[Purpose]To investigate the choice of medical institutions for the first-treatment of can-cer patients after diagnosis and the factors influencing it,so as to provide a reference basis for the rational allocation of health resources and the promotion of hierarchical diagnosis and treatment of cancer.[Methods]A total of 1 140 common cancer patients from 1 provincial,3 municipal and 6 county-level medical institutions in Shandong Province were included in the study,and a ques-tionnaire survey was conducted on their basic personal information and the selection of medical institutions.Chi-square test and Fisher exact test were used to compare different groups,and mul-ti-classification unordered Logistic regression were used to explore the factors influencing the se-lection of cancer patients.[Results]1 077 valid questionnaires were collected.The selection rates of first-treatment institutions for cancer patients were county hospitals(29.90％),city hospitals(35.28％),and provincial hospitals(34.82％),and the high level of medical care was the main reason for the selection of first-treatment institutions for cancer patients.The results of multi-clas-sification unordered Logistic regression showed that when choosing municipal and county medical institutions as the first treatment institution compared to choosing a county medical institution for the first treatment as a reference,compared to patients with stage Ⅰ tumors,patients with tumor stages at stage Ⅲ(OR=1.789,95％CI:1.014～3.158)and stage Ⅳ(OR=2.005,95％CI:1.179～3.409)were more likely to choose municipal medical institutions;and patients with annual house-hold income of 10 000～＜50 000 CNY(OR=0.625,95％CI:0.414～0.943)were less likely to choose mu-nicipal medical institutions compared to those with an annual household income of＜10 000 CNY.When choosing provincial and county medical institutions as the first treatment institution com-pared to patients in stage Ⅲ(OR=2.885,95％C1:1.549～5.372)and stage Ⅳ(OR=3.104,95％CI:1.724～5.586)compared to patients with stage Ⅰ tumors when choosing a county medical institu-tion for the first treatment was used as a reference;married(OR=2.248,95％CI:1.127～4.484)patients were more likely to choose provincial healthcare organizations than unmarried/divorced/widowed patients;patients with a family history of cancer compared to patients without a family history of cancer(OR=1.650,95％CI:1.115～2.441)were more inclined to choose provincial healthcare institutions;compared with patients＜45 years old,patients over 60 years old(OR=0.483,95％CI:0.242～0.962)were less inclined to choose provincial hospitals;and compared with patients who were not aware of knowledge related to cancer,those who were aware of knowledge related to cancer(OR=0.613,95％CI:0.441～0.852)patients were less inclined to choose provin-cial hospitals.[Conclusion]Vigorously carrying out publicity on cancer prevention and treatment knowledge,improving the cancer prevention and treatment literacy of cancer patients.strengthen-ing vertical cooperation among medical institutions at all levels,improving the provincial-munici-pal-county cancer prevention and treatment network,and promoting the sinking of high-quality medical resources are important ways to improve the cancer prevention and treatment capacity of counties and promote the work of hierarchical medical system.

Tic disorder is a chronic neuropsychiatric disorder with complex etiology and diverse phenotypes,and its incidence has been increasing significantly in recent years.Most scholars believe that abnormalities in the cortico-striatal-thalamo-cortical circuit and its interconnected brain regions are closely related to the development of tic disorder.Chinese materia medica intervention in tic disorders is characterized by multi-targets,multi-mechanisms and holistic nature,and has a good prospect for research application.This article summarized the experimental studies of TCM compound intervention in tic disorder in recent years,which have shown that TCM compounds could reduce the damage of nerve cells through the regulation of neurotransmitters,inflammatory response,immune function and the"colony-gut-brain axis"to improve and prevent tic disorder,which could provide a reference for the research and development of new medicines for tic disorder and for the clinical research.

