Objective To fully assess the status of cancer chemotherapy quality of secondary and tertiary hospitals in Shanghai City in order to improve the quality control system of cancer chemotherapy.Method According to the supervision plan of Shanghai Cancer Chemotherapy Quality Control Center,all of the 103 secondary and tertiary hospitals in Shanghai City which administrated chemotherapy to cancer patients have been inspected in 2015.SPSS13.0 was used for data aggregation and analysis.Result The cancer chemotherapy quality was significantly different between the secondary and tertiary hospitals,as well as between the oncoiogy and non-oncology departments,the main problems were as follow.:the informed consent content was incomplete (33.04％);pathological diagnosis was incomplete or missing (15.50％);tumor stage was not standardized or no staging (56.27％);the chemotherapy purposes (42.44％) and the chemotherapy indications (37.47％) and contraindications (12.21％) were incomplete or missing;the evaluation of chemotherapy efficacy was incomplete or not evaluated (24.10％);the mid-term assessment was incomplete or not evaluated (27.72％);admission history (16.28％) and records of the chemotherapy day (32.04％) were incomplete or missing.Conclusion The quality of medical records of cancer chem0therapy in Shanghai City is significantly related to hospital level and specialty.The hospital authorities should learn the quality control standards based on their own problems.

To study whether the late-acting co-stimulatory molecules ICOS can suppress the apoptosis and sustain the survival and proliferation of T cells through the survivin pathway, ICOS signals deficient T-cells were infected with adenovirus carried survivin gene, other T-cells were given ICOS co-stimulatory signals, then infected with adenovirus carried dominant-negative mutant survivin gene. Apoptosis and proliferation were determined by TUNEL and CCK-8 respectively. The results show that engagement of ICOS signal increased the expression level of survivin significantly. Survivin can sustain co-stimulatory deficient T cells survival and suppress the apoptosis. Mutant survivin inhibits ICOS signal positive T cells survival and increase its apoptosis. Late-acting co-stimulatory molecules ICOS can suppress the apoptosis and sustain the survival of T cells through the survivin pathway.

Objective To identify the expression of complement regulatory protein CD46, CD55, and CD59 on primary murine pallium astrocytes and the effect of inflammatory factors on it in order to lay the foundation for studying the complement system in AD. Methods The primary murine astrocytes were cultured and purified. The expression of CD46, CD55, and CD59 on the levels of mRNA and protein was assayed by immunofluorescence before and after the stimulation of LPS and IFN-?. Results The expression of CD59 mRNA was confirmed, but the expression of CD46 and CD55 was indefinite. There was no significant difference between stimulation and non-stimulation groups. Immunofluorescence results indicated that CD59 was positive, while CD46 and CD55 were weakly positive. Conclusion Protectin CD59 expresses copiously on primary murine astrocytes, which presumably protects astrocytes from the lysis of complement.

Objective To study the different types of medication guidance for community doctors in the context of essential medicine system,and analyze its influencing factors.Methods SPSS 1 9.0 was called into play for statistical analysis of data gathered,and the medication guidance behavior of the doctors were graded on the two dimensions of personal willingness and practical action.With important quadrant method,the medication guidance behavior of such doctors was classified,while the multiple linear regression was used to study the influencing factors.Results Most of the community doctors of the fourteen counties fall into the area of “high willingness and less action”,with only a few falling into the area of the “high willingness and more action”. Major influencing factors of their willingness on medication guide were found to include impacts on job autonomy,attention to essential medicine system, and the forms to improve income.Major factors of the doctors'actions on medication guide include awareness of essential medicines,awareness of essential medicines catalog,and training outcomes. Conclusion The community doctors have high personal willingness for medication guidance related to essential medicines,but only a number of them carried it in their work.Therefore,it is necessary to take actions to strengthen awareness of the doctors for medication guidance and encourage them to carry it out.

