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Transcatheter arterial chemoembolization (TACE) is recommended by domestic and international guidelines for the treatment of patients with unresectable hepatocellular carcinoma (uHCC), and it is one of the most common treatment methods for patients with uHCC. The chemotherapy drugs commonly used in TACE for HCC include epirubicin, cisplatin, and fluorouracil, while it is still unclear which chemotherapy drug has a better clinical effect. This article summarizes the studies of different TACE regimens using different chemotherapy drugs in the treatment of patients with uHCC in the recent five years. TACE combined with sorafenib can significantly improve the survival of patients with advanced HCC and has been recommended for the treatment of such patients by Chinese Society of Clinical Oncology guidelines, and the efficacy of TACE combined with other tyrosine kinase inhibitors (TKI) has become a research hotspot. Studies have shown that compared with TACE combined with sorafenib in the treatment of patients with advanced HCC, TACE combined with lenvatinib can achieve a significantly longer progression-free survival time and a tendency of increase in median overall survival time. However, due to the variation of target receptors or downstream signals, resistance to molecular-targeted agents is still a challenging problem. TKI combined with immune checkpoint inhibitors may be a promising strategy for the treatment of patients with uHCC. Some studies suggest that triple therapy using TACE combined with TKIs and anti-PD-1/PD-L1 monoclonal antibody has better efficacy in improving the survival of patients with uHCC. This article reviews the studies of the efficacy and safety of TACE combined with targeted agents and TACE combined with anti-PD-1/PD-L1 monoclonal antibody in the treatment of patients with uHCC in the recent five years.
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Objective To study and estimate the public dose constraint and the atmospheric radiation capacity of an isotope industrial park, and to provide a basis for management of radioactive effluent discharge in isotope industrial parks. Methods We collected the natural environment data, meteorological data, and population distribution and dietary data as well as the source terms of radioactive airborne effluents of an isotope industrial park. The public dose constraint value of the isotope industrial park was determined based on the natural environmental radiation hazard level. The atmospheric environmental radiation capacity of the industrial park was estimated by the all-pathways method. Results The public dose constraint value of the industrial park was 0.2 mSv/a. At the end of industrial park planning, the maximum individual effective dose to the public caused by airborne effluent discharge was 1.07×10−6 Sv/a, which accounted for 0.54% of the public dose constraint value. The proportions of discharges of airborne radionuclides to respective environmental radiation capacities ranged from 0.04% to 4.34%. Conclusion The determined public dose constraint value of the isotope industrial park can be used as the total radiation capacity of the regional atmospheric environment to constrain the discharge of radioactive effluents. The environmental radiation capacity of each radionuclide can be estimated by the all-pathways method considering the comprehensive impact of radionuclide discharges, which is suitable for the control and management of isotope production enterprises in industrial parks.
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Background: The subtypes of chronic urticaria share a common clinical expression, but may show differences phenotypically. Meanwhile, two or more different subtypes of chronic urticaria can coexist in any given patient which may involve different phenotypes. Aims: The study aims to compare the two phenotypes in terms of demographics, clinical profile and treatment response. Methods: In this retrospective study, 2678 chronic urticaria patients were divided into the single subtype chronic urticaria group and mixed subtype chronic urticaria group as was appropriate.The differences in the clinical features, possible causes, urticaria activity score of seven days, dermatology life quality index score, laboratory investigations and response to treatments were evaluated among the two groups. Results: An obvious female predominance was detected in chronic urticaria, especially in mixed subtype chronic urticaria patients. Of the 2678 chronic urticaria patients, there were 837(31.25%) mixed subtype chronic urticaria. Chronic spontaneous urticaria combined with symptomatic dermographism was the most common group in the mixed subtype chronic urticaria. Patients with mixed