Objective To construct and identify a patient-derived organoid model,and to investigate the sensitivity of chemotherapy drugs using this model.Methods Pancreatic cancer cells were obtained from the surgical specimens of two female patients with a confirmed diagnosis of pancreatic cancer after tumor tissue digestion,and then the cells were inoculated into a culture dish using matrigel for three-dimensional culture.Paraffin sections were prepared for HE staining and immunohistochemical staining and were compared with the parent tumor tissue to determine whether the histopathological features of the tumor in vivo were preserved.The pancreatic cancer organoids were treated with seven chemotherapy drugs at different concentrations;Cell Titer-Glo?3D reagent was used to measure cell viability,and the results of drug sensitivity were analyzed.Results Two patient-derived pancreatic cancer organoids were successfully constructed,and HE staining and immunohistochemical staining showed that the pancreatic cancer organoids had consistent histopathological features with the tumors of the corresponding patient.Both pancreatic cancer organoids were more sensitive to gemcitabine monotherapy and the combination of oxaliplatin+SN38+fluorouracil,and patient 1 was more sensitive than patient 2.There were individual differences in the response to drugs between the organoids from different patients.Conclusion The pancreatic cancer organoid model successfully constructed in this study can reflect the histological classification of parent pancreatic tumors and can be used for in vitro chemotherapy drug sensitivity test,which is expected to provide a reference for clinical medication.

Objective To explore the distribution characteristics of endogenous metabolites in Crocus sativus L. corms from different origins. Methods A method based on desorption electrospray ionization mass spectrometry imaging and optimized sample pretreatment was developed for directly visualize metabolites in C. sativus corms. Results In situ characterization of metabolites such as flavonoids, organic acids, amino acids, carotenoids, and cyclic enol ether terpene glycosides was achieved. L-Citruline, phenylacetylglycine, sativol, and geniposide were specifically distributed in the corms. Apigenin 7-（6''-O-acetyl）-glucoside, isorhamnetin-3-O-β-D-Glucoside, dhurrin 6'-glucoside, and Apigenin 7-O-diglucuronide were mainly distributed in the terminal bud. For compounds distributed in the corms, the highest abundance was found in corms from Shanghai, followed by Zhejiang and the lowest from Anhui. Conclusion The distribution of metabolites in different parts of C. sativus corms from different origins and the same origin varies significantly. Flavonoids and flavonoid derivatives such as isorhamnetin-3-O-β-D-Glucoside and apigenin derivatives are mainly distributed in the terminal buds, in addition, the natural plant protection agent dhurrin 6'-glucoside is also mainly distributed in the terminal corms, whereas amino acids, which are used as energy and material supplies, are mainly accumulated in the corms.

Kingella kingae (K. kingae) is a facultative anaerobic gram-negative bacterium that primarily colonizes the oropharynx of infants and young children. The difficulty of isolating this organism using traditional culture methods has led to underreporting, especially in developing countries. Advances in nucleic acid amplification tests, including 16S rRNA PCR and specific PCR for K. kingae, have significantly enhanced detection sensitivity in Western developed countries. K. kingae is now recognized as the leading pathogen in osteoarticular infections (OAIs) among children aged 6-48 months, overtaking Staphylococcus aureus (S. aureus). Children affected by K. kingae OAIs often present with septic arthritis and osteomyelitis, and occasionally with conditions such as pyogenic spondylitis/discitis, pyogenic tenosynovitis, pyogenic sacroiliitis, and chest wall osteoarticular infections. These infections generally exhibit a slow progression, mild to moderate symptoms, and respond well to effective antibiotic therapy, resulting in favorable outcomes. Given the challenges of obtaining joint fluid or purulent samples from young children without anesthesia, some scholars recommend predictive models based on serological results or imaging examinations to identify K. kingae infections. However, these methods have practical limitations. Most K. kingae-related OAIs can be managed non-surgically with intravenous antibiotic therapy. In regions where K. kingae identification is feasible, β-lactam antibiotics are the treatment of choice. Otherwise, empirical therapy should cover both K. kingae and S. aureus, particularly in children aged 6-48 months. In areas with a high prevalence of methicillin-resistant S. aureus, combination therapy with vancomycin may be warranted. Investigating the carriage rate of K. kingae among Chinese children and its detection rate in OAIs could simplify treatment procedures, improve outcomes, and optimize antibiotic use, highlighting its significant clinical importance.

