Promoting health knowledge and improving the public's health literacy is an inherent requirement of the Healthy China Initiative.In the era of deepening implementation of the Healthy China strategy and rapid development of all media,large public hospitals play an irreplaceable and important role in leading the popularization of health knowledge and impro-ving the quality of information.However,in the process of carrying out health popularization work,many hospitals still face prob-lems such as lack of a regular working mechanism,lack of comprehensive team building,and lack of differentiated operation strategies.In response to these problems,the First Affiliated Hospital of Sun Yat-sen University has established a health populari-zation working mechanism led by the Party organization and coordinated at all levels,and has innovated in terms of personnel team,platform construction,content creation,and expression form,exploring a new model of health popularization work to pro-vide reference for other hospitals.

The incidence rate of biliary tract cancer is increasing year by year. Systemic therapy is the most important treatment for patients with advanced or unresectable biliary tract cancer. Gemcitabine combined with cisplatin is still the standard first-line chemotherapy, while gemcitabine combined with TS-1 and gemcitabine combined with nab-paclitaxel are also the first-line treatment options. Studies have confirmed that immunotherapy as a back-line treatment has a significant advantage in survival, and the disease control rate of nivolumab is 61% and the median overall survival is more than 1 year. In addition, targeted drugs targeting FGFR2, IDH1/2, HER-2 and other major driving genes of biliary tract cancer also show good antitumor activity, and become research hotspots in the treatment of advanced biliary tract cancer. Summarizing the research progress of systematic chemotherapy, immunotherapy and molecular targeted therapy for advanced biliary tract cancer can provide help for clinical practice.

Objective:To investigate epithelial-mesenchymal transition and to explore the effects of mitochondrial dysfunction and increased expression of TGF-β1 pathway on epithelial-mesenchymal transition (EMT) in pancreatic adenocarcinoma after X-ray irradiation.Methods:Split-dose irradiations of total 40 Gy (2 Gy × 20 and 4 Gy × 10) of 6 MV X-rays were performed on PATU1 988 t cells. The migration of the cells were examined through transwell filter chambers. Real-time PCR was adopted to detect the expression of EMT-related factors E-cadherin, Vimentin, N-cadherin, and MMPs (MMP2 and MMP9), critical subunits of mitochondrial complex I, and TGF-β1. The expression of EMT-related factors and content of TGF-β1 was detected after carbonylcyanide-m-chlorophenylhydrazone(CCCP) treatment. Meanwhile, the migration potential of pancreatic cells was detected after small interfering RNA (siRNA) knockdown of the expression of TGF-β1.Results:After irradiation, the migration capacities of the cancer cells increased ( t=21.90, 35.64, P<0.05). The expression of N-cadherin ( t=4.42, 4.77, P<0.05), Vimentin ( t=4.57, 3.02, P<0.05), MMP2 ( t=7.27, 26.08, P<0.05), and MMP9 ( t=13.26, 7.29, P<0.05) all increased, while the expression of E-cadherin deceased ( t=8.37, 6.77, P<0.05). The expression of TGF-β1 ( t=90.49, 35.17, P<0.05) increased. The expression of TGF-β1 decreased with small interfering RNA, which paralleled the inhibition of the epithelial-mesenchymal transition and migration ( t=38.66, 11.54, P<0.05). Mitochondrial dysfunction was reflected by the decline in the membrane potential ( t=6.94, 29.71, P<0.05) and complex-related subunits. The expression of TGF-β1 ( t=47.93, P<0.05) and EMT-related factors further increased after mitochondrial function was destroyed ( t=16.51, P<0.05). Conclusions:Radiation-induced mitochondrial dysfunction can increase the expression of TGF-β1, which promotes epithelial-mesenchymal transition, and result in the migration of pancreatic cancer cell line.

Objective: To investigate the relationship between systemic inflammatory markers such as neutrophil/lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CAR), and lymph node metastasis in patients with cN0 gastric cancer. To establish a nomogram model to predict the risk of lymph node metastasis in patients with cN0 gastric cancer. Methods: The preoperative systemic inflammatory markers and clinical data of 134 patients with cN0 gastric cancer were retrospectively analyzed, and these markers of patients with negative (pN0) or positive (pN+ ) lymph node metastasis in postoperative pathological diagnosis were compared. The receiver operating characteristic (ROC) curve was used to evaluate the predictive effect of preoperative systemic inflammatory markers on lymph node metastasis. The influencing factors for lymph node metastasis were assessed by univariate analysis and multivariate logistic regression analysis. A nomogram subsequently established by R software was validated by Bootstrap resampling as internal validation. Results: Compared with pN0 group, NE (P=0.022), CRP (P<0.001), NLR (P<0.001), PLR (P=0.003) and CAR (P<0.001) were higher, LY (P=0.003) and Alb (P=0.042) were lower in pN+ group. ROC curve analysis showed that the area under the curve (AUC) of postoperative pathological lymph node metastasis in patients with cN0 gastric cancer diagnosed by NLR, PLR and CAR were 0.687, 0.651 and 0.694, respectively, and the best cutoff values were 2.12, 113.59 and 0.02, respectively. The corresponding sensitivity and specificity were 62.9% and 72.2%, 77.4% and 48.6%, 74.2% and 58.3%, respectively. Univariate analysis showed that tumor size, depth of invasion, NLR, PLR and CAR were associated with lymph node metastasis in cN0 gastric cancer patients (all P<0.05). Multivariate analysis showed that depth of invasion, NLR and CAR were independent influencing factors of lymph node metastasis in patients with cN0 gastric cancer. OR were 8.084, 3.540 and 3.092, respectively (all P<0.05). The C-index of the nomogram model was 0.847 (95% CI: 0.782-0.915). The predicting calibration curve was properly fit with the ideal curve in calibration chart. Conclusion Combination of NLR and CAR to establish a nomogram model has a good consistency and can accurately predict the risk of lymph node metastasis in patients with cN0 gastric cancer.

