doctors from 72 township health centers in 3 counties of Jiangxi Province were given a written test in basic medical knowledge, clinical knowledge of prevention and healthcare and professional knowledge. The rate of excellence of the scores was 45.4% while the rate of failure was 16.9%. A comparative analysis is made of the differences in the scores of doctors of different sexes, ages, specialties, educational backgrounds, and professional titles. It is suggested that it is imperative to conduct training for all doctors so as to enhance the overall quality, to lay stress on the key points and focus on the tackling of the weak links, and to perfect the mechanism so as to promote the renewal of knowledge.

Objective To analyze the current situation of TB control in Hefeng County and probe into the role of medical institutions in TB control. Methods In-depth interviews were conducted with health workers of TB prevention, TB patients and their family members; data on registered TB patients were collected; the current situation of TB control was analyzed and countermeasures were put forward. Results The TB epidemic was pretty serious in Hefeng County, with a high morbidity rate and a low cure rate. According to an epidemiological survey in 1990, the TB morbidity rate in the county was 1000/100000. Conclusion Hefeng County failed to give full play to the role of hospitals in TB control and the treatment of TB patients was separated from their management. Hence the deplorable results of TB control. The following countermeasures were presented: ①giving full play to the role of general hospitals in TB control; and ②perfecting the three-level medical networks of prevention and healthcare.

Objective To investigate the effects of spleen preservation on hepatic fibrosis and relevant cytokine in rabbits with advanced schistosomiasis. Methods After hepatic cirrhosis was induced by infecting Schistosoma japonicum cercariae in rabbits, total splenectomy (TSG), subtotal splenectomy (SSG) or sham operation (model control group, MCG) were performed respectively on these rabbits. Meanwhile,a normal control group (NCG) was established. The serum levels of tumor necrosis factor alpha (TNF-α) , interleukin-6 (IL-6) and interleukin-1 beta (IL-lβ) were detected respectively by radioimmunoassay(RIA) at the 8th, 15th and 21st week post-infection. The expressions of transforming growth factor betal (TGF-β1), type Ⅰ and type Ⅲ collagen in liver tissues were determined by immunohistochemistry before and after the operations. Results Compared with NCG, the serum levels of TNF-α, IL-6 and IL-1β of MCG rabbits increased significantly at the 8th week post-infection (P <0.01). However, the levels of them decreased to a lower level at the 15th week. At the 6th week after operation,no significant difference was found among the three model groups ( MCG, TSG, SSG) (P > 0.05). The expressions of TGF-β1, type Ⅰ and type Ⅲ collagen in liver tissue of MCG rabbits were significantly higher than those of NCG rabbits before the operation (P < 0. 01). No significant difference was found among the three model groups at the 6th week after the operation ( P > 0.05). Conclusion The residual splenic tissue after subtotal splenectomy does not aggravate the hepatic fibrosis at advanced schistosomiasis. The mechanism may be that the relevant cytokines of hepatic fibrosis (TGF-β1, TNF-a, IL-6, IL-1β) decreased to a lower level at this time,and splenectomy does not influence the levels of them.

Objective To compare efficacy of procedure for prolapse and hemorrhoids (PPH) and rubber band ligation (RBL) in treatment of Ⅲ degree internal hemorrhoids.Methods One hundred patients with Ⅲ degree internal hemorrhoids were randomly divided into two groups and received PPH (42 cases) and RBL (58 cases) respectively.At once and after two weeks and two and six months the efficacy were compared.Results PPH and RBL were equally effective in controlling symptomatic prohpse (P>0.05),but RBL was associated with an increased incidence of recurrent bleeding (PPH 8/42 vs RBL 30/58,P<0.05);there was no difference in scores of patient satisfaction (P>0.05); PPH was associated with increased pain and analgesia usage at both at once and 2-week follow-up (P<0.05);the rate of complications in PPH was higber than in RBL (7/42 vs 0/58,P<0.05).Conclusion RBL can be used as treatment of first-line treatment of Ⅲ degree internal hemorrhoids.

