Our understanding of the immunological mechanisms of rejection has greatly improved over the past 10 years. The allografts have maintained long survival without immunosuppressive treatment in the several organ-transplant recipients combined with hematopoietic stem cell transplantation. The authors attributed the successful outcome to the cotransplantation of donor stem cells. The review will analyze firstly conditions of the recipients, and then review the theoretical basis and history regarding donor-specific tolerance of allograft, and it will also clarify that there is no direct link between the donor-specific transplantation tolerance and hematopoietic stem cell transplantation.

OBJECTIVE:To develop a new way for the extration and determination of naringin in Davallia mariesii. METH-ODS:Naringin in D. mariesii was extracted by ASE350 accelerated solvent extraction system;HPLC was performed for the con-tent determination of naringin in D. mariesii,the column was Kinetex XB-C18 with mobile phase of methanol-5%acetic acid(25∶75, V/V)at a flow rate of 0.8 ml/min,detection wavelength was 283 nm,column temperature was 40℃,and injection volume was 10 μl. RESULTS:The linear range of naringin was 0.073 0-0.730 0 μg(r=0.999 9);the limit of quantitation was 0.73 μg,the limit of detection was 0.022 μ g;RSDs of precision, stability and reproducibility tests were lower than 2% ;recovery was 98.92%-100.85%(RSD=0.72%,n=6). CONCLUSIONS:The method is simple,accurate and specific,and can be used for the content determination of naringin in D. Mariesii.

Treatment of CIN2～3 includes cervical ablation,cervical local excision and hysterectomy,while cervical local excision is the standard procedure for CIN2～3.The recurrence rate was 0.7%～21% after surgery treatment of CIN2～3;The high risk factors of recurring are positive margin,serious lesion and age over 40.The follow-up items for postoperation involve cytology,colposcopy,ECC and HPV testing;If there were 2 LSIL or 1 HSIL for cytology,the patients should be given colposcopy examination and ECC.Retreatment must be clinically individual one.It is the same significance for follow-up and treatment of CIN2～3.

The division of specialists and general practitioners is the important of the establishment of a GP system. According to the theory of labor division, the study analyzes the evolution mechanism on the division of spe-cialists and general practitioners and discusses the main factors influencing the division in China. It is found that transaction costs of general practices are not much lower than that of specialist medical care, which encourages outpa-tients to visit specialists in hospitals. Additionally, transaction costs of referral are much higher than profits. There-fore, while there is no division of specialists and general practitioners, it has been difficult to address competition between them and the quality and the efficiency of general practice care in community health centers. Moreover, the income gap does not attract medical students to work in general practices, which has worsened the quality and effi-ciency of general practices. Finally, the transaction costs of general practices have continually increased. This vicious cycle has hindered the division of specialists and general practitioners in China.

Objective To study the effect improvation of lung function and prognosis of singulair and seretide for moderate to severe AECOPD . Methods 78 patients associated with moderate to severe AECOPD from January 2014 to June 2016 in our hospital were researched.They were divided randomly into observation and control groups according to the order of admission, 39 cases in each group.In the control group, they were treated by conventional anti-infective, expectorant, oxygen, suction seretide.In the observation group, using singulair on the basis of the control group.Clinical data, clinical efficacy, clinical symptoms begin to improve time, hospitalization time, blood gas analysis (PaO2, PaCO2) after five days and pulmonary function after treatment forced expiratory volume in one second ( FEV1 ) , call gas peak velocity ( PEF) , forced expiratory volume in one second than the forced vital capacity (FEV1/FVC), maximum mid-expiratory flow rate (MMEF) were compared with each other.Results Their clinical data of patients and other general information and basic condition had no significant difference between each other.The effective rate of observation group and control group were 97.44%and 87.18%, clinical effecicy of observation group was better than the control group, the difference was statistically significant (u=2.2805, P<0.05).Postoperative hospital stay, time of symptoms began to improve of the observation group were shorter than the control group, the difference was statistically significant (P<0.05), PaO2 of 5-day post-treatment of observation group was higher, and PaCO2 was lower, the difference was statistically significant (P<0.05).Lung function of two groups of patients had no significant difference before treatment, after treatment, pulmonary function in the observation group (including FEV1, PEF, FEV1/FVC, MMEF) was better than the control group, the difference was statistically significant (P<0.05).Conclusion Seretide combined with singulair to treat severe AECOPD has a good effect, it can significantly improve the therapeutic effect and improve the patient's lung function.

