Objective To explore the factors that affect the coordinated development of blood banks and apheresis plas-ma collection banks(hereinafter referred to as plasma banks),and explore feasible measures for the coordinated develop-ment of blood banks and plasma banks.Methods The blood information management system and blood source information management system were used to retrieve related data of blood and plasma donation from 9 cities in Shandong province from 2017 to 2021.The number of blood donors and plasma donors and the intersection of them were analyzed.The data analysis was performed using chi-square test,and a questionnaire survey was conducted to investigate the policies and information status,as well as expectations for coordinated development for blood and plasma donation.Results From 2017 to 2021,the total number of blood donors in 9 cities was higher than that of plasma donors,both have been increasing year by year,and the increase in plasma donors was significantly higher than that of blood donors(131.78%vs 23.90%,P<0.05).The inter-section proportion of blood and plasma donors had increased from 0.45%in 2017 to 1.04%in 2021,with an increase of 131.11%.Among the administrative regions where the participating blood and plasma banks located,94.2%have not re-leased relevant policy to promote the coordinated development of blood and plasma donation.The majority(63%)expected blood banks and plasma banks to be set at a distance more than 50 km apart.The top four functional requirements for the in-terconnection between blood banks and plasma banks management information system were blood test results(94.61%),ID number(87.54%),blood and plasma donation records(85.51%)and health consultation/examination results(82.15%).The top four elements of coordinated development between blood and plasma banks were policy support(96.25%),informa-tion networking(92.36%),top-level design(87.44%)and cultural construction(86.58%).Conclusion The number of donors who donate both blood(mainly whole blood)and plasma has been increasing year by year,which deserves our close attention.To achieve the coordinated development of blood donation and plasma donation,policy support is the most crucial and fundamental means.Establishment of a standard system and the share of blood and plasma donation information is neces-sary for blood informatization construction.It was critical to promote the coordinated development of blood and plasma dona-tion and ensure blood safety with improving legislation,formulating policies for coordinated development,strengthening top-level design,standardizing the publicity of blood and plasma donation and establishing the idea that blood and plasma dona-tion are equally honorable.

Ultrasound examination has the advantages of non-radiation, non-invasive, low cost and high efficiency, and is the most commonly used method of liver imaging examination. In recent years, the application of computer vision technology to the intelligent analysis of ultrasound images has become a research hotspot in the field of intelligent healthcare. Through large-scale data training, the intelligent analysis model of ultrasound omics based on machine learning algorithm can assist clinical diagnosis and therapy, and improve the efficiency and accuracy of diagnosis. Based on the literature, the authors summarize the application proprect of computer vision technology assisted ultrasonography in the evaluation of diffuse liver lesions, focal liver lesions, microvascular invasion of liver cancer, postoperative recurrence of liver cancer, and postoperative therapy response to trans-catheter arterial chemoembolization.

[摘 要] 目的：探讨miR-125a-5p通过调控Bcl-2相关永生基因4（Bcl-2-associated athanogene 4，BAG4）的表达抑制胃癌细胞迁移和侵袭的分子机制。方法：选用2014年1月至2015年12月兰州大学第一医院手术切除的82例胃癌组织标本及配对的癌旁组织以及人胃癌细胞系MGC803、BGC823、SGC7901、HGC27及人胃黏膜上皮细胞（GES-1），qPCR法检测胃癌组织、癌旁组织及胃癌细胞系中miR-125a-5p的表达水平。分别将miR-125a-5p mimic、miR-125a-5p inhibitor、（si-BAG4）siRNA-BAG4及阴性对照质粒转染至胃癌细胞，划痕愈合实验和Transwell侵袭实验分别检测miR-125a-5p/BAG4信号轴对胃癌细胞迁移和侵袭能力的影响。WB检测胃癌细胞中BAG4蛋白的表达。荧光素酶报告基因实验验证miR-125a-5p和BAG4之间的靶向调控关系。结果：miR-125a-5p在胃癌组织和细胞系中均低表达（均P<0.01）。miR-125a-5p的表达与患者的性别（P=0.953）、年龄（P=0.772）、肿瘤部位(P=0.867)、组织学分级（P=0.745）和肿瘤大小（P=0.088）无相关性，与胃癌患者的T分期（P=0.003）、N分期（P=0.001）、M分期（P=0.027）和TNM分期（P=0.035）显著相关，差异有统计学意义。miR-125a-5p低表达是胃癌患者总生存时间的独立危险因素。过表达miR-125a-5p显著抑制胃癌细胞的迁移和侵袭能力（均P<0.01）。敲降BAG4可逆转miR-125a-5p inhibitor对胃癌细胞迁移和侵袭能力的抑制作用。荧光素酶报告基因实验证实miR-125a-5p可与BAG4 3'非翻译区（untranslated regions，UTR）结合抑制其表达。结论：miR-125a-5p通过靶向下调BAG4的表达水平进而抑制胃癌细胞的迁移和侵袭。

