BACKGROUND: Human embryonic stem cells (hESCs) are pluripotent cells which may differentiate into tissues of all three germ layers. Such research as the feeder-free growth of hESCs is few in China. Fibroblast growth factor (FGF) is a major factor to maintain the undifferentiated state of hESCs.OBJECTIVE: To evaluate the ability of FGF at different concentrations in maintaining the undifferentiated state and pluripotency of hESC lines in the long-term culture.METHODS: Two cell lines of hES-8 and hES-18 were cultured with mouse embryonic fibroblast condition medium for 3 passages and then transferred into mouse embryonic fibroblast condition medium containing different concentrations of FGF: 100, 160, 250 μg/L for 8 passages. The hESCs were removed from the petri dish, cell clusters were digested with collagenase IV and gathered. Cell differentiation and pluripotency were observed. The eighth generation of the hESCs were collected and incubated into severe combined immunodeficiency mice, so as to observe teratoma formation. Morphologies of the cells were evaluated. Alkaline phosphatase staining, surface labeling immunocytochemical analysis and RT-PCR assay method were utilized to determine the OCT-4 expression and tumorigenesis in vivo.RESULTS AND CONCLUSION: Cultured in mouse embryonic fibroblast condition medium containing 160 and 250 μg/L FGF, two cell lines of hESC could maintain undifferentiated state: Clones were round with a high ratio of nucleus to cytoplasm. Large areas in the center of clones were undifferentiated cells, while surrounding the clones were differentiated cells; Strong positive expression for alkaline phosphatase staining was observed; Two cell lines showed high levels of OCT-4 transcription factor protein; The surface markers SSEA-4, TRA-1-60, TRA-1-81 were all positive on both two lines; The hESC clusters could form embryoid body in vivo 10 days later; 3 germ layers of teratomas were also obtained after implanted into severe combined immunodeficiency mice. Mouse embryonic fibroblast condition medium containing 100 μg/L FGF was not sufficient to maintain the long-term proliferation of hESCs, and most of the cells differentiated and died after 4 passages. Alone with concentration 160 μg/LbFGF or more could maintain two hESC lines undifferentiated stably in vitro, has no influence on the differentiation and totipotency of two cell lines.

[Objective] To observe clinical therapeutic effect of combined acupuncture and acupoint thread implantation on insomnia. [Methods] The seventy two cases were randomly divided into a treatment group(37cases) and a control group(35cases).The treatment group were treated with acupuncture and acupoint thread implantation; The control group were treated with acupuncture alone. Acupuncture treatment was provided every other day,they were totally treated for 10 times;Acupoint thread implantation was provided one time every week,observe the clinicial therapeutic effect after 3 times of treatment. [Result] The effective rate on chloasma was 89.19%in the treatment group and 71.42%in the control group.The clinical effect in the treatment group was significant better than that in the control group(P<0.05). [Conclusion] Acupuncture combined with acupoint thread implantation shows a better therapeutic effect on insomnia.

Objective To profile the types of bacteria in bile culture and study their antibiotic sensitivity pattern in patients with varying de-grees of acute cholangitis and to provide data guidance for the prevention and treatment of bacterial infection.Methods The clinical data of 230 patients with acute cholangitis who were admitted to our hospital from April 2010 to April 2014 were retrospectively analyzed.Classifica-tion of pathogenic bacteria and the antibiotic sensitivity test in bile cultures were performed using VITEK 2 Compact Biomerieux microbiologi-cal system.Results Within the 230 patients,172 tested positive for biliary bacteria,and the positive rate was 74.78%(172/230).There were 237 strains of pathogenic bacteria,including 135 strains of Gram-positive bacteria (56.96%),comprised mainly of Enterococcus and Staphylococcus aureus,96 strains of Gram-negative bacteria (40.5 1%),comprised mainly of Pseudomonas aeruginosa,Escherichia coli, and Klebsiella pneumonia,and 6 strains of fungi (2.53%),comprised mainly of yeast.Significant difference in the positive rate of bacteria was detected between patients with mild and severe cholangitis (χ2 =4.58,P =0.028).Gram-negative bacteria were the predominant i-solates in patients with mild and moderate acute cholangitis,while multiple bacterial infection was more common in patients with severe cholangitis.Biliary bacteria had a higher rate of susceptibility to vancomycin,imipenem,and amikacin compared with other antibiotics. Conclusion Gram-positive bacteria are the predominant pathogens in acute cholangitis.Early detection,immediate intervention,and ac-curate drug susceptibility test should be implemented at regular intervals to direct effective clinical therapy.

In the patients with end-stage renal disease (ESRD) with hepatitis B virus (HBV) infection who underwent hemodialysis, the viral load of HBV DNA is relatively low and stable.For this phenomenon, some studies suggest that hemodialysis can reduce the HBV DNA load.The mechanism, which remains unclear, may be as follows: when HBV DNA enters the dialysate through the dialysis membrane, it was adsorbed onto the dialysis membrane;some virus particles were destroyed, and antiviral substances were produced in the course of hemodialysis.At present, there is no consensus on the mechanism responsible for the influence of maintained hemodialysis on the viral load of HBV DNA.This article reviews the factors involved in the influence of maintained hemodialysis on the viral load in ESRD patients with HBV infection and the recent progress.

