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.

Liver ferritin of Sphyrna zygaena(SZLF) with purity of mass spectrum was prepared in batch. Under) the condition of acidifying medium at pH 1.0, PAGE showed that SZLF subunits treated for 20 min began) to dissociate. A whole process of subunit dissociation and recombination was monitored by transmission electron microscopy(TEM). In addition, the changes of size of both protein shell and iron core were also determined) by TEM directly. It was found that in the acid dissociation process of SZLF subunits, the size of iron) core and protein shell showed the same trend of change, which might be related to not only the iron release) of inner iron core but the dissociation and unfolding of the protein shell. The passway of SZLF recombination is a fast step, which is a conversion process from incompact moltenglobule to compact ferritin. Under the assistant of matrix acidity pH 3.0 and laser, SZLF mixed with horse spleen ferritin(HSF) still has capacity to release) its subunits to form subunit ions for mass analysis by a MALDI-TOF mass spectrometer, which indicates that the interaction intensity between the subunits was weaken but they were not unfolded under this pH condition. TEM technology can be applied in studying both dissociation and recombination in ferritin subunits.

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.

OBJECTIVE To investigate the effect of ischemic postcondioning on cochlea following cochlear ischemia-reperfusion injury in rats. METHODSForty two healthy male SD rats were randomly divided into 3 groups, namely, the sham operation control group, the ischemia reperfusion group and ischemic postcondinging group. There were 14 rats in each group. The content of molondialdehyde(MDA) as well as the activity of catalase(CAT)in cochlea was measured by histochemistry. The ultrastructural changes of stria vascularis capillaries of the cochlea in experimental rats were examined by transmission electron microscopy(TEM). RESULTS In the ischemia reperfusion group, the CAT activities were decreased and MDA concentrations were increased significantly compared with those in the control group. However, in the ischemic postcondinging group, the activities of CAT were increased and MDA concentrations were decreased compared with those in the ischemia reperfusion group. Moreover, lesions were detected in the stria vascularis capillaries in all the three groups. The capillaries of stria vascularis were injured severely in ischemia reperfusion group. In the ischemic postcondinging group, the damage of capillary of stria vascularis were reduced significantly compared with that in ischemia reperfusion group, the structures were near normal, and no obvious destruction was observed. COCLUSION Ischemic postconditioning may markedly reduce the excessive generation of oxygen free radical during the process of ischemia-reperfusion injury and might be a potential strategy for its therapy.

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 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.