The main progress in international critical care medicine in 2020 are: the reflections on the mandatory of implementation of the 1-hour cluster treatment strategy for sepsis are still continuing; the "metabolic resuscitation" therapy, represented by large dose of vitamin C, failed to yield positive results; the global epidemic of coronavirus disease 2019 (COVID-19) continues to spread, with evidences indicating Dexamethasone, Remdesivir or interferon β-1b (IFNβ-1b), Lopinavir/Ritonavir and ribavirin as promising therapy; conservative oxygen therapy did not exert positive effects neither for mechanical ventilated patients nor for acute respiratory distress syndrome (ARDS) patient; the concept of lung- and diaphragm-protective mechanical ventilation illuminates a new opportunity to potentially improve clinical outcomes for critically ill patients; there was no positive evidence for stress ulcer prophylaxis and timing of endoscopy for severe acute upper gastrointestinal bleeding; early initiation of renal-replacement therapy (RRT) for critically ill patients with acute kidney injury (AKI) has not shown positive effect. At last, artificial intelligence (AI) has shown good potential in identifying ARDS phenotypes and early predicting sepsis.

Abdominal pain is one of the common symptoms in children with diseases.Acute abdominal pain accounts for some parts of all primary presenting diseases in the emergency department.The clinical features and treatments of fulminant myocarditis,Henoch-Schonlein purpura and diabetic ketoacidosis initially presented with abdominal pain in children were reviewed in the article.

Objective To evaluate the correlation between antiphospholipid (APLA) antibodies and retinal vein occlusion (RVO).Methods A computerized search was conducted in the Pubmed,Chinese Biological Medicine Database,China National Knowledge Infrastructure,VIP database,Wanfang Database combined with manually searching of literature reference proceedings.The search time was ranged from establishment of each database to August 1st,2012.After the data extraction,quality of RCT was assessed.The meta analysis was performed by Stata 11.0.Results In total,12 case-control studies (1324subjects) that fulfilled the eligibility criteria were included in the meta-analysis involving 505 patients in RVO group and 819 subjects in control group.The odds ratio (OR) and 95％ confidence interval (CI) of APLA,anticardiolipin antibodies (ACA),lupus coagulation inhibitor and RVO were 5.01 and 3.33-7.53,4.38 and 2.38 8.05,1.72 and 0.73-4.04,respectively.The OR and 95％ CI of APLA,ACA and central RVO were 4.80 and 2.59-8.88,6.02 and 2.06-17.63,respectively.The OR and 95％ CI of APLA,ACA,lupus coagulation inhibitor and branch RVO were 4.22 and 1.67-10.63,3.69 and 1.32-10.32,2.07 and 0.79-5.41,respectively.Conclusions APLA may increase the rick of RVO,especially ACA has a prediction function to RVO.It is necessary to screening for APLA in RVO patients.

Objective To analyze and compare the incidence of diarrhea between cerebral hemorrhage and infarction. Method We observed and compared the time when diarrhea occurred in both 147 cases of cerebral hemorrhage patients and 142 cases of cerebral infarction patients by using statistical methods. Result The incidence of diarrhea in former group was 36.05%, and that of latter was 16.91%. Conclusions The incidence in patients with diarrhea of cerebral hemorrhage was markedly higher than that of patients with cerebral infarction. This may attribute to the higher intracranial pressure in cerebral hemorrhage patients than that of cerebral infarction ones. The complications of reduction of immune function,intestinal infection and hypoproteinemia may be the other factors resulting in the higher incidence of diarrhea in cerebral hemorrhage patients than that of cerebral infarction ones.

In this paper the causes of deficiency of public welfare were analyzed in medical research,and some strategies were proposed to enhance the public welfare of public health care services according to the cardinal principles of new healthcare reform package in 2009.These were benefit to maintain the public welfare of public medical and health care services,and to reach the goal of medical research served as the clinic and the patients.