Objective:To explore the application of endoscopic narrow-band imaging(NBI) in the early diagnosis of throat malignant tumors.Methods:From January 2014 to December 2019, 512 patients with suspected benign or malignant diseases of the throat in the First People's Hospital of Wenling were selected, and all patients were performed white light endoscopy and NBI endoscopy.The biopsies were taken for pathological examination.The histopathological results were seemed as gold standard for diagnosis.Results:NBI endoscopy was superior to white light endoscope in terms of microvascular morphology and lesion outline(χ 2=457.497, 293.209, all P<0.05). The diagnostic coincidence rate, sensitivity and negative coincidence rate of NBI endoscope for malignant tumors were higher than those of white light endoscope(χ 2=10.131, 6.197, 4.084, all P<0.05). The sensitivity of NBI endoscope type Ⅰ-Ⅱ in the diagnosis of benign lesions was 90.65%, and the specificity was 96.88%.The sensitivity and specificity of NBI endoscope type Ⅲ-Ⅳ in the diagnosis of mild-moderate dysplasia were 80.99% and 97.52%, respectively.The sensitivity and specificity of NBI endoscopy type Va in the diagnosis of severe atypical hyperplasia were 15.18% and 98.54%, respectively.The sensitivity and specificity of NBI endoscope Va-c in the diagnosis of invasive cancer were 93.24% and 96.93%, respectively. Conclusion:Compared with white light endoscope, NBI endoscope can more clearly show the outline of lesions and submucosal blood vessels, and can more accurately diagnose malignant tumors in the throat, especially can more recognized the pre-cancerous lesions and early malignant tumors.It has important clinical application value in early diagnosis of malignant tumor in the throat.

Objective To evaluate the present development and status of quality control for intensive care unit (ICU) in Sichuan Provincial traditional Chinese medicine (TCM) hospitals including integrated traditional Chinese and western medicine hospitals and ethnic hospitals, and to provide practical references for improving the service quality of ICU. Methods Supervisory Group of Sichuan Provincial Critical Care Medicine Quality Control Center of TCM was established in September 2018. From September 8th to 17th, 2018, according to the Scoring Criteria of Quality Control and Supervision Project of TCM for Critical Care Medicine, a 10-day quality control professional guidance was hand out to TCM hospitals with independent ICU in Sichuan Province. The service level of different aspects of hospital quality control was evaluated and ranked from equipment and resource support, medical team, service capacity and level, ward quality, completion of critical care core indicators, completion of quality control of TCM, development of new technologies, diagnosis and treatment schemes for dominant diseases. Results There were 52 TCM hospitals across the province that had an ICU. Thirty-three hospitals were third-class (63.5%), while the rest 19 hospitals were second-class (36.5%). Province-level, city-level and county-level hospitals were accounted for 9.6% (5/52), 38.5% (20/52), and 51.9% (27/52), respectively. Average bed ratio of ICU was 1.8%. Doctor-bed and guard-bed ratios were 0.71∶1 and 2.0∶1, respectively. The average annual admission rate of patients and the average daily admission rate of beds were higher, which were basically 1%. Ward quality was high; the incidence of nosocomial infection was controlled below 10%. Compliance rate of septic shock bundle treatment was high. The incidences of ventilator-associated pneumonia (VAP), catheter-related bloodstream infection (CRBSI) and catheter-associated urinary tract infection (CAUTI) were 0.45%, 0.22%, and 0.30%, respectively. Participation rate of TCM was about 83.4%. Average number of new technologies was about 4.4. Average number of disease schemes was about 2.62. Conclusions ICU of Sichuan Provincial TCM hospitals reaches the standard level in service capacity and level, ward quality, critical medicine quality control, and participation rate of TCM treatment. Improvements are required for other prospects, including department scale, medical personnel allocation, new technical development, diagnosis and treatment schemes of dominant diseases.

Objective To construct and assess the competency scale for emergency physicians in our country. Methods Learning from the milestone project in America, we developed the scale through Delphi method . The application effect was evaluated among 81 emergency physicians by questionnaire survey. Excel was used to do data entry. SPSS 20.0 was adopted to do data analysis. Factor analysis method was employed to verify the structure validity of the scale. Results The competency scale comprises six dimensions and 13 items. The scale of total Cronbach's alpha coefficient was 0.98 and the split half reliability was 0.95. Two factors were extracted by principal component analysis with cumulative contribution rate of 86.5%. The differ-ences of competency score on six aspects of different ages, titles, working years and training situation were tested and all had statistically significant differ-ence (P<0.01). Conclusion The scale developed in our study can reflect the growth stage of the emergency physicians and serve the purpose as an evaluation tool for the competency of emergency physicians in our country.