subtype chronic urticaria were more likely to have associated chest tightness/shortness of breath and showed greater urticaria activity. In patients with single subtype chronic urticaria, the positive rate of family history with allergic rhinitis, asthma or urticaria was lower. Based on evaluation of the treatment, control with second-generation antihistamines at licensed doses was achieved in only 38.83% of mixed subtype chronic urticaria patients, compared with 56.32% of patients with single subtype. Limitations: First, this study was a single-center design retrospective study. Second, omalizumab treatment was not included. Third, the differences between different subtypes of mixed subtype chronic urticaria were not discussed in detail. Conclusion: This study showed that mixed subtype chronic urticaria had some distinct features. Comprehensive knowledge about it may help us define effective therapeutic strategies and improve symptom control and the quality of life for chronic urticaria patients
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Objective:To analyze the prognostic factors and evaluate the accuracy of existing survival prediction models in patients with lung cancer-derived spinal metastases who have undergone open surgery.Methods:According to the inclusion criteria, the data of 76 patients with spinal metastasis of lung cancer who underwent open surgery in the department of Orthopedics in Guangdong Provincial People's Hospital were collected from January 2019 to November 2021. The relationship between the number of bone metastasis, pathological type, visceral metastasis, epidermal growth factor receptor mutation, serum alkaline phosphatase (ALP), hemoglobin (Hb), Frankel grade and postoperative survival time in 76 cases was analyzed by Cox logical regression analysis and Kaplan-Meier method to determine the potential prognostic factors. The accuracy of Tomita score, Tokuhashi revised score, Katagiri New score, New England Spinal Metastasis Score score (NESMS) and Skeletal Oncology Research Group (SORG) machine learning algorithm in predicting postoperative survival time was verified by drawing receiver operating characteristic (ROC) curve.Results:The median follow-up time of the patients was 18.0 months (2.3-36.0 months). The median survival time was 12.6 months [95% CI (10.8, 14.4)]. The survival rates at 6 and 12 months after operation were 71.6% and 52.0%, respectively. Multivariate regression analysis showed that ALP [ HR=0.23, 95% CI (0.11, 0.48), P<0.001], Hb [ HR=4.48, 95% CI (2.07, 9.70), P< 0.001] and EGFR mutation [ HR=2.22, 95% CI (1.04, 4.76), P=0.040] were independent predictors of prognosis. The accuracy of Tomita score, Tokuhashi revised score (2005), Katagiri New score and NESMS score in predicting 1-year mortality was 58.7%, 65.7%, 70.5% and 65% respectively, and the accuracy in predicting 6-month mortality was 63.7%, 62.2%, 61.2% and 56.8% respectively. The accuracy of SORG machine learning algorithm in predicting 1-year and 90 d mortality was 81.1%, 67.5%, respectively. Conclusion:No EGFR mutation, ALP>164 U/L and Hb≤125 g/L were risk factors affecting the survival of patients with spinal metastasis of lung cancer. SORG machine learning algorithm has good accuracy in predicting the postoperative survival rate of patients with lung cancer spinal metastasis.
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Objective To investigate the radiation dose to operators in the process of 241Am-Be neutron source logging, and discuss neutron source management and protective measures for operators in well logging. Methods Through on-site observation and measurement of 241Am-Be neutron source logging in a company, we obtained the surface γ dose rate and neutron dose rate of the neutron source, as well as the operating time and distance of various processes including source taking, transfer, and loading, calculated the radiation dose to operators in various processes, and analyzed the source and proportion of the personal effective dose to operators. Results The effective doses of neutron irradiation and γ irradiation were 94.17 μSv and 2.72 μSv, respectively, for the combined processes of source tank inspection, transfer, and detection; 36.66 μSv and 24.08 μSv, respectively, for source loading and unloading; and 130.83 μSv and 26.80 μSv, respectively, for the whole neutron source logging process. The total annual effective dose of neutron source logging was 15.78 mSv, as estimated by logging 100 times per year. Conclusion In the process of 241Am-Be neutron source logging in the company, the effective dose to operators mainly arises from neutron irradiation. Therefore, it is necessary to strengthen neutron source management and take effective protective measures against neutron radiation.
