Objective To investigate the effect of the artificial cycle on the prognosis after transcervical resection of adhesion (TCRA) and its mechanism .Methods 80 patients with intrauterine adhesion were randomly divided into the observation group and the control group .The observation group were performed TRCA and postoperative artificial cycle for successive 3 months :oral es-tradiol valerate(9 mg once daily) for 21 d ,adding oral medroxyprofgesterone acetate(10 mg once dialy) on 15 d ,then the medication discontinuation for 7 d ,which was taken as 1 cycle;the control group received only TCRA .The re-examination was performed after 3 months .The levels of follicle stimulating hormone(FSH) ,luteinizing hormone(LH) ,estradiol(E2 ) ,prolactin(PRL) ,progesterone (P) and testosterone(T) were examined by ELISA after TCRA three months .The expression of MMP-9 and TGF-β1 in adhesive endometrium were detected by real-time PCR and Western blot .Results Compared with the control group ,the artificial cycle thera-py combined with the operation could significantly increase the effective rate of TCRA for treating mild and moderate intrauterine adhesion(P<0 .05);the seum levels of FSH ,LH ,E2 ,PRL ,P and T had no statistical differences between the observation group and the control group(P>0 .05);the artificial cycle significantly improved the adhesive degree of intrauterine adhesion ,increased the MMP-9 expression and decreased the TGF-β1 expression .Conclusion Artificial cycle could improve the degree of uterine cavity ad-hesion after TCRA ,which the mechanism might be related to the increase of MMP-9 expression and decrease of TGF-β1 expres-sion .

Objective To study the presence of microflammation state in ESRD patients and the relationship between microinflammation state and atherosclerosis. Methods Inflammatory cytokines and carotid artery B ultrasound data of 246 ESRD patients and 43 cases with normal renal function as control were collected. The presence of microflammation state and its relationship to atherosclerosis were studied. Results The levels of inflammatory cytokines(CRP,IL 6,TNF ?)in ESRD patients were mostly in normal range, but still much higher than those in control.According to the level of CRP,the patients were divided into three groups.Significant differences of carotid artery B ultrasound and prevalence of cerebrocardiovasculer events were found between two groups with CRP levels less and higher than 4 mg/L. According to the history of atherosclerosis cerebrocardiovasculer disease,patients were divided into two groups. Levels of CRP, IL 6, TNF ?were higher in patients with cerebrocardiovasculer disease than those in patients without, but still in normal range. Conclusions There is a microinflammation status in ESRD patients. The microinflammation status may be a risk factor of high prevalence and mortality of atherosclerosis related cardiovascular events in ESRD patients.

Abstract: Objective To construct a shuttle vector pHT315-AaCPR100A with two spore-producing-dependent promoters and the target gene AaCPR100A in Escherichia coli-Bacillus thuringiensis. Methods The forward promoter of Cry3A, named Pro-1 (+), was amplified by PCR using pSVP27A plasmid as the template, and the target gene AaCPR100A was amplified using Aedes aegypti RNA reverse conversion cDNA as the template. The plasmid pHT315 was linearized by digestion with Hind Ⅲ and Sal Ⅰ. The forward promoter and the target gene were inserted into the linearized vector pHT315 successively by in-fusion cloning according to the transcription direction. The synthesized plasmid containing the Cry3A reverse promoter sequence was used as the template, and the Pro-1 (-) reverse promoter was amplified by PCR. The intermediate vector containing the forward promoter and the target gene was linearized by EcoR I restriction enzyme, and the reverse promoter was inserted downstream of the target gene by in-fusion cloning in the direction of transcription. Results By agarose gel electrophoresis, the forward promoter, target gene AaCPR100A and reverse promoter bands were clear and of good quality, which could be used for in-fusion cloning experiments. The two spore-producing-dependent promoters and target gene fragments were connected by In-fusion cloning. The recombinant vector pHT315-AaCPR100A was verified by PCR. The forward promoter, target gene fragment and reverse promoter were successfully amplified in the recombinant vector. Nucleotide sequencing verified that the sequencing results of the bidirectional promoter sequence and the target gene sequence were basically consistent with the sequence alignment results, which met the requirements of the construction of vector elements and proved that the recombinant vector was successfully constructed. Conclusions Based on the above results, this study proves that the recombinant shuttle vector with two spore-producing-dependent promoters can be successfully constructed by in-fusion cloning technology, laying the foundation for the construction of engineered Bacillus thuringiensis expressing dsRNA of AaCPR100A.

The retinal blood oxygen quantification method is a fast and non-invasive new retinal vascular imaging technology, which is used to reflect the metabolism of retinal blood oxygen and the micro-circulation of whole body by measuring, analyzing and quantifying the blood oxygen saturation of the main arteries and veins of the retina. The circulation state provides a reliable basis for medical diagnosis. Retinal blood oxygen saturation can be used as a biomarker for the diagnosis and evaluation of ophthalmologic and brain diseases such as diabetic retinopathy, central retinal vein occlusion, retinitis pigmentosa, glaucoma and Alzheimer's disease.

Big data will change the way of managing,analyzing,and utilizing data in any industries.In the medical and healthcare field,health management is the development direction of the future medical model.Health management is the most basic and representative functions of the national big data platform for medical and healthcare management.For individuals,effective health management can achieve the purpose of not pre-emptive treatment,and for the society,effective health management can effectively control the development of group disease,reduce the loss of medical resources,reduce medical expenses and improve the utilization of medical resources.Although the application of healthcare big data is still restrained by factors such as data quality,data missing,data silos,data security and data processing technologies,the health management based on the national big data platform is expected to play an important role in some research fields including prevention and control of chronic noncommunicable diseases,intervention technology of sub-health status,health status detection and evaluation,and the pathogenesis of infectious diseases.Based on the essence and function of health management,the significance the national big data platform for medical and healthcare management was expounded.

