Study on the nasal colonization of Staphylococcus aureus among healthcare workers in a hospital in Shaanxi Province / 中国热带医学

@#Abstract: Objective　To determine the rate of nasal carriage Staphylococcus aureus among healthcare workers in Department of Infectious Diseases department of the First Affiliated Hospital of Xi'an Jiaotong University Hospital, and to perform characterization on isolated strains. Methods　A cross-sectional study was performed on 86 healthcare workers from February 2022 to June. Nasal swabs were collected from the healthcare workers, and S. aureus were identified after incubation. Antibiotic susceptibility, including chlorhexidine and mupirocin, was assessed by disk diffusion and minimal inhibitory concentration method. The PCR technique was used to detect the biocide resistance genes (qacAB, smr, lmrS mepA, and sepA), virulence genes (pvl, fnbA/fnbB, sea, seb, sec, sed, tst, eta, etb) and mecA gene. SCCmec typing and multilocus sequence typing was performed. For mupirocin-resistant strains, PCR amplification and sequencing were used to identify whether the strains had ileS gene mutations or carried resistant genes (mupA and mupB). Results　S. aureus was isolated from 37 of the 86 healthcare workers (43.02%) , including 13 methicillin-resistant Staphylococcus aureus (MRSA) strains. The strains showed low resistance rates to levofloxacin (2.70%, 1/37), chloramphenicol (8.11%, 3/37), tetracycline (8.11%, 3/37), gentamicin (10.81%, 4/37), and ciprofloxacin (10.81%, 4/37). A total of 17 strains were identified as multidrug-resistant strains. Four SCCmec types were identified in MRSA strains, with the type II being the most frequent (53.85%, 7/13), followed by type IV (30.77%, 4/13). ST59 (46.15%, 6/13) was the most frequent among MRSA strains, while ST5 (41.67%, 10/24) was the most frequent among methicillin-susceptible S. aureus (MSSA) strains. sea was the most frequent virulence gene (56.76%, 21/37). sepA and mepA were detected in all 37 isolates. One Staphylococcus aureus strain was not sensitive to chlorhexidine, two strains had the missense mutation V588F (G1762T) and showed low level resistance to mupirocin, and one strain carrying mupA gene was highly resistant to mupirocin. Conclusion　The nasal colonization rate of Staphylococcus aureus among healthcare worker in the investigated hospital was high, indicating a risk for nosocomial infections. Strengthened monitoring and decolonization treatment should be carried out to reduce these risks.

Trends in incidence and mortality of stroke in Ningbo Cityfrom 2012 to 2021 / 预防医学

Objective@# To investigate the trends in incidence and mortality of stroke in Ningbo City, Zhejiang Province from 2012 to 2021, so as to provide the evidence for improving the stroke control strategy in Ningbo City.@*Methods@# Data pertaining to the stroke incidence and mortality in Ningbo City from 2012 to 2021 were captured from Ningbo Municipal Chronic Disease Collaborative Management System, and the incidence and mortality of stroke was estimated and standardized by the Sixth National Population Census in 2010. The trends in incidence and mortality of stroke were evaluated using annual percent change (APC) in Ningbo City from 2012 to 2021. @*Results@# A total of 185 747 residents with stroke were reported in Ningbo City from 2012 to 2021. The crude incidence of stroke was 312.78/105 in Ningbo City from 2012 to 2021, which appeared a tendency towards a rise (APC=2.429%, t=5.507, P<0.001), and the standardized incidence of stroke was 188.86/105, with no remarkable changes seen (APC=-0.399%, t=-1.544, P=0.161). There were 47 355 deaths due to stroke in Ningbo City from 2012 to 2021, and the crude and standardized mortality rates were 79.74/105 and 42.79/105, which both appeared a tendency towards a decline (APC=-4.778%, t=-6.867, P<0.001; APC=-8.269%, t=-13.729, P<0.001). Higher standardized incidence and mortality were seen among men (226.05/105 and 50.14/105) than among women (153.37/105 and 35.89/105), and the crude incidence and mortality of stroke appeared a tendency towards a rise with age (χ2trend=3 671.325, 1 419.107, both P<0.001). The standardized incidence and mortality of hemorrhagic stroke were 40.38/105 and 18.56/105, both showing a tendency towards a decline (APC=-5.042%, t=-12.958, P<0.001; APC=-11.570%, t=-14.979, P<0.001), and the standardized incidence of ischemic stroke was 143.91/105, appearing a tendency towards a rise (APC=1.254%, t=3.223, P=0.012), while the standardized mortality of ischemic stroke was 19.65/105, with no obvious changes seen (APC=-2.110%, t=-2.150, P=0.064). @* Conclusions@# The incidence of stroke appeared a tendency towards a rise and the mortality appeared a tendency towards a decline in Ningbo City from 2012 to 2021. Men and the elderly are at high risk of stroke.

