Wuhu City has been exploring,since 2007,an innovative health and medical system featuring both the reform of public hospitals and that of the primary care system.This reform aims at strengthening the public health service system,improving the basic medical service system,speeding up the construction of the medical security system,and improving the drug supply system.It is characteristic of a core,two wings,and four-wheel drive,which tells the essence of Wuhu' s reform practices and outcomes.

Objective To provide references for improving the quality of TCM decoction pieces through the analysis on sample inspection of TCM decoction pieces of Huguosi TCM Hospital of Beijing University of Chinese Medicine (hereinafter referred to as our hospital). Methods In our hospital from January 2014 to December 2015, TCM decoction pieces with problems in this sample inspection were categorized according to reasons. Results Quality problems found in the sample inspection were categorized into 3 types, i.e. collection and preparation (69.79%), storage (20.93%) and other problems (9.31%). Cutting in collection and preparation (13.95%), worming in storage (9.30%) and breaking/crumbing (6.98%) were the most obvious problems. Conclusion Strengthening the management of procurement acceptance, strict control of storage and storage conditions, and paying attention to the use of other aspects of management can improve the quality of TCM decoction pieces.

Objective To explore the effect of Curcumae on acute hepatic injuried mice.Methods The model mice of acute hepatic injury were established with intraperitoneal injecting 0.2% carbon tetrachloride (CCl4) 0.2 ml/10mg. 48 mice were randomized into 6 groups: model group, control group, Ganlixin group (25 mg/kg) and three treating groups of Curcumae which were administrated by gavage at the doses of 2.5 g/kg, 5 g/kg, 10 g/kg once everyday.7 d later, all mice were put to death. The liver index, the activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in serum, the activities of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in hepatic tissue were observed. Pathological change was observed under HE staining. Results Compared with the model group, Curcumae could decrease the liver index and the activities of ALT and AST in serum, MDA in hepatic tissue significantly (P<0.05), and increase the activities of SOD (P<0.05). The pathological changes were less in three treating groups than that of the models. Conclusion Curcumae can protect the liver from acute hepatic injuried induced with CCl4 in mice.

Objective To observe the effect of Yujin on cerebral function of acute hypoxia mice.MethodsThe acute hypoxia mice model was reproduced by cutting heads and establishing normal-pressure and closed hypoxic experimental settings. In yujin groups, the mice were treated with Yujin at the doses of 10 g/kg, 20 g/kg, 40 g/kg respectively through the intragastric tubes everyday. 6 days later, the mice survival time, the open-mouth times after cutting heads and the breathing time were observed. The activity of superoxide dismutase (SOD) and content of maleic dialdehyde (MDA) in cerebral tissues were measured. The morphological changes of the cerebral tissues under the microscope were examined.ResultsYujin could significantly prolong the survival time ( P<0.001) and the breathing time and increase the open-mouth times ( P<0.05～0.001), increase the activity of SOD ( P<0.001) and decrease the content of MDA ( P<0.01～0.001) in cerebral tissues. Compared with control group, the Yujin group mice had no obvious pathological alteration except some cerebral vascular dilatation.ConclusionYujin has an obvious protective effect on cerebral tissues of acute hypoxia mice.

Objective To demonstrate the clinical outcome of bilateral gluteus maximus musculocutaneous flap in conjunction with continuous postoperative negative pressure wound therapy in reconstruction of sacral soft tissue defects.Methods From January, 2008 to April, 2013, 18 patients (8 males and 10 females, aged from 34 to 78 years old) with full-thickness sacral soft tissue defects were treated.The size of the defects after initial debridement ranged from 3.0 cm × 2.0 cm to 18.0 cm × 14.0 cm, with the exposure of sacrum or ligament.Bilateral gluteus maximus musculocutaneous flap were applied in all the patients.Two drainage tubes were placed on each side of the flaps during the surgery and suck for 10 to 12 consecutive days after the operation.Results The size of the harvested flaps ranged from 12.0 cm × 8.0 cm to 18.0 cm × 12.0 cm, and all the donor sites of the flaps were closed with primary suture.Thirty-five flaps in 17 patients survived without any complication.Partial necrosis of one flap was found in 1 patient and managed successfully with conservative dressing change.Fourteen patients were followed-up ranged from 8 months to 2.5 years (mean follow-up was 18 months).Color and texture of the flaps were satisfactory and no recurrence of sacral defect was noted.Conclusion Bilateral gluteus maximus musculocutaneous flap in conjunction with continuous postoperative negative pressure wound therapy may serve as a useful option for fullthickness sacral soft tissue defects.

