Low self-certainty of patient satisfaction evaluation in patient satisfaction survey is found in the survey to be the main cause for the failure that satisfaction scores cannot precisely indicate the correct satisfaction level of patients for medical services received; it is stated in the study that psychological bias in the survey can be reduced by means of reasonable choice of survey scenario, clear notice of survey's objective, and independent completion of survey questionnaire by the patients; it also stated the theoretic references and research clues in studying patient satisfaction uncertainty, as a mathematic model is built for such study, for the purposes of better advancement of the theoretic study and practice of patient satisfaction.

Vascular cell adhesion molecule 1 (VCAM - 1) is a member of immunoglobulin superfamily. The principal ligand for VCAM - 1 is integrin ?4|?1/VLA - 4(very late antigen 4). In recent years, VCAM - 1 was found to be expressed on macrophages and dendritic cells, but little is known about its identity on these professional antigen presenting cells (APC). In the present study we analyzed VCAM - 1 expression on macrophages by fluorescence - activated cell sorting (FACS) and found that VCAM- 1 was constitutively expressed on macrophages and its expression level was up-regulated by soluble tumor associated antigen (TAA: freeze - thaw lysates of FBL - 3 tumor cells) and TNF - a. In macrophages and allogenic T cells mixed lymphocyte reaction (MLR) assays, we observed that blocking VCAM - 1/VLA - 4 interaction with anti - VCAM - 1 or anti - VLA - 4 mAbs caused significant inhibition of the proliferative response and inhibition of IL - 2 production. These findings suggest that VCAM - 1 on macrophages not only allows for increased cell-to-cell contact through adhesive interaction but also plays a role in the costimulation of T cells via its interaction with VLA-4.

In the present study, the expression of MHC class I molecule and ICAM - 1 on the surface of B16 melanoma cells were observed, and their roles in the induction of CTL were investigated. The results showed that both MHC class I and ICAM - 1 expression increased after IL-2, IL-4, or IL-6 gene transfection. The splenocyte CTL activity was enhanced significantly after in vivo immunization with cytokine gene - transfected B16 melanoma cells. The CTL induction was partly inhibited by anti-ICAM-1 mAb and was completely abolished by anti-MHC class I mAb. These results suggested the increased immunogenicity of IL-2,IL-4 or IL-6 gene-transfected B16 melanoma cells may be related to the upregula-tion of ICAM-1 or MHC class I molecules after cytokine gene transfection.

Objective The beam data is compared with those obtained from Monte Carlo (MC)simulation and measurement to investigate their feasibility and reliability for X-ray small fields.MethodsThe beam data,including the total scatter factor (Scp),percentage depth dose (PDD) was acquired byneasurement and calculation with the field size ranging from 0.5 cm × 0.5 cm to 10 cm x 10 cm.The resultswere compared and analyzed.Results All the data is most consistent for the fields size of ≥3.5 cmx 3.5cm,but they are obvious different for the fields size of ≤ 3.0 cm × 3.0 cm.The measurements seem toreliable using the chambers of CC04 and CC13 for the fields size of ≥2.0 cm x 2.0 cm.Conclusions It isdemonstrated that the accurate measurements and calculations of Scp and PDD can be obtained for the fieldssize of ≥2.0 cm ×2.0 cm,but they needed morc rcscarchcs for thc smaller fields.

Objectives To explore different factors (clinical presentations and laboratory investigations ) between the severe and mild Guillain-Barré syndrome (GBS) in southeast China ,and to find the predictors of severe GBS. Meth?ods Retrospective analysis was conducted on 101 cases of patients with GBS admitted to our Hospital from Jan. 2006 to Nov. 2015, who were divided into mild and severe groups according to Hughes scale. The different factors were compared between these two groups such as age, sex, precursor infection factors, the initial symptoms, bulbar dysfunction, cranial nerves involvement, autonomic nervous dysfunction, peripheral nerve axonal damage to find the predictors for the severe GBS. Results Severe GBS more frequently presented with non-paresthesia as initial symptom (P<0.001) , bulbar dysfunc?tion (P<0.001), cranial nerves involvement (P=0.025), autonomic nervous dysfunction (P=0.018), motion system involve?ment (P = 0.004) and peripheral nerve axonal damage (P<0.001). After multivariable logistic regression analysis, we found that the axon damage(P=0.008, OR=4.632), bulbar dysfunction(P=0.010, OR=10.420), and cranial nerves in?volvement(P=0.047, OR=0.076)were the independent risk factors for sever GBS. Conclusion Axon damage, bulbar dys?function, and cranial nerves involvement might be significant predictors of sever GBS.

Objective:In order to study the antitumor immune response induced by antigen pulsed,IL 18 gene modified dendritic cells in vivo.Methods:①C57BL/6 mice were immunized twice subcutaneously by tumor antigen peptide pulsed,IL 18 gene modified dendritic cells(DC IL 18/mut1)(1?10 5 cells/mouse),then the NK activity and CTL activity were determined.②In block test,C57BL/6 mice were first immunized once 2?10 5 cells/mouse DC IL 18/mut1 subcutaneously,and then challenged by 5?10 5 3LL Lewis lung cancer cells/mouse with blocking different immune components by monoclonal antibody,the tumor growth were observed.Results:Specific CTL activity and NK activity could be induced most significantly in mice immunized with DC IL 18/mut1.The block test showed that CD4 +T,costimulating pathway,the production of IFN ? involved in the induction phase of immunization with DC IL 18/mut1,and CD8 +T?IFN ??NK cells involved in the effect phase but CD4 +T cells unnecessary.Conclusion:Immunization with DC msIL 18/mut1 could induce potent antitumor immune activity,whose mechanisms involved effective antigen presentation,increased CTL activity and NK activity,CD4 +?CD8 +T?NK cells incorporation,and the production of IFN ?.

