Molecular and morphological evidence supports the resurrection of Chrysospleniumguangxiense H.G.Ye & Gui C.Zhang (Saxifragaceae).

Chrysospleniumguangxiense H.G.Ye & Gui C.Zhang was first described as a new species in 1994 but later synonymized in the Flora of China treatment with C.glossophyllum H.Hara. Plastid genomes and nrDNA sequences were used to infer the phylogenetic relationships of selected taxa in Chrysosplenium. Our phylogenetic analyses revealed that C.guangxiense belongs to sect. Alternifolia, is closely related to Chrysospleniumhydrocotylifolium H.Lév. & Vaniot but distant from C.glossophyllum. Morphologically, C.guangxiense could be easily distinguished from C.glossophyllum by having robust rhizomes, basal leaves with a long cuneate base and fewer teeth in the margin, curled sepal margins, and red, larger seeds. It could also be easily distinguished from C.hydrocotylifolium by possessing long elliptic leaves and a long cuneate leaf base. Along with the phylogenetic studies, the complete plastid genome of C.guangxiense was also reported. The plastid genome was 154,004 bp in length and comprised two inverted repeats (IRs) of 28,120 bp, separated by a large single-copy of 80,646 bp and a small single-copy of 17,118 bp. A total of 111 functional genes were discovered, comprising 78 protein-coding genes, 29 tRNA genes, and four rRNA genes. Based on assessment of morphological and molecular data Chrysospleniumguangxiense H.G.Ye & Gui C.Zhang is resurrected from C.glossophyllum H.Hara at species level. A global conservation assessment classifies C.guangxiense as Vulnerable (VU).

Identification of fatty acids synthesis and metabolism-related gene signature and prediction of prognostic model in hepatocellular carcinoma.

BACKGROUND: Fatty acids synthesis and metabolism (FASM)-driven lipid mobilization is essential for energy production during nutrient shortages. However, the molecular characteristics, physiological function and clinical prognosis value of FASM-associated gene signatures in hepatocellular carcinoma (HCC) remain elusive. METHODS: The Gene Expression Omnibus database (GEO), the Cancer Genome Atlas (TCGA), and International Cancer Genome Consortium (ICGC) database were utilized to acquire transcriptome data and clinical information of HCC patients. The ConsensusClusterPlus was employed for unsupervised clustering. Subsequently, immune cell infiltration, stemness index and therapeutic response among distinct clusters were decoded. The tumor immune dysfunction and exclusion (TIDE) algorithm was utilized to anticipate the response of patients towards immunotherapy, and the genomics of drug sensitivity in cancer (GDSC) tool was employed to predict their response to antineoplastic medications. Least absolute shrinkage and selection operator (LASSO) regression analysis and protein-protein interaction (PPI) network were employed to construct prognostic model and identity hub gene. Single cell RNA sequencing (scRNA-seq) and CellChat were used to analyze cellular interactions. The hub gene of FASM effect on promoting tumor progression was confirmed through a series of functional experiments. RESULTS: Twenty-six FASM-related genes showed differential expression in HCC. Based on these FASM-related differential genes, two molecular subtypes were established, including Cluster1 and Cluster2 subtype. Compared with cluster2, Cluster1 subtype exhibited a worse prognosis, higher risk, higher immunosuppressive cells infiltrations, higher immune escape, higher cancer stemness and enhanced treatment-resistant. PPI network identified Acetyl-CoA carboxylase1 (ACACA) as central gene of FASM and predicted a poor prognosis. A strong interaction between cancer stem cells (CSCs) with high expression of ACACA and macrophages through CD74 molecule (CD74) and integrin subunit beta 1 (ITGB1) signaling was identified. Finally, increased ACACA expression was observed in HCC cells and patients, whereas depleted ACACA inhibited the stemness straits and drug resistance of HCC cells. CONCLUSIONS: This study provides a resource for understanding FASM heterogeneity in HCC. Evaluating the FASM patterns can help predict the prognosis and provide new insights into treatment response in HCC patients.