Non-communicable chronic diseases are important public health problems. Most chronic diseases can be avoided through preventive care and effectively controlled through early detection, and the therapeutic effect can be improved by active communication. The existing chronic disease management is based on public health management which cannot meet the needs of prevention and control of chronic disease in China. On the basis of healthcare data collection and monitoring on chronic disease patients, high risk population of chronic diseases and healthy individuals, a new chronic disease management mode can be achieved using data mining, cloud computing and other technologies. In this mode, the model of chronic disease prediction and analysis is established, and leading to risk factors for chronic disease is positioned. The healthy people can receive guidance on health management, the high-risk groups can get health risk assessment and early warning so as to guide their effective intervention, and the chronic disease patients can take personalized treatment and prognosis tracking by using this model. In this paper, the meaning, problems and methods of chronic disease management based on the big data platform for medical and healthcare management were introduced and analyzed.

The reform of medical and healthcare system is the inevitable process for the medical and healthcare developing in China.The main contents of the reform include establishing a scientific and reasonable system of medical treatment and classification,a scientific and effective modern hospital management system,a universal medical insurance system with efficient operation,a standardized and orderly drugs and medical equipment supply,and a strict and standardized comprehensive supervision system.The national big data platform for medical and healthcare management can play an important role in the reform of medical and healthcare system in China.First,it can help to improve the treatment effect of the disease,improve the prognosis,reduce the morbidity and mortality rate,and improve the health level.Second,it can effectively control the risk of medical insurance funds,and reduce the fund operational risk.Third,it can improve the efficiency of healthcare services and medical service resource utilization,so as to reduce medical costs.Fourth,it can help to build the link between residents and family doctors and hospitals,and to promote the medical consortium and hierarchical medical system through electronic signatures,online booking,telemedicine,real-time health monitoring,and two-way referral.Fifth,it can help to establish a medicine and medical equipment circulation system with the characteristics of source-traceable,full controllable,risk-preventable,responsibility-assessable,performance-assessable,and open-and-transparent.Finally,it can effectively improve the quality evaluation and regulatory level of the medical system in China.The existing problems in medical reform in China were introduced,and the relationship and the significance of the national big data platform for medical and healthcare management to medical and healthcare system reform were analyzed.

Medical services, medical insurance institutions, medical administrations, pharmaceutical and medical device manufacturers, pharmaceutical and medical device research institutes, and health-related service providers produce large amounts of data in the operation, which constitute medical and healthcare big data. Medical and healthcare big data is the important basic strategic resource of a country. The construction of the national big data platform for medical and healthcare management is of great significance to the development of healthcare in China, and will bring new development and change. Medical devices and equipments are essential to the provision of quality services, the lack of safe and effective and functional medical equipments will affect the quality of healthcare services, affect the diagnosis and treatment of patients, and even threaten the healthy development of the entire healthsystem. Application of IoT technology and big data technology, and with the help of the national big data platform for medical and healthcare management, can solve many problems existing in the supervision and evaluation of medical devices, medical device adverse event control, hospital medical equipment maintenance (such as maintenance, condition monitoring, accident retrospective, evaluation and scrap) and medical device acquisition process, so as to improve the management efficiency and management level of medical devices and improve the efficiency of medical equipment production enterprises in product registration, after-sale service and adverse events protection. This process has a realistic driving significance and long-term strategic significance to our medical system. In this paper, the problems in the management of medical equipment in China were analyzed, and the function of the national big data platform for medical and healthcare management in medical equipment management were introduced and analyzed.

The fundamental goal of China's medical insurance is to build a multi-level social security system covering the whole people, urban and rural planning, clear rights and responsibilities, moderate protection, and sustainable development. It is required to unify the medical insurance system, achieve fairness in medical insurance, improve the degree of protection, and increase the protection project, so as to effectively meet the needs of the basic health care services of the national diversification and to comprehensively improve the national health level. It is help to reduce the incidence of diseases, improve the quality of life, reduce the expenditure on medical expenses, and regulate the health habits of the people by emphasizing the importance of active prevention in the medical insurance sector. That is consistent with the ultimate goal of the health system reform. Active health insurance based on the national big data platform for medical and healthcare management can implement effective health interventions through various medical and economic means, helping to block risk factors before disease formation, thereby extending the individual health cycle and achieving the purpose of maintaining health. It can be foreseen that with the implementation of active medical insurance, the awareness rate of major chronic diseases will increase, and theincidence of major chronic diseases and the number of patients will gradually decrease. Therefore, the economic burden of the national medical and health system will gradually be reduced, so as to meet the growing needs of people for health care.

In the field of medicine and healthcare,giant medical and heaithcare information is created by medical institutions,medical information platforms,digital medical equipments,intelligent health electronic products,wearable personal health equipment,and other heahh-related information platforms.The sum of these information forms the medical and healthcare big data.The development and application of this big data not only can improve the medical and health system,but also can promote the development of health industry,which has realistic and long-term strategic significance to national economic development.In this paper,the basic characteristics of medical and healthcare big data were introduced,and the problems and challenges in the application of this big data in China were analyzed.In order to improve the level of informatization and management efficiency of medical and healthcare management in China,a national medical and healthcare big data platform was proposed,which can integrate omnidirectional and full-cycle health-related information of institutions and individuals in China.In addtion,the construction mode,operation mode,data source and platform function of this platform were introduced.