Saikosaponin D alleviates cancer cachexia by directly inhibiting STAT3.

Cancer cachexia is a metabolic syndrome that is characterized by progressive loss of skeletal muscle mass, and effective therapeutics have yet to be developed. Saikosaponin D (SSD), a major bioactive component of Radix Bupleuri, exhibits antiinflammatory, anti-tumor, anti-oxidant, anti-viral, and hepatoprotective effects. In this study, we demonstrated that SSD is a promising agent for the treatment of cancer cachexia. SSD could alleviate TCM-induced myotube atrophy and inhibit the expression of E3 ubiquitin ligases muscle RING-finger containing protein-1 (MuRF1) and muscle atrophy Fbox protein (Atrogin-1/MAFbx) in vitro. Moreover, SSD suppressed the progression of cancer cachexia, with significant improvements in the loss of body weight, gastrocnemius muscle, and tibialis anterior muscle mass in vivo. Mechanism investigations demonstrated that SSD could directly bind to STAT3 and specifically inhibit its phosphorylation as well as its transcriptional activity. Overexpression of STAT3 partially abolished the inhibitory effect of SSD on myotube atrophy, indicating that the therapeutic effect of SSD was attributed to STAT3 inhibition. These findings provide novel strategies for treatment of cancer cachexia by targeting STAT3, and SSD may be a promising drug candidate for cancer cachexia.

Exploration of cultural norms and behavioural beliefs about zoo animal behaviour, welfare, ethics and husbandry practices in a sample of the international zoo community.

Beliefs influence the intentions of people to behave in certain ways towards animals. This study presents survey responses from 237 people working in zoos in China and Europe and describes their demographic characteristics. It explores their beliefs about zoo animal behaviour, welfare and ethical issues, and zoo practices, using a survey methodology. These beliefs may be influenced by individual demographic or cultural factors such as age, gender and region of employment, as well as experiential or situative 'norms' within the work environment. Beliefs were significantly influenced by the region of employment with Chinese respondents beliefs being significantly different to beliefs from respondents in the United Kingdom or the rest of Europe. Hierarchical cluster analysis of the survey generated clusters of people from both regions who indicated positive beliefs about zoo animal welfare as well as clu sters indicating a lack of understanding of some zoo animal welfare issues. In addition, a cluster suggesting cognitive dissonance between beliefs about animals welfare and zoo practices was generated from Chinese responses. Factor analysis identified that prioritisation of in-situ conservation within good animal welfare was a key feature in Chinese respondents, whereas European beliefs prioritising in-situ conservation were distinct from those on supporting good animal welfare. This paper identifies similarities and differences in beliefs about zoo animal welfare and zoo husbandry practices between Europe and China, and discusses the underlying norms and values that these beliefs may reflect.

Serum IgE Predicts Difference of Population and Allergens in Allergic Diseases: Data from Weifang City, China.

BACKGROUND: Immunoglobulin E (IgE) is the most important promoter of allergic inflammation. However, there are few systematic studies on IgE in age range, genders, disease spectrum, and time regularity. AIM: To screen the common allergens, allergen spectrum, and IgE difference between type 2 inflammatory allergic diseases and other allergic diseases in Weifang, China. METHODS: A retrospective study was performed by estimating patients' clinical data suffering from allergic diseases (urticaria, pollinosis, allergic rhinitis, atopic dermatitis, and bronchial asthma) between May 2019 and April 2020 using an allergen detection kit of Macro-Union Pharmaceutical. RESULTS: 732 of the 1367 patients showed different antigen positive, and the positive rate was 53.5%. The most common allergens were dust mites, mixed fungi, Artemisia pollen, cat/dog dander, and cockroaches. There were 27.0% (369/1367) of the patients with single positive allergen-specific IgE (sIgE), 26.5% (363/1367) with multiple-positive IgE. The total immunoglobulin E (tIgE) levels varied with gender, age, and type of disease. There was a difference in the distribution of allergens between children and adults. A positive correlation between the serum-specific IgE and the corresponding local inhaled allergen density was observed. CONCLUSIONS: In this study, we found that type 2 inflammatory allergic diseases have higher serum IgE and a higher probability of inhaled sIgE positive. According to age, gender, and condition, serological IgE detection of allergens provides new insight into the early diagnosis and prevention of allergic diseases.

