Objective To optimized the culture conditions of the human umbilical cord blood mesenchymal stem cells.Methods The umbilical cord blood was taken in Guangzhou Hua Qiao Hospital between Oct.2004 to Feb.2005.The isolation method,planting density,the time of the first medium changing,the influence of culture medium on the growth of MSC were analyzed. Mesenchymal stem cells were identified using the surface marker by flow cytometry.Osteoblast was identified by Von Kossa staining and alkaline phosphatase staining,adipocyte was identified by Oil Red O staining. Results When the other conditions were the same,the hespan isolation was better than Ficoll isolation;5?10~6/cm~2 was the best planting density;the best first medium changing was on the seventh day at primary culture. Under optimized conditions,the MSC expressed adhesion molecules CD_ 13 ,CD_ 29 and CD_ 44 ,but not antigens of hematopoietic CD_ 34 ,CD_ 45 ,CD_ 14 and not antigens of endothelia CD_ 106 . Exposure of these cells to osteogenic inductive agents resulted in an increase in expression of alkaline phosphatase and the appearance of hydroxyapatite nodules. Incubation with adipogenic inductive agents resulted in morphological change and staining with Oil Red O. Conclusion Mesenchymal stem cells exist in Cord blood,but slower to establish in culture.Cord blood may prove to be a new source of cells for cellular therapeutics.

In this paper , we discussed the financing mechanisms of premarital healthcare services from their properties combined with the status quo financing in our country .We then provided the scientific basis and decision-making reference for improving financing mechanism to improve the premarital healthcare system .A literature or doc-umentary and field researches have combed the present situation of the premarital healthcare services financing mech -anisms at home and abroad .Related data were collected in eight research areas , namely Fujian, Guangxi, Yunnan, Hubei, Jiangsu, Heilongjiang, Beijing and Tianjin and the related personnel from health administrative department , civil affairs departments , maternal and child healthcare institutions were interviewed in terms of Field Research .From the main content at present , premarital healthcare services belong to the category of quasi-public goods .We dis-cussed the financing mechanisms from the financing levels , sources of funds , fund allocation , payment and financial regulatory and other aspects .Finally, some policy recommendations were put forward including making clear the na-ture of premarital healthcare service property , establishment of a special financial investment mechanism , unify the basic financing service standard after scientific feasibility studies , timely and fully allocate special premarital health-care service funds to strengthen the fund supervision policy recommendations .

Based on the policy framework , the premarital healthcare policy of Guangxi was analyzed from four aspects including policy background , process, content and actors.We analyzed the factors influencing this policy and their interactions , and discussed the important impact of Thalassemia prevention , multi-sectoral consensus and appro-priate premarital healthcare measures to the policy building and implementation .Then the lessons such as strengthe-ning the multi-sector cooperation , specifically making clear the pre-marital screening projects and implementing the“one-stop” service model were summed up in Guangxi province .Finally, combined with existing major problems , some policy recommendations were put forward including clarify the funding criteria and strengthen the premarital healthcare publicity in order to promote the sustainable development of premarital healthcare services .

Objective:To study the chronic disease management’s key factors in community health service insti-tution based on the Innovative Care for Chronic Conditions Framework ( ICCC ) . Methods: The purposive sampling method was adopted. Twelve community health service centers were selected as the field survey sites in Beijing, Shanghai, Zhengzhou and Chengdu. During the key factors description at macro-, meso-and micro-level in the IC-CC framework, thematic framework analysis was used to describe the key factors at maro-, meso-and micro level in the ICCC framework. Results:From the community health institutions’ perspective, the key factors at meso level in the ICCC framework played a better role in the management of chronic conditions while the key factors in both macro and micro level still lacked. Conclusion:Based on the ICCC framework, the management of chronic diseases needs to emphasize the cooperation with relevant departments outside the health area and legislative strategies at macro level, the ability of community supporters to mobilize and coordinate resources at meso level and the improvement of self-management skills for the patients with chronic diseases.

Objective:To analyze the concerning guarantee mechanisms during the transformation of the com-munity health service mode. Method:Purposive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou, and Chengdu, where the transformation of the community health service mode was pi-loted earlier and representative, were selected as the field survey sites. The qualitative method was used to collect da-ta accompanied by the quantitative method. Results: The guarantee mechanisms related to the transformation of the community health service mode could be concluded into four main types:collaboration mechanism, health profession-al training mechanism, incentive mechanism, and policy guarantee mechanism. All of the four mechanisms contribu-ted to the improvement of general teamwork, dual referral systems, and the development of contract and appointment services. Conclusion:During the transformation of the community health service mode, priority strategies include top-down design, health professional training mechanisms, and performance-based incentive mechanism, all of which should be implemented in the future.

Objective To observe the clinical effect of Xingnaojing injection combined with naloxone in the treatment of hypoxic ischemic encephalopathy.Methods 62 patients with hypoxia ischemia encephalopathy were randomly assigned into the control group(31 cases)and the treatment group(31 cases).The control group used naloxone treatment on the basis of the conventional treatment.The treatment group received Xingnaojing injection combined with naloxone treatment on the basis of routine treatment.The changes in different time of Glasgow Coma Scale(GCS) scores of the two groups after treatment were compared.Results After treatment for 1 ,5,1 0,1 5d,the GCS scores in the control group were (5.27 ±0.87)points,(9.03 ±0.72)points,(1 0.03 ±0.72)points,(1 3.03 ±0.72)points respectively,which in the treatment group were (5.1 4 ±1 .03)points,(9.24 ±1 .06)points,(1 3.31 ±2.83)points, (15.31 ±0.93)points.The differences of GCS scores after treatment for 15,10d between the two groups were statistically significant(t =1 5.1 1 3,1 0.501 ,P =0.00,0.00).In the control group,the total effective rate was 50.0%,which of the treatment group was 82.7%,the total effective rate between the two groups had statistically significant difference (χ2 =6.437,P <0.05).Conclusion On the basis of routine treatment,Xingnaojing injection combined with naloxone in the treatment of hypoxic ischemic encephalopathy has better effect than the single use of naloxone treatment.

