With the continuous development of China's economy,the people expect for higher quality medical services,and medical humanistic care is increasingly emphasized.Under this background,the"Duplex Linkage Mode",which integrates medical social workers and volunteers,has emerged.This paper reviews the current state of applying the mode in China,ex-pounds its benefits,and details its application within hospital services.This application covers guidance for outpatient and emer-gency department,inpatient ward services,hospice care,and community residents volunteer services.In addition,this paper proposes suggestions on furth for optimizing recruitment and training programs,improving management systems,establishing intel-ligent management systems,and improving volunteer support mechanisms.These measures aim to promote the sustainable and healthy development of medical humanistic services and to support the implementation of the Healthy China Initiative.

Objective:To investigate the association of risky drinking and decision-making ability among off-spring of fathers with alcohol dependence(OFAD).Methods:A case-control study was conducted according to the cutoff of the Alcohol Use Disorder Identification Test(AUDIT)(delimited as 7).OFAD were divided into"risky drinking group"(n=29)and"non-risky drinking group"(n=43).The Iowa Gambling Task(IGT)was used to e-valuate the decision-making ability.Covariance analysis was used to compare differences of IGT between the two groups,and multivariate logistic regression was used to explore the association between risky drinking and decision making ability.Results:There was no significant difference in total scores of IGT between the risky drinking group and the non-risky drinking group(P＞0.05).Risky drinking group had less Selection 2 in block 5 of IGT[(3.8± 2.5)v.s.(5.7±3.1),P＜0.05]than non-risky drinking group.Selection 2 in block 5 was still associated with risky drinking after controlling the covariates(OR=0.72,95％CI:0.57～0.90,P＜0.05).Conclusion:This study indicates that risky drinking group in offspring of parents with alcohol dependence may have better decision-making ability.

Objective:To explore the relationship between red meat intake level and the incidence of stroke in Chinese adults.Methods:The baseline data were from China Chronic Disease Surveillance Project conducted in 60 surveillance sites in 11 provinces in China in 2010. A total of 27 762 subjects with complete data in baseline survey were included in the cohort follow-up from 2016 to 2017. Multivariate nutrient-density cox proportional hazards regression model was used to analyze the association between red meat intake level and the incidence of stroke. Subgroup analysis were performed based on baseline characteristics. Sensitivity analysis was performed by using standard multivariate model, energy partition model and nutrient residual model.Results:In the 26 187 subjects, 1 259 stroke cases, including 1 074 ischemic stroke cases, occurred during an average of 6.0 years of follow-up, the incidence density was 815.0/100 000 person-years for stroke and 692.0/100 000 person-years for ischemic stroke. In models using the multivariate nutrient-density model of energy adjustment, compared with quintile group, red meat intake in quintile 2 group showed no significant association with stroke [hazard ratio ( HR)=1.07, 95% CI: 0.87-1.32] and ischemic stroke ( HR=1.03, 95% CI: 0.80-1.32) and in group of quintile 3-5, the red meat intake related risk for stroke increased by 23% ( HR=1.23, 95% CI: 1.00-1.51), 27% ( HR=1.27, 95% CI: 1.03-1.58) and 32% ( HR=1.32, 95% CI: 1.06-1.64), respectively, while the risk for ischemic stroke increased by 32% ( HR=1.32, 95% CI: 1.04-1.68), 35% ( HR=1.35, 95% CI: 1.05-1.73) and 38% ( HR=1.38, 95% CI: 1.07-1.79), respectively. Subgroup analysis revealed that blood pressure had modification effect on the association between red meat intake and incidence of stroke (interaction P=0.037). The sensitivity analysis showed no changes. Conclusions:These findings suggest that higher intake of red meat is significantly associated with an increased risk for stroke and ischemic stroke. It is necessary to take red meat intake level as one of the important indicators of stroke prevention and control.