Effect of Anti-HBs on Mortality Among Resolved HBV Infection: a Population-Based Prospective Cohort Study.

INTRODUCTION: Surveillance programs after hepatitis B surface antigen (HBsAg) loss are not yet well established, and the role of hepatitis B surface antibodies (anti-HBs) remains controversial. We aimed to evaluate the risk factors for increased mortality and the association between anti-HBs and all-cause and cause-specific mortality in a representative US (United States) population of patients with resolved HBV (Hepatitis B virus) infections. METHODS: Data were taken from the US National Health and Nutrition Examination Survey (NHANES) 1999-2018. A total of 3455 US adults with resolved HBV infection [defined as hepatitis B surface antigen (HBsAg) negative/anti-hepatitis B core antigen (anti-HBc) positive] were enrolled in this study. The primary outcome measures were all-cause and cause-specific mortality from baseline until 31 December 2019. RESULTS: During a mean follow-up of 10.3 years, 741 deaths occurred. Age, race, marital status, smoking status, physical activity level, and presence of cirrhosis, diabetes, cardiovascular diseases, chronic obstructive pulmonary diseases, cancer, and anti-HBs were significant factors for increased mortality, and a nomogram tool was developed and validated for the risk stratification of mortality. Compared with participants who were anti-HBs positive, those who were anti-HBs negative had a 23% (hazard ratio 1.23, 95% CI 1.02-1.46) higher risk of all-cause mortality in NHANES 1999-2018. For cause-specific mortality, the fully adjusted hazard ratios of participants who were anti-HBs negative were 0.71 (95% CI 0.48-1.06) for heart disease, 1.44 (95% CI 1.01-2.05) for cancer, and 1.44 (95% CI 1.13-1.83) for other conditions, compared to those of participants who were anti-HBs positive. CONCLUSIONS: Among US adults with resolved HBV infections, anti-HBs-negative status was associated with an increased risk of death from all causes and cancer, implying that the role of anti-HBs in resolved HBV infection should not be ignored. On the public health level, more rigorous surveillance was needed for populations of individuals who were isolated anti-HBc positive.

Multi-disciplinary open comprehensive training program in improving the post competency of medical imaging students / 中华医学教育探索杂志

Objective:To evaluate the teaching effect of multi-disciplinary integrated training program on the open comprehensive training room to improve the post competency of medical imaging students.Methods:A total of 122 residential students of five-year medical imaging from Batch 2014 of The First Affiliated Hospital of Chengdu Medical College were divided into experimental group and control group. The experimental group carried out the multi-disciplinary open comprehensive training program, and the control group carried out open-ended exercises. The comprehensive discipline theory examination, assessment of clinical thinking and comprehensive skill appraisal, and satisfaction questionnaire results were compared between the two groups. SPSS 23.0 was used for t test. Results:①Comprehensive discipline theory examination scores were higher in experimental group than the control group [(80.33±3.70) vs. (74.56±5.09)], with statistical differences ( P<0.05). ②Experimental group scored higher in clinical thinking and comprehensive skills than the control group did, and the difference was statistically significant [(87.58±3.15) vs. (74.52±3.66), P<0.05]. ③The questionnaire investigation showed that the experimental group students did better in improving autonomous learning ability, expression ability, the team cooperation ability, the ability to find and fix problems and the degree of self-esteem than control group, with statistically significant differences ( P<0.05). Conclusion:The multi-disciplinary open comprehensive training program has a good effect on optimizing the open-ended exercises. Students' knowledge of multi-disciplinary comprehensive theoretical knowledge and imaging skills have been improved, and the ability of teamwork, problem-solving ability, self-learning ability and innovation ability required by the core competence of the profession have been developed and improved, which meets the modern medical treatment of education "to create an educational platform of medical education collaboration and multi-disciplinary integration, and to cultivate students' innovative and autonomous learning."