Study on clinical efficacy of a 3D model based on crown-root integration in clear aligners / 口腔医学

Objective@#To evaluate the clinical effect of clear aligners in the anterior region in non-extraction cases by establishing a three-dimensional model of crown-root fusion to guide clinical application.@*Methods@#Eleven patients visiting the orthodontic department of Xuzhou Stomatological Hospital from December 2020 to December 2021 were collected, and the orthodontic plan was designed using Maestro 3D Dental Studio scheduling software to obtain the expected three-dimensional model of the patient's orthodontic treatment result. CBCT, intraoral scan, and 3D reconstruction software were used to create a postoperative model of the patient. The crown and root data were aligned in Geomagic Studio 2014, and differences in torque and axial inclination between the actual model after treatment and the predicted model of the anterior teeth before treatment were compared in 3-matic.@*Results@#The actual torque angles of the anterior teeth were all smaller than the predicted angles before treatment, with the highest realization rate of 77.55% for lateral incisors and the lowest of 60.70% for central incisors; the actual axial inclination angles of the anterior teeth were also smaller than the predicted angles before treatment, with the highest realization rate of 81.49% for central incisors and the lowest of 74.95% for cuspids. @*Conclusion@# A digital model of crown-root integration based on a combination of 3D reconstruction and intraoral scanning techniques is advantageous in assessing the efficacy of clear aligners. In non-extraction cases with clear aligner, the efficiency of movement is higher for small areas of the anterior region.

Fibronectin extra domain A as a drug delivery targeting epitope for rheumatoid arthritis

Abstract Objectives: To assess the ability of monoclonal antibodies (mAbs) specific for fibronectin extra-domain A (FnEDA) to target diseased tissues of mouse collagen induced arthritis (mCIA) models. To explore the parameters of the targeting exhibited by anti-FnEDA mAbs including timing and location. Methods: Targeting capabilities of anti-FnEDA mAbs were demonstrated by biodistribution study where i.v. injected antibodies were detected by conjugated near-infrared (NIR) fluorophore, 125I label and immunohistochemistry (IHC) of the injected antibody. Location of FnEDA expression in both mCIA and human RA tissue were mapped by IHC. Quantification of anti-FnEDA mAbs targeted to disease tissue was measured by whole-body autoradiography (WBA). Timing of the targeting was interrogated with fluorescent and confocal microscopy using anti-FnEDA mAbs labeled with different fluorophores and injected at different times. Results: Anti-FnEDA mAbs show specific targeting to diseased paws of mCIA animal. The targeting was focused on inflamed synovium which is consistent with FnEDA expression profile in both mCIA and human RA tissues. Anti-FnEDA mAbs accumulated in diseased tissue at pharmacologically relevant concentrations, the targeting was sustained for up to 14 days and FnEDA was able to support targeting of multiple doses of anti-FnEDA mAbs given 5 days apart. Conclusion: FnEDA is specifically upregulated in the inflamed tissues of mCIA. Antibodies specific for FnEDA can be useful as molecular delivery vehicles for disease specific targeting of payloads to inflamed joint tissue.

