Necrolytic Migratory Erythema—A Case Report of Pancreatic Occupying Lesion / 罕见病研究

Glucagonoma is a rare neuroendocrine tumor of α cells of the pancreas. The tumor excessively secretes glucagon and causes glucagonoma syndrome.70%-90% of patients with glucagonoma will develop necrolytic migratory erythema (NME). We reported a patient of glucagonoma syndrome who was presented to the dermatology outpatient clinic with a 2-year-history of recurrent erythema and scaling on the skin migrating throughout the body. A skin biopsy was performed and resulting features matched with NME, whilst imaging examinations suggested a soft tissue density tumor present in the tail of the pancreas with somatostatin receptor expression and laboratory tests found an elevated levels of serum glucagon. After the diagnosis was confirmed, the patient was treated with surgical resection of the glucagonoma and the skin eruptions resolved rapidly in 4 days. Meanwhile, we reviewed relevant literature published in recent years and summarized its clinical characteristics in order to improve its understanding by clinicians, including clinical manifestations, laboratory and imaging examinations, diagnosis and treatments.

Knowledge, attitudes and practices regarding tuberculosis prevention and control:analysis of influencing factors of prevention and control behavior among college students in Wuhan, China / 中国学校卫生

Objective@#To determine the knowledge, attitudes and practices (KAP) regarding tuberculosis prevention and control among college students in Wuhan, China, while analyzing the factors affecting tuberculosis prevention behavior.@*Methods@#Referring to the National KAP Questionnaire for Tuberculosis Prevention and Control among College Students, which was designed by China Center for Disease Control and Prevention, 22 colleges and universities in Wuhan were selected using a judgment sampling method, and a questionnaire survey was carried out through the online questionnaire platform. The formation of tuberculosis prevention and control behavior among this population was analyzed by single factor and multi factor Logistic regression.@*Results@#The total awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan was 79.69%; the awareness rate of core knowledge was 79.28%, and the passing rate was 92.46%. The correct attitude holding rate was 89.69%, while the passing rate was 90.56%. In respect to correct behavior, the formation rate was 72.11%, with a passing rate of 96.62%. The multivariate Logistic regression analysis showed that the following factors were more likely to promote tuberculosis prevention and control behaviors that met the target: female college students ( OR =1.86); college students whose father had a primary school education level, junior high school and equivalent, high school and equivalent, and junior high school students ( OR =2.94, 3.05, 3.17, 3.24 ); no history of tuberculosis ( OR =3.32); the passing knowledge of core knowledge ( OR =9.91), and the passing attitude holding score ( OR =7.35)( P <0.05).@*Conclusion@#The overall awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan is acceptable,the mainly influenced factors are gender, history of tuberculosis, awareness rate of core knowledge about prevention and control, attitudes and cognition, and parents educational background.

Carcinoma-associated fibroblast-derived lysyl oxidase-rich extracellular vesicles mediate collagen crosslinking and promote epithelial-mesenchymal transition via p-FAK/p-paxillin/YAP signaling / 国际口腔科学杂志·英文版

Carcinoma-associated fibroblasts (CAFs) are the main cellular components of the tumor microenvironment and promote cancer progression by modifying the extracellular matrix (ECM). The tumor-associated ECM is characterized by collagen crosslinking catalyzed by lysyl oxidase (LOX). Small extracellular vesicles (sEVs) mediate cell-cell communication. However, the interactions between sEVs and the ECM remain unclear. Here, we demonstrated that sEVs released from oral squamous cell carcinoma (OSCC)-derived CAFs induce collagen crosslinking, thereby promoting epithelial-mesenchymal transition (EMT). CAF sEVs preferably bound to the ECM rather than being taken up by fibroblasts and induced collagen crosslinking, and a LOX inhibitor or blocking antibody suppressed this effect. Active LOX (αLOX), but not the LOX precursor, was enriched in CAF sEVs and interacted with periostin, fibronectin, and bone morphogenetic protein-1 on the surface of sEVs. CAF sEV-associated integrin α2β1 mediated the binding of CAF sEVs to collagen I, and blocking integrin α2β1 inhibited collagen crosslinking by interfering with CAF sEV binding to collagen I. CAF sEV-induced collagen crosslinking promoted the EMT of OSCC through FAK/paxillin/YAP pathway. Taken together, these findings reveal a novel role of CAF sEVs in tumor ECM remodeling, suggesting a critical mechanism for CAF-induced EMT of cancer cells.