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OBJECTIVE@#To explore the effect of carvacrol on the biological behavior of leukemia cells and its regulation to circ-0008717/miR-217 molecular axis.@*METHODS@#Human acute lymphoblastic leukemia cells Molt-4 were cultured in vitro, and different concentrations of carvacrol were added to the cells. si-NC and si-circ-0008717 were transfected into Molt-4 cells (si-NC group, si-circ-0008717 group). pcDNA, pcDNA-circ-0008717, anti-miR-NC, anti-miR-217 were transfected into Molt-4 cells and then added to carvacrol-treated cells (carvacrol+pcDNA group, carvacrol+pcDNA-circ-0008717 group, carvacrol+anti-miR-NC group, carvacrol+anti-miR-217 group). MTT, plate clone formation experiment, and flow cytometry were used to detect the viability of the cell, colony formation number, and apoptosis rate of cells, respectively. The RT-qPCR method was used to detect the expression levels of circ-0008717 and miR-217. The dual luciferase reporter gene experiment was used to detect the targeting relationship between circ-0008717 and miR-217.@*RESULTS@#After carvacrol treatment, the cell viability decreased significantly (r=-0.9405), expression level of circ-0008717 decreased (r=-0.9117), colonies formed number decreased (r=-0.9256), while the cell apoptosis rate increased (r= 0.8464), and the expression level of miR-217 increased (r=0.9468). Compared with the si-NC group, the expression level of miR-217 in si-circ-0008717 group increased (P＜0.001), the cell apoptosis rate increased (P＜0.001), while cell viability decreased (P＜0001), the number of colonies formed decreased (P＜0.001). Compared with the carvacrol+pcDNA group, the cell viability of the carvacrol+pcDNA-circ-0008717 group increased (P＜0.001), the number of colonies formed increased (P＜0.001), while the cell apoptosis rate decreased (P＜0.001). circ-0008717 could target miR-217. The cell viability of the carvacrol+anti-miR-217 group increased (P＜0.001), and the number of colonies formed increased (P＜0.001), while the cell apoptosis rate decreased (P＜0001) as compared with the carvacrol+anti-miR-NC group.@*CONCLUSION@#Carvacrol can promote the expression of miR-217 by down-regulating the expression of circ-0008717, thereby reducing the proliferation and cloning ability of leukemia cells and promoting cell apoptosis.
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Humans , Antagomirs , Apoptosis , Cell Line, Tumor , Cell Proliferation , Cymenes , Leukemia , MicroRNAs/geneticsABSTRACT
Nucleic acid aptamers, broad-spectrum target-specific single-stranded oligonucleotides, serve as molecules in targeted therapy, targeted delivery and disease diagnosis for the treatment of tumor or microbial infection and clinical detection. Due to the existence of components in the use of traditional Chinese medicine(TCM), the target is difficult to concentrate and the specificity of treatment is poor. The effective components of TCM are toxic components, so a highly sensitive detection method is urgently needed to reduce the toxicity problem at the same time. The combined application of TCM and modern medical treatment strategy are difficult and cannot improve the therapeutic effect. Aptamers, advantageous in biosensors, aptamer-nanoparticles for targeted drug delivery, and aptamer-siRNA chimeras, are expected to connect Chinese medicinals with nanotechnology, diagnostic technology and combined therapies. We summarized the preparation, screening, and modification techniques of nucleic acid aptamers and the biomedical applications and advantages in therapy, targeting, and diagnosis, aiming at providing a reference for the in-depth research and development in TCM.