Association between bile acid metabolism and bone mineral density in postmenopausal women

OBJECTIVES: Previous studies have not shown any correlation between bile acid metabolism and bone mineral density (BMD) in women with postmenopausal osteoporosis. Thus, the current study evaluated the association between bile acid levels as well as BMD and bone turnover marker levels in this group of women. METHODS: This single-center cross-sectional study included 150 postmenopausal Chinese women. According to BMD, the participants were divided into three groups: osteoporosis group, osteopenia group, and healthy control group. Serum bile acid, fibroblast growth factor 19 (FGF19), and bone turnover biomarker levels were assessed. Moreover, the concentrations of parathyroid hormone, 25-hydroxy vitamin D [25(OH)D], procollagen type I N-peptide (P1NP), and beta-CrossLaps of type I collagen containing cross-linked C-terminal telopeptide (β-CTX) were evaluated. The BMD of the lumbar spine and proximal femur were examined via dual-energy X-ray absorptiometry. RESULTS: The serum total bile acid levels in the osteoporosis and osteopenia groups (5.28±1.56 and 5.31±1.56 umol/L, respectively) were significantly lower than that in the healthy control group (6.33±2.04 umol/L; p=0.002 and 0.018, respectively). Serum bile acid level was positively associated with the BMD of the lumbar spine, femoral neck, and total hip. However, it negatively correlated with β-CTX concentration. Moreover, no correlation was observed between bile acid and P1NP levels, and the levels of the other biomarkers that were measured did not differ between the groups. CONCLUSION: Serum bile acid was positively correlated with BMD and negatively correlated with bone turnover biomarkers reflecting bone absorption in postmenopausal women. Thus, bile acid may play an important role in bone metabolism.

Selection of modeling time for type 2 diabetes mellitus mouse / 中国应用生理学杂志

OBJECTIVE@#To analyze the changes of blood biochemical index and the pathological changes of myocardium and kidney in type 2 diabetic mouse at different time points, which can provide the basis for the selection of type 2 diabetic modeling time for later research.@*METHODS@#After 6 weeks of feeding with high-fat diet, 24 healthy male ICR mice were injected with streptozocin (STZ, 30 mg/kg) intraperitoneally for 5 days to establish diabetic models. After 9 days, a random blood glucose ≥ 11.1 mmol / L was measured as diabetic mice. 4, 6 and 8 weeks after successfully preparing the diabetic mouse, 8 diabetic mice (a group)would be sacrificed each time. Then the biochemical and pathological conditions were analyzed: ① the indexes of heart and kidney were calculated. ②the serum levels of creatine kinase (CK), lactate dehydrogenase (LDH), creatinine (Cr) and blood urine nitrogen (BUN) were determined. ③ Histopathological changes of myocardium and renal tissues were observed by hematoxylin and eosin (HE) staining. Masson staining was used to observe the fibrosis of myocardium. PAS staining was adopted to observe the pathological changes of renal tissue. In addition, 8 ICR male mice were taken as the control group.@*RESULTS@#At the 4, 6 and 8 week, cardiac organ coefficient, the values of LDH and CK were all increased compared with the control group. Cardiomyocyte hypertrophy and myocardial fibrosis could be observed. Renal organ coefficient, the values of Cr and BUN were increased. Glomerular hypertrophy, basement membrane thickening and atrophy could be perceived.@*CONCLUSION@#At the 6 week, related biochemical and pathological changes in diabetic mice were comparatively obvious and breeding time was relatively short. Thus, 6 weeks after the preparation of the diabetic mice would be the optimal time for type 2 diabetes mellitus modeling, proper for inventions of drugs and other research purposes including pathology, physiology, biochemistry, etc.

