In 2012, the contracted service with the general practitioners ( rural doctors) was implemented in Zhejiang Province. This paper conducted an analysis on the existing problems in the contracted service from three as-pects of policy background, policy objective, main measures and the following suggestions have been put forward:Strengthening the whole family team of doctors and information construction, and improving the multi sectoral coopera-tion mechanism in order to establish the classified diagnosis and treatment system as targeted to lay a good foundation.

Objective Compare the efficacy of transvaginal cesarean scar pregnancy debridement surgery(treatment group) and the uterine artery embolization company with the curettage(control group) in the treatment of cesarean scar pregnancy and ana-lyze the related factors of the failure of the surgery .Methods Postoperative vaginal bleeding ,incidence of postoperative scar preg-nancy again ,and time of hospital stays after surgery were compared in two groups .Relationships between gestational age ,cesarean section ,the value of serum HCG ,B-mass size ,live births and surgical success rate were discussed .Results The mean amount of blood bleeding during operation of the treatment group was(85 .38 ± 13 .27)mL ,the rate of continue pregnancy after surgery was 2 .56% ,mean time of hospital stays was(5 .13 ± 0 .77)d ,Significantly lower than the control group[(163 .11 ± 34 .87)mL ,11 .90% , (8 .12 ± 1 .88)d ,all P< 0 .05] ;Blood HCG value ,B-mass size ,and live births were related with surgical success rate(P< 0 .05) ,But times of cesarean section and gestational age had no significant relationship with the surgical success rate(P> 0 .05) .Conclusion Tansvaginal cesarean scar pregnancy debridement surgery showed less damage on the treatment of cesarean scar pregnancy ,and re-duced the recurrence rate of the patient ,who had high blood HCG levels ,embryo survival and larger volume .

0.05). At 4 and 20 h,the RR in the S group was significantly lower than that in the T group (P

Objective To study the immunoregulatory ability of mesenchymal stem cell (MSC) on T cells. Methods MSC were isolated and cultured from bone marrow and CD3 + T cells from peripheral blood. Then the action of MSC on T cell proliferation was investigated. ELISA assay tested IFN-? and IL-10 secretion of CD3 + T cells. Results The data showed that MSC inhibited T cell proliferation in a dose dependent manner when there was 2?10 5/well (96-well plate) CD3 +T cells. While MSC stimulated T cell proliferation when there was 5?10 4/well CD3 + T cells. High dose CD3 +T cells produced high level IFN-? and IL-10 in the absence of MSC, while when there were MSC in the culture, 5?10 4/well CD3 +T cells secreted more IFN-? and IL-10 than 2?10 5/well CD3 + T cells. Conclusion The result suggested that the effect of MSC on T cells was complex, not only correlating with the cell concentration of MSC but also of T cells.

BACKGROUND: Mesenchymal stem cells (MSCs) have the abilities of self-renewal, multidirectional differentiation and immunomodulation, and have become the focus of current research. OBJECTIVE: To summarize the immunomodulation of MSCs to different immune cells and the clinical applications of MSCs in the treatment of immune-related diseases. METHODS: The first author searched the PubMed and the CKNI databases for relative articles from January 1974 to December 2016. The key words were mesenchymal stem cells, immunomodulation, MSC1 and MSC2, autoimmune diseases in English and Chinese, respectively. Finally, 52 representative articles were included. RESULTS AND CONCLUSION: MSCs can inhibit the function of T lymphocytes, reduce the activation, proliferation and antibody secretion of B lymphocytes, affect the polarization of macrophages, inhibit the maturation of dendritic cells, inhibit the proliferation and toxicity of NK cells, so MSCs have the great potential in the treatment of immune-related diseases. However, MSCs exhibit the opposite immunomodulatory abilities under different inflammatory microenvironments, and moreover the definite and controllable mechanism of this phenomenon is still unclear, Therefore, future investigations may focus on the specific mechanism of MSCs in the clinical treatment of immune-related diseases.

Confocal microscope and flow cytometry were used to study the adhesion and the expression of adhesive molecules between different metastatic lung cancer cells and endothelial cells (EC) in vitro. Tea polyphenols (TP) were tested for their effect on tumor cell endothelial adhesion.The results showed that the adhesion and expression of CD44?CD54 were significantly higher in PG cells than those in D9 cells. Treatment of EC monolayers with LPS(0 5ug/ml) for six hours caused an increase in adhesion of PG to EC and adhesive molecules expression. TP could inhibit the adhesion of PG to EC and expressions of CD44 and CD54 in dose dependent manner. It suggested that adhesion molecules might play an important role in mediating the adhesion of lung carcinoma to EC and hematogenous metastasis; TP had an inhibitory effect on metastasis of lung cancer.