Analysis of SCI paper output and research hotspots of Chinese dental research institutions / 中华医学科研管理杂志

Objective:To statistically analyze SCI paper output and research hotspots of Chinese stomatology research institutes from 2011 to 2020.Methods:The papers of Chinese stomatology research institutions in the Web of Science database were searched and analyzed by bibliometric methods in various dimensions including publication time, institutional and journal distribution, international (regional) cooperation, and research hotspots.Results:The number and quality of publications in Chinese dental research institutions have increased significantly in the past decade, and the top four institutions in terms of publication number were Sichuan University, Peking University, Shanghai Jiaotong University, and Air Force Military Medical University. The distribution of the journals to which the articles belong was relatively scattered, and the research hotspots mainly focused on squamous cell carcinoma, periodontitis, bone regeneration, and materials science.Conclusions:The output of SCI papers and the number of high-quality papers in Chinese stomatology research institutions increased year by year during 2011-2020, and the scientific research strength continued to increase.

Challenges and countermeasures in building national regional medical centers for mental health / 中华医院管理杂志

As guided by the policy of building national regional medical centers, it is imperative to advance the construction of the national regional medical centers for mental health to achieve the sustainable and balanced development of the mental health cause of the country. The authors summarized the current status of national regional medical centers, and analyzed challenges faced in management and operation mode, government investment and compensation mechanism, expansion of high-quality psychiatric medical resources, as well as research and innovation of mental diseases of these centers. On such basis, the authors put forward corresponding countermeasures and suggestions for the next stage of development.

The value of gadoxetate disodium enhanced MRI in the quantitative assessment of liver fibrosis / 中华放射学杂志

Objective:To evaluate the value of quantitative analysis of the relative signal intensity (SI) of liver gadolinium disodium enhanced MRI in the grading of liver fibrosis.Methods:From January 2018 to October 2020, the relevant data of 131 patients who underwent gadoxetate disodium enhanced MRI examination were retrospectively analyzed in Henan Provincial People′s Hospital. All patients had histopathological results. According to the Laennec grading system of liver fibrosis, the patients were classified in F0-F1 (27 cases), F2 (19 cases), F3 (17 cases) and F4 (68 cases). The signal intensity of the liver, erector spinae and spleen were measured before and after the enhancement; and 5 post-contrast relative SI parameters were calculated, including the relative enhancement (RE), liver-to-muscle contrast ratio (LMC), liver-to-spleen contrast ratio (LSC), LMC increase rate, LSC increase rate. The differences of 5 post-contrast relative SI parameters among the different fibrosis grades were compared using one-way analysis of variance. The receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic efficacy of 5 post-contrast relative SI parameters in the diagnosis of clinically significant liver fibrosis (F2-F4), advanced liver fibrosis (F3-F4) and liver cirrhosis (F4).Results:The differences of RE, LMC, LSC, LMC increase rate, LSC increase rate among different liver fibrosis grades were statistically significant (all P<0.001). With the increasing of the degree of liver fibrosis, the RE, LMC increase rate and LSC increase rate showed decreased. ROC results showed that the area under the curve (AUC) of RE, LMC increase rate, LSC increase rate in diagnosing liver fibrosis in all levels were greater than those of LMC and LSC. The AUC values of RE, LMC increase rate, LSC increase rate in the diagnosis of significant fibrosis (F2-F4) were 0.89, 0.86, 0.83, with the sensitivity as 81.7%, 71.2%, 81.7%, and the specificity as 96.3%, 85.2%, and 74.1%, respectively. The AUC values of RE, LMC increase rate, LSC increase rate in the diagnosis of advanced liver fibrosis (F3-F4) were 0.93, 0.88, 0.86, with the sensitivity as 84.7%, 72.9%, 91.8%, and the specificity as 91.3%, 87.0 %, 71.7%; and the AUC values for diagnosing liver cirrhosis (F4) were 0.92, 0.86, 0.85, with the sensitivity as 82.4%, 76.5%, 92.7%, and the specificity as 88.9%, 81.0%, 65.1%, respectively. Conclusion:Gadoxetate disodium enhanced MRI relative SI parameters including RE, LMC increase rate and LSC increase rate might be used as a useful imaging marker in liver fibrosis grading.