Radiational dose detection for natural uranium container port / 上海预防医学

Objective To determine the level of radiation dose in port workplace for loading and unloading natural uranium ore containers, and to provide a basis for occupational health management of the operators. Methods Workplace investigation was conducted to understand the loading and unloading process of natural uranium ore containers, operation time and frequency, etc. A radiation dose rate meter was used to detect the radiation dose rate at 5 cm from the outer surface of 168 natural uranium ore containers. At the same time, we selected one container and detected the level of dose rate at 5-200 cm away from each side surface of the 5 container surfaces except for the bottom side. Results The dose rate level at 5 cm at outer surface of 168 containers ranged from 27 μSv/h to 44 μSv/h, and the average dose rate level was 35.6 μSv/h. The average dose rate levels at 5, 30, 50, 100 and 200 cm were 21.3, 14.6, 11.3, 7.1 and 3.5 μSv/h, respectively. In normal operation, the personal exposure dose of port worker were estimated to be less than 580 μSv/a. Conclusion In normal operation, the dose rate level at any workplace on the outer surface of natural uranium ore container is far below the national standard limit.

Prime-boost vaccination of mice and Rhesus macaques with two novel adenovirus vectored COVID-19 vaccine candidates

COVID-19 vaccines are being developed urgently worldwide, among which single-shot adenovirus vectored vaccines represent a major approach. Here, we constructed two novel adenovirus vectored COVID-19 vaccine candidates on simian adenovirus serotype 23 (Sad23L) and human adenovirus serotype 49 vectors (Ad49L) carrying the full-length gene of SARS-CoV-2 spike protein (S), designated Sad23L-nCoV-S and Ad49L-nCoV-S vaccines, respectively. The immunogenicity elicited by these two vaccine strains was individually evaluated in mice. Specific humoral and cellular immune responses were proportionally observed in a dose-dependent manner, and stronger response was obtained by boosting. Furthermore, five rhesus macaques were intramuscularly injected with a dose of 5x109 PFU Sad23L-nCoV-S vaccine for prime vaccination, followed by boosting with 5x109 PFU of Ad49L-nCoV-S vaccine at 4-week interval. Three macaques were injected with Sad23L-GFP and Ad49L-GFP vectorial viruses as negative controls. Both mice and macaques tolerated well the vaccine inoculations without detectable clinical or pathologic changes. In macaques, prime-boost vaccination regimen induced high titers of 103.16 S-binding antibody (S-BAb), 102.75 cell receptor binding domain (RBD)-BAb and 102.38 neutralizing antibody (NAb) to pseudovirus a week after boosting injection, followed by sustained high levels over 10 weeks of observation. Robust IFN-{gamma} secreting T-cell response (712.6 SFCs/106 cells), IL-2 secreting T-cell response (334 SFCs/106 cells) and intracellular IFN-{gamma} expressing CD4+/CD8+ T cell response (0.39%/0.55%) to S peptides were detected in the vaccinated macaques. It was concluded that prime-boost immunization with Sad23L-nCoV-S and Ad49L-nCoV-S vaccines can safely elicit strong immunity in animals in preparation of clinical phase 1/2 trials.

Development of a quantum-dot lateral flow immunoassay strip based portable fluorescence smart-phone system for ultrasensitive detection of IgM/IgG to SARS-CoV-2