Objectiye To explore the expression of COX-2 and VEGF and its clinical significance in non-Hodgkin lymphoma (NHL). Methods The expression of COX-2 and VEGF were detected by immunohistochemistry in 42 cases of NHL and 20 cases of lymph node with benign pathological change. Results The positive rate of COX-2 and VEGF was 45.24% and 73.81% in NHL respectively. The expression rate of VEGF was positively correlated with that of COX-2 in tissues of NHL ( x2 = 4. 63, P ＜ 0. 05).The expression of COX-2 was related to clinical stage and histopathologic grade of NHL ( x2 = 5.43, P ＜0. 05), but it had no association with gender, age, B symptoms, and IPI. The expression of VEGF was significantly related with aggression, B symptoms and IPI ( x2 =8. 979, 8. 893,6. 434, P ＜0. 05), but it had no association with age, gender and clinical stages. Conclusion COX-2 and VEGF may be involved in NHL tumorgenesis, and COX-2 may accelerate angiogenesis by increasing VEGF expression. Specific COX-2 inhibitors may be a novel therapeutic approach for NHL.

Objective To investigate the association of thyroid carcinoma and urine iodine level in Urumqi region,intent to provide the evidence of individual iodine supplement of this region.Methods In this case-control study,there were 100 patients with thyroid carcinoma and 300 patients with normal thyroid function as the control group in Xinjiang Tumor Hospital between February 2012 and December 2012 as the case group.All the cases were detected for urine iodine concentration by arsenic-cerium catalytic spectrophotometry.Results The mean level of urinary iodine in the case group (272.69 μg/L) was higher than that in the control group (161.40 μg/L) (P ＜ 0.05).The level of iodine was excessive (urinary iodine ＞ 300 μg/L) in 34 ％ (34/100) patients in the case group and 10 ％ (30/300) patients in control group (P ＜ 0.05).Conclusion The average urinary iodine content of the thyroid carcinoma in Urmuqi region are generally higher than that of the healthy control group,which indicates that the iodine nutritional status in patients with thyroid carcinoma are better than that in the general population.The relationship between thyroid carcinoma and excessive iodine intake should be necessary for further study.

BACKGROUND: It is difficult to in vitro isolate and culture the ovarian surface epithelium with high purity, strong vitality and stable biological characteristics. Tissue adherence and enzymatic digestion are commonly used for primary culture, but there are certain problems in cel col ection, cel viability and cel purity. OBJECTIVE: To establish a method for primary isolating, culturing and identifying human ovarian epithelium. METHODS: The ovarian surface epithelium was obtained with cel brush innovatively, and then the cells were isolated and purified with erythrocyte spal ation and differential adherence. The epidermal growth factor was added into the serum-free Dulbecco’s modified Eagle’s medium-F12 medium for cel culture. The cel morphology was observed under inverted microscope, and hematoxylin-eosin staining and immunocytochemical staining were used to identify the cells, then the growth curve was draw. RESULTS AND CONCLUSION: The ovarian surface epithelium became adherent after cultured for 24 hours, and reached fusion basical y after cultured for 6-12 days. The cells were polygonal or flat with strong transparency and refraction. The morphological characteristics of the cells were in line with those of the normal epithelial cells, and almost al the isolated cells could express the epithelial cells surface marker CK19. The cells could be passaged for 6-8 generations with wel growth and the cel growth curve was in “S” shape. The purity of the cells was more than 95%. The results suggest that cel brush method is simple to operate and can obtain a large amount of ovarian surface epithelium rapidly. The purity of the isolated cells can reach to 95% after treated with erythrocyte spal ation and differential adherence method and the cells are in stable growth.

Objective To establish an effective post-operative oral care procedure for patients with oral cavity cancer.Methods Eighty five post-operational patients with oral cavity cancer admitted to Sichuan Cancer Hospital during March 2011 and March 2013 were randomly divided into control group (42cases) and study group (43 cases).Patients in control group were given routine oral care,and those in study group received a special care procedure:normal saline washing + dioxogen cleaning + normal saline washing + normal saline gargle.Oral cleanliness,oral and lung infections were observed in both groups,and SPSS 17.0 was used for statistical analysis.Results Oral cleanliness,rates of oral infection and lung infection at d3 after operation,time of infections,the delayed wound healing and operating comfort were improved in the study group (Z/t/x2 =-2.48,4.57,4.64,2.36,2.25,-2.51,4.18,respectively; all P ＜ 0.05).Conclusion The oral care procedure containing normal saline washing + dioxogen cleaning +normal saline washing + normal saline gargle can improve oral cleanliness early after operation,reduce complications and increase the operating comfort.