One-Step Synthesis of Ultrasmall and Ultrabright Organosilica Nanodots with 100% Photoluminescence Quantum Yield: Long-Term Lysosome Imaging in Living, Fixed, and Permeabilized Cells.

Water-dispersible nanomaterials with superbright photoluminescence (PL) emissions and narrow PL bandwidths are urgently desired for various imaging applications. Herein, for the first time, we prepared ultrasmall organosilica nanodots (OSiNDs) with an average size of ∼2.0 nm and ∼100% green-emitting PL quantum efficiency via a one-step hydrothermal treatment of two commercial reagents (a silane molecule and rose bengal). In particular, the structural reorganization and halide loss of rose bengal during the hydrothermal treatment contribute to the ultrahigh quantum yield and low phototoxicity of OSiNDs. Owing to their low pH-induced precipitation/aggregation property, the as-prepared OSiNDs can be used as excellent lysosomal trackers with many advantages: (1) They have superior lysosomal targeting ability with a Pearson's coefficient of 0.98; (2) The lysosomal monitoring time of OSiNDs is up to 48 h, which is much longer than those of commercial lysosomal trackers (<2 h); (3) They do not disturb the pH environment of lysosomes and can be used to visualize lysosomes in living, fixed, and permeabilized cells; (4) They exhibit intrinsic lysosomal tracking ability without the introduction of lysosome-targeting ligands (such as morpholine) and superior photostability; (5) The easy, cost-effective, and scalable synthetic method further ensures that these OSiNDs can be readily used as exceptional lysosomal trackers. We expect that the ultrasmall OSiNDs with superior fluorescence properties and easily modifiable surfaces could be applied as fluorescent nanoprobes, light-emitting diode phosphor, and anticounterfeiting material, which should be able to promote the preparation and application of silicon-containing nanomaterials.

HEROD: a human ethnic and regional specific omics database.

MOTIVATION: Genetic and gene expression variations within and between populations and across geographical regions have substantial effects on the biological phenotypes, diseases, and therapeutic response. The development of precision medicines can be facilitated by the OMICS studies of the patients of specific ethnicity and geographic region. However, there is an inadequate facility for broadly and conveniently accessing the ethnic and regional specific OMICS data. RESULTS: Here, we introduced a new free database, HEROD, a human ethnic and regional specific OMICS database. Its first version contains the gene expression data of 53 070 patients of 169 diseases in seven ethnic populations from 193 cities/regions in 49 nations curated from the Gene Expression Omnibus (GEO), the ArrayExpress Archive of Functional Genomics Data (ArrayExpress), the Cancer Genome Atlas (TCGA) and the International Cancer Genome Consortium (ICGC). Geographic region information of curated patients was mainly manually extracted from referenced publications of each original study. These data can be accessed and downloaded via keyword search, World map search, and menu-bar search of disease name, the international classification of disease code, geographical region, location of sample collection, ethnic population, gender, age, sample source organ, patient type (patient or healthy), sample type (disease or normal tissue) and assay type on the web interface. AVAILABILITY AND IMPLEMENTATION: The HEROD database is freely accessible at http://bidd2.nus.edu.sg/herod/index.php. The database and web interface are implemented in MySQL, PHP and HTML with all major browsers supported. CONTACT: phacyz@nus.edu.sg.

Dynamic variations in platelet counts may reflect the severity and prognosis of stingray injuries in the early phase.

There is often a delay in offering quality and prompt treatment after a stingray sting. We present 3 cases of stings and discuss the Poisoning Severity Score (PSS) and a simple tool to assess the severity of such injuries. A 34-year-old man, who worked as an aquarium keeper, presented a wound on the left fifth digit caused by a stingray. Acute myocardial injury and rhabdomyolysis were detected. After 6weeks, the wound had almost healed. A 27-year-old man who experienced a stingray injury on the left second digit recovered without sequelae after 5weeks. A 45-year-old man with a history of diabetes, who was accidentally stung in the right palm by a stingray, experienced rhabdomyolysis and returned to work after 2months. We performed debridement, administered the tetanus toxoid and antibiotics, and immersed the wounded hand in warm water (about 43°C) for all three cases. Meanwhile, patients with rhabdomyolysis were administered intravenous hydration. Upon presentation at the emergency department, we recorded the severity of the injury by using PSS. We found that relatively high PSSs were associated with lower platelet counts that happen due to various adverse events. We suggest that dynamic changes in platelet counts may be associated with the severity of the injury. Furthermore, lower platelet counts in the normal or abnormal range may indicate poor prognoses.