Objective: To study the treatment of experimental lung metastasis by intratracheal injection of IL 18 gene recombinant adenovirus. Methods: (1)The mouse IL 18 mRNA was detected by RT PCR, the concentrations of IL 18, associated cytokines in lung lavage and blood were determined by ELISA at different times after intratracheal injection of IL 18 recombinant adenovirus. (2)The lung metastasis nodes, mouse survival period, survival rates were investigated in the treatment of experimental lung metastasis in C57BL/6 mouse model. The NK activity and CTL activity were determined by 51 Cr 4 h release method. Results: (1)The IL 18 mRNA could be detected in lung tissue 6 h after intratracheal use of IL 18 recombinant adenovirus, and the concentrations of IL 18 in lung lavage was higher than that of peripheral blood, and both IL 18 mRNA and IL 18 could not be detected in control groups. (2)Intratracheal use of IL 18 recombinant adenovirus had significant therapeutic effect on experimental lung metastasis with the results of increased CTL and NK activity, and with longer survival period and higher survival rates compared with the control groups. Conclusion: Intratracheal usage of adenovirus vector containing IL 18 gene has therapeutic effect on the lung metastasis, denoting that gene therapy of lung diseases can be done through airway directly with recombinant adenovirus.

Objective To investigate the role of poly(ADP-ribose) polymerase (PARP) inhibitor PJ34 in regulating blood-brain barrier (BBB) permeability and matrix metalloproteinases-9 (MMP-9) expression in a mouse model of traumatic brain injury (TBI).Methods A total of 136 adult male BALB/c mice were randomly divided into sham-operated group,injured group and PJ34-treated group according to the random number table.Controlled cortical impact in mice was established.At 6 and 24hours postinjury,neurological deficit was evaluated,including motor,sensory,reflex and beam balance tests ; BBB permeability and brain water content were detected using Evans blue test and gravimetric technique; brain contusion volume was measured using HE staining; levels of MMP-9 in cytosolic fractions were detected using Western blotting.Results At 6 and 24 hours postinjury,neurological severity score in PJ34-treated group (8.00 ± 0.26,7.50 ±0.25) were lower than those in injured group (12.50 ±0.39,11.80 ± 0.32) ; brain contusion volume in PJ34-treated group [(11.25 ± 0.91) mm3,(13.55 ±1.06) mm3] was lower than those in injured group [(25.37 ± 1.75) mm3,(28.24 ± 1.51) mm3] ; BBB permeability in PJ34-treated group [(440.08 ± 3.10) μg/mg,(860.46 ± 3.86) μg/mg] was lower than those in injured group [(936.96 ± 4.71) μg/mg,(1 302.23 ± 5.89) μg/mg] (all P ＜ 0.01).Brain water content lowered significantly in PJ34-treated group than in injured group at 6 hours postinjury [(80.77 ± 0.76) ％ vs (82.55 ± 0.73) ％,P ＜ 0.0l],but between-group difference was not significant at 24 hours postinjury.Lower levels in MMP-9 were also observed in PJ34-treated group compared with injured group at 6 and 24 hours postinjury(P ＜ 0.05 or 0.01).Conclusion PARP inhibitor PJ34 can attenuate MMP-9 up-regulation,inhibit BBB injury and hence protect the brain against TBI in mice.

Objective: To investigate the case-mix method by clinical pathway. Methods: K-MEANS cluster analysis was applied to case-mix classification and artificial neural network was used for case-mix prediction. Results: Five hundred and twenty three inpatient records constructed a case-mix classification scheme of 4 groups.Statistical significant difference of costs existed in 4 groups.The training error of artificial neural network was low(0.0 029) and the predicting result was accurate(98.91%). Conclusion: Case-mix result was more reasonable using records under clinical pathway.The existing models of case-mix depend on dividing individual variables, but artificial neural network does not.

Objective To survey symptom occurrence degree of maintenance hemodialysis (MHD) patients,and its related factors,and to provide a basis for clinical symptom management. Methods A total of 142 MHD patients were selected with convenience sampling method from a hospital in Ningxia from July 2015 to September 2015 and investigated with the Dialysis Symptom Index ,the Pittsburgh Sleep Quality Index and the family Adaptation,Partnership,Growth,Affection and Resolve(APGAR)Scale. Results The occurrence rate of various symptoms ranged from 53.5%to 92.3%. Fatigue(92.3%),itching(86.6%)and dry skin(85.9%)were the top three prevalent symptoms. Fatigue (30.3%),difficulty falling asleep (27.5%),hyposexuality (27.5%) and trouble in sleeping deeply(27.5%)were the most serious symptoms.Multivariate linear regression analysis showed that gender,nationality,sleep quality,combining with hypertension and arrhythmia had significant influence on the occurrence degree of symptom in MHD patients(P < 0.05). Conclusion Symptoms in MHD patients are preva-lent. Efficient symptom management should be performed to improve the quality of life of MHDpatients.