Three techniques of proximal root reconstruction and long term outcomes following repair of acute type A aortic dissection / 中国胸心血管外科临床杂志

@#Objective To compare the early and late outcomes of different techniques of proximal root reconstruction during the repair of acute type A aortic dissection, including aortic valve (AV) resuspension, isolated supracoronary ascending aorta replacement, and aortic root replacement procedure (Bentall). Methods All patients who underwent acute Type A aortic dissection repair between January 2010 and December 2015 in Fuwai Hospital were retrospectively analyzed in our study. There were 673 patients with 512 males and 161 females at mean age of 48.80±11.22 years. There were 403 patients as an AV resuspension group (287 males and 116 females at average age of 50.61±9.95 years), 95 patients as an isolated supracoronary ascending aorta replacement group (76 males and 19 females at average of 49.83±12.21 years), and 175 patients as an AV resuspension group (149 males and 26 females at average of 44.07±11.99 years). The differences of preoperative aortic insufficiency, intraoperative variables and postoperative aortic insufficiency were compared in the three groups. Results Five hundred ninety-one patients (87.8%) had aortic valve commissure involved. The proportion of mild degree, moderate degree, and severe degree among the three groups were statistically significant (31.7%, 52.4%, 15.9%; 87.4%, 12.6%, 0.0%; 23.4%, 56.0%, 20.6%; P < 0.01). The diameter of aortic sinus in the three groups was 39.06±5.11 mm, 38.27±4.41 mm, 50.39±6.22 mm, respectively, with a statistical difference ( P< 0.01). The duration of surgery, cardiopulmonary bypass time, aorta cross-clamp time were also statistically significant (P < 0.01). The in-hospital mortality was 11.73% in the whole group. There was no difference among the three groups (12.2% vs. 13.7% vs. 9.7%, P=0.58). Five-year survival rate was similar (83.06% vs. 81.27% vs. 83.05%, P=0.85). The 5-year free from over moderate aortic insufficiency rate were 95.2%, 98.6% and 100% respectively, with no statistical difference (P=0.07). There was no re-do operation for aortic root diseases in the whole group. Conclusion According to aortic root processing strategy in our center, AV resuspension, isolated supracoronary ascending aorta replacement, and aortic root replacement can achieve satisfactory results. However, there is higher incidence of aortic insufficiency through AV resuspension. Further study is needed to evaluate its efficacy.

A simple bedside model to predict the risk of in-hospital mortality in Stanford type A acute aortic dissection / 中国胸心血管外科临床杂志

@#Objective     To investigate predictors for mortality among patients with Stanford type A acute aortic dissection (AAD) and to establish a predictive model to estimate risk of in-hospital mortality. Methods     A total of 999 patients with Stanford type A AAD enrolled between 2010 and 2015 in our hospital were included for analysis. There were 745 males and 254 females with a mean age of 49.8±12.0 years. There were 837 patients with acute dissection and 182 patients (18.22%) were preoperatively treated or waiting for surgery in the emergency department and 817 (81.78%) were surgically treated. Multivariable logistic regression analysis was used to investigate predictors of in-hospital mortality. Significant risk factors for in-hospital death were used to develop a prediction model. Results     The overall in-hospital mortality was 25.93%. In the multivariable analysis, the following variables were associated with increased in-hospital mortality: increased age (OR=1.04, 95% CI 1.02 to 1.05, P<0.000 1), acute aortic dissection (OR=2.49, 95% CI 1.30 to 4.77, P=0.006 1), syncope (OR=2.76, 95% CI 1.15 to 6.60, P=0.022 8), lower limbs numbness/pain (OR=7.99, 95% CI 2.71 to 23.52, P=0.000 2), type Ⅰ DeBakey dissection (OR=1.72, 95% CI 1.05 to 2.80, P=0.030 5), brachiocephalic vessels  involvement (OR=2.25, 95% CI 1.20 to 4.24, P=0.011 7), acute liver insufficiency (OR=2.60, 95% CI 1.46 to 4.64, P=0.001 2), white blood cell count (WBC)>15×109 cells/L (OR=1.87, 95% CI 1.21 to 2.89, P=0.004 9) and massive pericardial effusion (OR=4.34, 95% CI 2.45 to 7.69, P<0.000 1). Based on these multivariable results, a reliable and simple bedside risk prediction tool was developed. Conclusion     Different clinical manifestations and imaging features of patients with Stanford type A AAD predict the risk of in-hospital mortality. This model can be used to assist physicians to quickly identify high risk patients and to make reasonable treatment decisions.

