Objective To learn the present situation and bottlenecks of human resources at private hospitals in Sichuan province.Methods Questionnaires,discussions and in-depth interviews were used to learn human resources of 35 private hospitals in the province.Results The findings indicate significant differences among doctors at such hospitals,most of whom age 30-40 years old(45.13％) ; technical titles of the medical workers are low in general,as only 20.08％ of them have vice-senior titles or above; employees are dissatisfied with the remuneration,training setup and culture of their hospitals.Conclusion Private hospitals must enhance training of professionalism,raise payment,improve training setup,and create a positive hospital culture if they want sustained development.In the meantime,hospital regulators should enhance supervision and provide supportive policies.

Objective To introduce extrapedicular infiltration anesthesia as an improved method of local anesthesia which applied to unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty.Methods From March 2015 to March 2016,20 patients in our hospital received percutaneous vertebroplasty or percutaneous kyphoplasty with 1％ lidocaine local infiltration anesthesia and extrapedicular infiltration anesthesia.The visual analogue score of patients during the operation and whether they needed additional sedative anesthesia were evaluated.The anaesthetic effect of nerve root block was observed.Results The visual analogue score of all the patients ranged from 1 point to 3 point,averagely (2.5 ± 0.7) point.Among the 20 patients,there were 2 cases of 1 point,7 cases of 2 point and 11 cases of 3 point.No patients required additional sedative anesthesia,and no nerve root block effects were observed.Conclusion Extrapedicular infiltration anesthesia provides good local anesthetic effects without significant complications,which deserved further use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

Objective To investigate the radiosensitization effects of the combination treatment of clioquinol (CQ) and zinc on human cervical cell line HeLa in vitro.Methods Cells were divided into the 4 groups:controls,drug,radiation,and combined drug and radiation group.Cytotoxic effect of CQ and zinc on cell viability was determined by CCK-8 assay.Radiosensitization effect of CQ and zinc on HeLa cells was detected by colongenic assay,and the single-hit multi-target model was used to stimulate the doseresponse curve of survival and to calculate radiosensitization parameters.The cell cycle and apoptosis of HeLa cells were analyzed with flow cytometry.Luciferase reporter assay was used to study NF-κB activity of HeLa cells.Results The combination of CQ and zinc inhibited cell growth in a dose-dependent manner (F =188.00,P ＜ 0.01).The mean lethal dose was 3.16 and 2.04 Gy for radiation group and combined drug and radiation group,respectively,and hence the SER was 1.55.Compared with the radiation group,the ratio of G2-phase cells in the combined drug and radiation group decreased(t =10.39,P ＜ 0.05),the apoptosis rate increased at 24 h post-irradiation (t =5.64,P ＜ 0.01),and the NF-κB activity decreased (t =21.42,P ＜ 0.05).Compared to the control group,the NF-κB activity increased in the radiation group(t=6.23,P＜0.05),but decreased in the drug group(t =12.48,P＜0.05).Conclusions The combination of CQ and zinc could increase the radiosensitivity of HeLa cells by decreasing the ratio of G2-phase cells,increasing apoptosis and the inhibiting of NF-κB activity.

Objective: To observe the effects of nerve block on MA and EA analgesia and mast cells degranulation in adjuvant arthritis rats in order to analyze the difference between the underlying peripheral mechanism of MA and EA analgesia. Methods: Zusanli (ST 36) was chosen as the acupuncturing point on adjuvant arthritis rats. Eighty SD rats were randomized into 10 groups, including control, model, normal+Lido, EA, Lido+EA, DLido+ZEA, Xlido+ZEA, MA, Lido+MA, Dlido+ZMA groups, with 8 rats in each group. Paw Withdraw Latencies and mast cells degranulation ratios were recorded and computed. Results: Compared with model group, the pain threshold (PT) and mast cells degranulation ratios of EA and MA groups were obviously increased (P<0.05 or P<0.01). The analgesia effects of both MA and EA were obviously attenuated after nerve block by pretreated with Lidocaine hydrochloride at the acupuncturing point or at the acupiont of proximal end in the same neural stem while they were not by the same manipulations at the acupoint of distal end. Degranulation ratios of mast cells caused by MA or EA were not obviously affected by nerve block. Conclusion: The effective signal of nerve conduction of MA analgesia is generated after the degranulation of mast cells in the process of acupoints activation or needle sense and it is the direct cause of generation of nerve signal. In the condition of EA, the acupoints activation is caused by the stimulation of electric signal on nerve receptor while the degranulation of mast cells is concomitant or feedback effect.

