploration in Shanghai Chongming region, the team from Chongming Branch of Xinhua Hospital has established the initial multidisciplinary diagnosis and treatment model of cancer pain, which includes the department of oncology, anesthesiology, pain, rehabilitation, psychology and so forth. By means of medical informationization, they take cancer pain management as the starting point and have initially real-ized a new model of the real-time assessment and treatment of cancer pain, which has helped patients effectively reduce the physical and psychological suffering, improved the quality of life, developed a healthy self-manage-ment of patients, and has reference significance to palliative care.

Objective: To evaluate the quality of Pneumoconiosis Network Direct Report in Sichuan Province in 2006-2016. Methods: download all the pneumoconiosis report cards from the Network Direct Report system. Screen out cards based on the diagnosis time that is between January 1st 2006 and December 31st 2016. Using R 3.4.0 software to analysis the number of missing or repeated cards, time-logical error rates, timeliness, reporting year, reporting intervals to evaluate the quality of Pneumoconiosis Network Direct Report and location distribution. Results: there are 38 855 pieces of Pneumoconiosis report card in total in 2006-2016. 352 pieces of cards were reported twice. 224 cards were missing. 229 cards have time-logical error. The rate of timely reporting for 2006-2016 years was 66.41% (2 5453/38 326) , 67.14% (24 658/36 726) for new cases, 58.87% (783/1 330) for promoting cases and 4.44% (12/270) for deaths. 87.38% (33 490/38 326) patients was reported in the same year. 10 days was needed to finish one report, confirming-filling cost much more time than filling-report (9.865/49.019) . Conclusion the records of pneumoconiosis report cards are much more complete, logical errors are less, and the timeliness was a little bit higher than the average level in China. But it also should be improved. The death cases are difficult to report. It takes longer to diagnose and fill in cards. Improving the timeliness rate can significantly improve the quality of network direct reporting.

Objective To explore the effect of long non-coding RNA CASC11(lncRNA CASC11)on the proliferation and invasion of colon cancer cells by targeting and regulating miR-146a-3p and its possible mechanism.Methods The expressions of lncRNA CASC11 and miR-146a-3p in three different human colon cancer cell lines HCT116,SW620 and SW480 were detected by real-time fluorescence quantitative PCR(qRT-PCR),and SW620 cells cultured in vitro were randomly divided into control group(untreated group),lncRNA CASC11 siRNA group,lncRNA CASC11 siRNA negative control group and lncRNA CASC11 siRNA+miR-146a-3p inhibitor co-transfection group.After corresponding treatment,the proliferation activity of SW620 cells in each group was detected by MTT and EdU staining;the invasion ability of SW620 cells was detected by Transwell chamber test;immunofluorescence staining(ICF)was used to detected the expression of apoptosis proteins Bax and Bcl-2 in each group;mRNA levels of miR-146a-3p and epithelial-mesenchymal transition marker proteins Vimentin and E-cadherin were detected by qRT-PCR and Western blotting;dual luciferase reporter assay was used to detect the targeting regulation effect of lncRNA CASC11 on miR-146a-3p in SW620 cells.Results Compared with human colonic mucosal epithelial cells,the expressions of ln-cRNA CASC11 in HCT116,SW480,and SW620 were significantly increased,while the expression of miR-146a-3p was signifi-cantly decreased(P＜0.05).Compared with the control group,the cell viability,EdU positive rate,invasive cell number and Vi-mentin mRNA expression in the lncRNA CASC11 siRNA group were decreased(P＜0.05),while the cell Bax/Bcl-2 ratio,miR-146a-3p and E-cadherin mRNA expression were increased(P＜0.05).There was no significant difference in the results between the control group and lncRNA CASC11 siRNA negative control group(P＞0.05);compared with the lncRNA CASC11 siRNA group,the cell viability and EdU positive rate,the number of invasive cells,and the expression of Vimentin mRNA were in-creased in co-transfection group(P＜0.05),while the ratio of Bax/Bcl-2,miR-146a-3p and E-cadherin mRNA expression were decreased(P＜0.05).In SW620 cells,lncRNA CASC11 could target miR-146a-3p and upregulate the expression of downstream c-Met gene.Conclusion lncRNA CASC11 mediates the biological behavior of colon cancer cells by targeting downregulation of miR-146a-3p.Knockdown of lncRNA CASC11 can promote the expression of miR-146a-3p and inhibit the proliferation and in-vasion of colon cancer cells.

