Objective:To investigate the content of interaction and construct the virtuous interaction among the hierarchical medical institutions in rural areas based on the theory of integration and system thinking.Methods:Literature research were applied to analyze the interaction with the use of the CNKI.WanFang and Vip.Results:Interaction was closely related to integration,and the interaction among the hierarchical medical institutions in rural areas mainly included resource interaction,management interaction and service interaction,whose subject was the rural three-level medical institutions.Conclusion:The ultimate goal of virtuous interaction was the quality and safety of the health service.Specific measures of the virtuous interaction included strengthening the construction of health personnel and capital flows,combing the interests of rural three-level medical institutions and integrated management,regionalization of two-way referral and upper-and-lower linkage.

In the health service field,health resources and health service supple capacity were related with the resource and capacity in economics.Health resources,health service supple capacity and their relationships were important factors for the cooperation and benign interaction of hierarchical medical institutions.However,inversion of health resources and health dislocation of service supply capacity exacerbated the agglomeration degree of patients in the tertiary medical institutions under the impact of residents' freely searching for medical service concept.Vicious interaction and mutual competition among hierarchical medical institutions had become an important obstacle for the implementation of hierarchical medical services.Therefore,its mechanism needed to be clarified while the corresponding policy recommendations should be proposed.

Objective To give a summary of the current researches on hematopoietic stem cell niche.Methods Through extensive reviewing the related domestic and abroad literatures,the present summary reviews the compo- nents of hematopoietic stem cell niche,related cell factors and related cell signaling pathway participating in regula- tion of hematopoietic stem cell.Results The activities of hematopoietic stem cells are regulated by the niche(micro- environment),which is composed of hematopoietic stem cell and its surrounding cells.The regulation cannot be completed through one signaling pathway.Also,the self-renewal and differentiation of hematopoietic stem cell can- not be completed only through osteoblastic cells.Conclusion The niche regulates hematopoietic stem cells by differ- ent ways.With study in-depth,we will comprehensively understand the nature of stem cells and the study will pro- vide a broader space to stem cell-based therapy.

Objective To investigate the clinical effect of posterior pedicle screw fixation combined with anterior decompression and fusion for the treatment of thoracolumbar burst fractures.Methods The clinical data of 53 patients underwent posterior pedicle screw fixation and anterior decompression and fusion were retrospectively analyzed.The vertebral height,Cobb angle,vertebral tube volume,the Frankel gradient and Fugl -Meyer score were recorded and compared before and after treatment.Results 49 patients were followed up.At the last time of follow -up,the vertebral height,Cobb angle,vertebral tube volume all significantly improved (t =24.047,P <0.001;t =21.815,P <0.001;t =31.699,P <0.001).The Frankel gradient before treatment was:A 6 cases,B 18 cases,C 15 cases,D 10 cases,E 4 cases.After treatment,it came to 3 cases,8 cases,11 cases,17 cases,10 cases,respectively.There was significant difference before and after treatment (Z =2.997,P =0.003).There was significant difference in Fugl -Meyer score before and after treatment[(74.65 ±8.42)points,(90.26 ±9.17)points,respectively,P <0.001 ].Conclusion There is excellent effect on posterior pedicle screw fixation followed by anterior decompression and fusion for the treatment of thoracolumbar burst fractures.It is good for the recovery of motion and spinal function.

Translational medicine has been on the rise for 20 years as a new model of biomedical research,which plays a positive role in narrowing the gap between basic research and clinical medicine and in development of medical sciences.This paper traced back the milestones of translational medicine,and analyzed the hurdles for China to develop translational medicine,namely the organization system,management model and benefit sharing.On such basis,the authors recommended on the development and strategy,especially in clinical medical institutions in China.

Objective To understand the career needs of the first session specialist nurses of intensive care unit (ICU) in Jiangxi province and to provide reference for their career management.Methods A qualitative research based on phenomenology was adopted.The first session specialist nurses of ICU in Jiangxi province were enrolled and received in-depth interviews.Results Three themes were found,including career identity needs,career development needs and career management needs.Conclusions Nursing managers should understand the ICU specialist nurses' real feelings and developing career management strategies.

Objective To analyze the ecological environmental differences of hibernation hole and temporary hole of Himalayan marmot based on global positioning system (GPS),remote sensing (RS) and geographical information system (GIS) in Yushu City,Qinghai Province.Methods Hibernation holes and temporary holes were located based on GPS.Ecological environment factors related with Himalayan marmot,such as land surface temperature (LST),digital elevation model (DEM),normalized different vegetation index (NDVI),were extracted based on RS and GIS.The ecological environment differences between hibernation hole and temporary hole were explored based on epidemiological statistical method.Results Monthly LST (degree Kelvin,K) of hibernation hole was slightly higher than that of temporary hole in the same period.Yearly day LST of hibernation hole was 1.1 K higher than that of temporary hole in the same period.Yearly night LST of hibernation hole was 0.3 K higher than that of temporary hole in the same period.Monthly NDVI of temporary hole was slightly higher than that of hibernation hole in the same period.Yearly NDVI of temporary hole was 0.001 higher than that of hibernation hole in the same period.DEM of temporary hole was about 40 m higher than that of hibernation hole.The top two ratios of soil type factors were both alpine meadow soil and dark felty soil for hibernation hole and temporary hole,which were 62.1％ and 29.3％,64.4％ and 25.6％.The top two ratios of land cover factors were both rainfed cropland and mosaic cropland for hibernation hole and temporary hole,which were 43.3％ and 25.8％,40.0％ and 26.2％.Conclusions Soil type factors and land cover factors for hibernation hole and temporary hole are similar.Lower DEM and higher LST are chose for hibernation hole,and better NDVI is chose for temporary hole,which is good for food intake.