To facilitate the expression of GL 7 ACA acylase gene in a recombinant E coli , a fragment of the gene, in which the signal peptide was deleted by PCR method, was inserted into a prokaryotic expression vector, pET 28a By colony PCR method screening, a recombinant plasmid pET ACY was obtained and then transformed into the expression host BL21 (DE3) The influences of induction conditions such as IPTG concentration, the time of induction and the induction temperature on the expression of the recombinant protein were investigated Under optimal condition, the enzyme activity could reach 266 U/L Finally, the recombinant GL 7 ACA acylase can be easily isolated to a purity of about 80% by a simple anion ion exchange chromatography with enzyme activity recovery of 50%

Objective: To observe the safety and clinical efficacy of tumor antigen-pulsed dendritic cell(DC) vaccine in treatment of advanced malignant tumor.Methods: Ninety-one patients with non-small cell lung cancer,colon and rectal cancer,melanoma,renal carcinoma,breast cancer and other malignant tumors were enrolled in this study.All patients met the selecting standard and signed informed consent.Human dendritic cells were obtained from peripheral blood monocytes by culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4.DC vaccine was prepared from tumor antigen pulsed immature dendritic cells in vitro.Patients received the vaccine therapy once every week and one cycle was defined as once every week for 3 weeks.Results: All the patients received 96 cycles of DC vaccine treatment.Symptoms of toxicity included fever,shivering,aching pain of muscle,asthenia,itching,stifle and transient fatigue;most of the symptoms automatically recovered.Clinical efficacy of the treatment was evaluated in 76 patients.Thirty-one of the 76 patients were stable after treatment and 45 were in progressive situation,with the clinical benefiting rate being 40.8%.Eighty-five patients were followed up.The median time for progression was 2.6 months;the overall survival time was 0.9-30.6 months;and the median survival period was 4.5 months,with the one year survival rate being 9.2%.Conclusion: The results suggest that the DC vaccine therapy is well tolerated in treating patients with advanced malignant tumors and has satisfactory clinical benefit;the clinical value of DC vaccine therapy needs to be further observed.

BACKGROUND AND PURPOSE: There are only a few cognitive screening tests for the Chinese-speaking population, and so this study aimed to validate the Chinese version of Addenbrooke's Cognitive Examination III (ACE-III) for detecting mild cognitive impairment (MCI) and mild dementia. Its diagnostic accuracy was compared with the Chinese versions of the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). METHODS: The 176 included individuals were divided into 3 groups: mild dementia group, MCI group, and normal control group. MMSE, MoCA, and ACE-III were administered to all participants by researchers who were blinded to the clinical grouping. The receiver operating characteristic (ROC) curves were analyzed. RESULTS: ACE-III exhibited good internal consistency and convergent validity. Age and education level significantly influenced the total ACE-III scores. When screening MCI, the area under the ROC curve (AUC) was significantly larger for ACE-III than for MMSE (0.88 vs. 0.72, p<0.05) and MoCA (0.88 vs. 0.76, p<0.05). ACE-III showed higher sensitivity (0.75) and specificity (0.89) than MMSE (0.64 and 0.63, respectively) and MoCA (0.67 and 0.77) at the optimal cutoff score of 88/89. For detecting mild dementia, ACE-III yielded satisfactory sensitivity (0.94) and specificity (0.83) at the optimal cutoff score of 74/75. The AUC of ACE-III was 0.95, which was comparable to those of MMSE (0.95) and MoCA (0.91). In participants with ≥12 years of education, the AUC was significantly larger for ACE-III than for MMSE when detecting MCI (0.90 vs. 0.68, p<0.05) and mild dementia (0.97 vs. 0.90, p<0.05). CONCLUSIONS: The present study has verified that ACE-III is a reliable and accurate tool for screening MCI and mild dementia in the Chinese-speaking population, and is significantly superior to MMSE and MoCA for detecting MCI.
Area Under Curve ; Asian Continental Ancestry Group ; Dementia ; Education ; Humans ; Mass Screening ; Methylenebis(chloroaniline) ; Mild Cognitive Impairment ; ROC Curve ; Sensitivity and Specificity

Objective:To analyze the expression of human leukocyte antigen G (HLA-G) in human T-cell leukemia virus type 1 (HTLV-1)-positive T cells, and to investigate its role in the occurrence and development of HTLV-1 infection.Methods:The expression of HLA-G in HTLV-1-positive T cell lines (MT2 and MT4) was detected by Western blot and real-time PCR. HLA-G gene in MT2 and MT4 cells was knocked down by siRNA, and the effects of HLA-G on the expression of HTLV-1 Tax and P19 at mRNA and protein levels were detected by Western blot and real-time PCR. Moreover, the changes in cytokine expression in MT2 and MT4 cells were monitored at RNA level after HLA-G gene silencing. The proliferation ability of MT2 and MT4 cells was analyzed by CCK8. Signal transducer and activator of transcription 3 (STAT3) pathway-related proteins were detected by Western blot.Results:Compared with HTLV-1-negative T cells (Jurkat and MOLT4), the expression of HLA-G increased significantly in MT2 and MT4 cells. After knocking down the HLA-G gene with siRNA in MT2 and MT4 cells, the expression of HTLV-1 Tax and P19 at mRNA and protein levels was decreased, and the expression of antiviral cytokines IFN-γ and TNF-α was increased. The proliferation of MT2 and MT4 cells and STAT3 phosphorylation in these cells were decreased.Conclusions:HTLV-1 could induce T cells to overexpress the immune tolerance molecule HLA-G. Silencing HLA-G gene in HTLV-1-positive T cells could promote the production of antiviral cytokines and reduce IL-6 expression and STAT3 phosphorylation, thereby effectively inhibiting the replication of HTLV-1.