Mycosis Fungoides and Variants of Mycosis Fungoides: A Retrospective Study of 93 Patients in a Chinese Population at a Single Center

Analysis of clinical and pathological diagnoses of 29 987 skin biopsy samples in Peking Union Medical College Hospital / 中华皮肤科杂志

Objective To analyze the disease constitution,accuracy of clinical and pathological diagnoses of skin biopsy samples in Peking Union Medical College Hospital.Methods A total of 29987 patients subjected to skin biopsy were collected from Department of Dermatology,Peking Union Medical College Hospital from June 2010 to November 2018,and clinical and histopathological diagnoses of these skin biopsy samples were analyzed retrospectively.Results According to the results of histopathological diagnosis,confirmed diagnoses of these patients could be classified into 33 categories and 242 kinds.Common disease categories included epidermal tumors (2931 cases,9.77％),connective tissue diseases (2809 cases,9.37％),melanocytic tumors (2078 cases,6.93％),erythematous scaly pustular dermatoses (1376 cases,4.59％),lichenoid dermatoses (1291cases,4.31％),allergic or eczematous skin diseases (1282 cases,4.28％)and infectious skin diseases (1156 cases,3.86％).Common skin diseases included scleroderma (1887 cases,6.29％),pigmented nevus (1755 cases,5.85％),seborrheic keratosis (1136 cases,3.79％),eczema (1089 cases,3.63％),psoriasis (881 cases,2.94％),lichen planus (867 cases,2.89％),lupus erythematosus (638 cases,2.13％),pemphigus (549 cases,1.83％),and basal cell carcinoma (501 cases,1.67％).Poor consistency was observed between clinical diagnosis and histopathological diagnosis of lichen planus,bullous pemphigoid,granuloma annulare and hypereosinophilic dermatitis.Conclusions Common disease categories of the skin biopsy samples in Peking Union Medical College Hospital were epidermal tumors,connective tissue diseases,melanocytic tumors,erythematous scaly pustular dermatoses,lichenoid dermatoses,and allergic or eczematous skin diseases.Poor consistency was observed between clinical and pathological diagnosis in some skin diseases,and understanding of these diseases should be improved.

Microsurgical treatment of the plexiform neurofibroma in the forearm and palm / 中华显微外科杂志

To explore the clinical effect of microsurgery in the treatment of the tumor which was diagnosed with the plexiform neurofibroma (PN) of the forearm and palm. Methods From January, 2014 to June, 2017, 6 cases of the PN in the forearm and palm were removed by microsurgery such as neurovascular transplantation, separation and anastomosis under microscope, etc. There were 4 males and 2 females, with an average age of 9.2 (range, 2-18 )years. There was 1 case with PN of the median nerve, ulnar nerve and their branches in the right fore-arm and palm, 2 cases with PN of the median nerve and its branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the left forearm and palm, and 1 case with PN of the ulnar nerve and its branches in the left forearm and palm.The postoperative function and feeling of the patients were evaluated by outpa-tient followed-up. Results The pathological results of 6 patients all showed PN, and their incisions healed primari-ly.The patients were followed-up for 6 to 36 months, with an average of 18 months. No obvious scar formation was observed in all incisions. Among them, PN of the palmar of the youngest patient recurred after the operation, and it was resected in a second operation.The remaining 5 patients had no recurrence during follow-up.The 2 point resolu-tion of each fingertip of the affected limb of the patients who had median and ulnar PN was 2-5 mm, with an average of 3.30 mm; the 2 point resolution of the thumb, indicator, middle and ring fingers of the affected limbs of the patients who had median PN was 2-5 mm, with an average of 2.95 mm; the 2 point resolution of the ring and little fingers of the affected limbs of the patients who had ulnar PN was 3-4 mm, with an average of 3.50 mm.According to the related evalu-ation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS), the results of the forearm and hand functions were excellent in 5 cases, good in 1 case. Conclusion The application of microsurgical techniques in the treatment of PN in the forearm and palm can be effective separation of tumor and nerve fibers, effectively protect the branches of the median nerve and ulnar nerve and their blood circulation, prevent recurrence and reduce nerve damage after operation.

