Objective:To analyze the satisfaction degree and related factors of community health services among residents in Zhejiang province.Methods:A service satisfaction survey was conducted during July to October 2019; using purpose sampling method three community health service centers were selected as survey sites in Hangzhou, Jiaxing, and Lishui cities, representing high, medium, and low economic development levels in Zhejiang province. The short-form Patient Satisfaction Questionnaire (PSQ-18) was used in the survey. SPSS 19.0 was adapted for data analysis, and multivariate logistic regression was applied use of analyze the affecting factors of satisfaction.Results:A total of 464 questionnaires were distributed, and 429 valid ones were returned with a response rate of 92.46%. Among them, 112 were from Hangzhou, 159 from Jiaxing, and 158 from Lishui. The overall satisfaction score of community health services was (4.22±0.59), and the satisfaction rate was 85.8%(368/429).Among the three cities, the overall satisfaction score in Lishui was the highest (4.28±0.51) with a satisfaction rate of 88.7% (140/158). The satisfaction scores of service quality, doctors' interpersonal communication ability, doctor-patient communication level, economic efficiency of service, timeliness of service, and accessability of service were (3.99±0.57), (4.10±0.77), (4.27±0.56), (3.54±0.84), (4.13±0.68) and (3.88±0.55); the satisfaction rates of those items were 59.6%(256/429), 79.4%(340/429), 86.3%(370/429), 43.6%(187/429), 78.9%(338/429)and 50.3%(216/429), respectively. Multivariate logistic regression analysis indicated that the quality of service, doctors' interpersonal communication ability, doctor-patient communication level and accessability of service were the affecting factors of the residents' satisfaction to community health services ( OR=3.734, 2.928, 7.732, 4.275; P<0.05). Conclusion:The residents of Zhejiang province have a high overall satisfaction with community health services. The quality of service, doctors' interpersonal communication ability, doctor-patient communication level and accessability of service are the affecting factors of the overall satisfaction degree.

Objective · To investigate the expression of the regulator of calcineurin 1 (RCAN1) and calcineurin A (CnA) in tissues of in-stent restenosis after intervention of arteriosclerosis obliterans (ASO), and to explore the relationship between their expression levels and the occurance of in-stent restenosis. Methods · Superficial femoral arterial tissues were collected from 15 ASO patients undergoing lower extremity amputation for in-stent restenosis in Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University from September 2013 to June 2016. H-E staining and Masson staining were performed on the stenosis tissues, as well as on the proximal and distal tissues, and the morphological changes of these tissues were observed under optical microscope. Western blotting was used to detect the protein levels of RCAN1, CnA and proliferating cell nuclear antigen (PCNA). The distribution of RCAN1 and CnA proteins was observed by immunohistochemistry and immunofluorescence methods. In addition, co-immunoprecipitation was used to validate the protein-protein interaction between RCAN1 and CnA in vascular tissues. Results · The expression of RCAN1 in the distal tissues was significantly elevated compared with the proximal tissues and the stenosis tissues (P<0.05). The expression of RCAN1 in the proximal tissues was higher than that in the stenosis tissues (P <0.05). The expression of CnA and PCNA in the stenosis tissues was significantly elevated compared with the proximal tissues and the distal tissues (P<0.05). Immunohistochemistry and immunofluorescence analyses showed that RCAN1 and CN proteins were mainly expressed in the cytoplasm of vascular smooth muscle cells. Co-immunoprecipitation analysis showed there is protein-protein interaction between RCAN1 and CnA in arterial tissues. Conclusion · The low expression of RCAN1 and the high expression of CnA are probably related to the occurrence of in-stent restenosis.

Objective To clone and express a membrane protein(Tetraspanin 2) gene of Schistosoma japonicum (SjTsp2). Methods A pair of primers was designed to amplify the SjTsp2 gene which was subcloned into prokaryotic plasmid pET28a(+). The recombinant plasmid was transformed into E. coli BL21(D3) and followed by expression of the protein induced by IPTG. The protein was purified by affinity chromatography and used to immunize BALB/c mice. Dilution of antibody against SjTsp2 was determined by ELISA. The protein was also identified by Western blotting. Results Big loop of SjTsp2-A, 228 bp, was amplified in vitro by PCR. Its deduced amino sequence shared 52% similarity with SmTsp2. The soluble recombinant SjTsp2-A was expressed in the experiment and high dilution antibody against the recombinant (1 ∶ 32 000 in maximum) was produced in immunized mice. SjTsp2-A reacted positively with sera of acute and chronic schistosomiasis patients but not with sera from healthy persons by Western blotting. Conclusion SjTsp2 has been expressed and shows certain antigenicity.

