Practice of Huzhou in promoting the reform of countywide medical and health governance system / 中华医院管理杂志

The construction of a countywide community for medical and health services is designed to upgrade the service capacity of primary medical and health institutions, to promote resource sharing and collaborative services, and promote the hierarchical medical system. Huzhou of Zhejiang province has launched its initiative in building a countywide community for medical services since 2018. The authors summarized its main practices in promoting the integration of the management system and optimizing operating mechanism of countywide medical and health institutions, promoting the reform of the county medical and health governance system, as well as the achievements and shortcomings, with a view to providing reference for promoting the high-quality development of the countywide medical and health service system.

Research on the operation status and countermeasures of official tiktok in Beijing municipal hospitals / 中华医院管理杂志

Objective:To analyze the operation status of official voice in Beijing municipal hospitals and explore the countermeasures to optimize the operation of official short video tiktok.Methods:The 21 Beijing municipal tertiary public hospitals were selected as the research objects. The 17 tiktok numbers which had been approved by the hospital as of December 31, 2020 were included. The data of basic accounts, fans, points, themes, contents, and number of periodicity were analyzed. The theme and the number of praise of the short video tiktok that broke through 10 thousand times were analyzed. The current situation and problems of official voice in Beijing municipal hospitals were analyzed.Results:The 17 official tiktok accounts of the hospital issued 2 059 pieces of tiktok, 1 737.5 thousand fans, and 9 231.8 thousand times of points, the average number of entries was 4.5 thousand times. The official tiktok construction of Beijing municipal hospitals was still in its infancy. The problems included: the weakening of IP image and the lack of system design, lack of content productivity and interaction, unclear positioning and lack of operation strategy.Conclusions:The optimization of hospital official tiktok operation needs to properly handle the relationship between science and interest, systematicness and efficiency. We should clarify the account positioning, improve productivity, strengthen interaction, enhance linkage, and do a good job in supervision.

Serum lipid level of patients with branch retinal vein occlusion / 中华眼底病杂志

Objective To observe the serum lipid level of patients with branch retinal vein occlusion (BRVO).Methods A total of 71 BRVO patients (BRVO group) were enrolled in this study.The patients included 31 males and 40 females,with an average age of (52.75 ± 10.2) years.All the patients were examined for visual acuity,slit lamp ophthalmoscopy combine with preset lens,fundus color photography and fundus fluorescein angiography (FFA) examination.Seventy-two age-and sex-matched normal subjects were enrolled in this study as control group.The subjects included 32 males and 40 females,with an average age of (53.10±9.5) years.The BRVO and control group were divided into four subgroup which including age with ＜40 years,40-49 years,50-59 years and ≥60 years.The plasma cholesterol and triglyceride level of BRVO group,control group,and age subgroups of BRVO and control group were comparatively analyzed.Results The average plasma cholesterol levels were (4.529±0.100) and (4.274±0.106) mmol/L in BRVO and control group,respectively.There was no difference between two groups (t=-1.738,P＞0.05).The average triglyceride levels were (1.500±0.129) and (1.319±0.095) mmol/L in BRVO and control group,respectively.There was no difference between two groups (t=-1.135,P＞0.05).There was no difference of average plasma cholesterol (t=-1.755,1.850,-1.892,-0.507) and triglyceride (t=0.846,-0.074,-1.288,-1.887) level in age subgroups of BRVO and control subgroup (P＞0.05).Conclusion There is no significant difference of serum lipid level between BRVO patients and controls.

Changes of cerebral matrix metalloproteinase-2 activity and oxidative glutathione level in newborn rats with persistent hypoglycemia / 中华围产医学杂志