Enhanced Fluorescence Emission and Singlet Oxygen Generation of Photosensitizers Embedded in Injectable Hydrogels for Imaging-Guided Photodynamic Cancer Therapy.

Benefiting from their inherent localized and controlled release properties, hydrogels are ideal delivery systems for therapeutic drugs or nanoparticles. In particular, applications of hydrogels for the delivery and release of photoresponsive drugs or nanoparticles are receiving increasing attention. However, the effect of the hydrogel matrix on the fluorescence emission and singlet oxygen generation efficiency of the embedded photosensitizers (PSs) has not been clarified. Herein, meso-tetrakis(1-methylpyridinium-4-yl)porphyrin (TMPyP) as a water-soluble PS was encapsulated into an injectable hydrogel formed by glycol chitosan and dibenzaldehyde-terminated telechelic poly(ethylene glycol). Compared to free TMPyP solution, the TMPyP encapsulated in the hydrogel exhibits three distinct advantages: (1) more singlet oxygen was generated under the same laser irradiation condition; (2) much longer tumor retention was observed due to the low fluidity of the hydrogel; and (3) the fluorescence intensity of TMPyP was significantly enhanced in the hydrogel due to its decreased self-quenching effect. These excellent characteristics lead to remarkable anticancer efficacy and superior fluorescence emission property of the TMPyP-hydrogel system, promoting the development of imaging-guided photodynamic therapy.

The 20kDa and 22kDa forms of human growth hormone (hGH) exhibit different intracellular signalling profiles and properties.

Human Growth Hormone (hGH) includes two main variants. The first is 22kDa GH (22K-GH), which is predominant in the blood circulation. The second most abundant variant is 20K-GH, which makes up 5-10% of the blood circulation. Both bind and activate the same receptor, called the human growth hormone receptor (GHR). However, the reason why 22K-GH and 20K-GH exhibit similar, but not identical physiological activities remains poorly understood. In this article, the intracellular signalling profiles between these two hormones were examined. Western blot analyses were performed in 3T3-F442A and CHO cells transfected with GHR (CHO-GHR). The results revealed that both 22K-GH and 20K-GH can activate Janus kinase 2 (JAK2) and signal transducers and activators of transcription 1, 3 and 5 (STATs 1/3/5). Both induced tyrosine phosphorylation of JAK2 and STAT/1/3/5 in a time-dependent and dose-dependent manner. However, there were significant differences in the intracellular signalling properties between 22K-GH and 20K-GH. In particular, the kinetics of signalling shown by 22K-GH and 20K-GH is different. In addition, we found that the 20K-GH-induced tyrosine phosphorylation of signalling proteins was weaker than that of 22K-GH. Together, these observations indicate that the levels and kinetics of phosphorylation mediated by the main signalling proteins triggered by 22K-GH or 20K-GH were not exactly the same. This may provide a possible explanation for the different biological activities exhibited by 22K-GH and 20K-GH.

[Cloning of tae-MIR156 precursor gene and sequence polymorphisms of tae-miR156 targeted TaSPL17].

Squamosa-promoter binding protein (SBP)-box genes, encoding plant-specific transcription factors, play an important role in plant development. Some members of the SBP-box gene family are regulated by miR156. In this study, we cloned the tae-MIR156 precursor gene, which could form a stem loop after its transcription. Sequence analysis showed that TaSPL3 and TaSPL17 had putative targets of tae-miR156 among the ten wheat SBP-box genes. The diploid donor species of hexaploid common wheat (Triticum aestivum, genome AABBDD), i.e., Triticum urartu (AA) UR209 and Aegilops speltoides Y2001 (SS, closely related to BB) possessed more than one copy of SPL17 (SPL17-A1, SPL17-A2 and SPL17-A3 from Triticum urartu; SPL17-B1, SPL17-B2 and SPL17-B3 from Aegilops speltoides), while Aegilops tauschii (DD) Ae38 only possessed one (SPL17-D). The identities between nucleotide sequences of SPL17-A2 and SPL17-B2, SPL17-A3 and SPL17-B3 or SPL17-D were higher than 99%. They were highly similar with the sequence of TaSPL17 in common wheat cultivars Chinese Spring, Hengguan 35 and Shuangfengshou. These genes might originate from a common ancestor and were highly conserved in the process of evolution. The target site of tae-miR156 in TaSPL17 was also highly conserved in two subgroups consisted of accessions with diverse spike number per plant and genetic background.

