In the procurement management of public hospitals, the proposal of procurement demands and the formulation of procurement budgets are completed by different departments, which can easily lead to the generation of ineffective demands. Strengthening procurement demand management has become an important management direction to promote cost reduction and efficiency increase in hospitals. The authors established a procurement demand management mechanism for public hospitals based on the KANO model. The procurement demands of public hospitals were identified according to basic, expected, charismatic, indifference, and reverse types. Then, a demand satisfaction principle that conforms to the hospital resource allocation principle was formulated, and the demand satisfaction process was supervised by establishing a risk sharing mechanism, selecting qualified decision agents, and establishing a process constraint mechanism. A certain hospital has been implementing procurement demand management practices based on this management mechanism since 2022, effectively strengthening the awareness of procurement demand management, improving the efficiency of resource allocation decision-making and the role of demand traction. This can provide reference for the procurement demand management of public hospitals.

LIN28 is an RNA binding protein with important roles in early embryo development, stem cell differentiation/reprogramming, tumorigenesis and metabolism. Previous studies have focused mainly on its role in the cytosol where it interacts with Let-7 microRNA precursors or mRNAs, and few have addressed LIN28's role within the nucleus. Here, we show that LIN28 displays dynamic temporal and spatial expression during murine embryo development. Maternal LIN28 expression drops upon exit from the 2-cell stage, and zygotic LIN28 protein is induced at the forming nucleolus during 4-cell to blastocyst stage development, to become dominantly expressed in the cytosol after implantation. In cultured pluripotent stem cells (PSCs), loss of LIN28 led to nucleolar stress and activation of a 2-cell/4-cell-like transcriptional program characterized by the expression of endogenous retrovirus genes. Mechanistically, LIN28 binds to small nucleolar RNAs and rRNA to maintain nucleolar integrity, and its loss leads to nucleolar phase separation defects, ribosomal stress and activation of P53 which in turn binds to and activates 2C transcription factor Dux. LIN28 also resides in a complex containing the nucleolar factor Nucleolin (NCL) and the transcriptional repressor TRIM28, and LIN28 loss leads to reduced occupancy of the NCL/TRIM28 complex on the Dux and rDNA loci, and thus de-repressed Dux and reduced rRNA expression. Lin28 knockout cells with nucleolar stress are more likely to assume a slowly cycling, translationally inert and anabolically inactive state, which is a part of previously unappreciated 2C-like transcriptional program. These findings elucidate novel roles for nucleolar LIN28 in PSCs, and a new mechanism linking 2C program and nucleolar functions in PSCs and early embryo development.
Animals ; Cell Differentiation ; Embryo, Mammalian/metabolism* ; Embryonic Development ; Mice ; Pluripotent Stem Cells/metabolism* ; RNA, Messenger/genetics* ; RNA, Ribosomal ; RNA-Binding Proteins/metabolism* ; Transcription Factors/metabolism* ; Zygote/metabolism*

Spinal cord injury has a high rate of disability in clinical practice, which can be divided into complete SCI and incomplete SCI according to different injury segments and severity.The main purpose of treatment is to protect the nerves.At present, acute spinal cord injury is mainly treated with surgical decompression, neurotrophic treatment, hormone therapy, hypothermia therapy, rehabilitation intervention and other clinical comprehensive treatment.In recent years, breakthroughs have been made in the field of endogenous and exogenous neural stem cell research, and important progress has been made in the basic research of stem cell transplantation.In the long run, nerve regeneration and nerve modulation may be the most promising therapy for the repair of spinal cord injury.

Background: High concentrations of particulate matter less than 2.5 μm in diameter (PM2.5) in poultry houses is an important cause of respiratory disease in animals and humans. Pseudomonas aeruginosa is an opportunistic pathogen that can induce severe respiratory disease in animals under stress or with abnormal immune functions. When excessively high concentrations of PM2.5 in poultry houses damage the respiratory system and impair host immunity, secondary infections with P. aeruginosa can occur and produce a more intense inflammatory response, resulting in more severe lung injury. Objectives: In this study, we focused on the synergistic induction of inflammatory injury in the respiratory system and the related molecular mechanisms induced by PM2.5 and P. aeruginosa in poultry houses. Methods: High-throughput 16S rDNA sequence analysis was used for characterizing the bacterial diversity and relative abundance of the PM2.5 samples, and the effects of PM2.5 and P. aeruginosa stimulation on inflammation were detected by in vitro and in vivo. Results: Sequencing results indicated that the PM2.5 in poultry houses contained a high abundance of potentially pathogenic genera, such as Pseudomonas (2.94%). The lung tissues of mice had more significant pathological damage when co-stimulated by PM2.5 and P. aeruginosa, and it can increase the expression levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α through nuclear factor (NF)-κB pathway in vivo and in vitro. Conclusions The results confirmed that poultry house PM2.5 in combination with P. aeruginosa could aggravate the inflammatory response and cause more severe respiratory system injuries through a process closely related to the activation of the NF-κB pathway.