Impact of climate change on aortic dissection onset / 中国胸心血管外科临床杂志

@#Objective     To explore impact of climate change on aortic dissection and to put forward a new way about prediction and prevention of aortic dissection. Methods     We retrospectively analyzed the characteristics of acute aortic dissection patients came from Hebei province in Fuwai Hospital between 2010 and 2016 year. Meanwhile, we collected monthly maximum temperature, minimum temperature, average temperature, average pressure, amount of rainfall, sunshine, humidity and other meteorological data. Generalized model was implied to explore climate change and the incidence of aortic dissection. Results     A total of 1 121 acute aortic dissection patients from Hebei province were admitted in Fuwai Hospital during the period of 6 years. There were 774 patients were type A aortic dissection, and 347 patients were type B aortic dissection. The average age was 51.4±12.0 years. There were 873 males and 248 females. There were 889 (79.3%) patients with hypertension, 99 (8.83%) with Marfan syndrome. It was found that temperature, humidity and air pressure were all statistically significant for indication aortic dissection through single variable analysis (P<0.01). The temperature was only variable by one-way analysis of variance (P<0.01). The lowest temperature has the best predictive effect on the occurrence of aortic dissection. The relative risk was 1.02 with 95% confidence interval 1.02 to 1.03. Conclusion     The change of climatic conditions can affect the occurrence of aortic dissection, and the lowest temperature is an important trigger factor for aortic dissection onset.

Effect of ursolic acid on cardiomyopathy of mice with diabetes and its mechanism / 中国应用生理学杂志

OBJECTIVE@#To study the effect of ursolic acid on cardiomyopathy in mice with diabetes induced by high-fat diet combined with low dose streptozotocin, and to explore its possible mechanism.@*METHODS@#Thirty male ICR mice were randomly divided into control group (=10) and moulding group (=20), the mice in the two groups were fed with regular diet and high-fat diet respectively for 6 weeks, and then the mice in the moulding group were injected with streptozotocin (30 mg/kg) for 5 successive days to induce diabetes mellitus (DM). Fasting blood glucose (FBG) was measured after 9 days. Mice with FBG over 11.1 mmol/L were regarded as DM. Twenty DM mice were randomly divided into model group and ursolic acid group (=10). Mice in each group were continuously administrated ursolic acid (100 mg/kg) or corresponding solvent intragastrically for 8 weeks. After that, FBG was measured, body weight (BW), heart weight and left ventricular weight were weighed in order to calculate the heart mass index (HMI) and left ventricular mass index (LVMI). Levels of creatine kinase (CK), lactate dehydrogenase (LDH) in serum and the level of superoxide dismutase (SOD), malondialdehyde (MDA) in myocardial tissue were detected. HE staining was used to observe pathological changes of myocardial tissue. Immunohistochemistry was employed to determine the expression of NOD-like receptor protein 3 (NLRP3) and interleukin 1β (IL-1β).@*RESULTS@#Compared with the control group, HMI, LVMI were apparently enlarged, levels of FBG, CK, LDH in serum and MDA in myocardial tissue were extremely increased, while the activity of SOD in myocardial tissue were extraordinary decreased in diabetic group. HE staining of myocardium showed that arrangement disorder of myocardial fibers, edema and hypertrophy in myocardial cell, as well as inflammatory cell infiltration in model group. Immunohistochemistry showed that the expression of NLRP3 and IL-1β in myocardial tissue increased obviously in model group, the above changes inursolic acid group were significantly ameliorated.@*CONCLUSIONS@#Ursolic acid has a obvious protective effect on myocardial injury in mice with diabetes induced by high-fat diet combined with low dose streptozotocin, and its mechanism may be associated with inhibiting NLRP3 inflammasome activation, reducing IL-1β generation and alleviating myocardial inflammatory injury.