Effects of Fluid Shear Stress on PCP Signaling Pathway and Ciliogenesis in Vascular Endothelial Cells / 医用生物力学

Objective To investigate the effect of different fluid shear stress (FSS) on the regulation of planar cell polarity (PCP) signaling, and further to explore the relationship among FSS, PCP signaling pathway and ciliogenesis. Methods The hydrodynamic cell model of adjustable FSS was established. qPCR and immunofluorescence were used to detect the mRNA expression of PCP signaling pathway core protein Dvl2 and cilia assembly protein IFT88, cell targeting and co-localization under different FSS. Western blot (WB) was used to detect the protein expression of Dvl2 at 18 h under different FSS. Results The qPCR result showed that compared with 1.5 Pa FSS, under 0.1 Pa FSS, the mRNA expression of Dvl2 was higher at 6 h and 18 h (P＜0.05), significantly higher at 12 h (P＜0.01); the mRNA expression of IFT88 was significantly higher at 18 h (P＜0.01). The WB result showed that compared with 0 h, under 0.1 Pa FSS, the protein expression of Dvl2 was higher at 18 h (P＜0.05), significantly lower under 1.5 Pa FSS (P＜0.01); compared with 1.5 Pa FSS, the protein expression of Dvl2 was higher at 18 h under 0.1 Pa FSS (P＜0.05). The immunofluorescence result showed that the positive expression of Dvl2 increased with the loading time on FSS increasing, and gradually aggregated at a point around the nucleus; the positive expression of IFT88 was gradually transferred from the nucleus to the cytoplasm and aggregated at a point under 0.1 Pa FSS, and gradually decreased and depolymerized under 1.5 Pa FSS. Protein Dvl2 and IFT88 were located in the same position in cells under 0.1 Pa FSS and before 18 h under 1.5 Pa FSS, and colocalization of proteins Dvl2 and IFT88 was not observed after 18 h under 1.5 Pa FSS due to IFT88 depolymerization. Conclusions Laminar FSS played an inhibition on the transduction of PCP signaling pathway and a hindrance on the process of ciliogenesis, while low FSS played a promotion on the transduction. PCP signaling pathway might regulate FSS-induced ciliogenesis by Dvl2.

High-frequency skin ultrasonographic and dermoscopic features of seborrheic keratosis / 中华皮肤科杂志