Simultaneous utilization of copper and non-metals from waste integrated circuits for precious metal melting capture and organics thermal detoxification.

Waste integrated circuits, with underlying resource attributes and environmental risks, are complex in composition. Current processes suffer from high resource inputs, excessive pollutant emissions and incomplete treatment of varied species. Therefore, a comprehensive resource recycling and safe disposal process integrated with precious metal enrichment, non-metal resource utilization, and organic detoxification was proposed. The copper and non-metals from waste ICs served as in-situ precious metal collector, slagging former and reducing agent for alternative to partial chemical inputs. Batch experiments indicated that optimized parameters enabled the recycling efficiencies of 94.3 %, 96.8 % and 98.4 % for copper, gold and silver, respectively. Meanwhile, oxide component, yielded as silicate slag, was synthesized into glass ceramics via high-temperature sintering. Furthermore, organic conversion process revealed that high-temperature smelting catalyzed bromine removal and contaminant detoxification, with decomposed reductive hydrocarbons facilitating metal capture in turn. And the capture mechanism was disclosed form thermodynamics and microdroplet motion perspectives. As process evaluation indicates, proposed recycling route allows remarkable reductions in negative environmental response and economic investment. In this work, metal recycling, waste minimization and pollutant detoxification were attained synergistically without residue, which contributes a novel insight into the disposal of comparable e-wastes.

Ralstonia solanacearum Infection Drives the Assembly and Functional Adaptation of Potato Rhizosphere Microbial Communities.

Bacterial wilt caused by Ralstonia solanacearum is a destructive disease that affects potato production, leading to severe yield losses. Currently, little is known about the changes in the assembly and functional adaptation of potato rhizosphere microbial communities during different stages of R. solanacearum infection. In this study, using amplicon and metagenomic sequencing approaches, we analyzed the changes in the composition and functions of bacterial and fungal communities in the potato rhizosphere across four stages of R. solanacearum infection. The results showed that R. solanacearum infection led to significant changes in the composition and functions of bacterial and fungal communities in the potato rhizosphere, with various microbial properties (including α,ß-diversity, species composition, and community ecological functions) all being driven by R. solanacearum infection. The relative abundance of some beneficial microorganisms in the potato rhizosphere, including Firmicutes, Bacillus, Pseudomonas, and Mortierella, decreased as the duration of infection increased. Moreover, the related microbial communities played a significant role in basic metabolism and signal transduction; however, the functions involved in soil C, N, and P transformation weakened. This study provides new insights into the dynamic changes in the composition and functions of potato rhizosphere microbial communities at different stages of R. solanacearum infection to adapt to the growth promotion or disease suppression strategies of host plants, which may provide guidance for formulating future strategies to regulate microbial communities for the integrated control of soil-borne plant diseases.

Progress in the study of reproductive toxicity of platinum-based antitumor drugs and their means of prevention.

Platinum-based antitumor drugs are broad-spectrum agents with unique mechanisms of action. Combination chemotherapy regimens based on platinum drugs are commonly used in cancer treatment. However, these drugs can cause various adverse reactions in the human body through different routes of administration, including reproductive toxicity, genetic toxicity, and embryonic developmental toxicity. Preventing adverse effects is crucial to enhance patients' quality of life and reduce healthcare costs. This article discusses the types and developmental history of antitumor active platinum compounds, their mechanisms of action, routes of administration, and their potential reproductive, genetic, and embryonic developmental toxicity. This text explores preventive measures based on animal experimental results. Its aim is to provide references for personalized treatment and occupational protection when using platinum drugs. The continuous progress of science and technology, along with the deepening of medical research, suggests that the application of platinum drugs will broaden. Therefore, the development of new platinum drugs will be an important direction for future research.

Melatonin alleviates cisplatin-induced mice spermatogenesis defects.