Objective To investigate the correlations between the soluble form of B7-H3 ( sB7-H3) and the cytokines of IL-17 and IL-8 in serum samples from patients with primary hepatocellular carcino-ma ( HCC) and to evaluate their clinical values for early diagnosis of HCC.Methods Serum samples were collected from 63 patients with HCC and 50 healthy subjects.The expression of sB7-H3, IL-17 and IL-8 in serum samples were detected by ELISA.Receiver operating characteristic ( ROC) curve was generated to an-alyze the diagnostic values of sB7-H3, IL-17 and IL-8 for hepatoma.The logistic regression model was used to predict the probability of hepatoma by using sB7-H3, IL-17 and IL-8 in combination.Results The levels of sB7-H3, IL-17 and IL-8 in serum samples collected from the patients with HCC were significantly higher than those from healthy subjects.A positive correlation was found between the levels of sB7-H3 and IL-17 in serum samples from patients with HCC.No correlation was found between sB7-H3 and IL-8.A negative cor-relation was found between the levels of IL-17 and IL-8 in serum samples from patients with HCC.ROC curve analysis showed that the area under the curve (AUC) of sB7-H3, IL-17 and IL-8 were 0.832, 0.657 and 0.953, respectively, indicating the statistical significance of them for the diagnosis of HCC.The logistic regression showed that the AUC, diagnostic sensitivity and specificity of the regression model PRE in the pre-diction of HCC were 0.960, 91.30% and 94.29%, respectively, which was much better than using the three indicators alone.Conclusion The levels of sB7-H3 were positively correlated to the levels of IL-17 in serum samples from patient with HCC.The logistic regression model of combination of sB7-H3, IL-17 and IL-8 obtained in this study could be used for early clinical diagnosis of HCC in the future.

To study performance problems found in China's essential medicine system.The SmithModel of system implementation was called into play in a systematic collation and analysis for the ideal policies,system implementation agencies,target groups and policy environment in its performance,along with relationships among the four factors.The system is found with a number of loopholes as the system itself is highly idealized,its system objectives set inappropriately,problems found with the four factors,and tension and conflicts among these factors.Given these problems found in its performance,it is inappropriate to make drastic changes to avoid instability of the system at its early stage.Government departments in question are advised to comprehensively analyze the four factors and their relationships then taking effective measures to deal with them and the tension,conflict among them.This can ensure effectively implementation of the essential medicine system.

Objective To identify the impact factors for community doctors with the essential medicine system in place,in support of mobilizing them and successful implementation of the essential medicine system in the community.Methods Based on the theory of ERG hierarchy of needs,the pathway analysis method was called into play to identify the three factors affecting community doctors,namely personal survival,interpersonal relations and self-development.Results Major factor of which is the interpersonal factor,with a score of 0.549,while the latter two factors do not directly affect the survival and development.The two however work on each other,and work on the interpersonal factor as well,with the impact coefficients of 0.320 and 0.402 respectively.Conclusion With the essential medicine system in place,the largest impact factor for community doctors'enthusiasm is the interpersonal one,involving the doctor-patient communications among others.This serving as the breakthrough point may improve the enthusiasm of the community doctors,paving the way for the system in the communities.

Objective To evaluate the township hospitals'medical service efficiency in Shandong province,and to provide references for the development in township hospitals under the background of the essential medicine system.Methods The method of data envelopment analysis(DEA)was used to analyze the township hospitals' medical service efficiency in Shandong province before and since the implementation of the essential medicine system.Results For the township hospitals in Shandong province in general,their relative efficiency ratio of the medical service efficiency dropped from 66.67% to 53.33% since the implementation of the essential medicine system.In terms of the input and output,the non-DEA effective township hospitals are found with insufficient output as measured by the output indicator,while some input indicators input were found as excessive.Conclusion The low scale efficiency has become the main factor for the low service efficiency of such hospitals since the implementation of the essential medicine system in Shandong province.In order to improve the medical service efficiency,it is important to continue to improve the essential medicine system,increase the medical staff's incentives, improve the fiscal compensation policy,and keep the policy continuity.