Background: The increasing incidence of radiation?induced osteosarcoma of the maxilla and mandible (RIOSM) has become a signiifcant problem that can limit long?term survival. The purpose of this study was to analyze the associa?tion of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma (NPC). Methods: We reviewed the medical records of 53,760 NPC patients admitted to Sun Yat?sen University Cancer Center during the period August 1964 to August 2012. Of these patients, 47 who developed RISOM and met inclusion criteria were included in this study. Two of these 47 patients refused treatment and were then excluded. Results: For all patients treated for NPC at Sun Yat?sen University Cancer Center during the study period, the total incidence of RIOSM after radiotherapy was 0.084% (47/53,760). Two patients (4.4%) had metastases at the diagnosis of RIOSM. Thirty?nine of the 45 (86.7%) patients underwent surgery for RIOSM; most patients (24/39; 61.5%) who under?went resection had gross clear margins, with 15 patients (38.5%) having either a gross or microscopic positive margin. All patients died. The 1?, 2?, and 3?year overall survival (OS) rates for the entire cohort of 45 patients were 53.3%, 35.6% and 13.5%, respectively. The independent prognostic factors associated with high OS rate were tumor size and treat?ment type. Conclusions: RISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely inter?vention. Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.

Objective: To evaluate the effect of levonorgestrel-releasing intrauterine system (LNG-IUS) plus oral megestrol acetate (MA) as fertility-preserving treatment in patients with early-stage endometrial cancer (EEC). Methods: In this single-center, phase II study with open-label, randomized and controlled design, young patients (18–45 years) diagnosed with primary EEC were screened, who strongly required fertility-preserving treatment. Patients were randomly assigned (1:1) into MA group (160 mg oral daily) or MA (160 mg oral daily) plus LNG-IUS group. Pathologic evaluation on endometrium retrieved by hysteroscopy was performed every 3 months. The primary endpoint was complete response (CR) rate within 16 weeks of treatment. The secondary endpoints were CR rate within 32 weeks of treatment, adverse events, recurrent and pregnancy rate. Results: Between July 2017 and June 2020, 63 patients were enrolled and randomly assigned. Totally 56 patients (26 in MA group; 28 in MA + LNG-IUS group) were included into primary-endpoint analyses. The median follow-up was 31.6 months (range, 3.1–94.0). No significant difference in 16-week CR rate were found between MA and MA + LNG-IUS groups (19.2% vs. 25.0%, p=0.610; odds ratio=1.40; 95% confidence interval=0.38–5.12), while the 32-week CR rates were also similar (57.1% and 61.5%, p=0.743), accordingly. More women in MA + LNG-IUS group experienced vaginal hemorrhage (46.4% vs. 16.1%; p=0.012) compared with MA group. No intergroup difference was found regarding recurrence or pregnancy rate. Conclusion Compared with MA alone, the addition of LNG-IUS may not improve the early CR rate for EEC, and may produce more adverse events instead.

Objective:To analyze the implementation effects of a medical laboratory talent training program based on local colleges and universities' applied talent-oriented cultivation principal as well as students' interests and industry needs.Methods:Based on the design principals of clarifying the professional orientation, meeting the national standard, reconstructing the curriculum system, introducing the spirit of innovation and entrepreneurship, and multi-dimensional collaborative education, as well as the reverse design path of the outcome-based education concept, we have built a medical laboratory applied talent training system focusing on humanity education, solid foundation, broad employment, and good competency and in accordance with the "three complete education" strategy, along with measures including creating an applied teaching atmosphere, developing an applied curriculum teaching model, providing vocational guidance and improving vocational identity, and promoting education via evaluation. The system was applied to the training and practice of students of grades 2021 and 2022 majoring in medical laboratory technology. SPSS20.0 software was used for statistical analysis.Results:With the concept of application-oriented talent training and the "four-in-one" practical teaching model, students' skills were improved, and the training path was broadened. Compared with those trained with the original program (grades 2019-2020), the graduates trained with the new program (grades 2021-2022) showed a significantly decreased employment rate in medical laboratory jobs in medical institutions from 71.25% to 42.86% ( χ2=12.36, P<0.001), a significantly increased employment rate in in-vitro diagnostics industry from 3.75% to 17.14% ( χ2=7.44, P<0.05), and a significantly increased rate of applying for postgraduate education from 17.05% to 32.86% ( χ2=4.74, P<0.05). Conclusions:The medical laboratory talent training program based on the talent training principal of local colleges and universities combined with students' interests and industry needs can help improve the quality of talent training and broaden the employment path of graduates.