Cisplatin (CDDP) is a chemotherapeutic drug that is used to treat many different types of tumors. However, it also has significant adverse effects on male reproduction, which are partially mediated oxidative damage. Melatonin (MLT) is a promising antioxidant that can be used for reproductive protection. In this paper, we investigated the effect of CDDP on spermatogenesis, as well as MLT's potential role in reproductive protection. CDDP (5 mg/kg BW) significantly reduced male mice testosterone levels and decreased sperm vitality and progressive motility. Additionally, a lower percentage of stage VII and VIII seminiferous tubules were observed in CDDP-treated mice. MLT administration significantly alleviated CDDP-induced testicular damages, CDDP-induced lowered male fertility in vivo, and enhanced in vitro embryonic development of two cells and blastocysts. These changes may be due to CDDP-mediated spermatogenesis defects in germ cell and Leydig cell proliferation, which are reflected in abnormal PCNA, SYCP3, and CYP11A1 expression levels and can be improved by MLT. CDDP treatment significantly decreased the total antioxidant capacity (TAC), as well as SOD and GSH levels, and increased MDA levels in mice testis, leading to increased apoptosis of germ cells and increased BAX/BCL2 ratios in mice testis. MLT treatment may reduce germ cell apoptosis by reducing oxidative damage in mice testis. This study demonstrated that CDDP affects sperm fertility by altering germ cell and Leydig cell proliferation via increased oxidative damage and that MLT can attenuate these damages. Our work provides potential information for further research on the toxic effects of CDDP and the protective effects of MLT on male reproduction.

Insights into the effect of cations on cathodic behavior and microstructure in cadmium electrochemical recovery process.

Secondary resources provide an essential source for cadmium recovery, but also bring severe environmental problems. Due to the short process and high product purity, electrodeposition is suitable for realizing the reduction, reuse, and recycling of cadmium, while the complex composition of the resources contributes to a complicated electrochemical system. In this work, the effect of common cations (Cu2+, Ni2+, Fe2+, and Zn2+) on cadmium electrochemical recovery was investigated from the perspective of electrochemical behavior and microstructure. The results indicated that Cu affected the electrochemical process most prominently, which was deposited on the cathode and formed microcell with Cd, not only impeding the recovery of Cd, but also influencing the purity severely. Comparatively, Ni showed a relatively minor effect, which made the formal potential more negative and alleviated cathodic polarization to some degree. Besides, Fe2+ was oxidized by the oxygen released from the anode, and followed by the reaction with Cd, resulting in the redissolution of Cd. With respect to Zn, a low concentration of Zn (≤1 g L-1) had little influence on electrochemical behavior of Cd, while it was deposited simultaneously with Cd on the cathode at a high concentration (5 g L-1). Based on the microstructural characterization, the lithops-like cathode cadmium grew up in the presence of Cu, while dendritic Cd was formed affected by Zn, Fe2+, and Ni, especially Fe2+.

Recovering metals from flue dust produced in secondary copper smelting through a novel process combining low temperature roasting, water leaching and mechanochemical reduction.

Flue dust from secondary copper smelting (FDSC) is a hazardous waste as well as a secondary resource due to the high content of Cl, Br, and valuable metals (Pb, Cu, Zn, Cd). Herein, a novel process, combined low-temperature roasting, water leaching, and mechanochemical reduction, was developed for recovering metals from the FDSC. The phase conversion and behavior of the main elements in the whole process were explored based on thermodynamic analysis, experimental research, and various characterization. First, thermodynamics calculation revealed that adding H2SO4 could significantly decrease the roasting temperature and promote the generation of soluble metal sulfates. The experimental results showed that more than 99% of Cl and Br were removed by roasting at 325 °C and 1.5 times H2SO4 addition. Subsequently, the Cu, Zn, and Cd were almost completely leached by water under the conditions of 80 â„ƒ, 2 h and L/S = 5 mL·g-1, while Pb was rejected and enriched in the residue. Finally, using iron powder as a reductant, 96.7% of PbSO4 was reduced to elemental lead at room temperature with the aid of mechanical force. The findings illustrated that the recovery performance of metals and environmental benefits will be greatly improved by the proposed process.

Co-treatment of copper smelting flue dust and arsenic sulfide residue by a pyrometallurgical approach for simultaneous removal and recovery of arsenic.