BackgroundSince December 2019, the outbreak of coronavirus disease (COVID-19) has been occurred by novel coronavirus (SARS-CoV-2). The rapid and sensitive immunoassays are urgently demanded for detecting specific antibodies as assistant diagnosis for primary screening of asymptomatic individuals, close contacts, suspected or recovered patients of COIVD-19 during the pandemic period. MethodsThe recombinant receptor binding domain of SARS-CoV-2 spike protein (S-RBD) was used as the antigen to detect specific IgM and the mixture of recombinant nucleocapsid phosphoprotein (NP) and S-RBD were used to detect specific IgG by the newly designed quantum-dot lateral flow immunoassay strip (QD-LFIA), respectively. ResultsA rapid and sensitive QD-LFIA based portable fluorescence smart-phone system was developed for detecting specific IgM/IgG to SARS-CoV-2 from 100 serum samples of COVID-19 patients and 450 plasma samples from healthy blood donors. Among 100 COVID-19 patients diagnosed with NAT previously, 3 were severe, 35 mild and 62 recovered cases. By using QD-LFIA, 78 (78%) and 99 (99%) samples from 100 COVID-19 patients serum were detected positive for anti-SARS-CoV-2 IgM or IgG, respectively, but only one sample (0.22%) was cross-reactive with S-RBD from 450 healthy blood donor plasmas that were collected from different areas of China. ConclusionAn ultrasensitive and specific QD-LFIA based portable fluorescence smart-phone system was developed fo r detection of specific IgM and IgG to SARS-CoV-2 infection, which could be used for investigating the prevalence or assistant diagnosis of COVID-19 in humans.

Genomic epidemiology of SARS-CoV-2 in Guangdong Province, China

COVID-19 is caused by the SARS-CoV-2 coronavirus and was first reported in central China in December 2019. Extensive molecular surveillance in Guangdong, Chinas most populous province, during early 2020 resulted in 1,388 reported RNA positive cases from 1.6 million tests. In order to understand the molecular epidemiology and genetic diversity of SARS-CoV-2 in China we generated 53 genomes from infected individuals in Guangdong using a combination of metagenomic sequencing and tiling amplicon approaches. Combined epidemiological and phylogenetic analyses indicate multiple independent introductions to Guangdong, although phylogenetic clustering is uncertain due to low virus genetic variation early in the pandemic. Our results illustrate how the timing, size and duration of putative local transmission chains were constrained by national travel restrictions and by the provinces large-scale intensive surveillance and intervention measures. Despite these successes, COVID-19 surveillance in Guangdong is still required as the number of cases imported from other countries is increasing. HighlightsO_LI1.6 million molecular diagnostic tests identified 1,388 SARS-CoV-2 infections in Guangdong Province, China, by 19th March 2020 C_LIO_LIVirus genomes can be recovered using a variety of sequencing approaches from a range of patient samples. C_LIO_LIGenomic analyses reveal multiple virus importations into Guangdong Province, resulting in genetically distinct clusters that require careful interpretation. C_LIO_LILarge-scale epidemiological surveillance and intervention measures were effective in interrupting community transmission in Guangdong C_LI

[Screening and Identification of Blood Group Alloantibody by Surface Plasmon Resonance Technique and Its Preliminary Application].

OBJECTIVE: To investigate the feasibilily of screening and identifying the red blood cell type alloantibodies by means of surface plasman resonance(SPR) technique so as to provide a new method for detecting the transfusion compatibility of red blood cells. METHODS: The RBC antigens for screening the alloantibody were fixed on the SPR chip surface by means of amino coupling method; the analysis conditions of SPR chip were optimized and then the control serum with RBC blood group antibody positive was detected; the performance of SPR chip for detection of serum was analysed; the consistance of rusults detected by SPR technique and microcolum agglutination for clinieal samples of 129 thalasstmia patients with history of lone-term blood transfusion were compared; at the same time, the blood group amtibodies in 7 patients with blood group antibody positive were identified before blood transfusion by using SPR chip so as to select the RBC antigen compatible blood for transfusion; and the efficacy of RBC transfusion was followed up and evaluated. RESULTS: The repeatability, sensitivity and specificity of SPR chip technique for detecting the blood group alloantibodies all were better. The SPR technique and microcolumn agglutination method were not significant different for screening blood group alloantibodies (χ2 = 0.333, P＞0.05), and the overall consistency was 97.2%; the results of SPR technique in 7 patients with positive blood group antibodies were as follows: 3 cases with anti-E, 1 case anti-M, 1 case anti-C, 1 case anti-Jka and 1 case autoantibody, which were consistent with the results of microcolumn agglutination tests, and the compatible red blood cells were selected for transfusion, of which the infusion of 6 cases was effective. In only 1 case the infusion was ineffective because of autoantibody. CONCLUSION: For screening and identification of blood group alloantibodies, the performance of SPR chip technique is equivalent to the micro-column agglutination, but the procedure of SPR technique is simpler, faster and high-throughput and label-free, which can meet the basic requirements for rapid screening and identification of blood group alloantibodies before transfusion of red blood cells.