Objective To probe into the relation of expressions of HIF-1α, VEGF and EGFR in esophageal squamous cell carcinoma with radiation therapy efficacy. Methods 73 of the patients with carcinoma of oesophagus from January , 2011 to May , 2014 in the General Hospital of Ningxia Medical University , were involved in this research , their clinical data reviewed and analyzed. Before radiotherapy , immunohistochemical SP was used to test expressions of HIF-1α, VEGF and EGFR in the cancer tissues. Relationships between the expressions and the efficiency of radiotherapy were analyzed. Results The positive expressions of HIF-1α, VEGF and EGFR were 70.0%, 84.9% and 80.8%, respectively. In terms of the single factor analysis related to recent curative effects, HIF-1α expression had significant correlation with recent curative effects (P=0.03). Conversely , multiplicity indicated that HIF-1α and EGFR expressions were notably associated with recent curative effects (P=0.007, 0.045, respectively). Conclusions The positive expressions of HIF-1α,VEGF and EGFR in the esophageal carcinoma may account for a largest proportion of the total. HIF-1α and EGFR expressions are associated with the short-term outcomes.

Background The Qingcaosha Reservoir is facing issues of algal blooms and eutrophication, and the resulting increase in the level of chlorination disinfection by-products in the water has been a major concern. Objective To evaluate the impact of "Algae Monitoring and Control Program in Qingcaosha Reservoir" (hereinafter referred to as the program) on the control of trihalomethanes (THMs) in conventional finished water. Methods From 2011 to 2019, water samples were collected from the Lujiazui Water Plant once per season, one sample each time, and the concentrations of four THMs (trichloromethane, dichlorobromomethane, monochlorodibromomethane, and tribromomethane) were measured in the samples. Using 2014 when the program was implemented as a cut-off point, the entire study period was divided into two phases: pre-implementation (2011–2013) and post-implementation(2014–2019). Segmented linear regression with interrupted time series analysis was applied to assess the concentrations and trends of THMs in the finished water before and after the program launch. Results The concentration of total THMs in finished water increased by 1.561 µg·L⁻¹ (P=0.010) for each season of time extension before launching the program. The change in the concentration of total THMs in finished water was not statistically significant after the program launch, but the THMs concentration showed a decreasing trend as the slope was −0.626 (P=0.001). From 2017 until the end of 2019, the average concentration of THMs in finished water of Lujiazui Water Plant dropped to 10 μg·L⁻¹ or less. Conclusions The algae and eutrophication control measures in Qingcaosha Reservoir have achieved good results, controlling THMs in finished water at a low level, and the trend of THMs has changed from a yearly increase pattern before the program to a yearly decrease pattern after the program.

The purpose of this research was to study the effect of Xingxiong sodium chloride injection on cerebral ischemia-reperfusion injury in rats. Rats were divided into five groups, namely sham group, model group, ginkgolide injection group(3 mg/kg), Xingxiong sodium chloride injection high-dose group(14 mg/kg)and low dose group(7 mg/kg). Except for the sham group, animals in other groups were subjected to ischemia for 2h and reperfusion for 72 h by middle cerebral artery occlusion(MCAO)with thread technique, and then drugs were administered continuously by tail intravenous injection during reperfusion period for 3 days. The neurological deficit score and the histopathological score were evaluated; infarction ratio, brain water content and biochemical indexes of animals in each group were determined. Compared with model group, reduction of neurological deficit score, brain water content and infarction area were observed obviously at 7 mg/kg and 14 mg/kg of Xingxiong sodium chloride injection. Additionally, reduction of histopathological score, H2O2 and MDA content, increase of the level of GSH, GSH-Px, SOD and also the capacity of inhibition of superoxide anion radical(·O-2)and hydroxyl radial(·OH)were observed at 14 mg/kg. The results suggested that Xingxiong sodium chloride injection could effectively enhance the ability of anti-oxidation in the brain tissues, and protect brain from ischemia-reperfusion injury.

Objective To explore the clinical value of adaptive statistical iterative reconstruction(ASIR)combined with automatic tube current modulation in low dose scan of chest CT.Methods 80 patients who underwent chest CT scan were randomly divided into four groups,with a noise index(NI)of 14,16,18,and 20,respectively.Automatic tube current modulation technique for chest CT scan was adopted for all patients.The standard dose group,with a NI of 14,was reconstructed with FBP.While the low-dose groups,with a NI of 16,18 and 20,were reconstructed with four ASIR levels(20% ASIR,40% ASIR,60% ASIR and 80% ASIR) in each group.The volume CT dose index(CTDIvol),dose length product(DLP)and effective dose(ED)were recorded of the four groups.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated of the different reconstruction groups. Two radiologists with more than five years of work experience blindly scored the subjective image quality.Results Effective dose of the four groups with different NI were(3.29 ± 1.21)mSv,(3.10 ± 1.07)mSv,(2.20 ± 0.82)mSv and(1.97 ± 1.21)mSv,respectively. In all the reconstruction groups,when NI was constant,the greater the ASIR,the lower the SD.When ASIR percentage was constant, the SD was increased and the SNR was reduced along with NI rising up.When the parameters were set as NI 18 and ASIR 60%,the SD would be smaller and SNR would be higher than that of a standard dose group.In aspect of the scores from subjective image quality evaluation,there was no significant difference(P> 0.05).The average ED was decreased by about 33.2% when compared to the standard dose group.Conclusion Combining automatic tube current modulation with ASIR has a certain clinical practicality.When the NI is set at 18 and ASIR is 60%,the image quality can be optimal for not only satisfying the requirements of clinical diagnosis, but also reducing radiation dose in chest CT scanning.

