Hospitals in China are evolving from the development pattern of resource-driven to connotation-driven, which propels the rapid growth of ambulatory care in the country.In consideration of the 76 typical ambulatory care cases presented at the Fourth Championship under China Healthcare Improvement Initiative(the Initiative), the authors studied and summed up innovations of China′s hospitals in their case management, organizational management and institutional management.Their efforts aim to understand the success of ambulatory care provision and analyze problems in this regard, for contributing to this model with China-unique experiences.

Objective To perform a meta-analysis on the associations of interleukin (IL)-6-174G ＞ C (rs1800795) and-634C ＞ G (rs1800796) polymorphisms with type 2 diabetic nephropathy (DN).Methods The data on the studies about the associations of IL-6-174G ＞ C and-634C ＞ G polymorphisms with type 2 DN were collected from Pubmed,Embace,CNKI,Wan Fang and VIP database during their inception and April 2017.The statistical analysis was performed with STATA 14.0 and Review manager 5.3 softwares.The heterogeneity in the eligible studies was assessed by Q-statistic and I2 statistic.When the significant heterogeneity was found,the random effect model was used for meta-analysis,otherwise,the fixed effect model was used.The publication bias was evaluated with funnel and Begger graphs.The pooled odds ratios (OR) and corresponding 95％ confidence intervals (95％ CI) were calculated for evaluating the associations of IL-6-174G ＞ C and-634C ＞ G polymorphisms with type 2 DN.In addition,the sub-group analysis was performed according to the regions of subjects.Results A total of 11 studies were enrolled,The studies on the association of IL-6-174G ＞ C polymorphism with type 2 DN included 1 688 subjects,while those on the association of IL-6-634C ＞ G with type 2 DN included 2 180 subjects.In the association analysis of IL-6-174G ＞ C polymorphism with type 2 DN of Asian population,the significant relationship was detected in an allelic genetic model (OR =0.461,95％ CI:0.274-0.777,P ＜ 0.01),a homozygote model (OR =0.126,95％ CI:0.022-0.734,P =0.021),a recessive genetic model (OR =0.146,95％ CI:0.026-0.827,P =0.030) and a dominant genetic model (OR =0.504,95 ％ CI:0.273-0.930,P =0.028),but not in a heterozygote model (OR =0.606,95 ％ CI:0.321-1.143,P =0.122).There was no significant relationship between IL-6-174G ＞ C polymorphism and type 2 DN in European population.In the association analysis of IL-6-634C ＞ G polymorphism with type 2 DN of Asian population,the significant relationship was found in an allelic genetic model (OR =1.467,95％ CI:1.238-1.737,P ＜0.01),a homozygote model (OR =2.793,95％ CI:1.844-4.230,P =0.021),a recessive genetic model (OR =2.296,95 ％ CI:1.586-3.323,P ＜ 0.01) and a dominant genetic model (OR =1.377,95％CI:1.109-1.711,P ＜ 0.01),but not in a heterozygote model (OR =1.733,95％ CI:0.932-1.476,P =0.174).There was no significant relationship between IL-6-634C ＞ G polymorphism and type 2 DN in European population.Conclusion In Asian population,IL-6-174CC genotype may prevent the progression of type 2 DN,however,IL-6-634GG genotype may promote the development of type 2 DN.But in European population,there is no relationship between IL-6-174G ＞ C and-634C ＞ G polymorphisms and type 2 DN.

Objective: To establish a method for simultaneous and rapid detecting of the polymorphisms in Cytochrome P450 2C9 (CYP2C9), CYP2C19, CYP4F2, Vitamin K epoxide reductase (VKORC1) and ATP-binding cassette subfamily B member1 (ABCB1) gene, which were associated with warfarin and clopidogrel, based on liquid phase chip technology. Methods: Method establishment. The eight gene sequences near targeted sites related to warfarin and clopidogrel were found in Genbank, and the specific primers and probes were designed. Through multiple PCR amplification, followed by allele specific primer extension (ASPE), and MagPlex-Tag microspheres hybridization, the suspension array Luminex 200 system step-by-step, the genotypes were determined by fluorescence signal. The reaction system was optimized and its methodological evaluation was performed. 260 patients with antithrombotic therapy from Dongguan houjie hospital were recruited in this study form June 2017 to December 2018. The eight genotypes of the 260 patients were detected by the established method, and the results were compared with the sequencing results. Results: The results of 260 samples showed that allelic median fluorescence intensity (MFI) ratios of homozygotes (mutant/wild-type) were all greater than 0.9 or less than 0.1, and all the allelic MFI ratios of heterozygotes were between 0.3 and 0.6. The within run and between run coefficients of variance for allelic MFI ratios were lower than 6.4% and 10.9%, respectively. The minimum DNA template requirements was 0.75ng. The genotypes of 260 patients determined by the established method were completely concordant with the sequencing results. Conclusion A method was established successfully for rapid detecting the genotypes which associated with warfarin and clopidogrel based on liquid phase chip technology.