Objective To investigate the relationship between systemic inflammatory markers such as neutrophil／lymphocyte ratio ( NLR) and C?reactive protein／albumin ratio ( CAR ), and lymph node metastasis in patients with cN0 gastric cancer. To establish a nomogram model to predict the risk of lymph node metastasis in patients with cN0 gastric cancer. Methods The preoperative systemic inflammatory markers and clinical data of 134 patients with cN0 gastric cancer were retrospectively analyzed, and these markers of patients with negative ( pN0 ) or positive ( pN+) lymph node metastasis in postoperative pathological diagnosis were compared. The receiver operating characteristic ( ROC ) curve was used to evaluate the predictive effect of preoperative systemic inflammatory markers on lymph node metastasis. The influencing factors for lymph node metastasis were assessed by univariate analysis and multivariate logistic regression analysis. A nomogram subsequently established by R software was validated by Bootstrap resampling as internal validation. Results Compared with pN0 group, NE (P＝0.022), CRP (P＜0.001), NLR (P＜0.001), PLR (P＝0.003) and CAR ( P＜0.001) were higher, LY ( P＝0.003) and Alb ( P＝0.042) were lower in pN+ group. ROC curve analysis showed that the area under the curve ( AUC) of postoperative pathological lymph node metastasis in patients with cN0 gastric cancer diagnosed by NLR, PLR and CAR were 0.687, 0.651 and 0.694, respectively, and the best cutoff values were 2.12, 113.59 and 0.02, respectively. The corresponding sensitivity and specificity were 62.9% and 72.2%, 77.4% and 48.6%, 74.2% and 58.3%, respectively. Univariate analysis showed that tumor size, depth of invasion, NLR, PLR and CAR were associated with lymph node metastasis in cN0 gastric cancer patients ( all P＜0.05). Multivariate analysis showed that depth of invasion, NLR and CAR were independent influencing factors of lymph node metastasis in patients with cN0 gastric cancer. OR were 8.084, 3.540 and 3.092, respectively ( all P＜0.05). The C?index of the nomogram model was 0.847 (95% CI: 0.782?0.915). The predicting calibration curve was properly fit with the ideal curve in calibration chart.Conclusion Combination of NLR and CAR to establish a nomogram model has a good consistency and can accurately predict the risk of lymph node metastasis in patients with cN0 gastric cancer.

Objective To investigate the relationship between systemic inflammatory markers such as neutrophil／lymphocyte ratio ( NLR) and C?reactive protein／albumin ratio ( CAR ), and lymph node metastasis in patients with cN0 gastric cancer. To establish a nomogram model to predict the risk of lymph node metastasis in patients with cN0 gastric cancer. Methods The preoperative systemic inflammatory markers and clinical data of 134 patients with cN0 gastric cancer were retrospectively analyzed, and these markers of patients with negative ( pN0 ) or positive ( pN+) lymph node metastasis in postoperative pathological diagnosis were compared. The receiver operating characteristic ( ROC ) curve was used to evaluate the predictive effect of preoperative systemic inflammatory markers on lymph node metastasis. The influencing factors for lymph node metastasis were assessed by univariate analysis and multivariate logistic regression analysis. A nomogram subsequently established by R software was validated by Bootstrap resampling as internal validation. Results Compared with pN0 group, NE (P＝0.022), CRP (P＜0.001), NLR (P＜0.001), PLR (P＝0.003) and CAR ( P＜0.001) were higher, LY ( P＝0.003) and Alb ( P＝0.042) were lower in pN+ group. ROC curve analysis showed that the area under the curve ( AUC) of postoperative pathological lymph node metastasis in patients with cN0 gastric cancer diagnosed by NLR, PLR and CAR were 0.687, 0.651 and 0.694, respectively, and the best cutoff values were 2.12, 113.59 and 0.02, respectively. The corresponding sensitivity and specificity were 62.9% and 72.2%, 77.4% and 48.6%, 74.2% and 58.3%, respectively. Univariate analysis showed that tumor size, depth of invasion, NLR, PLR and CAR were associated with lymph node metastasis in cN0 gastric cancer patients ( all P＜0.05). Multivariate analysis showed that depth of invasion, NLR and CAR were independent influencing factors of lymph node metastasis in patients with cN0 gastric cancer. OR were 8.084, 3.540 and 3.092, respectively ( all P＜0.05). The C?index of the nomogram model was 0.847 (95% CI: 0.782?0.915). The predicting calibration curve was properly fit with the ideal curve in calibration chart.Conclusion Combination of NLR and CAR to establish a nomogram model has a good consistency and can accurately predict the risk of lymph node metastasis in patients with cN0 gastric cancer.