Objective:To estimate the diagnostic value of anti-cyclic citrullinated peptide (CCP) antibody for juvenile idiopathic arthritis (JIA) by Meta-analysis.Methods:The databases, including Wanfang Database, VIP citation databases, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc, Excerpta Medica Database (EMbase), PubMed, Cochrane Library, were searched for the studies related to the diagnostic value of anti-CCP antibody for JIA. After extracting literature data and assessing the articles by Quality Assessment of Diagnostic Accuracy Studies tool. The sources of heterogeneity, sensitivity (SEN), specificity (SPE), area under the curve (AUC) were calculated by the summary receiver operator characteristic (SROC) curve by Stata 12.0 software.Results:A total of 30 literature reports were included in this Meta-analysis. The heterogeneity and the threshold effect of the included articles were tested, a mixed effects model was selected to calculate the pooled weighted SEN [0.16, 95% CI(0.11, 0.22)], SPE [0.99, 95% CI(0.98, 0.99)] and AUC [0.86, 95% CI(0.83, 0.89)]. The sensitivity estimates were highly heterogeneous, which was partially explained by the higher sensitivity in the rheumatoid factor-positive polyarthritis (RF+PA) subtypes [0.65, 95% CI (0.51, 0.76)] than in the other subtypes. The ability of diagnostic differentiation between of JIA and healthy children was better than the diagnostic differentiation between JIA and other patients ( Z=7.9, P<0.01). Conclusion:Although anti-CCP antibody cannot be used as an early diagnostic indicator of JIA, it can provide a certain guiding role in the initial screening and early treatment of the disease. CCP has clinical value in the differential diagnosis of RF+PA subtypes.

Objective To study doctor-patient interest demands satisfaction and its influencing factors of the payment system reform of the new rural cooperative medical care scheme to provide reference for the reform. Methods Cross-sectional survey was conducted from September 2016 to February 2017. Multi-stage stratified random sampling was used in six counties of three provinces in the eastern, middle and western regions of China, and mathematical statistics was applied to analyze the data. Results The doctor-patient overall interest demands satisfaction was high, but the satisfaction was lower both with the income and ability improvement of medical staff and with the benefits of farmers. The influencing factors of the satisfaction of managers in medical institutions included the type of payment, educational level and work unit (P＜0.05). The influencing factors of medical staff's satisfaction included the type of payment, work unit, and working years among others(P＜0.05). The influencing factors of farmers'satisfaction included the type of payment and the average annual income, etc(P＜0.05). Conclusions The core interest demands of both doctors and patients should be valued to enhance their satisfaction. Diseases related groups should be promoted and applied scientifically, and appropriately integrated with other methods of payment. Both doctors and patients'understanding of the payment reform should be improved by propaganda and training, to get their support and cooperation.

Based on synergetics, system theory and dissipative structure theory, the connotation and composition of the compound system of rural public health service in country area are described in the paper. The authors proposed that the synergy degree model of the compound system for rural public health service in county areas comprises the order degree model and the synergy degree model of the compound system, which are composed of such subsystems as functionality, service network, demand, and economy. They also probed into the evaluation method for synergy degree and built the measuring index system of synergy degree comprising 59 level-2 evaluation indicators.

Objective To measure and analyze the order degree of the internal subsystems and the synergetic degree of the compound system of rural public health service in county areas based on the synergy model of the compound system. Methods According to the distribution of eastern, central and western regions in China, Xiangshan county in Zhejiang province, Wuzhi county in Henan province and Bin county in Shaanxi province were sampled. Based on the index system of synergetic degree measurement including the 52 level-2 evaluation indicators, a questionnaire survey was used to measure the synergetic degree of the compound system of rural public health service in county areas. Results The highest synergetic degrees of the compound system of rural public health service in Xiangshan county, Wuzhi county and Bin county were only 0. 18153, 0. 18068 and 0. 21312 respectively. This indicated the synergy at a low degree. And the synergy of the supply-demand system was an important influential factor for synergy of this compound system, as their development trends were consistent basically. Conclusions The synergy model of the compound system can play a useful role in rural public health service system in county areas. The demand of rural residents deserves more attention and the difference between the service supply and demand should be reduced.