Objective To observe the effect of panaxadiol saponins (PDS) on intellectual decline and cerebral lesion induced by destabilization of cervical vertebra in mice.Methods44 mice were randomly divided into the normal control group, model group, high PDS doses group and low PDS doses group with 11 animals in each group. The model of destabilization of cervical vertebra was established by operating and intraperitoneal injection of PDS performed in the PDS high doses group (14 mg/kg) and low doses group (7 mg/kg) once everyday for 50 days. The memory ability of mice was evaluated by the water-maze test and tittup platform experiment. 50 days later, all mice were executed and the activities of superoxide dismutase (SOD), lactic dehydrogenase (LDH) and the content of maleic dialdehyde (MDA), nitric oxide (NO) in encephalon were tested.ResultsIn the PDS groups, the incubation period and error times in water-maze test shortened significantly ( P<0.05), aod the reaction period in tittup platform experiment shortened and wrong times decreased obviously ( P<0.01) compared with the model group. The activities of SOD, LDH increased ( P<0.01), and the content of MDA and NO decreased ( P<0.01, P<0.05) in the PDS group compared with the model group.ConclusionPDS has certain protective and improving effect on the decline of memory ability and cerebral lesion induced by destabilization of cervical vertebra in mice.

Objective To investigate the immunologic properties of osteogenic differentiated bone mesenchymal stem cells (BMSCs). Methods BMSCs were isolated from normal volunteers and induced in osteogenic medium for two weeks. Then,non-differentiated/osteogenic differentiated BMSCs were co-cultured with allogenic T cells and phytohemagglutinin (PHA).The proliferation of T cells was examined by MTT method.The concentrations of TGF-β1 in osteogenic differentiated BMSCs supernatants at week 2 and mixed lymphocytes reaction (MLR) supernatants at day 5 were determined by ELISA.Also,anti-TGF-β antibody was added into the MLR to detect the response of the mixed T cells. Results Non-differentiated and osteogenic differentiated BMSCs did not induce proliferation of the allogeneic T cells but both suppressed the proliferation of the T cells mediated by PHA.The TGF-β1 concentrations had significant elevation in the MLR.Anti-TGF-β antibody could counteract the immunosuppressive function of the osteogenic differentiated BMSCs. Conclusion Osteogenic differentiated BMSCs possess low immunogenicity and immunosuppressive property.

BACKGROUND: Osteolysis has always occurred in pelvis. Percutaneous injection of bone cement stabilized bone fracture, relieved pain or even treated tumor. However, leakage of bone cement might cause severe complications. OBJECTIVE: To explore the therapeutic effect of peroutaneous injection of bone cement on treating osteolysis pelvic disease in 9 cases by the CT guidance. METHODS: By the CT guidance, needing degree was determined firstly. Focal size and scanning layers were used to calculate focal volume and estimate injected dose of bone cement. Three-dimensional targeting device was used to introduce the puncturation. The bone cement which was 0.2-0.5 mL less than the calculated volume was injected into osteolysis site. The accuracy, injected dose, clinical efficacy, and complications were investigated. RESULTS AND CONCLUSION: The following-up ranged from 5 months to 4 years, with mean duration of 1.5 years. At 1-48 hours after operation, symptoms were recovered, including complete recovery (n=6), partial recovery (n=2), and light recovery (n=1). Leakage of bone cement was not detected out around focal region. This suggested that percutaneous injection of bone cement into the erosion site is an effective method to treat pelvic osteolysis disease, characterizing by security, effective, and less invasive.