Rectal cancer is one of the most common malignant tumor in our country,among them with highest incidence of low rectal cancer.With the further study on the biological behavior of rectal cancer and the development of diagnostic and therapeutic techniques,gastrointestinal oncologists have proposed a new treatment strategy-local resection and wait-and-see.This strategy can better preserve anal function and improve the quality of life of patients without losing the good tumor control of the traditional standard treatment model.

Staphylococcus aureus, or methicillin-resistant S. aureus (MRSA), is a significant pathogen in both nosocomial and community infections. Community-associated MRSA (CA-MRSA) strains tend to be multi-drug resistant and to invade hospital settings. This study aimed to assess the antimicrobial resistance and molecular characteristicsof nasal S. aureus among newlyadmitted inpatients.In the present study, 66 S. aureus isolates, including 10 healthcare-associated MRSA (HA-MRSA), 8 CA-MRSA, and 48 methicillin-sensitive S. aureus (MSSA) strains, were found in the nasal cavities of 62 patients by screening 292 newlyadmitted patients. Antimicrobial resistance and molecular characteristics of these isolates, including spa-type, sequence type (ST) and SCCmec type, were investigated. All isolates were sensitive to linezolid, teicoplanin, and quinupristin/dalfopristin, but high levels of resistance to penicillin and erythromycin were detected. According to D-test and erm gene detection results, the cMLSB and iMLSB phenotypes were detected in 24 and 16 isolates, respectively. All 10 HA-MRSA strains displayed the cMLSB phenotypemediated by ermA or ermA/ermC, while the cMLSB CA-MRSA and MSSA strains carried the ermB gene. Molecular characterization revealedall 10 HA-MRSA strains were derived from the ST239-SCCmec III clone, and four out of eight CA-MRSA strains were t437-ST59-SCCmec V. The results suggest that patients play an indispensable role in transmitting epidemic CA-MRSA and HA-MRSA strains.
Anti-Bacterial Agents/*pharmacology ; Bacterial Proteins/genetics ; Drug Resistance, Multiple, Bacterial/genetics ; Humans ; Inpatients ; Methicillin-Resistant Staphylococcus aureus/*drug effects/genetics/isolation & purification ; Methyltransferases/genetics ; Microbial Sensitivity Tests ; Nasal Cavity/*microbiology ; Staphylococcal Infections/diagnosis/microbiology ; Staphylococcus aureus/*drug effects/genetics/isolation & purification

Objective To explore a clear picture of the health human resources allocation in tertiary general hospitals in Beijing ,and propose strategies to optimize the configuration of human resources at the same level hospitals ,so as to improve the medical service quality for society. Methods Basic operational data and human resources configuration of 16 tertiary general hospitals with more than 800 beds in Beijing were col?lected by using clustering sampling and literature review ,and then a descriptive analysis of the human resource configuration data at the same level hospitals was carried out by SPSS18.0 and Excel2010. Results The number of patients increased year by year,but the average days of hospitaliza?tion showed a downward trends during 2009?2011. According to the previous way of beds to determine personnel ,there was significantly different from the actual situation. A significant quantitative correlation was foung between the physicians and the nurses,pharmacists,medical laboratory technician,and the ratio between physicians and these staffs is stable. Conclusion With the development of hospital service and increase of health human resources,health manpower ratio has changed significantly in tertiary general hospitals. A stable proportion of physicians can be used as the reference standard for hospital human resources configuration at the same level hospitals.

Objective To analyze the concept of Peabody Developmental Motor Scale-Fine Motor (PDMS-FM). Methods Concept con-tained in each item of PDMS-FM was discussed and determined by 3 rehabilitation physicians or therapists. They were linked to the catego-ries of International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) by 2 rehabilitation physi-cians according to the linking rules after discussion. Third party intervened informally if there was a disagreement. Results Ninety-eight items from the PDMS-FM linked to 21 categories of the 3rd level within 13 categories of the 2nd level, belong to b1 Mental Functions, b7 Neuromusculoskeletal and Movement-related Functions, d1 Learning and Applying Knowledge, d4 Activities and d5 Self-care, a total of 5 categories of the 1st level. Eighty items linked to d4, and 40 items linked to d1. Conclusion PDMS-FM mainly focuses on the activities, es-pecially Carrying, Moving and Handling Objects and Basic Learning of Learning and Applying Knowledge.