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Aptamers, Nucleotide , Drug Delivery Systems , Medicine, Chinese Traditional , Nucleic Acids , RNA, Small InterferingABSTRACT
In this study, 23 germplasm resources of Chrysanthemum morifolium used in medicine and tea were collected from Dabie Mountains and its surrounding producing areas, and the contents of 13 mineral elements were determined and compared. The thermal maps of correlation analysis, principal component analysis and cluster analysis were used for comprehensive evaluation. The results showed that the average content of each element in Ch. morifolium of different germplasm resources was: K>N>P>Mg>Ca>Fe>Mn>Zn>Cu>Ni>Cr>Pb>Cd, and the leaves were: K>N>Ca>Mg>P>Fe>Mn>Zn>Cr>Cu>Ni>Pb>Cd. There are rich contents of N, P, K, Ca, Mg and Fe in Ch. morifolium flowers and their leaves, among them, K element has the largest change range, while N, Ca, Fe, Mg and Zn elements have a larger change range. The absorption and accumulation of each element in the leaves of different germplasm resources varied greatly. The correlation analysis shows that there is a strong positive correlation between Ca element, Mg, Mn and Cd element.Principal component analysis in Ch. morifolium flowers characteristic elements for Mn, Cr, Cu, P, K, can be used as a Ch. morifolium resources to identify the characteristics of the elements, choose top five principal component(F1-F5) comprehensive evalua-tion of medicinal Ch. morifolium, scored in the top five varieties for Hangiu-Fuhuangju, Hangju-Xiaoyangju, Hangju-Sheyangju, Hangju-Dayanghua, Hangju-Subeiju,indicates that in terms of mineral elements, the five medicinal Ch. morifolium resources quality is better. The PCA score chart can divide 23 Ch. morifolium resources into 4 groups, and the cluster analysis heat map divides 23 Ch. morifolium resources into 5 groups. All the Ch. morifolium resources of the same type can be well clustered together, indicating that the difference in mineral element content of Ch. morifolium germplasm resources is closely related to genetic factors.
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Chrysanthemum/genetics , Flowers/genetics , Minerals , Plant Leaves , TeaABSTRACT
Objective:To investigate the clinical efficacy of uterine compression suture in the treatment of postpartum hemorrhage resulting from uterine atony.Methods:100 patients with postpartum hemorrhage due to uterine atony who received treatment between May 2017 and May 2018 in the First People's Hospital of Yongkang were included in this study. They were randomly assigned to undergo either conventional uterine suture (control group, n = 50) or uterine compression suture (observation group, n = 50). Clinical efficacy was compared between the observation and control groups. Results:Total effective rate in the observation group was significantly higher than that in the control group [94.0% (47/50) vs. 68.0% (34/50), χ2 = 12.421, P < 0.01]. There was no significant difference in operative time between observation and control groups [(62.99 ± 10.87) minutes vs. (60.98 ± 8.12) minutes, t = 1.048, P > 0.05]. The amount of blood loss within 2 and 24 hours postpartum, abdominal circumference, and uterine height in the observation group were (216.85 ± 16.85) mL, (356.19 ± 25.71) mL, (98.56 ± 5.86) cm and (35.17 ± 2.33) cm respectively, which were significantly less or lower than those in the control group [(485.29 ± 28.41) mL, (596.38 ± 34.18) mL, (108.59 ± 2.65) cm, and (38.45 ± 4.19) cm, t = 85.652, 65.325, 16.584, 3.256, all P < 0.05]. The incidence of complications in the observation group was significantly lower than that in the control group [4.0% (2/50) vs. 28.0% (14/50), χ2 = 12.032, P < 0.01]. Conclusion:Uterine compression suture for the treatment of postpartum hemorrhage resulting from uterine atony has greater clinical efficacy and leads to lower incidence of complications than conventional suture technique.
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Objective:To study the distribution characteristics of mineral elements in <italic>Gastrodia elata </italic>samples<italic> </italic>with different grades and specifications （variants） from diverse producing areas and their classification and identification evidences. Method:Fourteen mineral elements in 31 batches of <italic>Gastrodia elata</italic> samples of different grades and specifications （variants） from diverse producing areas were determined by atomic absorption spectrophotometry， Mo-Sb colorimetry， and curcumin colorimetry， and then subjected to correlation analysis （CA）， discriminant analysis （DA）， and principal component analysis （PCA）. Result:The content of K， N， and P in <italic>G. elata</italic> was the highest， enabling them to serve as the nutritional limiting factors affecting its growth. The <italic>G. elata</italic> samples could be identified by the variation trend of elements （K>N>P>Mg>Ca>Fe>B>Zn>Mn>Cu>Ni>Cr>Pb>Cd）. The comparison of <italic>G. elata</italic> samples from multiple producing areas showed that <italic>G. elata</italic> from Zhaotong has the highest P， Fe， and Cd content， that from Lijiang the highest K content， that form Luotian the highest Zn and Cr content， and that from Jinzhai the highest Cu and Pb content. The content of Mg， B， Pb， and Cr in <italic>G. elata</italic> f. <italic>elata</italic> was higher than that in <italic>G. elata </italic>f. <italic>glauca</italic>. It was found that the content of P， Cu， and Cd in commercially available <italic>G. elata </italic>products gradually increased with the decrease in the commercial grade， while that of Mg， Fe， B， and Ni mostly decreased. As revealed by CA， Fe was positively correlated with Mg， Cr， and B. The producing areas of <italic>G. elata</italic> samples could be effectively identified by DA with Cd， Pb， Cr， Cu， B， and Ni as the main variables， and the accuracy reached up to 85.71%. According to the PCA of mineral elements in <italic>G. elata</italic> f. <italic>glauca</italic> from Zhaotong， Yunnan Province， Fe， Cr， Mg， Cd， P， Mn， B， Pb， and Cu exerted a greater influence on <italic>G. elata</italic>. Conclusion:The determination of mineral elements in <italic>G. elata</italic> samples contributes to identifying their authenticity and origin due to the easy operation， accurate results， and good stability.