Herpesvirus infections in Cervidae are a serious threat affecting some deer species worldwide. In our attempt to identify malignant catarrhal fever-associated herpesviruses in deer herds, ten gammaherpesviral DNA fragments were identified in five species of deer in herds in China by using a pan-herpesvirus polymerase chain reaction assay targeting viral DNA polymerase. Notably, in sambar (Rusa unicolor), a novel gamma-2 herpesvirus was identified that showed a close relationship with fallow deer lymphotropic herpesvirus (LHV), while the other fragments were phylogenetically grouped together with Elk-LHV. Determination of whether these viruses have any clinical implication in these deer species should be undertaken urgently.
Animals ; Cattle ; China ; Deer ; DNA ; DNA, Viral ; Herpesviridae Infections ; Herpesviridae ; Malignant Catarrh ; Polymerase Chain Reaction

Objective To conduct an epidemiological investigation on a case of familial arsenic poisoning in Yunnan Province,to find arsenic poisoning source and create a archive of typical cases,in order to raise awareness of endemic arsenicosis and provide scientific materials for prevention and treatment of the disease.Methods In Xiaxiaoying Village of Yunnan Province,all members of a family with arsenic poisoning patients were investigated in 2013,their health examination and epidemiological survey of arsenic poisoning were carried out,and arsenic poisoning family profiles and personal files were established.Drinking water,hair and urine samples were collected for arsenic content determination,blood samples were collected for biochemical detection,excessively keratose skin was collected for pathological biopsy.Results A total of 33 family members were investigated.Among them 15 were exposed to arsenic and 18 were not exposed to arsenic.Fifteen people exposed to arsenic were found to be have skin lesions,and two eldest males died of skin cancer and cerebral hemorrhage in 1994 and 2009,respectively.The survey found out that 15 patients born in 1935-1983 had been drinking arsenic pesticides polluted well water for 5 to 16 years from 1973 to 1989.As of 2013,the arsenic exposure had been stopped for 24 years,the content of arsenic in the polluted wells was 0.624 mg/L,which was 62.4 times the recommended maximum limit (0.01 mg/L) of the World Health Organization.The median of hair and urinary arsenic in arsenic exposed population and non-arsenic exposed population was 4.2,3.7 mg/kg and 60.9,41.0 μg/L,respectively.There was no statistically significant difference in hair arsenic (Z =-1.905,P ＞ 0.05),but the difference of urinary arsenic was statistically significant (Z =-3.002,P ＜ 0.05).The median of aspartate aminotransferase (AST),gammaglutamyltransferase (γ-GT) and 24 hours urinary ereatinine (Cr) in arsenic exposed population and non-arsenic exposed population was 37.5,31.0 U/L,25.5,12.0 U/L,13 834.0,and 6 843.0 μmol/L,respectively.The differences between the two groups were statistically significant (Z =-2.776,-2.311,-2.502,P ＜ 0.05).Twelve cases of arsenic poisoned patients who were conducted health examination and epidemiological investigation showed typical triad of skin,among them 2 cases were moderate and 10 cases were severe.Pathological biopsy results showed 8 cases had basal cell carcinoma or squamous cell carcinoma.Conclusions Drinking arsenical pesticide contaminated water can induce chronic arsenic poisoning,even after the cessation of arsenic exposure.We should pay close attention to its long-term serious harmful effect.