Screening and Identification of Blood Group Alloantibody by Surface Plasmon Resonance Technique and Its Preliminary Application / 中国实验血液学杂志

OBJECTIVE@#To investigate the feasibilily of screening and identifying the red blood cell type alloantibodies by means of surface plasman resonance(SPR) technique so as to provide a new method for detecting the transfusion compatibility of red blood cells.@*METHODS@#The RBC antigens for screening the alloantibody were fixed on the SPR chip surface by means of amino coupling method; the analysis conditions of SPR chip were optimized and then the control serum with RBC blood group antibody positive was detected; the performance of SPR chip for detection of serum was analysed; the consistance of rusults detected by SPR technique and microcolum agglutination for clinieal samples of 129 thalasstmia patients with history of lone-term blood transfusion were compared; at the same time, the blood group amtibodies in 7 patients with blood group antibody positive were identified before blood transfusion by using SPR chip so as to select the RBC antigen compatible blood for transfusion; and the efficacy of RBC transfusion was followed up and evaluated.@*RESULTS@#The repeatability, sensitivity and specificity of SPR chip technique for detecting the blood group alloantibodies all were better. The SPR technique and microcolumn agglutination method were not significant different for screening blood group alloantibodies (χ2 = 0.333, P＞0.05), and the overall consistency was 97.2%; the results of SPR technique in 7 patients with positive blood group antibodies were as follows: 3 cases with anti-E, 1 case anti-M, 1 case anti-C, 1 case anti-Jka and 1 case autoantibody, which were consistent with the results of microcolumn agglutination tests, and the compatible red blood cells were selected for transfusion, of which the infusion of 6 cases was effective. In only 1 case the infusion was ineffective because of autoantibody.@*CONCLUSION@#For screening and identification of blood group alloantibodies, the performance of SPR chip technique is equivalent to the micro-column agglutination, but the procedure of SPR technique is simpler, faster and high-throughput and label-free, which can meet the basic requirements for rapid screening and identification of blood group alloantibodies before transfusion of red blood cells.

Mechanism of Traditional Chinese Medicine Compound in Preventing and Treating Hepatocellular Carcinoma / 中国实验方剂学杂志

Hepatocellular carcinoma(HCC) is the most common malignancy in the world. Although there is progress in HCC diagnosis and treatment, it is still the third leading cause of cancer death worldwide because it is not easily diagnosed early and the disease progresses quickly. China is a high-risk area for HCC, and the number of cases is high and on the rise. Its prevention and treatment is a pressing problem. At present, western medicine is still unclear about the complex pathogenesis and clinical treatment of HCC. There are still many shortcomings and huge challenges. Traditional Chinese medicine(TCM) has its unique advantages in the treatment of HCC. With an overall concept, it has unique therapeutic effect and fewer side effect on HCC,it can not only inhibit tumor growth, but also alleviate patients' clinical symptoms and improve their quality of life. Therefore, the study of the effect of TCM in treating HCC has attracted the attention from many clinicians and researchers. However, the chemical composition of TCM formula is complex, with many targets and huge network of pharmacodynamic mechanisms, which greatly limits the research on the development of clinical drugs for the Chinese medicine formula. In recent years, there have been achievements in the studies of anti-hepatocarcinoma efficacy and mechanism of action of Chinese medicine compound, which mainly focused on the compound's effect in inhibiting the proliferation of hepatocarcinoma cells, blocking cell cycle and inducing apoptosis and autophagy, inhibiting liver cancer cell invasion and metastasis, regulating the immune function, synergism and attenuation, and reversing the drug resistance. In this paper, domestic and foreign literatures on the above-mentioned pharmacodynamics and mechanism of anti-liver cancer of TCM compound were studied, analyzed, summarized and summarized. This paper briefly reviews the research progress of its anti-hepatocarcinoma mechanism, and provides scientific ideas and evidence for the future study of the anti-hepatocarcinoma mechanism of TCM compound and its rational clinical application.