Objective To investigate the effect of persistent hypoglycemia on the cerebral oxidative stress and matrix metalloproteinase-2 (MMP-2) activity of newborn rats and to explore the potential mechanism of hypoglycemia-induced brain injury of newborn.MethodsSeven-day-old rats were injected insulin subcutaneously to induce persistent hypoglycemia.Cerebral cortex,hippocampus and thalamus were collected after 36 hours' observation and stored in -80 ℃.Glutathione (GSH)and glutathione disulfide (GSSG) were detected by commercial kit and GSSG/GSH was calculated.MMP-2 activity was detected by gelatin zymography. The data were analyzed by t test,one or two-wayanalysis of variance and Pearson correlation analysis.Six rats were set as the normal glucose group. ResultsThirty-six hours after induction of hypoglycemia, the cerebral GSSG and GSSG/GSH of hypoglycemic pups elevated about 1.5 times higher than those of control group [GSSG:(15.89 ± 5.46) vs (6.15 ± 3.42) mg/g protein,t =3.704,P =0.004; GSSG/GSH:(5.58± 1.79) ％ vs (2.79±1.76) ％,t =2.712,P=0.022].The GSSG and GSSG/GSH in thalamus of hypoglycemia were significantly higher than those of control [GSSG:(15.93 ± 5.75) mg/g protein vs (5.03±5.14)mg/g protein,P＜0.05; GSSG/GSH:(6.50±3.25) ％ vs (2.41±3.12) ％,P＜0.05],whereas there were no significant differences in the cortex ard hippocampus.The total MMP-2 activity of hypoglycemic animals (2.22±0.59) was significantly higher than that of control (1.21± 0.17)(t=4.064,P=0.002),and significant differences were found between the two groups in cortex (2.14 ± 0.5 vs 1.17± 0.27),hippocampus (2.31± 0.72 vs 1.22 ± 0.37) and thalamus (2.22±0.68 vs 1.24±0.18) with all P＜0.01].The activity of MMP-2 was positively related to GSSG (r=0.575,P=0.0002) and GSSG/GSH (r=0.484,P=0.0003).ConclusionsOxidative stress might play an important role in the persistent hypoglycemia induced brain injury of 7-day-old rat pups and thalamus might be most vulnerable to hypoglycemia.Hypoglycemia might also elevate MMP-2 activity which is positively related to GSSG level and GSSG/GSH of the brain.

Dendritic cell vaccine immunotherapy for patients with colorectal cancer / 中华普通外科杂志

Objective To evaluate dendritic cell vaccine immunotherapy in postoperative colorectal cancer patients. Methods 40 colorectal cancer patients were divided into two groups. Group A was not treated with the dendritic cell vaccine after chemotherapy, Group B was treated with four courses of autologous dendritic cell vaccine. The level of cytokines was tested before and after the therapy in both groups. DTH were tested after the last course of treatment. Results The levels of cytokines significantly increased in group B after vaccination compared with that in group B before vaccination and that in group A.8 patients were DTH positive in 15 patients that were tested after the vaccination. The PTS (progression-free survival) was 22 months in group B compared with 17 months in group A. The recurrence of the disease was not observed in patients with DTH positive. Conclusion DC vaccine in postoperative colorectal cancer patients improves the immune status and elicits tumor-specific response.

Immune surveillance on postoperative patients with advanced gastric cancer treated with concurrent chemotherapy and dendritic cells vaccine / 中华消化杂志

Objective To evaluate clinical outcome in postoperative patients with advanced gastric cancer treated with concurrent chemotherapy and dendritic cells (DCs) vaccine as well as alteration of immune function. Methods Sixty-four postoperative patients with advance gastric cancer were divided into control group and DC vaccine group, In control group, 38 patients were treated with LCH regimen consisted of 5-fluorouracil 0.75 g/d_(1-5) and oxaliplatin 0.2 g/d_1. In DC vaccine group,blood sample was obtained from 26 patients who were followed by LCH regimen treatment next day.One week after the chemotherapy, patients were immunized with DC vaccine for 2 times at interval of one week. The second cycle was performed after 28 days. The percentages of T lymphocytes and natural killer (NK) cells and cytokine levels before and after treatment were compared between two groups. The therapeutic effects (including no remote metastasis and enlarged lymph nodes in cavity and/or tumor reduced in volume) were also evaluated. Results The concentrations of T lymphocytes (CD3~+ and CD4~+ ), NK cells, interleukin (IL)-2, IL-12 and interferon-γ in DC vaccine group were significantly increased after vaccination compared with those before vaccination (P＜0.05), and even higher than those in control group (P＜0.05). The effective rate was higher in DC vaccine group (80. 76%) than that in control group (68.42%) with significant difference (P＜0. 05). The side effects of chemotherapy such as the decreased peripheral white blood ceils and immune cells were less serious in DC vaccine group compared with control group (P＜ 0.05), while the uncomfortable incidence of gastrointestinal tract and peripheral neuritis showed no significant difference between two groups (P＞0.05). Conclusions Application of concurrent chemotherapy and DC vaccine in patients with advanced gastric cancer after surgical treatment may achieve a short-term efficacy, meanwhile it can reduce the side effects induced by chemotherapy.

Analysis in treatment of femoral peritrochanteric fracture by internal fixation / 中国医师进修杂志

Objective To explore the surgical types in fractures of the proximal femur by internal fixation. Methods One hundred and three cases of femoral peritrochanteric fracture underwent operation were studied retrospectively. According to AO classification, the cases of each type were treated by four methods of internal fixation: the cannulated compression screw, dynamic hip screw (DHS), anatomical plate and proximal femoral nail (PFN). Results All patients were followed up from 6 to 40 months. All fractures were healed. Complications occurred in 9 patients, including aseptic necrosis of the femoral head in 2, coax magna in 7. According to Sanders standard of function of joint, the final effect was satisfactory. Conclusion It is important to select different surgical types according the different peritrochanteric fracture separately.