OBJECTIVE:To provide reference for further comprehensive evaluation of the improvement of the accessibility of family medicines after the implementation of the new health care reform. METHODS:Sampled as 180 households from 2 urban ar-eas,2 counties and 2 rural areas in Chengdu,a questionnaire survey was adopted based on the WHO’s manual for the Household Survey to Measure Access and Use of Medicines to investigate the situation of drug use,storage and accessibility,and the results were statistically analyzed. RESULTS:Totally 180 questionnaires were sent out,179 were effectively received with effective recov-ery of 99.44%. In the terms of medicines taken for the acute illness,there were more than 60% rural households obtained drugs from the public health care facilities,while more than 60% counties households purchased drugs in public medical and health insti-tutions;in the terms of medicines taken for the chronic illness,the proportion of households reporting a chronic illness who did not take any medicines was low(3.80%);in terms of medicines storage,the proportion of households without reserve drugs was low (13.41%). In terms of drug accessibility,the proportions of respondents who agreed that the location and opening hours of their public healthcare facility were convenient were high;there was no situation for“patients did not take prescribed drugs because med-icines were not available at the healthcare facility and drug store”,while more than 95% respondents who agreed that drugs were available at their public health care facilities and drug stores;the essential medicines in the household use of chronic drugs in Chengdu accounted more than 60%;more than 85% can afford the drug costs,while the proportion of the monthly costs for acute illness and chronic illness in the total month costs was low;the health insurance coverage reached 90% in the survey households, but the proportions of households which could reimburse acute,chronic illness drug cost were lower(14.13% and 12.66%). CON-CLUSIONS:At present,the level of drug accessibility in Chengdu is high;the implementation of National Essential Medicines System has a positive effect on reducing the economic burden of chronic disease family. But there are shortcomings in the Medicare reimbursement levels and antibiotics use,it is suggested to take effective measures to solve it,such as exploring the stable and ef-fective medical insurance fund raising channels,improving the compensation level and the level of insurance reimbursement,formu-late and implement the corresponding antibacterial drugs supervision system and regulate the rational use of antibiotics in residents.

Objective to observe the correlation between the expression and prognosis of osteosarcoma Insulin-like growth factor receptor(IGF1R),explore the factors affecting the prognosis of patients with osteosarcoma.Methods between January 2005 and April 2014 menstrual standardized comprehensive treatment of 60 cases of patients with stage ⅡB osteosarcoma were retrospectively analyzed.Using immunohistochemical method,the detection of osteosarcoma tissue and IGF1R expression rate in normal tissue adjacent to tumors and to analyze its correlation with survival of patients with osteosarcoma and factors affecting the prognosis.Results IGF1R in the positive expression rate of osteosarcoma tissues was 80.0％ (48/60),expression in normal tissue adjacent to tumor rate was 4/8,has a statistically significant difference between (P =0.032).IGF1R positive expression in osteosarcoma tissues group median disease-free survival time and the median overall survival time were significantly lower than the negative expression group (P =0.023,P =0.040) respectively.IGF1R expression level and pathological necrosis rate of preoperative chemotherapy,the time of first visit to the lung metastasis,and the survival prognosis of patients have significant correlation (P ＜ 0.05),and age,tumor location,tumor size,the serum LDH and ALP levels,is urgent to make a diagnosis and give treatment time,factors such as operation,preoperative chemotherapy times no significant correlation (P ＞ 0.05).Condusion IGF1R positive expression rate in stage Ⅱ B osteosarcoma tissue significantly negatively correlated with the prognosis of patients with osteosarcoma,is the independent prognostic factors of patients with osteosarcoma.

The therapeutic methods for the treatment of primary liver cancer is in abundant supply, yet the prognosis far from satisfactory. The article mainly introduces the progress in hepatectomy, liver transplantation, ablation therapy, interventional therapy, radiotherapy, drug therapy, and biological immunity in the treatment of primary liver cancer, and it also briefs us on the multidisciplinary and comprehensive treatment of primary liver cancer, believing that comprehensive treatment is the key to improving the overall response of primary liver cancer by giving full play to the superiority of each treatment and achieving the optimal therapeutic effect.

Background: The side effects of glucocorticoid in treatment of systemic lupus erythematosus (SLE) have been the focus of debate, and our preliminary study indicates that ginsenosides can enhance the efficacy of dexamethasone. Objective: To observe the effects of ginsenosides combined with prednisone in SLE patients. Design, setting, participants and interventions: A total of 60 SLE patients from Department of Rheumatology and Immunology, Changhai Hospital, Second Military Medical University, were randomly divided into treatment group and control group, with 30 patients in each group. Patients in the treatment group were given routine treatment with prednisone plus ginsenosides, while those in the control group were given routine treatment with prednisone plus placebo. They were all treated for 3 months. Main outcome measures: After three-month treatment, syndrome score in traditional Chinese medicine (TCM), total response rate and symptom improvement rate were measured and evaluated. Results: Twenty-eight cases in treatment group and twenty-seven cases in control group were included in analysis. The total response rates in the treatment group and control group were 89.28% and 66.67% respectively, and there was a significant difference between the two groups (P<0.05). After treatment, the TCM syndrome scores in the two groups were lower than those before treatment (P<0.01), and prednisone plus ginsenosides was better in decreasing the TCM syndrome score than prednisone plus placebo (P<0.05). The symptoms were improved in the treatment group as compared with the control group (P<0.05). Conclusion: Prednisone combined with ginsenosides can increase the clinical effective rate and improve the clinical symptoms of SLE patients.