Objective To describe high-frequency skin ultrasonographic and dermoscopic features of seborrheic keratosis (SK).Methods Between August and December in 2017,46 outpatients with SK were enrolled from the Department of Dermatology of Peking Union Medical College Hospital,and 50 SK lesions were observed by 50-and 20-MHz high-frequency skin ultrasonography and dermoscopy.The highfrequency ultrasonographic and dermoscopic features of SK lesions were summarized and analyzed.Statistical analysis was done by using chi-square test for comparisons of evaluation results of SK lesions between 50-and 20-MHz ultrasonography,and the correspondence between high-frequency skin ultrasonographic and dermoscopic features of SK was analyzed by calculating the simple matching coefficient.Results As 50-and 20-MHz ultrasonography showed,ultrasonographic features of SK lesions from top to bottom were enhanced hyperecho (48/50 vs.39/50,respectively,P =0.007),enhanced hyperechoic masses or spots in the stratum corneum (22/50 vs.11/50,respectively,P =0.019),sound shadows behind the epidermis (34/50 vs.13/50,respectively,P ＜ 0.001),skin lesions with regular shapes and clear borders (46/50 vs.41/50,respectively,P =0.137),heterogeneous hypoechoic areas in the lesions (50/50 vs.47/50,respectively,P =0.079) and internal hyperechoic spots (25/50 vs.2/50,respectively,P ＜0.001),the lesional bottom being at the same level (40/50 vs.36/50,respectively,P =0.349),and reduced dermal echogenicity below the lesion (50/50 vs.28/50,respectively,P ＜ 0.001).In regard to the overall evaluation of the above 8 ultrasonographic characteristics,50-MHz ultrasonography was superior to 20-MHz ultrasonography (P =0.002).The common dermoscopic features of the 50 SK lesions were clear borders (n =50),comedo-like openings (n =45),ridge or cerebriform pattern (n =31),hairpin-like vessels (n =30),multiple milia-like cysts (n =24),moth-eaten border (n =21) and shiny white streaks (n =3).Under 50-and 20-MHz ultrasonography,the simple matching coefficients between enhanced hyperechoic masses or spots in the stratum corneum and comedo-like openings under dermoscopy were 42％ (21) and 20％ (10) respectively,and the simple matching coefficients between internal hyperechoic spots and multiple milialike cysts (＞ 3) under dermoscopy were 58％ (29) and 48％ (24) respectively.Conclusion Highfrequency skin ultrasonography and dermoscopy both are of great value to the assessment of SK lesions,and 50-MHz ultrasonography is superior to 20-MHz ultrasonography for imaging skin lesions.

The cost-effectiveness of stroke rehabilitation care :a systematic review of randomized controlled trails studies / 中华老年医学杂志

Objective To perform a systematic review of the literature on the cost-effectiveness of stroke rehabilitation care ,and to provide evidence for medical insurance payment and clinical decision making on stroke rehabilitation care. Methods We included published randomized controlled trails (RCTs)which compared rehabilitation care (RC)and usual care(UC)on stroke ,and summarized clinical outcome ,resource use ,costs ,and other indexes as outcomes of interest. Results Among included eight RCT studies ,the results of four models of stroke care were found as following. (1)Four studies involving early supported discharge(ESD)showed lower costs in rehabilitation care ,but similar(n＝3) or better(n＝1)clinical outcome. (2)Two studies involving home-based rehabilitation showed similar costs in one and lower costs in the other ,with no difference in clinical outcome between two trials. (3) One study involving stroke unit care showed higher costs and better clinical outcome. (4)One trial involving integration stroke service was associated with lower costs ,but no difference in the effectiveness. Conclusions For patients with stroke ,rehabilitation care leads to significant improvements on cost-effectiveness. Promoting the clinical use of rehabilitation care will bring about clinical benefits ,increase the efficiency of medical resources use ,and improve patient's quality of life.

Correlation of quantitative parameters from dynamic contrast-enhanced MRI with pathological grades of esophageal squamous cell carcinoma / 中华放射学杂志

Objective To investigate the correlation between dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) quantitative parameters and pathological grading in esophageal squamous cell carcinoma(SCC). Methods Prospective analysis of esophageal squamous cell carcinoma confirmed by electronic gastrointestinal endoscopy was performed. Thirty nine patients who underwent radical resection of esophageal carcinoma with MRI examination one weeks before operation were included. All patients underwent routine chest MRI and DCE-MRI scans, and DCE-MRI quantitative parameters including volume transfer constant (Ktrans), exchange rate constant (Kep) and extravascular extracellular volume fraction(Ve)were measured.Pathological analysis of postoperative specimens,including pathological grading(highly differentiated,moderately differentiated,poorly differentiated,undifferentiated),gross tumor pathological type(ulcerative type,medullary type,fungating type,sclerotic type)and local infiltration degree (T staging) were performed. Kruskal-Wallis H test was used to compare the differences of quantitative parameters between different pathological T staging,gross tumor pathological types and pathological grades of DCE-MRI,and a Dunn-Bonferroni test for post hoc comparisons.Spearman rank correlation analysis was used to evaluate the correlation between DCE-MRI parameters and pathological grading of esophageal squamous cell carcinoma.The ROC curves was used to evaluate the efficiency of different parameters in the diagnosis of poorly differentiated esophageal squamous cell carcinoma. Result Among the thirty nine patients, they were divided into three group according to pathological findings: well differentiated (12 patients),moderately differentiated(15 patients)and poorly differentiated group(12 patients);ulcerative type (19 patients), fungating type(10 patients), medullary type(10 patients);T1, 2 stage(16 patients), T3 stage(14 patients), and T4 stage(9 patients). There was no significant difference in the value of Ktrans, Kepand Ve between different T staging groups and different tumor pathological types groups(all P>0.05).The differences of Ktrans, Kepand Vebetween different pathological grading groups were statistically significant (all P<0.05). There were positive correlation between Ktrans, Kep, Veand the pathological grading, rs value were 0.874, 0.672, 0.578 respectively, all P<0.01. The ROC curve area of Ktrans, Kepand Vein the diagnosis of poorly differentiated esophageal squamous cell carcinoma was 0.941,0.809 and 0.773 respectively.The diagnostic efficiency of Ktranswas the best.Conclusions The quantitative parameters of DCE-MRI are correlated with the pathological grading of esophageal squamous cell carcinoma. Ktrans, Kepand Vecan reflect the perfusion characteristics of esophageal squamous cell carcinoma.