Evaluation and exploration on the effect of the management of chronic obstructive pulmonary disease in rural areas through an internet-based network consulting room

Objective: This study aims to improve the management quality of chronic obstructive pulmonary disease [COPD] in rural areas

Methods: Two hundred forty discharged COPD patients were divided into an intervention group and a control group. In the intervention group, 120 patients established contact with doctors through the network consulting room, i.e., the doctor's mobile platform, and were managed through video, voice, and text by the doctors, kept close contact with the doctors after discharge [education, consultation], and received electronic prescriptions, and drugs were sent to the patients' door by online retailers. The patients in the control group were managed in the traditional manner. One year later, the predicted forced expiratory volume in 1 s [FEV1]%, FEV1/forced vital capacity [FVC], and CAT scores and the number of rehospitalized patients were compared between these 2 groups

Results: After 1 year of follow-up, the predicted FEV1% and the FEV1/FVC ratio were significantly higher in the intervention group than in the control group [p < 0.05]. CAT scores were lower for patients in the intervention group than for those in the control group after 1 year of follow-up [p < 0.05]. After 1 year of follow-up, 22 [18.33%] patients were rehospitalized in the intervention group and 58 [48.33%] patients were rehospitalized in the control group [p < 0.05]

Conclusion: Doctors can improve the quality of life of patients with COPD and reduce the number of rehospitalizations through use of the network consulting room

Simultaneous Synthesis and Characterization of Biomass Multi-elements Self-doped Titanium Dioxide by Ultrasonic Irradiation / 分析化学

The biomass multi-elements self-doped TiO2was synthesized simultaneously by ultrasonic irradiation assisted sol-gel method, and characterized by field emission scanning electron microscopy (FESEM), X-ray diffraction(XRD), X-ray photoelectron spectroscopy (XPS), UV-Vis diffuse reflectance spectroscopy (UV-Vis-DRS), Fourier transform infrared (FT-IR) spectroscopy, and photoluminescence (PL). The characterization results showed that,multiple elements, C, N, P, Cl and K, were doped in the composite TiO2. Compared with pure TiO2,the band gap of the composite catalyst was narrowed by 0.21 eV, and possessed more surface hydroxyl radical and active sites, lower recombination rate of photo-generated carriers, higher crystallinity and higher specific surface area. The photocatalytic ability of the composite catalyst was studied,using methylene blue (MB) as target pollutant. The experimental results showed that, under visible light irradiation,the degradation efficiency of methylene blue was up to 98% after photocatalytic reaction for two hours by the composite catalyst.

Optimized Exon-Exon Junction Library and its Application on Rodents' Brain Transcriptome Analysis

ABSTRACT Background: Alternative splicing (AS), which plays an important role in gene expression and functional regulation, has been analyzed on genome-scale by various bioinformatic approaches based on RNA-seq data. Compared with the huge number of studies on mouse, the AS researches approaching the rat, whose genome is intermedia between mouse and human, were still limited. To enrich the knowledge on AS events in rodents' brain, we perfomed a comprehensive analysis on four transcriptome libraries (mouse cerebrum, mouse cerebellum, rat cerebrum, and rat cerebellum), recruiting high-throughput sequencing technology. An optimized exon-exon junction library approach was introduced to adapt the longer RNA-seq reads and to improve mapping efficiency. Results: In total, 7,106 mouse genes and 2,734 rat genes were differentially expressed between cerebrum and cerebellum, while 7,125 mouse genes and 1,795 rat genes exhibited varieties on transcript variant level. Only half of the differentially expressed exon-exon junctions could be reflected at gene expression level. Functional cluster analysis showed that 32 pathways in mouse and 9 pathways in rat were significantly enriched, and 6 of them were in both. Interestingly, some differentially expressed transcript variants did not show difference on gene expression level, such as PLCβ1 and Kcnma1. Conclusion: Our work provided a case study of a novel exon-exon junction strategy to analyze the expression of genes and isoforms, helping us understand which transcript contributes to the overall expression and further functional change.