Objectives:To investigate the predictive effect of regional homogeneity (ReHo) from resting-state functional magnetic resonance imaging (rs-fMRI) in acute phase on memory function of chronic phage in ischemic stroke patients and the effects of residual learning (REL) on the predictive performance of machine learning models.Methods:From June 2019 to June 2021, rs-fMRI data of one-week after stroke (acute phase) were collected from 35 first-time ischemic stroke patients, and their memory scores were assessed by the Rey auditory verbal learning test (RAVLT) at 6 months after stroke (chronic phase). Using ReHo from rs-fMRI data in acute phase of ischemic stroke patients, the support vector regression (SVR) and the REL-based SVR (REL-SVR) were constructed to predict the patients’ memory scores at 6 months after stroke, and the performance of the two models was compared using Pearson correlation coefficient.Results:Based on the ReHo from acute phase, the correlation coefficient between the predicted values and the true scores from the SVR model was r=0.524, P=0.001, while the correlation coefficient obtained by the REL-SVR model was r=0.671, P<0.001. Brain regions with relatively higher weights such as Temporal_Pole_Mid_R (weight value: 1.03), Temporal_Mid_R(weight value: 1.03), Temporal_Inf_R (weight value: 1.03), Occipital_Mid_R (weight value: 0.57), Frontal_Mid_L (weight value: 0.32), Frontal_Sup_Medial_L (weight value: 0.53), SupraMarginal_L (weight value: 1.54), Calcarine_L (weight value: 0.65), Lingual_L (weight value: 0.58), Cuneus_L (weight value: 0.65), Precuneus_L (weight value: 0.83), cerebellum(weight value>1.0) made larger contributions to the prediction model. Conclusions:ReHo in the acute-phase can effectively predict memory in the chronic phase of ischemic stroke patients. Furthermore, REL can improve the performance of the traditional SVR model and achieve higher predictive accuracy.

Objective:To examine the expression of programmed cell death 1 (PD-1) and its ligand (PD-L1) in epithelial ovarian cancer (EOC) tissues, and investigate the correlation among their expression, clinicopathological features and prognosis.Methods:The specimens of 180 patients with EOC treated in the First Affiliated Hospital of Dalian Medical University from October 2002 to December 2013 were confirmed by pathological examination. The pathological tissue specimens of subtypes ，included 120 cases of serous carcinoma, 30 cases of mucinous carcinoma, 20 cases of endometrioid carcinoma, and 20 cases of clear cell carcinoma. The normal paracancerous tissues of 50 cases randomly selected from the 180 patients as control group. Immunohistochemical SP method was used to detect the expressions of both PD-1 and PD-L1 in epithelial ovarian cancer tissues, and the relationships among their expressions,the clinicopathological parameters and prognosis were respectively analyzed.Results:（1） PD-1 was expressed in lymphocytes infiltrated in EOC tissues, and PD-L1 was expressed in the cell membranes of cancer tissues. In all EOC cases, 33 cases (18.3%, 33/180) of both PD-1 and PD-L1 were highly expressed, and only 1 (2.0%, 1/50) of control group showed high expression. There was statistically significant difference between two groups ( P<0.01). (2) Among the four subtypes tissue specimens of EOC, the high expression rate of PD-1 was 25.0% (30/120) for serous carcinoma, 3/15 for endometrioid carcinoma, 0 (0/30) for mucinous carcinoma, and 0 (0/15) for clear cell carcinoma. The high expression rate of PD-L1 was 23.3% (28/120) for serous carcinoma, 3.3% (1/30) for mucinous carcinoma, 2/15 for endometrioid carcinoma, and 2/15 for clear cell carcinoma. Both PD-1 and PD-L1 expressions in the four sub-types of tissue specimens were significantly different ( P<0.05). The high expression rate of both PD-1 and PD-L1 was 9.2% (8/87) in the early stage and 26.9% (25/93) in the late stage. There was a statistically significant difference between the two groups ( P<0.01). Similarly, the expression of both PD-1 and PD-L1 were significantly higher in the cases of high-grade EOC （type Ⅱ） than those of low-grade （type Ⅰ） and in the cases of EOC distributed bilaterally than that distributed unilaterally, and there were statistically significant differences ( P<0.05). (3) The Kaplan-Meier survival analysis showed that the survival time were respectively 35 and 36 months in the cases with high expressions of both PD-1 and PD-L1, and the survival time were the same as 61 months in the cases with low expression of both PD-1 and PD-L1, and the comparison was statistically significant ( P<0.05). Conclusions:The expression levels of PD-1 and PD-L1 in EOC tissues are higher than those in adjacent tissues, especially in serous carcinomas. The expression of both PD-1 and PD-L1 is higher in specimens of the patients with advanced stages. The results showed that the high expression of both PD-1 and PD-L1 is an indicator of poor prognosis of patients suffering from EOC.