β-catenin high expression in atherosclerotic vessel wall caused by rabbit carotid artery cannula / 重庆医学

Objective To investigate the effects of rabbit carotid artery cannula on atherosclerosis formation and β-catenin expression.Methods Fifteen 2-month-old New Zealand rabbits weighing(2.0±0.2)kg were randomly divided into three groups,high-fat diet group,left common carotid artery cannula group and left common carotid artery cannula plus high-fat diet group,5 cases in each group,and taking the right blood vessels in the left common carotid artery cannula group served as the control group.The animals were sacrificed after 9-week feeding,and the total rabbit carotid artery in each group was taken;the real-time PCR and immunohistochemistry were used to detect β-catenin mRNA and protein expression targeting in rabbit common carotid artery tissue.Results The real-time PCR results showed that the β-catenin mRNA expression in the left common carotid artery cannula group was higher than that in the control group,high fat diet group and the left common carotid artery cannula + high-fat diet group.The immunohistochemistry results showed that,except for the control group,various groups had the β-catenin protein location in the cytoplasma,moreover which in the left carotid artery cannula group and left common carotid artery cannula +high-fat diet group mainly located in the area of intimal hyperplasia.Conclusion β-catenin is highly expressed in the atherosclerotic vessel wall caused by rabbit carotid artery cannula.

Dermoscopic features of primary cutaneous amyloidosis / 中华皮肤科杂志

Objective To describe common dermoscopic features of primary cutaneous amyloidosis (PCA),and to explore the application value of dermoscopy in assisting the diagnosis of PCA.Methods Seventeen patients with PCA were collected from Department of Dermatology of Peking Union Medical College Hospital between April 2014 and December 2016.A total of 45 skin lesions were subjected to dermoscopy,and their dermoscopic features were analyzed.Results The common dermoscopic features of PCA included central hubs,which could be white,brown or scar-like areas,various pigment structures and shiny white streaks.Dermoscopy showed that central hubs could be observed in all the lesions (100％),while white center hubs alone were observed in 14 (31％) lichenoid lesions,both white center hubs and scar -like areas in 5 (11％) lichenoid lesions,brown center hubs alone in 8 (18％) macular lesions,both white and brown center hubs in 6 (13％) lichenoid lesions and 17 (38％) macular lesions.All the lesions showed various pigment structures.Shiny white streaks were observed in 4 (9％) lichenoid lesions.Conclusion Dermoscopy has good application value in assisting the diagnosis of PCA.

Clinical Analysis of 122 Cases of Langerhans Cell Histiocytosis / 中国医学科学院学报

Objective To investigate the features of Langerhans cell histiocytosis (LCH). <b>Method</b> Skin lesions,systemic involvement,imaging characteristics,laboratory tests,immunophenotying,treatment response,and survival of 122 LCH patients treated at our center from February 1983 to August 2013 were retrospectively analyzed. Results LCH was associated with diverse skin lesions. Lung was the most involved organ,followed by bone,skin,lymph nodes,liver,spleen,oral cavity,and thyroid. Multisystem LCH was more common than single-system LCH. Single-system LCH was mostly treated by surgery,whereas multisystem LCH by combined chemotherapy. Conclusion LCH has diverse clinical manifestations,with lungs being the most often involved organ. Surgery or chemotherapy is the mainstream treatment.