Objective:To compare the effect of different methods of sputum aspiration in children with bronchopneumonia and explore the appropriate sputum aspiration methods for children with bronchopneumonia.Methods:This study was a randomized controlled trial. The convenience sampling method was used to select 165 children with bronchopneumonia treated in the Third Affiliated Hospital of Zhengzhou University from October 8, 2020 to September 30, 2021 as the research objects. They were divided into group A, group B and group C by random number table method, with 55 cases in each group. Group A used sputum aspirating tube to aspirate sputum through mouth and nose, group B used olive head to aspirate sputum through nose, and group C used both sputum aspirating tube to aspirate sputum through mouth and olive head through nose. The sputum aspirating effect, respiratory mucosal injury rate and satisfaction degree of children′s parents were compared among the three groups.Results:Finally, there were 53 cases in group A, 54 cases in group B and 53 cases in group C. The total effective rate of sputum aspiration was 96.21%(584/607) in group C, which was higher than that in group A 94.32% (581/616) and in group B 74.12% (464/626), the difference was statistically significant ( χ2=194.62, P<0.01), pairwise comparison among the three groups showed statistical difference ( χ2=95.95, 11.32, 132.16, all P<0.017). The respiratory mucosal injury rate was 1.12% (7/626) in group B, which was lower than that in group C 3.13% (19/607) and in group A 10.39% (64/616), the difference was statistically significant ( χ2=63.53, P<0.01), pairwise comparison among the three groups showed statistical difference ( χ2=49.52, 25.47, 6.04, all P<0.017). The satisfaction degree of children′s parents in group C was 98.11% (52/53), which was higher than that in group B 90.74% (49/54) and in group A 81.13% (43/53), the difference was statistically significant ( χ2=8.54, P<0.05). There was no statistically significant difference in the satisfaction degree of children′s parents between group A and group B, and between group B and group C( P>0.017). There was statistically significant difference in the satisfaction degree of children′s parents between group A and group C ( χ2=8.22, P<0.017). Conclusions:The combination of oral suction tube and nasal suction with olive head can improve the sputum aspirating effect of children with bronchopneumonia and the satisfaction degree of their parents, with a low rate of respiratory mucosal injury and high safety, which is worthy of clinical reference.

Objective:To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for early colorectal cancer and its precancerous lesions by using novel lifting clip-assisted traction.Methods:From March to July 2021, 42 patients with colorectal lesions who received ESD at the Digestive Endoscopy Center of Shanghai Tenth People's Hospital were included in the retrospective study. Nineteen patients were enrolled as the observation group using the novel lifting clip, and 23 others in the control group without the help of an auxiliary method. The operation time, the hospital stay, hospital expenses and the incidence of complications of the two groups were compared.Results:All 42 patients successfully received ESD. The operation time of the observation group was significantly shorter than that of the control group [31.00 (21.00, 58.00) min VS 60.00 (30.00, 75.00) min, Z=-2.04, P=0.04]. The postoperative hospital stay of the observation group was significantly shorter than that of the control group [2.00 (1.00, 2.00) d VS 2.00 (2.00, 3.00) d, Z=-1.99, P=0.04]. The hospital cost was lower than that of the control group, but the difference was not statistically significant (19 331.42 ± 3 481.20 yuan VS 19 802.40 ± 2 548.50 yuan, t=-0.49, P=0.63). No intraoperative perforation occurred in either group. There was no significant difference in intraoperative blood loss between the observation group and the control group [0.00 (0.00, 5.00) mL VS 3.00 (0.00, 7.00) mL, Z=-1.42, P=0.16]. There was 1 case of postoperative abdominal pain in the observation group, 2 cases of postoperative abdominal pain and 1 case of fever in the control group. There was no significant difference in the overall incidence of postoperative complications between the observation group and the control group [5.3% (1/19) VS 13.0% (3/23), χ2=0.73, P=0.39]. Conclusion:The novel lifting clip-assisted colorectal ESD is safe and effective, which can significantly shorten the ESD operation time and postoperative hospital stay without increasing the economic burden of patients.