Association of Connexin Gene Polymorphism with Essential Hypertension in Kazak and Han Chinese in Xinjiang, China / 华中科技大学学报（医学）（英德文版）

Essential hypertension (EH) is affected by both genetic and environmental factors.The polymorphism of connexin (Cx) genes is found associated with the development of hypertension.However,the association of the polymorphism of Cxs with EH has not been investigated.This study aimed to investigate the association of the polymorphism of connexin (Cx) genes Cx37,Cx40,and Cx43 with EH in Kazak and Han Chinese in Xinjiang,China.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) were used to analyze the polymorphism of Cx genes in Kazak and Han EH patients as well as their normotensive controls.The results showed that there were no significant differences in the frequencies of different three genotypes (A/A,A/G,and G/G) and A and G alleles of Cx40 rs35594137 and rs11552588 between EH patients and normotensive controis.However,in Kazak EH patients,the frequencies of three genotypes (A/A,A/G;and G/G) of Cx37 rs1630310 were 24.8％,47.2％ and 28.0％,respectively,which were significantly different from those in Han EH patients.In Han EH patients,the frequencies of the three genotypes (C/C,C/G and G/G) of Cx43 rs1925223 were 6.4％,35.6％ and 58.0％,respectively.Frequencies of the other four genotypes had no statistical differences among Kazak and Hart EH patients and their normotensive controls.These results suggest polymorphisms of Cx37 rs 1630310 and Cx43 rs 1925223 genes may be associated with the pathogenesis of EH.Carrying Cx37 rs1630310-A or Cx43 rs1925223-G genotypes may protect against the development of EH.

MiR-20 Regulates Myocardiac Ischemia by Targeting KATP Subunit Kir6.1 / 华中科技大学学报（医学）（英德文版）

This study aimed to examine the functional role of microRNA-20 (miR-20) and its potential target,Kir6.1,in ischemic myocardiocytes.The expression of miR-20 was detected by real-time PCR.Myocardiocytes were stained with terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) reagent for apoptosis evaluation.Western blotting was used to detect the Kit6.1 protein in ischemic myocardiocytes transfected with miR-20 mimics or inhibitors.Luciferase reporter gene assay was performed to confirm the targeting effect of miR-20 on KCNJ8.The results showed that miR-20 was remarkably down-regulated,while the KATP subunit Kir6.1 was significantly up-regulated,during myocardial ischemia.The miR-20 overexpression promoted the apoptosis of ischemic myocardiocytes,but showed no such effect on normal cells.Under ischemic condition,myocardiocytes transfected with miR-20 mimics expressed less Kir6.1.On the contrary,inhibiting miR-20 increased the expression of Kir6.1 in the cells.Co-transfection of miR-20 mimics with the KCNJ8 3’-UTR plasmid into HEK293 cells consistently produced less luciferase activity than transfection of the plasmid alone.It was concluded that miR-20 may regulate myocardiac ischemia by targeting KATP subunit Kir6.1 to accelerate the cell apoptosis.Therefore miR-20 may serve as a therapeutic target for myocardial ischemic disease.

Satisfaction of Village Doctors with the Township and Village Health Services Integration Policy in the Western Minority-inhabited Areas of China / 华中科技大学学报（医学）（英德文版）

