An analysis of the readmission service in rural townships and counties.Based on the concept of health integration,the authors proposed the service integration among hierarchical institutions in alignment with hierarchical medical system,and the autonomous service integration among differentiated hierarchical institutions.The purpose is elevation of quality of care in rural areas and better capital usage efficiency in NRCMS.

Objective:To construct a recombinant adenoviral vector carrying the specific siRNA of Survivin gene,and to observe its effect on the expression of Survivin gene and on the radiosensitivity of cancer cells in tumor-bearing mice.Methods:The specific siRNA of Survivin gene was designed and synthesized,and a recombinant adenovirus AdEGFP-siRNA was subsequently constructed.SMMC 7721 xenograft models were established with nude mice and were divided into the following 5 groups:siRNA+radiotherapy and siRNA groups(intratumoral injection of AdEGFP-siRNA),siRNA(-)group(injected every other day with AdEGFP-siRNA[-],2?108 pfu/100 ?l per time,total 5 times),pure radiotherapy group and blank control groups(injected with the same volume of normal saline).On day 10,12,14,and 16,the mice in siRNA+radiotherapy and pure radiotherapy groups were given 5 Gy/time radiotherapy.The tumor volumes were measured regularly.The expression of Survivin in tumor tissues was determined immunohistochemically.Results:Adenovirus AdEGFP-siRNA harboring the specific siRNA of Survivin gene and enhanced green fluorescent protein gene(EGFP)was successfully recombined.The growth of SMMC 7721 xenografts in nude mice was inhibited after injecting AdEGFP-siRNA,with the inhibition rate being 56.2%.The inhibition rate in AdEGFP-siRNA therapy + radiotherapy increased to 82.6%.Immunohistochemistry study showed that the specific siRNA markedly silenced the expression of Survivin gene in hepatocarcinoma cells.Conclusion:The specific siRNA can markedly silence Survivin gene and subsequently inhibit the growth of cancer;meanwhile,it can also increase the radiosensitivity of cancer cells so as to improve the treatment effect.

The Tongmai Yangxin pill (TMYX) has potential clinical effects on no-reflow (NR); however, the effective substances and mechanisms by which this occurs remain unclear. This study evaluates the cardioprotective effects and molecular mechanisms of TMYX against NR. We used a myocardial NR rat model (2 h after myocardial ischemia and 2 h after reperfusion) to confirm the effect and mechanism of action of TMYX in alleviating NR. In vitro studies in isolated coronary microvasculature of NR rats and in silico network pharmacology analyses were performed to reveal the underlying mechanisms of TMYX and determine the main components, targets, and pathways of TMYX, respectively. The experiment was approved by the Ethics Committee of Hunan University of Chinese Medicine (LLBH-202212160001). TMYX showed therapeutic effects on NR by improving cardiac structure and function, reducing NR, ischemic areas, and cardiomyocyte injury, and decreasing the content of cardiac troponin I (cTnI). Moreover, the mechanism of TMYX predicted by network pharmacology is related to the hypoxia inducible factor-1 (HIF-1), nuclear factor kappa-B (NF-κB), and tumor necrosis factor (TNF) signaling pathways. TMYX increased the expression of G protein-coupled estrogen receptor (GPER), phospho-extracellular signal-regulated kinase (p-ERK), and HIF-1α. In vitro, TMYX enhanced the diastolic function of coronary microvascular cells; however, this effect was inhibited by GPER inhibitor (G-15), eNOS inhibitor (L-NAME), and sGC inhibitor (ODQ). This study integrates pharmacology and experimental evaluation to reveal that TMYX activates HIF-1α/eNOS signaling pathway by upregulating GPER to relax coronary microvessels, thereby significantly alleviating NR.

Objective To evaluate the value of IL-17 and IL-23 expression in response prediction of infliximab treatment in Crohn's disease (CD).Methods A total of 23 CD patients were enrolled in this study including 19 males and 4 females.Another 17 patients with colonic polyps were recruited as control group.The tissue expression of IL-17 and IL-23 in intestinal mucosa was measured by immunohistochemistry (IHC).In each specimen, IL-17 or IL-23 positive cells were counted and recorded in 10 random high power fields (HPFs).Results Infliximab was effective in sixteen patients (69.6％), while 7 patients (30.4％) did not response.The numbers of IL-17 or IL-23 positive cells were much more in responders than those in nonresponders.The median numbers of IL-17 positive cells were 26.7 (18.0, 38.6)/HPF in responders, 11.8 (7.0, 14.0)/HPF in nonresponders, 3.0 (2.0,4.0)/HPF in controls (P =0.004).The median numbers of IL-23 positive cells were 74.5(44.8, 128.6)/HPF in responders, 22.4(19.0, 38.8)/HPF in nonresponders, 3.0(2.0, 4.0)/HPF in controls (P =0.018).IL-17 or IL-23 positive mucosal cells were significantly decreased after infliximab treatment.Conclusion High expression of IL-17 and IL-23 in mucosa may predict the response to infliximab in CD patients.

