A picture of great market potential and mismatch of supply and demand in Anhui was drawn in the paper,with five challenges analyzed for the industry in general.The authors proposed to integrate medical resources and aging care resources,to build a diversified and tiered health care and aging care supply system,an integrated administrative coordination mechanism,and enhance fiscal support among other policy suggestions.These proposals were designed to encourage the development of the aging care industry featuring a combination of medical resources and aging care.

Objective To study the echocardiographic characteristics and its diagnosis value on congenital supravalvular aortic stenosis (SVAS) in children. Methods Thirty-one patients with SVAS diagnosed by multiplane echocardiography were enrolled in the study. Their echocardiographic characteristics were compared with cardiac catheterization, operation, and gene detection results. Echocardiographic changes were mainly observed in aortic valve, supravalve, descending aortic arch, pulmonary artery valve, main pulmonary artery and its branches,and coronary artery. Results Of the 31 patients,26 had hourglass type SVAS,4 hypoplastic type,and 1 membranous type; 2 patients had extremely mild stenosis (defined as a Doppler gradient <25 mm Hg) ,20 mild (25～49 mm Hg) ,5 moderate (50～75 mm Hg) ,and 4 severe C>75 mm Hg) ones. Nineteen patients were diagnosed with Williams syndrome by gene detection. Three patients were associated with aortic valve stenosis including one missed at the initial diagnosis; 10(32.26%) patients with pulmonary stenosis, including pulmonary valve stenosis in 6, left and right pulmonary artery stenosis in 3 ,and branch stenosis in 1:6 patients with coronary stenosis. Conclusions The sternal border and five chamber apical views are the best to detect SVAS. Williams syndrome patients are prone to SVAS.Pulmonary stenosis echocardiography forms a great proportion of the SVAS patients. Routine examination is necessary for coronary stenosis in cases of SVAS.

0 05). However, the scores at all the 4 time points of 1 week, 1 month, 3 month and 6 month follow up after surgery, were higher than the scores before surgery( P

Systemic sclerosis is an autoimmune disease characterized by skin thickening and tightness.Digestive system is the most commonly damaged system secondary to skin,and as to unspecific clinical manifestations,this complication is often ignored in the early,the prognosis and quality of life of patients will be affected.This article overviews the recent research developments on pathology,clinical features,management of systemic sclerosis with digestive system involvement,to draw attention to early diagnosis and treatment of this condition for the improvement of the prognosis.

Objective:To analyze the clincial characteristics and laboratory findings of patients with neurobrucellosis (NB).Methods:Using retrospective analysis, clinical diagnosed patients with NB from June 2016 to February 2019 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analyze the general characteristics, clinical symptoms, laboratory examination results [white blood cell (WBC), hemoglobin(Hb), c-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), cerebrospinal fluid routine and biochemical, serum tube agglutination test (SAT), blood culture and cerebrospinal fluid culture of Brucella] , diagnosis and treatment effect. Results:A total of 25 patients were diagnosed with NB, including 19 males and 6 females, with an average age of (41.7 ± 14.2) years old, ranged from 11 to 70 years old. The main clinical symptoms were fever, headache, joint pain, vomiting and sweating, which accounted for 92.0% (23/25), 88.0% (22/25), 76.0% (19/25), 64.0% (16/25), and 64.0% (16/25), respectively. Positive neck ankylosis and mumbness of lowerlimbs were both 9 cases (36.0%), and mental disorders were 7 cases (28.0%). In 25 patients with NB, the WBC increased in 5 cases (20.0%), Hb decreased in 4 cases (16.0%), CRP increased in 13 cases (52.0%), ALT and AST both increased in 6 cases (24.0%), TP decreased in 21 cases (84.0%); SAT was positive in 25 cases (100.0%), cerebrospinal fluid SAT positive in 7 cases (28.0%); and blood culture was positive in 2 cases (8.0%). Cerebrospinal fluid changes were mainly manifested in 14 cases (56.0%) of chloride reduction, 13 cases (52.0%) of gluose reduction and 19 cases (76.0%) of protein increase. In 25 patients with NB, 17 cases were treated with doxycycline + rifampicin + ceftriaxone, 7 cases with etimicin + rifampicin + ceftriaxone, and 1 case with doxycycline + rifampicin + piperacillin sulbactam. After 6 to 12 months follow-up, 21 cases recovered well, whereas mild sequelae were observed in 4 patients.Conclusion:Clinical features of NB are hetorogeneous, and nerurological symptoms and cerebrospinal fluid examination are of great value in the diagnosis of NB.

Objective To explore the application of washing fluid in the prevention of postoperative incision infection of colorectal cancer. Methods 350 patients with colorectal cancer underwent colorectal surgery from Jan. 2012 to Dec. 2015 were randomly divided into three groups: sterile saline, 0.50% metronidazole, 0.50% Povidone-iodine solution group, while part of the rinse liquid heated to 37 ~38℃ before use, then record the operation time, surgical site, postoperative incision infection, incision infection, timely delivery statistical analysis was performed by using single factor analysis and logistic multivariate regression analysis. Age, operation time, surgical site, type of irrigating fluid and temperature of flushing fluid were analyzed statistically. Results The incision infection rate of the patients ≥60 years old and the operation time ≥2 h was higher than the age <60 years, and the operation time was less than 2 h, P < 0.05, the difference was statistically significant; 0.50% metronidazole, 0.50% Povidone-iodine solution group, the infection rates of 0.50% metronidazole and 0.50% povidone-iodine group were 7.69% and 8.55%, respectively, which were significantly lower than those of the saline group 16.38% The infection rate of the rinsing fluid after heating was 7.22% and 14.71%, respectively, lower than that of the normal temperature rinsing solution (P < 0.05), the difference was statistically significant. Conclusions The risk factors of incisional infection in colorectal cancer patients with colorectal cancer were : ≥60 years of age and ≥2 h of operation, while 0.50%metronidazole, 0.50% povidone-iodine solution and heated washing fluid were protective factors. It can be applied to prevent incision infection after laparoscopic surgery.