Objective To investigate the expression and prognostic value of FOXO1 gene in liver cancer tissues based on TCGA and HPA databases. Methods The RNA-seq data of FOXO1 gene in liver cancer were downloaded from TCGA. The difference of FOXO1 gene expression between tumor and adjacent tissues was obtained via R software. The correlation between FOXO1 and clinicopathological features of liver cancer patients was analyzed. Survival analysis was carried out to evaluate the prognostic significance of FOXO1 gene expression in liver cancer patients. Univariate and multivariate Cox analyses were performed to explore prognostic factors. The correlation between FOXO1 expression and TIICs in tumor microenvironment was performed by CIBERSORT. KEGG pathways enrichment analysis was performed for the potential function of FOXO1 gene in liver cancer. Results FOXO1 was downregulated in liver cancer tissues compared with normal tissues (P=1.321E-15). Survival analysis showed that high expression of FOXO1 was positively associated with favorable OS of liver cancer patients (P < 0.05). Clinical stage, T and M stages could be prognostic indicators while FOXO1 wasn't an independent prognostic factor in patients with liver cancer. In TME of liver cancer, the expression of FOXO1 was positively correlated with resting memory CD4 T cells and naive B cells while negatively related to activated memory CD4 T cells and macrophages M2. GSEA identified that FOXO1 participated in multiple cancer-related pathways. Conclusion FOXO1 is down-regulated in liver cancer tissues, and its expression level is associated with OS of patients. FOXO1 might be a biomarker related to the prognosis of liver cancer patients and is expected to be a target for diagnosis and treatment of liver cancer.

Objective To OxplorO thO OffOct of lactobacillus vaginal capsulO in thO trOatmOnt of sOnilO vaginitis.Methods From January 2017 to FObruary 2018, 100 OldOrly patiOnts with vaginitis in thO SOcond POoplO＇s Hospital of Haining wOrO sOlOctOd in thO study. ThOy wOrO randomly dividOd into obsOrvation group and control group according to thO digital tablO, with 50 casOs in Oach group. ThO obsOrvation group was trOatOd by lactobacillus vagina capsulO, and thO control group was trOatOd by compound mOtronidazolO suppository. ThO clinical OffOcts of thO two groups wOrO comparOd.Results ThO total OffOctivO ratO of thO obsOrvation group (96.00% ) was significantly highOr than that of thO control group(76.00% ),thO diffOrOncO was statistically significant(χ2 =12.547,P<0.05).ThOrO was no statistically significant diffOrOncO in vaginal pH bOforO trOatmOnt bOtwOOn thO two groups[(6.89 ± 1.32) vs. (6.91 ± 1.26),t=0.102,P>0.05],and thOrO wOrO statistically significant diffOrOncOs in vaginal pH of thO two groups bOforO and aftOr trOatmOnt(t=8.204,5.112,all P<0.05),thO vaginal pH of thO obsOrvation group aftOr trOat-mOnt was significantly lowOr than that of thO control group, thO diffOrOncO was statistically significant[(4.49 ± 0.11) vs.(5.76 ± 0.37),t=5.024,P<0.05].In thO obsOrvation group, only 1 casO had rOcurrOncO at 2 months aftOr trOatmOnt, and no rOcurrOncO was obsOrvOd at 3 months and 6 months aftOr trOatmOnt, thO rOcurrOncO ratO was 2.00%. In thO control group, thOrO wOrO 2 casOs,4 casOs,6 casOs had rOcurrOncO at 2 months,3 months and 6 months aftOr trOatmOnt, and thO rOcurrOncO ratO was 24.00%. ThO rOcurrOncO ratO of thO obsOrvation group was significantly lowOr than that of thO control group (χ2 =25.634,P <0.05).Conclusion Lactobacillus vaginal capsulO in thO trOatmOnt of sOnilO vaginitis has curativO OffOct is distinct, thO rOcurrOncO ratO is low, also thO usO procOss is vOry simplO, has high clinical application valuO.

A series of 4-phenyl-pyrrolo[2,3-d] pyrimidine derivatives were synthesized through modifying the structure of the lead compound ruxolitinib by molecular hybridization strategy.It was synthesized from pyrimidine-4,6-diol by Vilsmeier-Haack reaction,SNAr reaction,cyclized,dehydration,Suzuki coupling and finally acylated to give 12 new compounds(12a-121).All structures of the synthesized compounds were confirmed by 1H NMR,13C NMR,and HRMS analysis.The biological activities were evaluated in vitro.Their JAK2 inhibitory activities were studied using JAK2 enzymatic and TF1-GMCSF cellular assays.The results indicated that compounds 12b,12e and 12h showed moderate activity.The anti-tumor activities were studied against JAK2-independent A549 cell line by the MTT assay.Results showed that the tide compounds exhibited potent antiproliferative effect on A549,especially compound 12c(IC50 =0.12 μmol/L),suggesting that this series compounds might be promising anti-tumor agents for futher investigation.