As the typical hazardous arsenic pollutants, copper smelting flue dust (CSFD) and arsenic sulfide residue (ASR) are produced extensively during copper smelting process, which pose significant pressure on environmental protection and green development of the copper industry. This work proposed an economic, efficient, and applicable approach to treat waste with waste, in which the simultaneous removal and recovery of As from CSFD and ASR were realized by a roasting process, with adding sulfuric acid, at a relatively low temperature (300-350 â„ƒ). The thermodynamic analysis and experiments confirmed that the main phases of As2S3 and S0 in the ASR were used as a reductant for reducing As(Ⅴ) in the CSFD, and the introduction of sulfuric acid favorably enhanced the thermodynamic driving force and greatly lowered the reaction temperature. The results indicated that removal and behavior of As were highly dependent on the mass ratio of ASR to CSFD, roasting temperature, and H2SO4 dosage. By regulating the parameters, the species As2S3, As2O5, and arsenate were all converted to volatile As2O3, which could be captured and deposited in cold water. In the optimized co-treatment, a satisfied As removal efficiency of 96.12% was achieved, while getting the 97.03% pure As2O3.

Efficient removal and recovery of arsenic from copper smelting flue dust by a roasting method: Process optimization, phase transformation and mechanism investigation.

The efficient removal and recovery of arsenic from copper smelting flue dust have received widespread attention due to its extremely high toxicity and carcinogenicity. In this research, a roasting method used for treating the dust at a relatively low temperature (300-400 â„ƒ), with adding sulfuric acid and bitumite, was proposed, in which the reduction of As(Ⅴ) and oxidation of arsenic sulfides were achieved simultaneously. It was proved by thermodynamic analysis and experiments that adding sulfuric acid was favorable for the removal of arsenic, through enhancing the thermodynamic driving force and promoting the transformation of arsenate and arsenic sulfides to As2O3. The phase transformation of arsenic was analyzed using XRD, SEM-EDS and XPS, which indicated that coal addition, roasting temperature and H2SO4 dosage play essential roles in arsenic removal. Based on the lab-scale experiments, the optimal conditions for arsenic removal were found to be at the roasting temperature of 300-400 °C, roasting time of 2-3 h, coal addition of 5% and H2SO4 dosage of 0.2-0.3 mL/g. Around 98% of arsenic was volatilized from the dust, while arsenic content in the residue was decreased to 0.57%. Eventually, arsenic was recovered as As2O3 with a high purity of 99.05%.

3D Cascaded Convolutional Networks for Multi-vertebrae Segmentation.

BACKGROUND: Automatic approach to vertebrae segmentation from computed tomography (CT) images is very important in clinical applications. As the intricate appearance and variable architecture of vertebrae across the population, cognate constructions in close vicinity, pathology, and the interconnection between vertebrae and ribs, it is a challenge to propose a 3D automatic vertebrae CT image segmentation method. OBJECTIVE: The purpose of this study was to propose an automatic multi-vertebrae segmentation method for spinal CT images. METHODS: Firstly, CLAHE-Threshold-Expansion was preprocessed to improve image quality and reduce input voxel points. Then, 3D coarse segmentation fully convolutional network and cascaded finely segmentation convolutional neural network were used to complete multi-vertebrae segmentation and classification. RESULTS: The results of this paper were compared with the other methods on the same datasets. Experimental results demonstrated that the Dice similarity coefficient (DSC) in this paper is 94.84%, higher than the V-net and 3D U-net. CONCLUSION: Method of this paper has certain advantages in automatically and accurately segmenting vertebrae regions of CT images. Due to the easy acquisition of spine CT images. It was proven to be more conducive to clinical application of treatment that uses our segmentation model to obtain vertebrae regions, combining with the subsequent 3D reconstruction and printing work.

Exploration of the Construction of National Regional Medical Center in Jiangxi Province from the Perspective of Stakeholder Groups / 中国医院管理

National regional medical center is a major measure to balance the distribution of high-quality medical resources.The construction of a large number of national regional medical centres in Jiangxi Province,with accurate disease selection,frequent consultation and scheduling,and rapid ideological unity.However,from the perspectives of interest groups such as the government,exporting hospitals,and dependent hospitals,there are still problems such as unclear top-level design,insufficient power of export and dependent hospitals.It is necessary to accelerate and improve the coordination mechanism,clarify the rights and responsibilities of the three parties,improve the evaluation and special shift system,optimize the green channel,strengthen the power of export hospitals,support the dislocation development of dependent hospitals,and create a sustainable model of bilateral cooperation and self-development of project hospitals.