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Four new compounds, asperisocoumarin G (1), asperisocoumarin H (2), (±)-asperisocoumarin I [(±)-3], along with the known pergillin (4) and penicisochroman L (5) were isolated from a mangrove endophytic fungus Aspergillus sp. 085242 by further chemical investigation. The structures of the new compounds, including their absolute configurations, were established by analysis of HR-ESI-MS and NMR spectroscopic data, and ECD calculation. Asperisocoumarins G-I (1-3) were new isocoumarins belonging to the class of furo[3, 2-h]isocoumarins which are rarely found in natural sources. All of the isolated compounds were evaluated for their α-glucosidase inhibitory effects, and compounds 1 and 4 showed moderate α-glucosidase inhibitory activity, respectively. In an antimicrobial test, the racemate of 3 showed antibacterial activity against Salmonella.
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Objective: To study the constituents from the roots of Paeonia lactiflora. Methods: The chemical constituents were isolated by various chromatographic techniques and their structures were elucidated by physicochemical properties and NMR data. Results: Eleven compounds were obtained and characterized as (4S)-perillic acid 6-O-α-L-arabinopyranosyl-(1'→6'')- β-D-glucopyranosyl (1), 4,9-dihydroxy-8,10-dehydrothymol-1-O-β-D-glucoside (2), emodin-8-O-β-D-glucoside (3), resveratrol (4), β-D-glucopyranosyl benzoate (5), ilexperphenoside A (6), catechol (7), methyl gallate (8), ethyl gallate (9), 3-methoxygallic acid (10), 1,2,3,4,6-penta-O-galloyl-β-D-glucopyranoside (11). Conclusion: Compound 1 is identified as a new compound, named perillic acid glycoside, compounds 2 and 5 are identified from the genus Paeonia for the first time.
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Objective:To explore the effects of action observation training based on mirror neuron system on motor function of upper extremities in stroke patients. Methods:From June, 2016 to June, 2017, 61 stroke patients were randomly assigned to control group (n = 30) and observation group (n = 31). They all accepted routine rehabilitation, and the observation group received action observation therapy in addition, for eight weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities, modified Ashworth Scale and modified Barthel Index before and after treatment. Results:All the indexes improved in both groups after treatment (|t| > 2.651, P < 0.05), and improved more in the observation group than in the control group (|t| > 2.048, P < 0.05). Conclusion:The action observation training may further improve the upper extremity motor function in stroke patients.
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AIM:To investigate the effect of 27nt-microRNA (27nt-miRNA) on the expression of smooth muscle 22α protein (SM22α) and the cell viability, migration and phenotypic changes of vascular smooth muscle cells (VSMCs).METHODS:The highly expression plasmids of 27nt-miRNA, and anti-27nt-miRNA and negative control plasmids were constructed, packaged with lentivirus and transfected into the rat primary VSMCs.Platelet-derived growth factor BB (PDGF-BB) was added to induce VSMCs phenotype conversion.The cell viability was measured by MTT assay.The migration ability was detected by scratch assay.The mRNA and protein expression of SM22αwas determined by RT-PCR, immunocytochemical staining and Western blot.RESULTS:Compared with normal group, the cell viability in PDGF-BB group was increased (P<0.05) , the migration ability was increased (P<0.05) and the expression of SM22αat mRNA and protein level was decreased (P<0.05).Compared with negative control lentiviral group, the cell viability in 27ntmiRNA over-expression group was decreased (P<0.05) , the migration ability was decreased (P<0.05) , and the mRNA and protein expression of SM22αwas increased (P<0.05).While in anti-27nt-miRNA group, the cell viability was increased (P<0.05) , the migration ability was increased (P<0.05) , and the mRNA and protein expression of SM22αwas decreased (P<0.05).CONCLUSION:27nt-miRNA significantly increases the expression of SM22α, while inhibits the viability and migration ability of VSMCs, and inhibits its phenotypic shift from contractile to synthetic.