Objective To systematically evaluate the effectiveness and safety of Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms. Methods Articles of clinical randomized controlled trials about Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms from the establishment of the databases to October of 2016 from CNKI, CBM, Chongqing Weipu, Wanfang database, Cochrane Library, PubMed and Embase were retrieved by computers. Bias risk assessment tools in Cochrane systematic evaluation handbook 5.1.0 was used to conduct quality evaluation for included articles. RevMan5.3 software was used to carry out Meta-analysis. Results Totally 12 articles and 839 patients were included. Results of Meta-analysis showed that Elemene combined with radiotherapy had more obvious curative effect on narrowing the neoplasm compared with pure radiotherapy [OR=2.73, 95%CI (1.97, 3.77), P<0.000 01], and improve patients' life quality at the same time [OR=3.85, 95%CI (2.23, 6.65), P<0.000 01], and relieve adverse reactions [OR=4.16, 95%CI (2.40, 7.22), P<0.000 01]. Conclusion Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms shows confirmed efficacy, and is relatively safe. But whether the program should be widely used in clinic, more large sample, multi-center, and high-quality clinical randomized controlled trials are still needed.

PURPOSE: The American Joint Committee on Cancer 8th edition (AJCC8) prognostic stage (PS) was implemented January 1, 2018, but it is complex due to multiple permutations. A North American group proposed a simpler system using the anatomic stage with a risk score system (RSS) of 1 point each for grade 3 tumor and human epithelial growth factor receptor 2 (HER2) and estrogen receptor (ER) negativity. Here we aimed to evaluate this risk score system with our database of Asian breast cancer patients and compare it against the AJCC8 PS. METHODS: Patients diagnosed with breast cancer stage I–IV in 2006–2012 were identified in the SingHealth Joint Breast Cancer Registry. Five-year breast cancer-specific survival (CSS) and overall survival (OS) were calculated for each anatomic stage according to the risk score and compared with the AJCC8 PS. RESULTS: A total of 6,656 patients were analyzed. The median follow-up was 61 (interquartile range, 37–90) months. There was a high receipt of endocrine therapy (84.6% of ER+ patients), chemotherapy (84.3% of node-positive patients), and trastuzumab (86.0% of HER2+ patients). Within each anatomic stage, there were significant differences in survival in all sub-stages except IIIB. On multivariate analysis, the hazard ratio for negative ER was 1.74 (1.48–2.06), for negative HER2 was 1.49 (1.26–1.74), and for grade 3 was 1.84 (1.55–2.19). On multivariate analysis controlled for age, ethnicity, and receipt of chemotherapy, the RSS (Akaike information criterion [AIC] = 10,649.45; Harrell's Concordance Index [C] = 0.85) was not inferior to the AJCC8 PS (AIC = 10,726.65; C = 0.84) for CSS, nor was the RSS (AIC = 14,714.4; C = 0.82) inferior to the AJCC8 PS (AIC = 14,784.69; C = 0.81) for OS. CONCLUSION: The RSS is comparable to the AJCC8 PS for a patient population receiving chemotherapy as well as endocrine- and HER2-targeted therapy and further stratifies stage IV patients.
Asian Continental Ancestry Group ; Biomarkers ; Breast Neoplasms ; Breast ; Drug Therapy ; Estrogens ; Follow-Up Studies ; Humans ; Joints ; Multivariate Analysis ; Trastuzumab

The Life Support Course for Nurses (LSCN) equips nurses with the resuscitation skills to be first responders in in-hospital cardiac arrests. Seventeen years after the initiation of the LSCN, a confidential cross-sectional Qualtrics™ survey was conducted in May 2016 on LSCN graduands to assess the following: confidence in nurse-initiated resuscitation post-LSCN; defibrillation experience and outcomes; and perceived barriers and usefulness of the LSCN. The majority of respondents reported that the course was useful and enhanced their confidence in resuscitation. Skills retention can be enhanced by organising frequent team-based resuscitation training. Resuscitation successes should be publicised to help overcome perceived barriers.

We report a case of mucinous adenocarcinoma arising in the perianal soft tissue in association with chronic fistula-in-ano in a 43-year-old man who had a relapse of perianal pain and bloody discharge after six years of defaulted follow-up. He underwent magnetic resonance (MR) and computed tomography imaging with correct identification of the disease entity on imaging. Mesh-like septations and an enhancing solid component with high diffusion-weighted imaging (DWI) and intermediate apparent diffusion coefficient signals were observed. He underwent abdominoperineal resection of the tumour but succumbed due to postoperative complications. Literature on the MR imaging features of this tumour remains scarce. We highlight the MR imaging features, including those seen on DWI, which were useful in making the correct diagnosis. Though uncommon, this would be an important condition to recognise since assessment of fistula-in-ano by MR imaging is considered to be the standard of care in current clinical practice. The clinical features of this entity are also briefly discussed.
Adenocarcinoma, Mucinous ; complications ; diagnosis ; Adult ; Anus Neoplasms ; complications ; diagnosis ; Chronic Disease ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; Humans ; Male ; Rectal Fistula ; complications ; diagnosis ; Tomography, X-Ray Computed