Taking JAK2 inhibitor baricitinib and fedratinib as the lead compounds,to design the novel 4-(3-sulfonylbenzene) amino-6-formylpyrrole[2,3-d] pyrimidine JAK2 inhibitors nucleus using the molecular hybrid drug design principle.17 target compounds were synthesized by derivatization of sulfonyl and formyl groups respectively.We used JAK2 kinase and GM-CSF-induced TF-1 cells to measure the activities of compounds.The results showed that most compounds had JAK2 inhibitory activities.Among them,compound 31 had excellent inhibitory activity on JAK2 kinase (IC50 =0.009 μmol/L) and GM-CSF-induced TF-1 cells (IC50 =0.136 μmol/L),which proved that the compound had potential research and development value.

OBJECTIVE:To explore the efficacy and safety of probucol combined with butylphthalide in the treatment of pa-tients with acute cerebral infarction. METHODS:172 patients with acute cerebral infarction were randomly divided into observation group and control group,86 cases in each group. All patients received conventional treatment for acute cerebral infarction,includ-ing thrombolysis,anti-platelet aggregation,reducing intracranial pressure,nutritional support,intensive lipid-lowering within onset 4.5 h,timely treatment of the underlying diseases;based on it,control group received Probucol tablet,0.5 g every times,bid. Ob-servation group additionally received Butylphthalide and sodium chloride injection,100 ml every times,bid,in 9:00 and 17:00 ev-ery day,infusion within 50-90 min. Both groups lasted for 2 weeks. Lipid metabolic indexes,the changes of serum S100β,NSE and hs-CRP levels,NIHSS score,clinical efficacy before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:Compared with before treatment,triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol (LDL-C) levels in 2 groups significantly decreased,high-density lipoprotein cholesterol level significantly increased, and TG,TC and LDL-C levels in observation group decreased more significantly,the differences were statistically significant(P<0.05). Serum S100β,NSE and hs-CRP levels and NIHSS scores in 2 groups significantly decreased,and NSE level NIHSS scores and in observation group decreased more significantly,the differences were statistically significant (P<0.05). The total effective rate in observation group was 89.5%,significantly higher than control group (62.8%),the difference was statistically significant (P<0.05). There were no obvious adverse reactions during treatment,and also no obvious liver and kidney function,blood coagula-tion and ECG changes. CONCLUSIONS:Probucol combined with butylphthalide can effectively improve the lipid metabolism and decrease serum NSE level in the treatment of patients with acute cerebral infarction,and plays positive role in early recovery of neu-rological function.

BACKGROUND:Stem cels can induce immune tolerance, prolong graft survival time and reduce rejection in organ transplantation, which have become a hot research. OBJECTIVE:To induce immune tolerance to alogenic kidney transplantation with amniotic fluid stem cels in recipient rats and to explore the mechanism underlying immune tolerance. METHODS: Amniotic fluid stem cels were isolated from Wistar rats. Two inbred male rat strains, Wistar rats and Sprague-Dawley rats, were selected as donors and recipients of kidney transplantation. The rat models of renal orthotopic transplantation were divided into the folowing four groups: a sham-operated group (n=10, Sprague-Dawley rats); an isograft group (n=10, Sprague-Dawley to Sprague-Dawley rats); a control group (n=10, Wistar to Sprague-Dawley rats, treated with 1 mL saline); and an experimental group (n=10, Wistar to Sprague-Dawley rats, treated with 1 mL of 3×106/L amniotic fluid stem cels). Serum levels of creatinine, urea nitrogen, interleukin-2, interferon-γ, parameters of oxidative stress were detected at 5 days after operation. Flow cytometry was employed to determine the percentage of CD4+ and CD8+ lymphocytes in the peripheral blood. Kidney transplants were observed pathologicaly. RESULTS AND CONCLUSION:Compared with the control group, the levels of creatinine, urea nitrogen, interleukin-2, interferon-γ, parameters of oxidative stress and proteinuria were lower in the experimental group (P < 0.05). Percentages of CD4+, CD8+ and CD4+/CD8+ ratio were also significantly lower in the experimental group than the control group. However, the rate of cretinemia clearance in the experimental group was significantly higher than that in the control group (P < 0.05). Furthermore, the degree of kidney injury in the experimental group was significantly lower than that in the control group. Our findings demonstrate that the amniotic fluid stem cel transplantation can induce immune tolerance, extenuate oxidative stress, attenuate pathological damage to the kidney transplant and preserve kidney function from acute rejection in rats undergoing kidney transplantation.