Objective To investigate the effect of high-mobility group box protein1 (HMGB1) on the expression of TNF-αand its mechanism in 16HBE in vitro. Methods groups with different HMGB1 (0, 100, 500, 2 000 ng/mL) concentration was set; RAGE antagonizing groups were as control, HMGB1-2000ng, anti-RAGE and anti-RAGE+HMGB1. The changes of TNF-αmRNA and secretion were determined by quantitative PCR and ELISA. RAGE protein level was measured by western blotting. Results HMGB1 intervention and TNF-α expression of 16HBE presented a positive dose-dependent relationship. Thechanges of RAGE was HMGB1positively concentration dependent. In comparison with HMGB1 2 000 ng/mL group, anti-RAGE+HMGB1showed a remarkable reduction of TNF-α secretion. Conclusion In vitro, HMGB1 increases TNF-α expression in 16HBE with a dose-dependent manner through RAGE.

Objective To study the incidence and distribution features of spontaneous decrease of hepatitis B virus (HBV) DNA level and its correlative factors in chronic hepatitis B (CHB) patients.Methods The incidence,demographic features and distribution of different clinical types of spontaneous decrease of HBV DNA were investigated with clinical epidemiological study in 315 CHB or live cirrhosis (LC) patients.The correlative factors of spontaneous decrease of HBV DNA were analyzed by Logistic regression methods.Results Among the 315 patients,171 patients (54.3%) underwent spontaneous decrease of HBV DNA within 12 weeks,of which 61 patients (19.4%) had undeteetable HBV DNA (＜3 lg copy/mL).The stratified study showed that the incidence of spontaneous decrease of HBV DNA in young patients was 58.6% (116/198 cases),which was higher than that (25.0%,2/8 cases) in juvenile patients (X2 = 2.956,P=0.048).The incidence of decrease in relatively more severe patients was higher than that in relatively less severe patients (all X2 in significant groups＞3.84,all P＜0.05),and the highest incidence was 78.7% (48/61 cases) in patients with chronic severe hepatitis B.The incidence of spontaneous decrease of HBV DNA in hepatitis E virus (HEV)/HBV coinfected patients was 75.0% (21/28 cases),which was higher than that (51.8%,146/282 cases) in single HBV-infected patients (X2 =5.530,P=0.019).The incidence of spontaneous decrease of HBV DNA in patients with alanire aminotransferase (ALT)＞400 U/L was 61.8%(102/165 cases),which was higher than that (46.0%,69/150 cases) in patients with ALT≤400 U/L (X2 =7.922,P=0.005).The incidence of spontaneous decrease of HBV DNA in patients with TBil＞200 μmol/L was 68.7% (79/115 cases),which was higher than that (46.0%,92/200 cases) in patients with TBil≤200 μmol/L (X2 = 15.155,P=0.000).The multivariate Logistic analysis demonstrated that chronic severe hepatitis B,ALT＞ 400 U/L and TBil＞ 200 μmol/L were the correlative factors with spontaneous decrease of HBV DNA in CHB or LC patients (all OR＞1,all P＜0.05).Conclusions The spontaneous decrease of HBV DNA level is a common phenomenon during the natural course (immune clearance phase) of CHB or LC patients.Patients with sever conditions,elevated levels of ALT and total bilirubin (TBil) tend to develop spontaneous decrease of HBV DNA.

The potential biodegradation of crude oil was assessed based on the development of a fermentative process with a strain of Pseudomonas aeruginosa which produced 15.4 g/L rhamnolipids when cultured in a basal mineral medium using glycerol as a sole carbon source. However, neither cell growth nor rhamnolipid production was observed in the comparative culture system using crude oil as the sole carbon source instead. As rhamnolipid, an effective biosurfactant, has been reported to stimulate the biodegradation of hydrocarbons, 1 g/L glycerol or 0.22 g/L rhamnolipid was initially added into the medium to facilitate the biodegradation of crude oil. In both situations, more than 58% of crude oil was degraded and further converted into accumulated cell biomass and rhamnolipids. These results suggest that Pseudomonas aeruginosa could degrade most of crude oil with direct or indirect addition of rhamnolipid. And this conclusion was further supported by another adsorption experiment, where the adsorption capacity of crude oil by killed cell biomass was negligible in comparison with the biologic activities of live cell biomass.
Biodegradation, Environmental ; Cell Culture Techniques ; methods ; Cell Proliferation ; drug effects ; Glycolipids ; pharmacology ; Petroleum ; metabolism ; microbiology ; Pseudomonas aeruginosa ; drug effects ; growth & development ; metabolism ; Water Pollutants, Chemical ; metabolism ; Water Purification ; methods