MicroRNA-26a inhibits cell migration and invasion in cervical cancer through targeting high mobility group protein A1(HMGA1) / 中华微生物学和免疫学杂志

Objective To investigate the role of microRNA-26a (miR-26a) in cell migration and invasion in cervical cancer and its regulatory effects on high mobility group protein A1(HMGA1). Methods Both HeLa and SiHa cells were divided into four groups:miR-26a mimic group,mimic control group,miR-26a inhibitor group and inhibitor control group. MiR-26a expression was evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). Target genes for miR-26a-5p were predicted by bioinformatics and verified by dual-luciferase reporting system. HMGA1 expression was evaluated by Western blot and qRT-PCR. Cell migration and invasion were analyzed by in vitro assays. Results (1) HMGA1 was predicted as one of the potential targets of miR-26a by TargetScan. Results of dual-luciferase activity assay further con-firmed that HMGA1 was directly regulated by miR-26a. (2) Expression of miR-26a and HMGA1 at mRNA level was respectively enhanced and inhibited in miR-26a mimic-transfected HeLa as well as SiHa cells as compared with those in the corresponding mimic control groups (P<0.05). On the contrary, expression of miR-26a and HMGA1 at mRNA level was respectively reduced and increased in miR-26a inhibitor groups as compared with those in the corresponding inhibitor control groups(P<0.05). (3) Expression of HMGA1 in miR-26a mimic-transfected HeLa and SiHa cells was lower than that in the corresponding mimic control groups(P<0.05). But expression of HMGA1 in miR-26a inhibitor groups was higher than that in the corre-sponding inhibitor control groups(P<0.05). (4) Abilities of cell migration and invasion were suppressed in miR-26a mimic groups as compared with those in the corresponding mimic control groups,but were enhanced in miR-26a inhibitor groups as compared with those in the corresponding inhibitor control groups(P<0.05). Conclusion MiR-26a can inhibit the proliferation and invasion of HeLa and SiHa cells through targeting HMGA1,suggesting that miR-26a is closely related to cervical cancer and might be associated with chemo-therapy resistance in cervical cancer. This study might provide a new strategy for the prevention and treat-ment of cervical cancer.

Development and Research of Supplier Induced Demand Theory / 中国卫生经济

Objective:To explain the supplier induced demand theory paradigm,track the empirical research progress,so as to provide references for health care reform in China.Methods:The new classical theory,game theory and behaviorism school were launched to process theoretical derivation of induced demand.The classical empirical research and the latest research progress were introduced to systemically review on supplier induced demand.Results:The generation of supplier induced demand was related with incentive system,the type of diseases and the crowd of research.Conclusion:It could effectively reduce the induced demand for health care that constraining hospital internal incentive,conducting medical supply side structural reform,developing the “Internet +medical” and building Diagnosis Related Groups (DRGs) payment system.

Research on Exploring the Design and Price Range of Health Service Packages Based on the End-of Life Expenditures in Patients with Advanced Cancer / 中国卫生经济

Objective:To investigate the health resources utilization efficiency from the perspective of the end-of-life medical costs in advanced cancer patients,estimate the method of calculating the price range for medical service package in community health service center.Methods:Taking the medical cost of cancer patients in final year of the end of life in Hubei under the dual-referal policy of high leveled hospitals and community medical institutions,it estimated the pricing range for palliative care medical package and designed the medical payment policy for hierarchy diagnosis.Results:With the new medical service package policy,maintained the same level of medical service quantity,the total medical cost would save a great amount.Conclusion:Based on the accurate budget calculation of end-of-life costs,it had great significance for the implementation of classified diagnosis policy,rationally design the link and pricing range between hospitals and community medical service package.