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This present study was to investigate the metabolism and excretion of characteristic polyphenols such as flavonoids and coumarins in urine and feces of rats after intragastric administration of ethanol extracts of Citri Reticulatae Pericarpium Viride and Citri Reticulatae Pericarpium. The urine and feces of rats were collected after intragastric administration of 70% ethanol extracts of Citri Reticulatae Pericarpium Viride and Citri Reticulatae Pericarpium. Rapid resolution liquid chromatography coupled with quadrupole tandem mass spectrometry (RRLC-QqQ-MSn) was applied to compare the contents of polyphenols in ethanol extract, urine and feces. By comparing with reference substance, 30 polyphenols were identified from the ethanol extracts of Citri Reticulatae Pericarpium Viride and Citri Reticulatae Pericarpium, including flavone glycosides, flavones, flavonone glycosides, flavonones, flavonol glycosides, polymethoxyflavones, coumarins, and limonoids and so on. The detection of various types of compounds showed differences in contents between the intestinal metabolism and excretion in the feces after systemic circulatory metabolism and renal excretion. The results showed that the polymethoxyflavones and flavonones were primarily excreted through urine, and the flavonone glycosides and limonoids were primarily excreted through feces. However, coumarins were hardly detected in feces and urine, indicating that coumarins may be metabolized in the body.
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Animals , Rats , Citrus , Drugs, Chinese Herbal , Feces , Flavonoids , Tandem Mass SpectrometryABSTRACT
Alzheimer's disease is the most common disease which causes dementia in senior citizens. It is a neurodegenerative disease which is characterized by the degradation of the neurons and synapses in the brain. Usually,the irreversible and progressive neuron loss particular in the regions of cortex and hippocampus,the plaques of the accumulation of amyloidosis outside the cells,as well as the neurofibrillary tangles which is made by the hyperphosphorylation of Tau microtubule proteins can be seen in the lesion loca-tion of the patients. The Insulin malfunction in the central nervous system is now regarded as an important pathogenesis of Alzheimer's disease. This review focuses on the development of the knowledge of the mechanism of the malfunction of insulin in the central nervous system leading to the sporadic type of Alzheimer's disease and its applications,aiming to provide a reference in the study of Alzheimer 's disease.
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AIM To establish a quantitative analysis of multi-components by single-marker (QAMS) method for the simultaneous content determination of five constituents in Roudoukou-8 Powder (Myristicae Semen,Auck landiae Radix,Lignum aquilariae Resinatum,etc.).METHODS The analysis of 75％ methanol extract of this drug was performed on a 30 ℃ thermostatic Apollo C18 column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of methanol-0.1％ phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 225,254,273,281 nm.With eugenol as an internal standard,the relative correction factors of the other four constituents were calculated,after which the content determination was made.RESULTS Ellagic acid,eugenol,costunolide,dehydroroma lactone,dehydrodiisoeugenol showed good linear relationships within the ranges of 0.227 0-1.135 2,5.272 2-26.361 0,0.540 8-2.704 0,0.530 4-2.652 0,0.059 0-0.299 5 μg (r ＞0.999 0),whose average recoveries (RSDs) were 96.37％ (2.07％),102.19％ (2.78％),101.66％ (1.66％),103.46％ (1.17％),98.25％ (1.98％),respectively.The results obtained by QAMS approximated those obtained by external standard method.CONCLUSION This stable and reliable method can be used for the quality control of Roudoukou-8 Powder.