Township and Village Health Services Integration Management (TVHSIM) is an essential form of China's two-tiered health service integration plan at the township and village level.Its main purpose,also one of the target goals in China's new healthcare reform,is to gradually integrate rural health services and appropriately allocate rural health resources.This study aims to assess the village doctors' satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM.A cross-sectional study was carried out in which 162 village doctors from Qinghai,Inner Mongolia and Xinjiang in western China were interviewed.Descriptive analysis,independent t-test,one-way ANOVA,Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors' personal characteristics and their satisfaction with TVHSIM and six subscales.Village doctors with different years of practice,social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels (all P＜0.05).Age (P＜0.05) and years of practice (P＜0.01) were negatively correlated with Drug and Medical Device Management and Financing Management.Essential medical knowledge level (P＜0.05) was negatively correlated with Operations Management as well.However,social insurance status (P＜0.05) was positively correlated with Human Resources Management and Drug and Medical Device management.Gender,age and years of practice respectively had significant influence on village doctors' satisfaction with TVHSIM (P＜0.01).In conclusion,in order to further promote TVHSIM policy in rural China,a well-rounded social insurance model for village doctors is urgently needed.In addition,the development of TVHSIM is regionally imbalanced.Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.

Association of catalase genotype with oxidative stress in the predication of colorectal cancer: modification by epidemiological factors / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This paper aims to assess the interaction between common variations in catalase (CAT) polymorphic gene and environmental factors for antioxidant defense enzyme in modulating individual susceptibility to colorectal cancer (CRC).</p><p><b>METHODS</b>A case-control study with 880 colorectal cancer cases and 848 controls was conducted to investigate whether variations in the catalase (CAT) gene, one of the genes involved in scavenging oxidative stress, influenced susceptibility to CRC.</p><p><b>RESULTS</b>The interaction between life style and genotypes as well as with their effects on colorectal cancer was deduced from the present study. Significant difference (P = 0.01) was identified in the distribution of CAT genotype between the colorectal cancer cases and the controls. The CRC cases had significantly lower mean activity than the controls (P < 0.01). Correlation analyses revealed statistically significant correlations between CAT activity and CAT genotype (P < 0.01).</p><p><b>CONCLUSION</b>The risk of CRC was associated with smoking, low vegetable consumption, high pork and poultry consumptions, and low or high BMI. This is the first study reporting an association of polymorphism CAT-21A > T with colorectal cancer. Low CAT activity was associated with an increased risk of CRC; however, no evidence was found to support an association between CAT-21A > T polymorphism and CRC risk.</p>

Exploring China's Western and Central County Systems Performance Measured by Outcomes Framework Scores——A Cross-sectional Survey of Routine Healthcare Data / 华中科技大学学报（医学）（英德文版）

This study was designed to measure the performance of county health systems in central and western China utilizing routine healthcare data.Drawing on a literature review and expert consultation,the study established a theoretical framework and an indicator system for performance review.Questionnaires were designed and disseminated to collect empirical data on health system performance in four counties of two central and western provinces.Quantitative data were subjected to descriptive statistical analysis through SPSS12.0.Three dimensions were introduced in the performance review framework-health outcomes,financial risk protection and consumer and provider satisfaction.Health outcomes were assessed from four secondary indicators:infant mortality rate; maternal mortality rate;under-5 child mortality rate; and the incidence of Class A and Class B notifiable diseases.Financial risk was assessed using two secondary indicators:the proportion of the cost of inpatient care that was reimbursed under the New Cooperative Medical System (NCMS) insurance scheme,and the rate of NCMS funds utilization.The assessment of satisfaction was made using two secondary indicators:the overall satisfaction of local residents with healthcare services,and the satisfaction of health practitioners at the township and village level.The study indicated better health system performance in the two counties in Chongqing than those in Shanxi.It was concluded that outcome framework scores can fairly reveal performance differences among county health systems in central and western China,and can provide practical evidence for optimizing the operation and inputs of county health systems.Caution needs to be exercised in generalizing such performance outcomes as many factors such as spending and organization that contribute to county health system performance were not included in the study.

Research of helicobacter pylori in gastric cancer development mechanism / 肿瘤研究与临床

Numerous studies showed that Helicobacter pylori (HP) infection and gastric cancer have a correlation, which is a important factor to influence the development of gastric cancer, with scholars' intensive research, it is found that the way of HP acting on gastric cancer is complicated and diverse, this review summarizes the role of HP in mechanism, correlation factor and action way of gastric cancer.