[Purpose]To investigate the choice of medical institutions for the first-treatment of can-cer patients after diagnosis and the factors influencing it,so as to provide a reference basis for the rational allocation of health resources and the promotion of hierarchical diagnosis and treatment of cancer.[Methods]A total of 1 140 common cancer patients from 1 provincial,3 municipal and 6 county-level medical institutions in Shandong Province were included in the study,and a ques-tionnaire survey was conducted on their basic personal information and the selection of medical institutions.Chi-square test and Fisher exact test were used to compare different groups,and mul-ti-classification unordered Logistic regression were used to explore the factors influencing the se-lection of cancer patients.[Results]1 077 valid questionnaires were collected.The selection rates of first-treatment institutions for cancer patients were county hospitals(29.90％),city hospitals(35.28％),and provincial hospitals(34.82％),and the high level of medical care was the main reason for the selection of first-treatment institutions for cancer patients.The results of multi-clas-sification unordered Logistic regression showed that when choosing municipal and county medical institutions as the first treatment institution compared to choosing a county medical institution for the first treatment as a reference,compared to patients with stage Ⅰ tumors,patients with tumor stages at stage Ⅲ(OR=1.789,95％CI:1.014～3.158)and stage Ⅳ(OR=2.005,95％CI:1.179～3.409)were more likely to choose municipal medical institutions;and patients with annual house-hold income of 10 000～＜50 000 CNY(OR=0.625,95％CI:0.414～0.943)were less likely to choose mu-nicipal medical institutions compared to those with an annual household income of＜10 000 CNY.When choosing provincial and county medical institutions as the first treatment institution com-pared to patients in stage Ⅲ(OR=2.885,95％C1:1.549～5.372)and stage Ⅳ(OR=3.104,95％CI:1.724～5.586)compared to patients with stage Ⅰ tumors when choosing a county medical institu-tion for the first treatment was used as a reference;married(OR=2.248,95％CI:1.127～4.484)patients were more likely to choose provincial healthcare organizations than unmarried/divorced/widowed patients;patients with a family history of cancer compared to patients without a family history of cancer(OR=1.650,95％CI:1.115～2.441)were more inclined to choose provincial healthcare institutions;compared with patients＜45 years old,patients over 60 years old(OR=0.483,95％CI:0.242～0.962)were less inclined to choose provincial hospitals;and compared with patients who were not aware of knowledge related to cancer,those who were aware of knowledge related to cancer(OR=0.613,95％CI:0.441～0.852)patients were less inclined to choose provin-cial hospitals.[Conclusion]Vigorously carrying out publicity on cancer prevention and treatment knowledge,improving the cancer prevention and treatment literacy of cancer patients.strengthen-ing vertical cooperation among medical institutions at all levels,improving the provincial-munici-pal-county cancer prevention and treatment network,and promoting the sinking of high-quality medical resources are important ways to improve the cancer prevention and treatment capacity of counties and promote the work of hierarchical medical system.

Tic disorder is a chronic neuropsychiatric disorder with complex etiology and diverse phenotypes,and its incidence has been increasing significantly in recent years.Most scholars believe that abnormalities in the cortico-striatal-thalamo-cortical circuit and its interconnected brain regions are closely related to the development of tic disorder.Chinese materia medica intervention in tic disorders is characterized by multi-targets,multi-mechanisms and holistic nature,and has a good prospect for research application.This article summarized the experimental studies of TCM compound intervention in tic disorder in recent years,which have shown that TCM compounds could reduce the damage of nerve cells through the regulation of neurotransmitters,inflammatory response,immune function and the"colony-gut-brain axis"to improve and prevent tic disorder,which could provide a reference for the research and development of new medicines for tic disorder and for the clinical research.

Ischemic stroke is the second leading cause of death worldwide with limited medications and neuroinflammation was recognized as a critical player in the progression of stroke, but how to control the overactive neuroinflammation is still a long-standing challenge. Here, we designed a novel SIRT6 activator MDL-811 which remarkably inhibited inflammatory response in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages and primary mouse microglia, which were abolished by silencing SIRT6. RNA-seq screening identified the forkhead box C1 (