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The implementation of knowledge management (KM) in hospitals affects efficiency and outcomes of hospitals.However,few studies explored the implementation of KM in China.Twenty-two questions were designed concerning KM implementation status in over 50 hospitals.In order to understand the KM level and attitude to KM of the hospital's managers,a random sampling survey was conducted among 138 managers from 50 different scales of hospitals in 15 provinces of China.The survey showed that overall level of KM implementation in Chinese hospitals was still low and differed among different scales of hospitals (P＜0.05,or P＜0.01).In all the hospitals investigated,63.8％ did not implement KM yet,among which 46％ even had not planned for that.49.8％ of the hospitals investigated had no training program about KM ever and the main source of hospital staff to get knowledge was iuternet.It suggested that hospital managers should make much more efforts to get to know and understand theories on KM,so that hospital KM could be promoted more rapidly.
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The implementation of knowledge management (KM) in hospitals affects efficiency and outcomes of hospitals.However,few studies explored the implementation of KM in China.Twenty-two questions were designed concerning KM implementation status in over 50 hospitals.In order to understand the KM level and attitude to KM of the hospital's managers,a random sampling survey was conducted among 138 managers from 50 different scales of hospitals in 15 provinces of China.The survey showed that overall level of KM implementation in Chinese hospitals was still low and differed among different scales of hospitals (P＜0.05,or P＜0.01).In all the hospitals investigated,63.8％ did not implement KM yet,among which 46％ even had not planned for that.49.8％ of the hospitals investigated had no training program about KM ever and the main source of hospital staff to get knowledge was iuternet.It suggested that hospital managers should make much more efforts to get to know and understand theories on KM,so that hospital KM could be promoted more rapidly.
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OBJECTIVE@#To determine whether chloroquine (CQ), an often used inhibitor of late autophagy and autophagosome/lyosome fusion, can inhibit proliferation of renal carcinoma cells and investigate its effect on sunitinib (ST)-induced apoptosis.@*METHODS@#Renal carcinoma cell line 786 O and ACHN had been used as cellular model and 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt (MTS) assay was carried out to detect the cell viability in response to CQ or ST treatment. Both transmission electron microscope and immunoblotting had been employed to observe apoptotic and autophagic process. To examine the involvement of autophagy in ST-dependent apoptosis, autophagy had been inhibited either chemically or genetically via utilizing autophagy inhibitor or specific small interference RNA (siRNA) targeted to either Ulk1 (unc-51-like kinase 1) or LC3 (microtubule associated protein 1 light chain 3 fusion protein), two essential autophagic proteins.@*RESULTS@#Both ST and CQ induced cell viability loss, indicating that either of them could inhibit renal cancer cell proliferation. Clone formation experiments confirmed the aforementioned results. Furthermore, the combined ST with CQ synergistically promoted the loss of cell viability. By transmission electron microscopy and immunoblotting, we found that the ST induced both autophagy and caspase-dependent apoptosis. While 3-MA, an early autophagy inhibitor, reduced the ST-induced cleavage of poly (ADP-ribose) polymerase-1 (PARP-1), a substrate of caspase 3/7 and often used marker of caspase-dependent apoptosis, CQ promoted the ST-dependent PARP-1 cleavage, indicating that the early and late autophagy functioned differentially on the ST-activated apoptotic process. Moreover, the knock down of either Ulk1 or LC3 decreased the ST-caused apoptosis.Interestingly, we observed that rapamycin, a specific inhibitor of mTOR (mammalian target of rapamycin) and an inducer of autophagy, also showed to inhibit cell viability and increased the cleavage of PARP-1 in the ST-treated cells, suggesting that autophagy was likely to play a dual role in the regulation of the ST-induced apoptosis.@*CONCLUSION@#ST activates both apoptotic and autophagic process in renal carcinoma cells. Although autophagy precedes the ST-induced apoptosis, however, early and late autophagy functions differentially on the apoptotic process induced by this compound. Additionally, ST can coordinate with the inducer of autophagy to inhibit the cell proliferation. Further research in this direction will let us illuminate to utilize CQ as a potential drug in the treatment of renal carcinoma.