Objective: To investigate whether acupoint penetration acupuncture (APA) could regulate chondrocyte autophagy and apoptosis via the PI3K/Akt-mTOR signaling pathway to reduce cartilage degeneration in knee osteoarthritis (KOA) rats. Methods: KOA was induced in rats via intra-articular injection of sodium iodoacetate resolution. Forty male Sprague-Dawley rats were randomly assigned to blank control, model, APA, electro-acupuncture (EA), and sham model groups (n = 8) and those in the APA and EA groups received their respective therapies. Following completion of the treatment course, histological examinations of cartilage and muscle were conducted. Levels of apoptosis- and autophagy-related factors, including Bax, Bcl-2, mTOR, ULK-1, and Beclin-1 protein, and mRNAs were assessed. Additionally, β-endorphin (β-EP) concentrations in the brain and serum were measured. Results: Histological analysis revealed that APA alleviated cartilage and muscle damage compared with the model group. APA inhibited cartilage degeneration by modulating the expression of apoptosis- and autophagy-related proteins and mRNA, thus preventing chondrocyte apoptosis. In the APA group, Bax and mTOR protein levels were significantly lower than those in the model group (both P = .024). Conversely, the Bcl-2 expression level was significantly higher than that in the EA group (P = .035). Additionally, ULK-1 expression was significantly lower than that in the EA group (P = .045). The mRNA level of Bax was significantly higher than that in the blank control group (P < .001). However, Beclin-1 levels were significantly higher than those in both the model and EA groups (both P < .001). ELISA results showed a significant decrease in the concentration of β-EP in the brains of the rats in the APA group compared with those in the model group (P = .032). Conclusions APA reduced osteoarthritis-related pain and alleviated cartilage damage by upregulating chondrocyte autophagy and down-regulating apoptosis via signaling pathways involving PI3K/Akt-mTOR in KOA rats.

OBJECTIVETo explore the relationship between CD133(+) subsets cells in human gastric cancer (GC) and molecules of drug resistance and their sensitivity to 5-FU.

METHODSThree gastric cancer cell lines therein KATO-III(, SGC7901 and MKN45 were sorted by immunomagnetic beads cell sorting method. Then above cell lines were further divided into un-sorted GC cells, CD133(+) subgroup and CD133(-) subgroup. The expressions of CD133, P-gp, Bax and Bcl-2 were determined by RT-PCR, Western blot and immunoflurescence. Meanwhile, the sensitivity to 5-FU of three subgroups was detected by CCK-8 Kit. The apoptosis induced by 5-FU in three subgroups was determined by Hoechst 33258.

RESULTSExpressions of CD133 in three CD133(+) subgroups were significantly higher than those in un-sorted GC cells and CD133(-) subgroup (all P<0.05). Expressions of P-gp and Bcl-2 in the three GC cell lines were different (all P<0.05). There were significant differences of expressions of P-gp, Bcl-2 and Bax among CD133(+) cells, un-sorted GC cells and CD133(-) cells (all P<0.05). CCK-8 detection showed that CD133(-) subgroup of MKN45 GC cell line was more sensitive than CD133(+) cells to 5-FU (P<0.05). Hoechst 33258 staining showed that there were more apoptotic cells in CD133(-) subgroup as compared to other two subgroups, and the least apoptotic cells were observed in CD133(+) subgroup of MKN45 GC cell line (P<0.05). CD133 sirna was transfected into MKN45 GC cell line and could down-regulate the expressions of CD133, P-gp, Bcl-2 and p-Akt, while the expression of Bax increased (all P<0.05).

CONCLUSIONSCD133 may contribute to the resistance of GC cells to chemotherapy drug through P-gp, Bcl-2 and Bax. PI3K/Akt signal pathway may be involved in this process.

AC133 Antigen ; ATP-Binding Cassette, Sub-Family B, Member 1 ; Antigens, CD ; metabolism ; Antineoplastic Agents ; pharmacology ; Apoptosis ; Cell Line, Tumor ; Drug Resistance, Neoplasm ; Fluorouracil ; Glycoproteins ; metabolism ; Humans ; Peptides ; metabolism ; Phosphatidylinositol 3-Kinases ; Proto-Oncogene Proteins c-akt ; RNA, Small Interfering ; Stomach Neoplasms ; drug therapy ; metabolism ; pathology ; bcl-2-Associated X Protein