Application of modified Mini-CEX in teaching rounds of standardized training for residents of anesthesia / 中华医学教育探索杂志

Clinical teaching round is one of main teaching methods during standardized training for residents. However, the particularity of standardized resident training in clinical anesthesia determines that it is difficult to apply the teaching round model of other disciplines. In this study, seven core contents of Mini-Clinical Evaluation Exercise (Mini-CEX) were modified after considering the characteristics of anesthesia specialty and applied to the teaching rounds of standardized training for residents of anesthesia , thus promoting the standardization and improving the quality of anesthesia teaching rounds.

Efficacy and Safety of Different Bisphosphonates for Bone Loss Prevention in Kidney Transplant Recipients: A Network Meta-Analysis of Randomized Controlled Trials / 中华医学杂志(英文版)

<p><b>Background</b>Mineral and bone disorder is one of the severe complications in kidney transplant recipients (KTRs). Previous studies showed that bisphosphonates had favorable effects on bone mineral density (BMD). We sought to compare different bisphosphonate regimens and rank their strategies.</p><p><b>Methods</b>We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to April 01, 2017, for randomized controlled trials (RCTs) comparing bisphosphonate treatments in adult KTRs. The primary outcome was BMD change. We executed the tool recommended by the Cochrane Collaboration to evaluate the risk of bias. We performed pairwise meta-analyses using random effects models and network meta-analysis (NMA) using Bayesian models and assessed the quality of evidence.</p><p><b>Results</b>A total of 21 RCTs (1332 participants) comparing 6 bisphosphonate regimens were included. All bisphosphonates showed a significantly increased percentage change in BMD at the lumbar spine compared to calcium except clodronate. Pamidronate with calcium and Vitamin D analogs showed improved BMD in comparison to clodronate with calcium (mean difference [MD], 9.84; 95% credibility interval [CrI], 1.06-19.70). The combination of calcium and Vitamin D analogs had a significantly lower influence than adding either pamidronate or alendronate (MD, 6.34; 95% CrI, 2.59-11.01 and MD, 6.16; 95% CrI, 0.54-13.24, respectively). In terms of percentage BMD change at the femoral neck, both pamidronate and ibandronate combined with calcium demonstrated a remarkable gain compared with calcium (MD, 7.02; 95% CrI, 0.30-13.29 and MD, 7.30; 95% CrI, 0.32-14.22, respectively). The combination of ibandronate with calcium displayed a significant increase in absolute BMD compared to any other treatments and was ranked best.</p><p><b>Conclusions</b>Our NMA suggested that new-generation bisphosphonates such as ibandronate were more favorable in KTRs to improve BMD. However, the conclusion should be treated with caution due to indirect comparisons.</p>

Clinical application of modified pedicled pectoralis major myocutaneous flaps in repairing postoperative defects following head and neck malignant tumor operation / 重庆医学

Objective To explore the clinical effects of modified pedicled pectoralis major myocutaneous flaps(PMMFs) in repairing postoperative defects following head and neck malignant tumor radical operation.Methods Twenty-eight patients with surgical defects after head and neck malignant tumor operation in this hospital from September 2013 to January 2017 were selected and performed the repairing reconstruction by modified PMMFs,then observed and followed up for the survival of the flaps.Results All 28 cases were followed-up for 3-36 months,all modified PMMFs survived.Using modified PMMFs to repair surgical defects following head and neck malignant tumor operation had the advantages of high survival rate and less trauma;meanwhile the swallow and language function could obtain the maximal recovery.Conclusion Using modified PMMFs to repair surgical defects following head and neck malignant tumor operation has good clinical curative effect and is worth clinical application.