Objective To report the clinical and imaging characteristics of 9 cases of gastric duplication in children,as well as to probe into all kinds of imaging examination methods,with an aim to improve preoperative diagnostic accuracy.Methods Nine cases of children with gastric duplication that received surgical resection and were pathologically confirmed in our hospital from January 2009 to November 2016 were retrospectively analyzed.The clinical manifestations,complications,complicated malformation and imaging findings of the cases were summarized.Three asymptomatic cases were carried out regular ultrasound examination follows-up preoperatively.Results Gastric duplication in children varied in terms of cliuical manifestations.All the 9 cases were performed ultrasonography preoperatively,and 5 of them were accurately diagnosed.Meanwhile,7 cases received preoperative CT examination,with 2 cases being confirmed.Three cases received magnetic resonance imaging (MRI) examination,with 2 cases being confirmed.And 2 cases had upper abdominal gastrointestinal imaging (GI) examination,but no definite diagnosis was made.Three cases of asymptomatic children with enlarged lesion can be seen in follow-up.Conclusions Gastric duplication is a rare congenital malformation,ultrasound allows to clearly display the capsule wall structure and the relation between gastric duplication with gastric wall,which is associated with high utilization rate and diagnosis rate,and it can be served as the preferred imaging examination method for gastric duplication in children.

Objective To explore the relationship between serum uric acid and pulmonary hypertension (PH) in patients with systemic sclerosis (SSc). Methods The echocardiography, electrocardiogram, nailfold videocapillaroscopy and laboratory parameters of 62 patients with SSc were retrospectively analyzed . Patients were divided into two groups according to presence of PH . Statistical analysis was performed using SPSS 17 software . Results Compared to patients without PH , patients with PH had significantly higher serum uric acid levels ( P < 0 . 01 ) , systolic pulmonary arterial pressure ( P < 0 . 01 ) , abnormality of electrocardiogram (P < 0.01), abnormality of nailfold video capillaroscopy and lower serum albunin levels (P < 0.01). Systolic pulmonary arterial pressure had correlation with Serum UA ( r = 0 . 26 , P < 0 . 01 ) as well as serum ablumin (r = -0.28, P < 0.03). Moreover, the mean value of serum UA was significantly different in two ECG groups (P < 0.01) and two nailfold videocapillaroscopy groups (P < 0.01). At the cutoff level of 374 μmol/L, serum uric acid had reasonable accuracy for predicting the presence of PH in SSc patients ( sensitivity 66 . 7% and specificity 84 . 0%) . Conclusion The serum uric acid may be useful as a practicable marker for predict PH in patients with SSc .

BACKGROUND:Endothelial progenitor cel s have been shown to play an important role in the pathogenesis of traumatic diseases in recent years. OBJECTIVE:To explore the effect of magnetic labeled endothelial progenitor cel transplantation on renal function of diabetic rats through a MRI imaging study.METHODS:Sixty Wistar rats were randomly divided into normal (no treatment), control and experimental groups. Intraperitoneal injection of 40 mg/kg streptozotocin was performed to make a rat model of type 1 diabetes in the control and experimental groups. Four weeks after modeling, rats in the experimental group were given intravenous injection of magnetic labeled endothelial progenitor cel s (0.15 mL, 1×109/L). Fasting blood glucose, serum insulin, serum creatinine, urea nitrogen and 24-hour urinary protein levels in rats were measured at 8 weeks after cel transplantation. MRI was used to trace transplanted cel s in vivo in comparison with renal biopsy findings, and rat body mass and kidney weight were measured to calculate kidney weight index. RESULTS AND CONCLUSION:After modeling, fasting blood glucose, serum creatinine, urea nitrogen and 24-hour urinary protein levels as wel as kidney weight index were increased significantly (P<0.05), while the insulin level decreased (P<0.05). Compared with the model group, the endothelial progenitor cel transplantation reversed these indices (P<0.05). Additional y, in the experimental group, there was slightly longer T1 and shorter T2 signals as wel as marked lesion edge, and the FLASH sequence became more remarkable compared with the T2-weighted RARE sequence. The other groups showed no significant low signal changes. Magnetic-labeled positive cel s in the experimental group showed by the MRI were consistent with the tissue biopsy results, while no positive cel s were found in the model and normal groups. To conclude, the magnetic labeled endothelial progenitor cel transplantation can improve renal dysfunction in diabetic rats to a certain extent.

Objective To investigate the chemical constituents in the stems and leaves of Arachis hypogaea.Methods The isolated compounds Ⅰ—Ⅳ were obtained by the combination of silica gel,ODS-18,and Sephadex LH-20 column chromatographies.Structural elucidation was conducted by the moedrn spectral method.Results Seventeen compounds were isolated and identified from the water extraction,and there were four norsesquiterpene compounds from butanol extraction.They are arachiside A(Ⅰ),cucubalactone(Ⅱ),roseoside(Ⅲ),and citroside A(Ⅳ).Conclusion Compound Ⅰ is a new compound named arachiside A and compounds Ⅱ—Ⅳ are isolated from the plants of Arachis Linn.for the first time.