Objective:To examine the correlations of C-reactive protein (CRP)/albumin ratio (CAR) with the postoperative complications of patients with colorectal cancer.Methods:The clinic data of 312 patients undergoing elective surgery for colorectal cancer in Hainan Hospital of People′s Liberation Army General Hospital between January 2013 and July 2018 was analyzed retrospectively. There were 188 males and 124 females, aged (61.0±12.9) years (range: 21 to 86 years). Logistic analysis was used to identify relative factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and compare diagnostic accuracy of the CAR and CRP levels.Results:Postoperative complications occured in 28.5% (89/312) cases. Hemoglobin on postoperative day(POD) 3 ( OR=0.977, 95% CI: 0.957 to 0.998, P=0.034), preoperative CRP ( OR=1.209, 95% CI: 1.055 to 1.386, P=0.006) and CAR on POD 3 ( OR=0.033, 95% CI: 0.016 to 0.067, P<0.01) were found to be significant independent relative factors for postoperative complications. The cutoff point of CAR on POD 3 was 0.325, patients with CAR≥0.325 were found to have more postoperative complications than those with CAR<0.325. The area under the curve of CAR on POD 3 and preoperative CRP were 0.872, 0.626, respectively. The positive predictive value of CAR on POD 3 was higher than that of preoperative CRP (79.9% vs. 55.1%). Conclusions:CAR is closely related to the occurrence of postoperative complications in colorectal surgery. Patients with CAR≥0.325 on POD 3 has higher incidence of postoperative complications.

Objective:To examine the correlations of C-reactive protein (CRP)/albumin ratio (CAR) with the postoperative complications of patients with colorectal cancer.Methods:The clinic data of 312 patients undergoing elective surgery for colorectal cancer in Hainan Hospital of People′s Liberation Army General Hospital between January 2013 and July 2018 was analyzed retrospectively. There were 188 males and 124 females, aged (61.0±12.9) years (range: 21 to 86 years). Logistic analysis was used to identify relative factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and compare diagnostic accuracy of the CAR and CRP levels.Results:Postoperative complications occured in 28.5% (89/312) cases. Hemoglobin on postoperative day(POD) 3 ( OR=0.977, 95% CI: 0.957 to 0.998, P=0.034), preoperative CRP ( OR=1.209, 95% CI: 1.055 to 1.386, P=0.006) and CAR on POD 3 ( OR=0.033, 95% CI: 0.016 to 0.067, P<0.01) were found to be significant independent relative factors for postoperative complications. The cutoff point of CAR on POD 3 was 0.325, patients with CAR≥0.325 were found to have more postoperative complications than those with CAR<0.325. The area under the curve of CAR on POD 3 and preoperative CRP were 0.872, 0.626, respectively. The positive predictive value of CAR on POD 3 was higher than that of preoperative CRP (79.9% vs. 55.1%). Conclusions:CAR is closely related to the occurrence of postoperative complications in colorectal surgery. Patients with CAR≥0.325 on POD 3 has higher incidence of postoperative complications.

Objective To analyze the composing principles of the traditional Chinese medicine (TCM) prescriptions for eczema by data mining methods.Methods The CNKI,VIP,Wanfang and SinoMed from inception to the December 31st 2016 were searched,which were collected into the traditional Chinese medicine inheritance support system (TCMISS) and analyzed by data mining methods,which included frequency analysis,Cluster Analysis and correlation rules.Results Based on the analysis of 51 cases of TCM prescriptions reported in literatures,16 herbs (frequency≥8) were found frequently used.And the results showed that 22 combination herbs (supporting coefficient=8),4 association rules (supporting coefficient=8 and confidence coefficient=0.8),7 core combinations and 1 new TCM prescription were found.Conclusions The TCM prescriptions for eczema are mainly composed of herbs with heat-clearing effect,especially with damp-drying effect,supplemented by herbs with blood-nourishing,blood-cooling and rheumatism effects.

Objective:To construct three image recognition models of manikin′s glottis using visual laryngoscopy based on deep-learning algorithm.Methods:The tracheal intubation manikin′s epiglottis was visualized using a videolaryngoscope, and then epiglottis was elevated to expose the glottis and acquire glottic images. A total of 149 images were obtained from various angles and orientations and randomly divided into training set and test set, and the annotation of image data was completed. Three glottal image recognition models of CenterNet, YOLOv3 and YOLOv4 were developed. The training set was used to complete the training of the models, and finally the test set was used to evaluate the model performance.Results:CenterNet, YOLOv3 and YOLOv4 three models were successfully constructed, the mean average precision of CenterNet, YOLOv3 and YOLOv4 was 92.33%, 89.52% and 89.02% respectively, the recall rates were 87.50%, 90.00% and 90.00% respectively, the precision rates reached 97.22%, 94.74% and 94.74% respectively, and the accuracy rates were 90.91%, 85.11% and 88.89% respectively. All three algorithms demonstrated an identical F1 score of 91.00%.Conclusions:The CenterNet, YOLOv3 and YOLOv4 models are successfully constructed, and three recognition models can accurately identify the glottis in the image, with the CenterNet model demonstrating the highest recognition precision.