ABO-incompatible living donor kidney transplantation / 中华器官移植杂志

Objective To investigate the clinical efficacy and safety of individualized preconditioning in ABO-incompatible living donor kidney transplantation.Methods A series of 36 living donor kidney transplants across a wide range of ABO blood group incompatibilities using individualized preconditioning protocols were performed from September 2014 to June 2017.Preconditioning included oral immunosuppressants with or without the administration of rituximab,PE or DFPP.Medical records and electronic databases were reviewed for isoagglutinin titers,patient and graft survivals,graft function,rejections,infections as well as surgical complications.Results Of 30 ABO blood group incompatibilities,there were 6 cases of AB to A,2 cases of AB to B,4 cases of A to B,3 cases of B to A,13 cases of A to O (13),and 8 cases of B to O.Median initial ABO antibody titers were 1∶32 (1∶2-1∶256) (IgM) and 1 ∶ 8 (0-1∶64) (IgG),respectively.Individualized preconditioning included oral immunosuppressants alone (10 cases),oral immunosuppressants + PE (4 cases),oral immunosuppressants + PE + DFPP (1 case),oral immunosuppressants + rituximab + PE (16 cases),oral immunosuppressants + rituximab + DFPP (2 cases),and oral immunosuppressants + rituximab + PE+ DFPP (3 cases).After individualized preconditioning,an acceptable ABO antibody titer (≤1 ∶ 16) was obtained on the day of transplantation.Median follow-up duration was 12 months (1-33).Graft and patient survival rate was 94.4％ (34/36) and 100％ (36/36) respectively.Median value of serum creatinine at one year posttransplantation was 89 μmol/L,and eGFR was (81.07 mL/min/1.73 m2).In total,there was one episode of urinary tract infection and upper gastrointestinal tract hemorrhage,two cases of hyperacute rejection (leading to graft loss),acutecelluar-mediated rejection,delayed graft function,bone marrow suppression and pneumonia,and 3 cases of acute antibody-mediated rejection and wound fat liquefaction,respectively.Conclusion Our initial experience indicates that individualized preconditioning protocol based on initial ABO antibody titers is safe and technically feasible,and leads to excellent short-term survival of ABOi living donor kidney transplantation.

Review on Pharmaceutical Pricing Reform of Urban Public Hospitals / 中国医院管理

Objective To describe and evaluate the strategies,status quo,effect and problems of pharmaceutical pricing reform in 4 batches of urban public hospitals in China.Methods Chinese database and website of Commission of Health and Family Planning were searched.Bibliometrics was done.Results A total of 33 studies were included by screening and reading the abstracts.Among them,4 were masters' theses,and 29 were research articles and reviews.Generally quantitative researches with strong study designs accounted for only a small proportion.Most of the local reforms achieved basic targets,such as cancelling medicine addition,increasing medical service price,improving hospital internal operating efficiency and controlling medical price,however problems still existed including incomplete adjustment for medical services prices and unmet needs of differentiated compensation plans.Conclusion The prices of medical services should make further adjustment.Efforts should still be made in terms of establishing dynamic compensation mechanism for urban public hospitals,coordinating the policy decision-making process for more integrated measurements including reforms on payment models and logistic process.