Percheron artery infarct (PAI) is uncommon clinically.One case had an acute onset of coma,impaired left limb activities,verbal incoherence,drinking cough and vertical gaze palsy after regaining consciousness.Magnetic resonance imaging (MRI) showed symmetrical high signal intensity on diffusion-weighted imaging (DWI) in bilateral paramedian thalami and a distinct pattern of V-shaped midbrain hyperintensity on DWI.Magnetic resonance angiography (MRA) showed left-sided embryonal posterior cerebral artery (PCA) from ipsilateral internal carotid artery (ICA).Systemic treatment yielded a poor prognosis.

Competency-based medical education and personnel training isbecoming a global trend, and the United States has developed a set of competence evaluation system to evaluate a pack-age of emergency, orthopedics, thoracic surgery physicians etc. in 26 specialties. This paper introduces the development background of the evaluation system, the structure of specialist competency evaluation form, content and methodologies , and uses emergency physicians for further evaluation to illustrate this. American physician competency evaluation system provides a unified framework for the country's medical graduates after graduating from medical education training. It helps tocombine process control withthe results ofthe evaluation, self-evaluation with the evaluation of others to makethe evaluation more objective and comprehensive . It can provide new reference to the evaluation and training of physicians in our country.

Objective To explore the expression of heat shock protein (HSP) 90α in outside of different metastatic hepatocellular carcinoma (HCC) cell lines and its role in the cells migration and invasion.Methods The expression of HSP90α was detected by Western blot analysis in conditioned media of MHCC97L and MHCC97H with low and high metastatic HCC cell lines.A small molecule cell-impermeant HSP90 inhibitor DMAG-N-oxide was used to inhibit extracellular HSP90α.Changes of the cells migratory and invasive capability were assessed by in vitro motility and invasion assay.The endogenous matrix metalloproteinase 2 (MMP-2) was demonstrated by Zymography.The expression of extracellular co-chaperone HSP70 and MMP-2 were tested by Western blots and the association between HSP90α,HSP70 and MMP-2 was analyzed by immunoprecipitation.The effects of HSP70 knockdown by siRNA,with or without MMP-2 inhibitor Batimastat,on the level of active MMP-2 and cell migration and invasion were also evaluated.Results HSP90α can express both inside and outside of different metastatic HCC cell lines,and the level of expression was consistent with metastasis potentials.After MHCC97-H cells were treated with a special HSP90α inhibitor DMAG-N-oxide for 24 h,the average migratory cell numbers (28.11 ±3.56) had a significantly reduction,compared with those without treatment group (80.12±4.16) and empty control group (82.24±4.12),respectively (P ＜ 0.01).In vitro invasion assay showed the average invaded cell numbers in treatment group (36.54±4.12) were more fewer than without treatment group (95.12±3.48) and empty control group (101.1 1±3.36),respectively (P =0.017),and accompanying with decreasing of the extracellular MMP-2 activity.HSP70 and MMP-2 could express outside of MHCC97-H cells and interact with HSP90α.Small molecular interfere RNA (siRNA) dramatically inhibited HSP70 expression and reduced the interaction HSP90α with MMP-2 and MMP-2 activity outside MHCC97-H cells,and also suppressed MHCC97-H cells migration and invasion.In addition,combining MMP-2 inhibitor had additive inhibition effects.Conclusion Extracellular HSP90α and HSP70 form chaperone complex to assist in MMP-2 activation and increases HCC cells migration and invasion,which maybe a novel therapeutic target against metastatic HCC.

The chromosome 17q21.31 inversion is a 900-kb common structural polymorphism found primarily in European population. Although the genetic flux within inversion region was assumed to be considerable suppressed, it is still unclear about the details of genetic exchange between the H1 (non-inverted sequence) and H2 (inverted sequence)haplotypes of this inversion. Here we describe a refined map of genetic exchanges between pairs of gene arrangements within the 17q21.31 region. Using HapMap phase Ⅱ data of 1,546 single nucleotide polymorphisms, we successfully deduced 96 H1 and 24 H2 haplotypes in European samples by neighbor-joining tree reconstruction. Furthermore, we identified 15 and 26 candidate tracts with reciprocal and non-reciprocal genetic exchanges, respectively.In all 15 regions harboring reciprocal exchange, haplotypes reconstructed by clone sequencing did not support these exchange events, suggesting that such signals of exchange between two sister chromosomes in certain heterozygous individual were caused by phasing error regions. On the other hand, the finished clone sequencing across 4 of 26 tracts with non-reciprocal genetic flux confirmed that this kind of genetic exchange was caused by gene conversion.In summary, as crossover between pairs of gene arrangements had been considerably suppressed, gene conversion might be the most important mechanism for genetic exchange at 17q21.31.