Objective:To investigate the role of phosphatase PP2CB in the innate immunity against RNA virus and the underlying mechanism.Methods:PP2CB expression in macrophages was silenced with the specific siRNA.The mRNA and protein expression level of type Ⅰ interferon was detected by Q-PCR and ELISA respectively.The phosphorylation level of TBK1 and IRF3 was analyzed by Western blot.Results:RNA virus VSV infection led to the expression change of PP2CB.Overexpression of PP2CB dose-dependently inhibited the activation of IFN-β reporter gene.PP2CB silencing by PP2CB siRNA significantly promoted the production of type Ⅰ interferon triggered by RNA virus VSV or SeV,and inhibited the replication of VSV in macrophages.Furthermore,PP2CB bound TBK1 upon RNA virus infection.PP2CB silencing up-regulated the phosphorylation level of TBK1 and IRF3.Conclusion:Upon RNA virus VSV or SeV infection,phosphatase PP2CB binds TBK1 and inhibits its phosphorylation to negatively regulate the activation of the antiviral innate immune signal pathway,which consequently suppresses the production of type Ⅰ interferon triggered by RNA virus VSV or SeV.

Objective To evaluate the clinical efficacy of staged treatment of complex tibial plateau fractures with temporary transarticular external fixation and delayed plate fixation.Methods Enrolled in this study were 44 cases of complex tibial plateau fracture who had been treated from January 2011 to January 2014.Temporary transarticular external fixation and delayed plate fixation was adopted in 22 patients (observation group),involving 14 men and 8 women with an average age of 45.5 ± 11.4 years,and 10 left sides and 12 right sides.By the Schatzker classification,13 cases were type Ⅴ and 9 type Ⅵ.Calcaneal traction and plate fixation was adopted in the other 22 patients (control group),involving 13 men and 9 women with an average age of 43.8 ± 10.4 years,and 8 left sides and 14 right sides.By the Schatzker classification,12 cases were type Ⅴ and l0 type Ⅵ.The 2 groups were evaluated by the time from hospitalization to plate fixation,operation time,intra-operative bleeding volume,hospitalization time,healing time,complications and Hospital for Special Surgery (HSS) scoring at the final follow-ups.The 2 groups were compatible with no significant differences regarding the preoperative general data (P ＞ 0.05).Results The 44 patients were followed up for 12 to 30 months (mean,18.6 months).There were significant differences between the 2 groups in the time from hospitalization to plate fixation,operation time,intra-operative bleeding volume and hospitalization time (P ＜ 0.05).There was also a significant difference in the complications rate (4.5％ (1/22) for the observation group versus 27.3％ (6/22) for the control group) (P ＜ 0.05),but there was no significant difference in the good to excellent rate by HSS scoring [86.3％ (19/22) versus 81.8％ (18/22)] (P ＞ 0.05).Conclusions Although both methods can treat complex tibial plateau fractures,temporary transarticular external fixation and delayed plate fixation may be preferable because it can lead to decreased hospitalization time,less intra-operative bleeding volume,fewer surgical complications and good functional recovery of the knee.

The γc cytokines play an important role in proliferation and survival of T cells. Blocking the γc signals can cause the activated donor-reactive T cells losing the ability to proliferate, and getting into apoptosis pathway, which contributes to induction of the peripheral tolerance. In this study, we induced the transplant tolerance through blocking the γc in combination with donor-specific trans-fusion (DST) in the cardiac transplantation. Following DST, on the day 2, 4 and 6, C57BL/6 recipients received anti-γc monoclonal antibodies (mAbs) injection, and those in control group were not given anti-γc mAbs. On the day 7, Balb/c cardiac allografts were transplanted. All recipients in experimental group accepted cardiac allografis over 30 days, and two of them accepted allografis without rejection until sacrifice on the 120 day. Animals only receiving DST rejected gratis within 5 days, and the mice receiving cardiac transplantation alone rejected gratis within 9 days. Our study showed that blockade of γc signaling combined with DST significantly prolonged allografi survival, which was probably associated with inhibition of antigen-specific T-cell proliferation and induction of apoptosis.