Objective To explore the relationship between serum miRNA-21 and miR-27b levels and prognosis of patients with renal clear cell carcinoma.Methods A total of 118 patients with renal clear cell carcinoma admitted to the Qinghai University Hospital from February 2019 to April 2021 were selected as the study subjects,and another 118 healthy patients in the same period as the control group.Real time fluorescence quantitative polymerase chain reaction(PCR)was used to detect the expression of miR-21 and miR-27b in the serum of all subjects.The relative expression levels of serum miR-21 and miR-27b between the patients with renal clear cell carcinoma and healthy control patients were compared.The expression and correlation of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma of different pathological stages and Fuhrman grading were analyzed.The relationship between the expression of serum miR-21 and miR-27b and the survival and prognosis of the patients was explored as well.Results The expression levels of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma were higher than those in the healthy control group(P＜0.05).The serum miR-21 expression level in stage Ⅲ patients was higher than in stageⅠ(P＜0.05),while the serum miR-21 expression level in the stage Ⅳ patients was higher than that in stagesⅠ,Ⅱ,and Ⅲ(P＜0.05).The expression level of miR-27b in the serum of patients gradually increased across the four stages,with a significant difference(P＜0.05).The pathological staging was positively correlated with the expression of miR-21 and miR-27b(P＜0.001).The expression levels of miR-21 and miR-27b in serum of patients gradually increased across grades Ⅰ,Ⅱ and Ⅲ by Fuhrman grading,with significant difference(P＜0.05).Fuhrman grading was positively correlated with the serum miR-21 and miR-27b expression(P＜0.001).There was a statistically significant difference in the survival curve between the miR-21 high expression group and the low expression group(P＜0.05).There was a statistically significant difference in the survival curve between the high expression group and the low expression group of miR-27b(P＜0.05).Conclusion The expression levels of serum miR-21 and miR-27b in patients with renal clear cell carcinoma is indicative of the progression and prognosis of the patient's condition.

Objective:To investigate the relationship between common functional gastrointestinal diseases symptoms with psychological factors, diet and lifestyles by using the network analysis method which has achieved great success in the field of psychology in recent years.Method:A questionnaire survey was conducted in two military units using the cluster sampling method during July 2020, and a total of 1 805 subjects were included. Functional gastrointestinal disease symptoms were evaluated with the Gastrointestinal Symptom Rating Scale (GSRS). The state, trait anxiety scale and stress response scale were used to evaluate the mental and psychological state by self-evaluation. R was used to build the network and calculate statistical parameters.Results:1 486 of the 1 805 subjects (82.3%) had experienced functional gastrointestinal diseases symptoms within 2 weeks, but most of them were mild. Network analysis shows that there was a strong interaction between digestive system symptoms with different clinical manifestations (Spearman coefficient ranges 0.31-0.56). There was a clear relationship between functional gastrointestinal symptoms and mental and psychological factors (Spearman coefficient ranges 0.16-0.27), but there was no clear interaction with diet, age, education level, body mass index, etc. Functional gastrointestinal diseases symptoms were connected with mental and psychological factors through two nodes: stress and indigestion. The stability coefficient of node strength correlation was 0.75, indicating that the network was stable.Conclusions:The current study revealed the network structure and features of functional gastrointestinal diseases symptoms with mental and psychological factors. The key linking nodes provided potential interfering target for controlling functional gastrointestinal symptoms related to mental and psychological factors.

Due to the reduction of patient cooperation and the limitation of clinical diseases, general practitioners lack effective acceptation training in the training process. To improve this situation, this study applies teacher standardized patients (TSP) combined case-based learning (CBL) to the acceptation ability training of general practitioners in medically unexplained physical symptoms (MUPS). And the acceptation ability and communication ability of 15 general practitioners were evaluated before, during and after the training. It shows that the application of "TSP + CBL" in the acceptation ability training of general practitioners in MUPS can effectively improve the acceptation ability and communication ability of general practitioners.