Relationship between motor complications of Parkinson's disease and phosphorylated GluR1Ser845 / 中华神经科杂志

Objective To explore the relationship between motor complications of Parkinson's disease(PD)with chronic L-dopa treatment and striatal phosphorylated GluR1Ser845.Methods The hemi-parkinsonian rat model was produced by injecting stereotaxically 6-OHDA to right medial forebrain bundle(MFB).Then the hemi-parkinsonian rat was treated intraperitoneally with L-dopa methylester(25 mg?kg-1?d-1,twice one day)for 22 days and rotational duration and frequency of off period were respectively estimated.After they were sacrificed,their subcellualr distribution of GluR1 and GluR1Ser845 phosphorylation was observed with immunofluorescence and Western blot.Results After the chronic treatment with L-dopa methylester,PD rats displayed shortened rotational duration and increased frequency of off period,which was similar to fluctuations of the symptoms and on-off phenomenon in PD patients.In the lesioned striatum of PD rats,the amount of GluR1 and phosphorylated GluR1Ser845 in striatal membrane was reduced to 73.0%?4.8% and 42.0%?5.6%,respectively,compared with those non-lesioned.After chronic treatment of PD rats with L-dopa,the amount of GluR1 and phosphorylated GluR1Ser845 in striatal membranes were increased to 104.0%?5.5% and 112.0%?3.4%.These unique changes occurred only in parvalbumin-positive interneurons.Conclusions These findings suggest that subcellular distribution and phosphorylation state of GluR1Ser845 in parvalbumin-positive interneurons may play a significant role in the pathogenesis of motor complications of chronic L-dopa treatment for PD.

Detection of fibroblast growth factor receptor 3 gene mutation at nucleotide 1138 site in congenita achondroplasia patients / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>[corrected] To investigate the mutation at the transmembrane domain of fibroblast growth factor receptor 3 (FGFR3) nucleotide 1138 site for identifying the major pathologic mechanism of achondroplasia (ACH) and to evaluate the efficacy of denaturing gradient gel electrophoresis(DGGE) method for screening the point mutations.</p><p><b>METHODS</b>The genomic DNA from 17 clinically diagnosed ACH patients where analysed by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) with Sfc I and Msp I restriction endonucleases and by PCR-DGGE technique for screening.</p><p><b>RESULTS</b>G to A transition mutation at nucleotide 1138 was detected in 14/17 of the ACH patients as heterozygotes by PCR-RFLP with Sfc I digestion. No 1138 G to C transition was detected by Msp I digestion. All of the 14 samples with G to A mutation were also found to be positive for point mutation by PCR-DGGE. No mutation was detected in 3 negative samples by PCR-RFLP, implying that there was actually no point mutation in this amplified region.</p><p><b>CONCLUSION</b>Nucleotide 1138 in transmembrane domain of FGFR3 gene is the hot point for mutation in ACH and hence its major pathologic cause. PCR-DGGE is a sensitive and reliable technique for point mutation screening, especially for the heterozygotes.</p>

Determination of Malondialdehyde Level and XanthineOxidase and Antioxidases Activity inScalding-injured Rats / 第三军医大学学报

The back of rats was immersed in 95℃ water for 10 seconds to produce 10% and 30% TBSA full thickness burn injury. Malondialdehyde (MDA) level in plasma, erythrocytes, the liver and the lungs, the activity of superoxide dismutase (SOD), glutathione peroxidase (GSSG-Px), and catalase (CAT) in the blood, liver and lungs, and the activity of liver xanthine oxidase (XO) were determined 4 hours postburn. It was found that MDA level and SOD activity in rat tissues, XO and CAT activity in the liver, and GSSG-Px activity in the lungs and blood increased significantly aftfe injury. The severity of these changes positively correlated with the area of scalding except the SOD activity in the liver and lungs which showed no significant difference in those animals with 10% and 30% TBSA scalding. However the CAT activity in the blood and lungs decreased postburn and the liver GSSG-Px activity in 10% and 30%TBSA scalding-injured rats was higher and lower than that of the control respectively.The results imply that when scalding involves less area of body surface, the function of anti-peroxidation system of the body will be enhanced by inducing the synthesis of antioxidases; when severe scalding covers larger body surface, the induction of enzyme synthesis will be deficient in some tissues of the body.