A comparison of ARIMA Model, BP Neural Network Model and combined model in health policy evaluation:An empirical study of public hospitals pricing reform / 中国卫生政策研究

Objective:To study the effectiveness of different time series models in the prediction of financial data in public hospitals,with the aim of obtaining a more reliable counterfactual in health policy evaluation. Methods:ARI-MA model,BP neural network and their combination were used for the estimation and prediction of drug revenue and medical service revenue based on a dataset for the period from November,2011 to October,2016 for hospital X before and after Nanjing medical pricing reform. Root mean square error (RMSE) was used to estimate the model accuracy. Results:RMSE of drug revenue from the three models were 692.82,501.44 and 380.80,and of medical service were 184.04,215.63 and 168.65. The findings shows that the combination model was proved to be the most efficient one a-mong the three. The combined model was used to calculate the net loss of drug revenue which was estimated to be 120, 440 million,and the net increase of medical service was estimated to be 185,326 million after the reform,which was 1. 539 times of the drug loss. Conclusions:The revenue data of public hospitals are usually complex with a both linear and non-linear trend. The combination model of ARIMA and BP neural network could solve the problem for once with an acceptable accuracy. However,ARIMA model is simpler to operate as compared to other two models, and also more consistent with the forecasting trend,therefore ARIMA is also recommended in the evaluation for health policies.

Changes in bone mineral density in a rabbit model of steroid-induced osteonecrosis of the femoral head / 中国组织工程研究

BACKGROUND:The rabbit model of osteonecrosis of the femoral head (ONFH) has been successfully established by glucocorticoid combined with lipopolysaccharide.OBJECTIVE:To observe the dynamic changes of bone mass in the early steroid-induced ON FH.METHODS:Twenty-four adult New Zealand white rabbits were randomly divided into experimental and control groups (n=12 per group).Rabbits in the experimental group were injected with lipopolysaccharide and glucocorticoid to establish the model of ONFH,while those in the control group given the same volume of normal saline.The changes in the femoral head structure,morphology and distribution of the trabecular bone at 5,1 0,15 and 20 days after modeling were observed through multi-slice spiral CT,micro-CT and hematoxylin-eosin staining;the bone mineral density and rate of empty lacunae were detected.RESULTS AND CONCLUSION:The imaging examinations showed that the rabbit femoral head was intact and smooth in both groups;on days 15 and 20,in the experimental group,the cortical bone became thinner,the trabecular bone became sparse and discontinuous,and the bone mineral density,tissue mineral density and bone volume/total volume were significantly lower than those in the control group (P ＜ 0.01).The histological observation indicated that there were more empty lacunae and adipocytes,as well as less osteocytes and hematopoietic cells in the experimental group;the rate of empty lacunae in the experimental group was significantly higher than that in the control group on days 15 and 20 (P ＜ 0.01).These findings suggest that in the early stage of ONFH,necrotic osteocytes increase in number,accompanied by trabecular micro-fractures,which leads to a decrease in bone mineral density,eventually resulting in bone remodeling disturbance.

miR-498 inhibits A549 cell migration and invasion by down-regulating FOXM1 / 西安交通大学学报(医学版)

Objective To verify whether miR-498 can inhibit A549 cell migration and invasion by down-regulating FOXM1.Methods miR-498 mimic and miR-NC were transfected into A549 cells.Wound healing and Transwell method were employed to test the migratory ability and invasion ability of A549 cells;Western blot was used to detect the expressions of COL1A1,COL1A5 and FOXM1 in A549 cells.Luciferase assay was used to confirm whether FOXM1 is the target gene of miR-498.Results Compared with those in the control group,the expressions of COL1A1,COL1A5 and FOXM1 were decreased,and the migration and invasion abilities of A549 cells were decreased in the miR-498 group (both P<0 .01 ).The luciferase activity of the FOXM1-3′-UTR plasmid was significantly suppressed by miR-498 (P<0 .05 );over-expression of FOXM1 could reverse the effect of miR-498 on A549 cells.Conclusion miR-498 inhibits A549 cell migration and invasion by down-regulating FOXM1.