Objective To investigate the therapy effects of bone marrow mesenchymal stem cells (MSCs) on renal recovery after ischemia-reperfusion injured. Methods Seventy-two Spargue-Dawley rats were randomly divided into 4 groups as normal control, sham operated control, I/R group(n=30) and the MSCs group. Rats were subjected to 45 min bilateral renal ischemial-reperfusion injury with microvascular clips, after 60 min of reperfusion they were injected in BrdU positive MSCs(1?106/mL)intravenously. The animals were sacrificed at 12 h, 3 d, 7 d, 14 d, and 42 d after reperfusion, and the bilateral kidney and blood samples were harvested. The blood urea nitrogen(BUN) and serum creatinine(Scr) were measured on automatic biochemistry analyzer. Renal morphologic changes were scored with Paller’s criterion on hematoxylin and eosin(H&E) stained sections. The apoptosis of tubular cells were examined by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL). PCNA positive tubular cells were detected immunohistochemically as proliferation index. And confocal microscopy were used to identified the distribution of BrdU positive MSCs. Results After 12 h, 3 d of reperfusion, the Scr value of MSCs group were signifcantly lower than I/R group(P

Objective:To explore the histogenesis and differentiation of dermatofibroma (DF) and dermatofibrosarcoma protuberans (DFSP). Methods: Clinical information and microscopic characteristics of 26 cases of DF and 26 cases of DFSP were investigated. The immunohistochemical study was performed on microarray sections by a panel of antibodies including FactorⅩⅢa, HLA-DR, CD34, CD14, S-100, MSA, and Ki67. Probe was labeled by in vitro transcription. The mRNA expression levels of TGF-? and bFGF were investigated by in situ hybridization. Results: All cases showed positive for Factor ⅩⅢa,HLA-DR and CD34 to different extent. The medians of positive rates in DF were FactorⅩⅢa 90%, HLA-DR 70%, and CD34 5%, and in DFSP were FactorⅩⅢa 10%, HLA-DR 5%, and CD34 80%. CD14 was positive in 3 cases of DF and 1 case of DFSP. S-100 was positive in 6 cases of DFSP and 2 cases of DF. MSA was positive in 5 cases of DFSP and 3 cases of DF. In all cases, positive rate of Ki67 was less than 5%. The mRNA expression levels of TGF-? was elevated in DF in comparison with DFSP. Conclusion: Both DF and DFSP can differentiate to dendritic cells (DC) in different degree. Considering the character of microscopic features and immunohistochemical phenotype, cells of DF are much similar to mature DC, while those of DFSP much similar to immature dermal reserve cell (DRC). The differences of cell differentiation between DF and DFSP result in different prognosis. DF is a benign tumor, while DFSP a low grade malignant tumor. The different expression of FactorⅩⅢa and CD34 may be helpful to differential diagnosis of DF and DFSP.

Objective To evaluate two methods measuring alveolar bone loss by micro computed tomography (micro-CT)based on periodontitis model in mice.Methods The silk ligatures were tied around the right maxillary second molars of mice to induce periodontitis model.The right half maxillaries of mice model were harvested for micro-CT analysis.Three dentists were recruited for the measurement with two different methods:Modified tomography (T) method and reconstruction (R) method.Accuracy and consistency of each method were estimated by standard deviation (SD).Results The SDs of R method managed by the same operator (measurement for 3 times) or different operators (3 operators) were 34.87μm and 35.67 μm respectively,while that of T method was 7.82 μm and 14.24 μm respectively.The SDs of T method were significantly lower than those of R method (both P＜0.05).Conclusion T method is more accurate and consistent than R method for evaluating alveolar bone loss in mice periodontitis model.

This paper discusses the current prevalence of hospital preparations backward quality standard test methods, quality standards for lack of a serious problem , and analyses the reasons from four aspects , proposed to strengthen the construction of a pharmaceutical ethics; examination and approval departments shall strictly agents registration review technical requirements;rectify and improve the quality of all preparation standards;Introduction and training of strengthen pharmacy personnel , and actively improve the quality standard revision work;hospital in-creasing hardware and software construction , support quality standards revision suggestions for the improvement of work, provide reference standard for quality improvement of hospital preparations .

Objective To discuss the perioperative nursing care for patients with hepatic cancer located near the central bile duct, who receive microwave ablation treatment by using bile duct cooling protection technique. Methods A total of 21 patients with hepatic cancer located near the central bile duct received percutaneous microwave ablation treatment (PMWA) using bile duct cooling protection technique. Preoperative routine nursing and psychological nursing, close cooperation, close postoperative observation and prompt nursing measures were strictly carried out. Results PMWA was successfully accomplished in all the 21 patients, and no biliary complications occurred. All 21 patients were cured at the time of discharge, no nursing-related complications or death occurred. Conclusion In treating hepatic cancer located near the central bile duct, bile duct cooling protection technique is a new treatment technology. Effective perioperative nursing care can improve the operative success rate and reduce the incidence of complications.

Objective To construct the ICAT gene interference lentivirus expression vector targeting and to establish stable transfected cell line HL60 .Methods The interference sequence targeted at human ICAT gene was designed and synthesized ,after annealing ,which was connected to PGLV3 interference vector and with PG‐p1‐VSVG ,PG‐p1‐REV ,PG‐p1‐RRE were co‐transfected into 293T cells The lentivirus particles were packaged and generated .The virus titer was detected .HL60 cells were transfected for establishing the stable cell line ;RT‐PCR and Western Blot techniques were used to detect ICAT gene and protein expression in sta‐ble HL60 cells ,then the results were compared with those in the control group .Results The lentivirus expression vector targeted at ICAT was successfully constructed and the virus titer was 2 × 108 U/mL .Stable transfected HL60 cell line was established .The effective interference verification revealed that shICAT could significantly reduce the mRNA and protein level of ICAT ( P<0 .001) .Conclusion The shRNA lentiviral expression vector of ICAT gene is successfully constructed and the HL 60 cell line stably interfering ICAT expression is established .