Objective To explore the effect of walking on residual beta cell function and glycemic control in patients with type 1 diabetes mellitus.Methods A total of 117 type 1 diabetes mellitus patients who usually walked less than 5000 steps per day were given health education about exercise and divided into three groups according to their self-estimates of the number of walking steps they had taken daily in the previous 4 months:an absent exercise group (＜ 5000 steps/day),a basic exercise group (5000-10000 steps/day) and an active exercise group (＞ 10000 steps/day).Among them,34 were in absent group (23.5％ for males),45 were in basis exercise group (40.0％ for males) and 38 were in active exercise group (52.6％ for males).Fasting C-peptide,postprandial C-peptide,and postprandial C-peptide to glucose ratio were used to evaluate the residual beta cell function,while glycated hemoglobin A1c (HbA1c) and insulin dose-adjusted HbAlc (IDAAlc) were used to evaluate their glycemic control.Results The beta cell function and glycemic control showed a tendency to improve with increases in the number of walking steps.Fasting C-peptide,postprandial Cpeptide and the postprandial C-peptide to glucose ratio also increased significantly,while HbA1c and IDAA1c decreased significantly.After balancing the initial difference in the analysis of covariance,significant differences were still found among the 3 groups in the subjects' beta cell function and glycemic control during the follow-up.Linear regression showed that a large number of steps independently predicted better beta cell function.Conclusions In patients with type 1 diabetes mellitus,walking exercise may be effective for improving residual beta cell function and glycemic control.

Aim To investigate the changes of serum metabolism after the treatment of DOA and DOO on myocardial ischemia reperfusion ( MI/R ) injury in rats, and to explore the pathogenesis of MI/R injury and drug action mechanism. Method The serum samples of Sham group, Model group, DOA group and DOO group of rats were acquired, gas phase time of flight mass spectrometry ( GC-TOF-MS) was applied to analyze the metabolic profiles of the samples. After da-ta preprocessing, they were processed into SIMCA 14. 1 software for multivariate statistical analysis. Results By principal components analysis ( PCA ) , partial least squares analysis ( PLS-DA) and orthogonal partial least squares analysis ( OPLS-DA ) , the Model group and Sham group were obviously separated, the drug in-tervention group and Model group were separated and close to Sham group. The therapeutic effect of DOO and DOA on MI/R injury in rats was proved. The ex-perimental results identified 13 endogenous biomark-ers, which were related to the glucose metabolism,lipid metabolism and amino acid metabolism pathway. Con-clusion DOA and DOO may protect the MI/R injured rats by regulating the glucose metabolism, lipid metab-olism and amino acid metabolism pathway.

Objective To develop a rapid and sensitive method for the determination of the percentage of blood chlormezanone by gas chromatograpy-mass spectrometry(GC/MS)for the clinical application on acute poisoning patients.Methods Chlormezanone in blood was extracted and separated with acetic ether.The acetic ether extractives from the blood were warmed with water at 80℃ and blown to dry with nitrogen gas.The dry extractives were then dissolved in 100?l of ethanol for GC/MS.To set up the linear equation for the determination of blood chlormezanone,draw the standard curve,calculate the extractive yield,detection limit and repeatability of chlormezanone.The GC was equipped with a 30m length,0.25mm I.D.,0.25?m film thickness HP-5MS(5% phenyl-methylpolysiloxane).Helium was used as the carrier gas at a constant flow rate of 1.0mL/min.The 1?l samples was injected GC/MS in split mode of 10∶1.The temperature program:160℃ for 2min,10℃/min up to 280℃ and hold for 10min.The injector,MS quadrupole rods,ion source and transfer line were kept at 250℃,150℃,230℃ and 280℃,respectively.The EI electron impact energy was 70eV.Results The extractive yield with acetic ether for blood chlormezanone was 82.1%,RSD=6.6%,implying that and acetic ether is an ideal extraction solvent.The calibration curve was y=13 852x+140 588,r=0.998 2.The detection limit was 4?g/L(SCAN m/z 30-280)and 0.1?g/L(SIM m/z 98,152,154).The RSD of precision in one day was 2.6%.The RSD of the precision between days was 4.9%.Conclusions The extraction and analysis method is suitable to the diagnosis of the acute poisoning patient of chlormezanone.