Objective To explore the effect of caregiver reaction on coping styles in cerebral infarction patients with the treatment of rehabilitation. Methods A total of 352 patients with cerebral infarction and their caregiver were valued by the Chinese version caregiver reaction assessment scale and Chinese version medical coping questionnaire. Pearson correlation analysis and multiple linear regression analysis were used to explore the effect of caregiver reaction on coping styles in patients with cerebral infarction. Results The scores of health problems, time arrangements disturbed, economic problems and lack of family support and self-esteem were respectively (2. 80 ± 0. 61), (3. 51 ± 0. 82), (3. 19 ± 0. 63), (2. 61 ± 0. 51) and (4. 08 ± 0. 90). For the coping styles, the scores of confrontation, surrender and avoidance were respectively (17. 85 ± 1. 64), (9. 61 ± 1. 34) and (17. 10 ± 1. 74). Pearson correlation analysis showed that the score of confrontation was significantly negatively correlated with health problems, time arrangements disturbed, economic problems and lack of family support (P<0. 05), but significantly positive correlated with self-esteem (P <0. 05); and the scores of surrender and avoidance were significantly positive correlated with health problems, time arrangements disturbed, economic problems and lack of family support (P <0. 05), but it negatively correlated with self-esteem (P<0. 05). There were significant difference of the score of confrontation, surrender, avoidance in the patients with different sex, age, educational level, marital status, family income, payment method, course of disease, NIHSS, frequency of attack and the the main caregivers with different sex, age and relationships with patients (P<0. 05). Multiple linear regression analysis showed that family income, course of disease, NIHSS and caregiver reaction were the influence factors of coping styles in patients with cerebral infarction (P<0. 05). Conclusions The caregiver reaction is an important influence factor of coping styles in patients with cerebral infarction.

By sorting out and analyzing the contents about pulse diagnosis in Tanksuqnameh, it was found that in terms of pulse theory, the book contains academic viewpoints of different periods and doctors about three portions and nine readings pulse method and nutritive qi operation law in Huang Di Nei Jing, the Cunkou pulse-taking method and the Cunguanchi theory in Nan Jing, the Renying and Qikou pulse-taking method and the three-region pulse-taking method in Mai Jing, and the seven superficies-indicating, eight interior-indicating and nine channels pulse of Mai Jue, etc.; in terms of pulse theory interpretation, multiple annotations from famous doctors are cited, and TCM basic theories and knowledge of astronomy and mathematics are applied, combined with the background of ancient Iranian medicine and local medical experience for explanation; in terms of pulse diagnosis techniques, pulse diagnosis techniques such as "three fingers determining three guan", "adjusting finger density", "floating and sinking pulse", "foot back pulse breaking life and death" were recorded in books of Nan Jing, Mai Jue, Lei Zheng Huo Ren Shu, etc.; in terms of influencing pulse factors, the male and female pulse, physical pulse, and four time pulse were recorded. Tanksuqnameh is a universal work of Persian Traditional Chinese Medicine, compiled by the author Rashid-ul-Din based on his research on Chinese culture and medical knowledge, combined with the unique customs, language and culture, and way of thinking in the Middle East region, to reorganize various pulse theories from before the Han Dynasty to the Tang and Song Dynasties in China. The publication of this book indicates that TCM pulse diagnosis had been promoted to the Middle East in the 14th century and provided valuable experience for local medical development. The author's sense of identification and research spirit towards different cultures provide a historical example for achieving cross-cultural communication between TCM and medicine in different regions. The preserved literature from the Tang and Song Dynasties in the book can provide clues for a deeper understanding of ancient pulse theory in TCM, but some details do not explain thoroughly or does not match the current clinical practice. Therefore, attention should be paid to distinguishing in research and application.