Objective: To isolate the cariogenic Streptococcus mutans (Sm) strains and study the therapeutical effect of egg yolk antibody (IgY) of the Sm on dental caries development. Methods: Sm strains were isolated from the children's dental plaque samples. Morphological, biochemical and molecular biological methods were applied to identify the serotype, acid producing and adhesion abilities of isolated Sm strains. After inactivation one of the Sm strains was used as antigen to immune laying hens to collect and extract the specific anti-Sm IgY. The rats were infected with Sm (serotype e). After 16 weeks of infection, all the rats were found developing dental caries. The rats were then randomly divided into two groups. The rats in experimental group were supplied with diet containing anti-Sm IgY while the rats in control group with normal IgY. All rats were sacrificed after another 8 weeks' observation. The degree of caries for each rat was assessed using Keyes' method. Results: We isolated 7 Sm strains from the children's dental plaque samples in the present study. The numbers of serotype c, e, f, k were 3, 2, 0 and 2, respectively. All strains showed similar morphological and biochemical characters as standard UA159 Sm strain, and possessed strong capabilities of acid production and adherence. Interestingly, even the same serotypec strains, such as No.3 and No.7 strains, demonstrated significant difference on acid producing and adherence capabilities. After 16 weeks infection with serotype e strain, the rats' mandibular teeth were apparently decayed, and treatment with specific anti-Sm IgY obviously attenuated the development of caries in the experiment group rats (16.4±2.0) compared with that in the control group rats (30.2±9.3) (P<0.05) determined by Keyes' method. Conclusions Seven cariogenic Sm strains of different serotypes were isolated, which possesses similar morphology and biochemical characters. Although belonging to the same serotype strains they always show significant difference in acid-producing and adherencec apabilities. Further experiment provides evidences that the serotype e strain could obviously induce caries independently, and employment of specific anti-Sm IgY as passive immunotherapy additive might effectively inhibit the further development of dental caries.

Antigenic purity is important for quality control of the foot-and-mouth (FMD) whole virus inactivated vaccine. The recommended method for evaluation the antigenic purity of FMD vaccine is to check the serum conversion to non-structural protein (NSP) 3AB antibody after 2 to 3 times inoculation of animals with inactivated vaccine. In this study, we developed a quantitative ELISA to detect the amount of residual 3AB in vaccine antigen, to provide a reference to evaluate the antigenic purity of FMD vaccine. Monoclonal antibody (Mab) of NSP 3A and HRP-conjugated Mab of NSP 3B were used to establish a sandwich ELISA to quantify the NSP 3AB in vaccine antigen of FMD. Purified NSP 3AB expressed in Escherichia coli was serially diluted and detected to draw the standard curve. The detectable limit was determined to be the lowest concentration of standard where the ratio of its OD value to OD blank well was not less than 2.0. Results: The OD value was linearly corelated with the concentration of 3AB protein within the range between 4.7 and 600 ng/mL. The correlation coefficient R² is greater than 0.99, and the lowest detectable limit is 4.7 ng/mL. The amount of 3AB protein in non-purified inactivated virus antigen was detected between 9.3 and 200 ng/mL depending on the 12 different virus strains, whereas the amount of 3AB in purified virus antigen was below the lowest detectable limit. The amount of 3AB in 9 batches of commercial FMD vaccine antigens was between 9.0 and 74 ng/mL, whereas it was below the detectable limit in other 24 batches of commercial vaccine antigens. Conclusion: the sandwich ELISA established in this study is specific and sensitive to detect the content of 3AB protein in vaccine antigen of FMD, which will be a useful method for evaluation of the antigenic purity and quality control of FMD inactivated vaccine.
Animals ; Antibodies, Viral ; Enzyme-Linked Immunosorbent Assay ; Foot-and-Mouth Disease/prevention & control* ; Foot-and-Mouth Disease Virus ; Viral Nonstructural Proteins/genetics* ; Viral Vaccines