Objective:To analyze the impact of the construction of county medical community led by a traditional Chinese medicine (TCM)hospital on the service capacity of township hospitals, in order to provide empirical evidence for deepening the reform of medical communities, improving the service capacity of township hospitals, and promoting the development of TCM services.Methods:Taking the county medical community led by the TCM Hospital in Mengcheng County, Anhui Province as the research object, and using the structure-process-outcome model to analyze the organizational conditions and the key measures for improving the service capacity of township hospitals, and evaluate the changes in service capacity of township hospitals before and after the construction of the medical community. In August 2023, a semi-structured in-depth interview method was used to interview six key informants on the implementation process, mechanism, and impact of the construction of county medical community on the service capacity improvement of township hospitals. The interview data was analyzed using a thematic framework method. At the same time, based on the Service Capacity of Township Health Centers (2022 Edition), a survey questionnaire was designed and 4 township hospitals was randomly selected to investigate their service capacity in 2015 (before the construction of the county medical community) and 2022 (after the construction of the county medical community), and descriptive analysis was conducted on the questionnaire data. Results:Mengcheng County has established a leading group and council for the construction of the county medical community, which was responsible for coordinating and promoting the construction of the medical community. The county-level leading hospital has gained greater autonomy to promote the optimal allocation of medical resources. Through the analysis of interview data, five key themes for enhancing the service capabilities of township hospitals have been identified: resource allocation and unified management, service integration and path optimization, technical assistance and capacity training, institutional construction and quality control, continuous improvement and regular assessment. The average qualification rate of the service capacity of each township hospital has increased from 71.50% in 2015 to 90.50% in 2022, and the average excellence rate has increased from 46.50% to 72.50%. In 2015, the three indicators related to TCM services, including TCM medical services, TCM health management, and TCM management, did not reach level A in all township hospitals. In 2022, they all reached level A.Conclusions:Through structural optimization and process improvement in the construction of county medical communities, the service capabilities of township hospitals can be enhanced, and TCM hospitals as leading units can effectively improve the chronic disease prevention and health management capabilities of township hospitals.

OBJECTIVETo investigate the mechanisms by which retinoic acid-induced gene G (RIG-G) protein regulates p21 gene expression.

METHODSWestern blot was used to detect the effects of RIG-G protein overexpression on p21 protein expression level in leukemia cell line NB4 cells and the phosphorylation of both c-Jun and JNK in U937 cells. The c-Jun expression plasmid and p21 gene promoter-containing reporter plasmid were co-transfected into 293T cells, to explore the regulatory effect of c-Jun protein on p21 gene expression by luciferase reporter assay.

RESULTSWestern blot showed that the overexpression of RIG-G protein significantly upregulated p21 protein level in the NB4 cells, and the level of p21 protein largely increased along with the induction of endogenous RIG-G protein during the differentiation of NB4 cells treated by all-trans retinoic acid (ATRA). Moreover, the phosphorylation of both c-Jun and JNK decreased in RIG-G-overexpressing U937 cells while total c-Jun and JNK proteins remained unchanged. After using the JNK inhibitor SP600125 to block JNK phosphorylation, the level of c-Jun phosphorylation was still dramatically reduced in the RIG-G-overexpressing U937T-RIG-G cells, compared with the control U937T-pTRE cells. These results indicated that the inhibitory effect of Rig-G protein on c-Jun phosphorylation could not only be through the JNK pathway, but also via some JNK-independent pathways. Luciferase reporter assay showed that when 0.1, 0.5, 1.0 and 2.0 µg c-Jun-expressing plasmids were respectively transfected into 293T cells, compared with the empty vector-transfected group, the relative luciferase activities were (83.0 ± 1.7)%, (73.7 ± 0.7)%, (68.9 ± 0.9)% and (64.1 ± 0.9)%, indicating that the transcriptional activity of p21 gene could be inhibited by c-Jun protein.

CONCLUSIONSRIG-G protein may suppress the phosphorylation of c-Jun protein through different signal pathways, thereby increasing the expression of p21 gene, arresting the cell cycle and inhibiting the cell growth in U937 cells.

Cell Cycle ; Cell Differentiation ; Cell Line ; Cell Proliferation ; Cyclin-Dependent Kinase Inhibitor p21 ; genetics ; metabolism ; GTP-Binding Proteins ; genetics ; metabolism ; Genes, Reporter ; Phosphorylation ; Signal Transduction ; Transfection ; Tretinoin ; metabolism ; Up-Regulation