Effect of microRNA-106b on the invasion and proliferation of trophoblasts through targeting MMP-2 / 中华妇产科杂志

Objective To investigate the expression of microRNA-106b(miR-106b)in the placentas of patients with pre-eclampsia and its relationship with matrix metallopeptidase(MMP)-2,and its effect on the invasion and proliferation of trophoblasts. Methods (1) Placental tissues were collected from patients with mild pre-eclampsia (mPE, n=30) , severe pre-eclampsia (sPE, n=30) and normal pregnant women (n=40). Human choriocarcinoma cell lines JAR and JEG3 were assigned to the miR-106b mimics group, the mimics negative control group, the miR-106b inhibitor group and the inhibitor negative control group, respectively. (2) The target gene of miR-106b(such as MMP-2) was predicted by bioinformatics. Dual-luciferase reporting system was used to verify the regulation of miR-106b on the expression of MMP-2. (3) The expressions of miR-106b and MMP-2 were measured by quantitative real-time PCR (qRT-PCR) and western blot. (4) Cell proliferation was determined by MTT assay. (5) Invasive activities in each group were assessed by cell transwell invasion assays. Results (1) Predicting result of bioinformatics indicated that MMP-2 was one of the target genes of miR-106b. Dual-luciferase activity assay demonstrated that MMP-2 was the direct target of miR-106b(P＜0.01).(2) The results of qRT-PCR.①The expression of miR-106b in the placentas of mPE, sPE, normal pregnant women were 2.89±0.04, 1.96±0.03, 1.01±0.03, respectively (P＜0.05). And the expression of MMP-2 mRNA in the placentas of mPE, sPE, normal pregnant women were 1.87±0.05, 0.69±0.03, 2.78±0.03, respectively (P＜0.05).②The expression of miR-106b in the JAR cell line in the miR-106b mimics group, the mimics negative control group, the miR-106b inhibitor group and the inhibitor negative control group were 2.39 ± 0.03, 1.03 ± 0.04, 0.73 ± 0.03, 1.11 ± 0.04, respectively (P＜0.05). And its expression in the JEG3 cell line were 2.17±0.04, 1.18±0.04, 0.61±0.03 and 1.22±0.03, respectively (P＜0.05). ③The expression of MMP-2 mRNA in the JAR cell line in the miR-106b mimics group, the mimics negative control group, the miR-106b inhibitor group and the inhibitor negative control group were 0.45±0.15, 1.02±0.03, 2.28±0.03, 1.11±0.03, respectively (P＜0.05). And its expression in the JEG3 cell line were 0.58±0.03, 1.25±0.15, 2.25±0.03, 1.21±0.03, respectively (P＜0.05). (3) The results of western blot.①The expression of MMP-2 protein in the placentas of mPE, sPE, normal pregnant women were 1.63 ± 0.04, 0.55±0.03, 2.82±0.03, respectively (P＜0.05).②The expression of MMP-2 protein in the JAR cell line in the miR-106b mimics group, the mimics negative control group, the miR-106b inhibitor group and the inhibitor negative control group were 0.41 ± 0.03, 0.97 ± 0.03, 2.25 ± 0.03, 1.01 ± 0.03, respectively (P＜0.05). And its expression in the JEG3 cell line were 0.53±0.03, 1.20±0.03, 2.31±0.04, 1.19±0.03, respectively (P＜0.05). (4) miR-106b could inhibit the proliferation of JAR and JEG3 cells, cell proliferation rates in the miR-106b mimics group were lower than that in the mimics negative control group (P＜0.05). And cell proliferation rate in the miR-106b inhibitor group was higher than the inhibitor negative control group (P＜0.05) . (5) The numbers of JAR cell that passed the membrane in the miR-106b mimics group, the mimics negative control group. The miR-106b inhibitor group and the inhibitor negative control group were 61±15, 79±13, 134±13, 80±12, respectively( P＜0.05). And the numbers of JEG3 cell that passed were 57±12, 71±15, 128±15, 70± 14, respectively (P＜0.05). Conclusion The miR-106b could inhibit the invasion and proliferation of JAR and JEG3 cells through targeting MMP-2, and have a relationship with the pathogenesis of pre-eclampsia.