Objective: To explore the imported medicine price’s pass-through effect on domestic western medicine’s price. Methods: Based on the time-series data from January 2003 to March 2013, the empirical research studied the effect of imported medicine’s price and other variables on domestic western medicine price. Results: The imported medicine’ price has short significant effect on domestic medicine. Conclusion: To reduce the effect of imported medicine price’s fluctuation, the government should intervene the medicine price moderately; the drug company and the hospital should pay attention to the efficacy and the promotion of the domestic western medicine.

Objective To evaluate the genotoxicity of europium nitrate to the Vicia faba L root-tip cells. Methods The primary roots of Vicia faba L were cultured for 6 hours in the solution of Eu series(64,32,16,8,4,2,1 ?g/ml) at 25℃.And then the roots were repair-cultured in double distilled water for 24 h. The root tips of Vicia faba L were dissected and fixed,stained and the micronucleus rate,mitotic index and the rate of chromosomal aberrations were determined. Results From 1 ?g/ml to 32 ?g/ml,the rate of micronucleus increased with the increasing of the europium nitrate dosage(D),presented a dosage-effect relationship(r=0.949). From 2 ?g/ml to 64 ?g/ml,mitotic index decreased with the increasing of the europium nitrate dosage,presented a dosage-effect relationship(r=-0.852). From 1 ?g/ml to 64 ?g/ml,chromosome fragments(CF) and frequency of chromosomal aberrations(FCA) increased with the increasing of the europium nitrate dosage with a dosage-effect relationship significantly(rD-CF=0.915,rD-FCA=0.872). Conclusion Europium nitrate has the certain genetic toxicity to the Vicia faba L root-tip cells. The chromosome fragments may be one of the reasons to produce micronucleus.

Confronted with the complex and volatile situation of the medical market, hospitals must formulate long-term development strategies, enhance their core competitiveness, and secure or maintain an undefeatable position amidst competition. The paper discusses the strategic management of large hospitals from five dimensions: improving hospital leaders' strategic-thinking and decision-making skills, continuously implementing brand marketing strategies, adopting the ideas and methods of strategic cost management, constructing information-based hospitals, and creating vigorous and dynamic hospital culture. It argues that only by strengthening strategic management can the sustainable and concerted development of hospitals be promoted.

[Objective]To investigate the expression and the clinical significance of macrophage migration inhibitory factor (MIF)in the serum and lung tissues of the patients with non-small cell lung cancer(NSCLC).[Methods]Eighty-eight eligible inpatients were confirmed by pathology of lung tissues ,including 66 patients with NSCLC and 22 patients with benign lung lesions. ELISA was performed to measure serum concentration of MIF of these patients ,which was compared with 30 healthy individuals. Meanwhile,immunohistochemistry(IHC)was performed to examine the expression of MIF in the lung tissues of the two groups. MIF expression level was compared between two groups and among different subgroups of NSCLC. The correlationship between serum MIF level and high expression rate in lung tissues was also analyzed. All the data were analyzed by SPSS17.0.[Results]The serum concentration of MIF in NSCLC group was significantly higher than that in healthy control(14.79 ng/mL vs 10.69 ng/mL,P=0.001), and was slightly higher but not significantly different from benign lung lesions group(14.79 ng/mL vs 13.68 ng/mL,P=0.580). The comparison among subgroups of NSCLC showed that the serum MIF level was not only correlated with the histological grade and clini?cal stage of the cancer,but also correlated with the gender and smoking history of the host. Immunohistochemistry showed that the MIF high expression rate in the lung tissues of NSCLC was markedly higher than that of benign lung lesions group(30.3%vs 4.5%, P=0.014). Among the subgroups of NSCLC,IHC showed MIF high expression rate was correlated with the histopathologic types and clinical stage of the cancer. Simultaneously ,the serum MIF level showed a positive correlation with MIF expression rate in the lung tissues in all patients and NSCLC group(P<0.05).[Conclusion]MIF was strongly related to the clinicopathological characteristics of NSCLC. It could be helpful for the diagnosis and clinical evaluation of NSCLC.

To compare the clinical effect and side-effect of intravenous PCA(PCIA) with epidural PCA (PCEA). Method: One hundred and eighty postoperative patients, who were randomly divided into three groups: group PCIA, group PCEA and control, were observed for 3 days after operation. Result: Overall patients in two PCA groups were satisfied with the postoperative analgesia. The incidence of urinary retention in group PCIA were significantly lower than that in group PCEA (P0.05). 10% in group PCIA were in medium sedation whereas no eases in group PCEA were in sedation. At 6th hour after operation,serum cortisol level of control patients was much higher than that of PCA patients. Conclusion=Both PCIA and PCEA have excellent analgesia and reduce stress response after operation. PClA has lower incidence of urinary retention and is performed easily,but inhibits gastrointestinal motility much more and has higher sedative incidence compared with PCEA.

Objective To evaluate the pain control, general condition and well-being of the patients with advanced cancer treated with transdermal fentanyl as well as the effects of transdermal fentanyl on heart rate variability (HRV) and endocrine function. Methods This open prospective study included 40 patients with advanced cancer. The direct conversion ratio from oral morphine to transdermal fentanyl system (TFS) was 100:1 daily. In patients who had never received any opioid before the initial dose of TFS was 25?g/h. The transdermal system was changed every 72h and the dosage was adjusted to the need of the patients according to the VAS scores and the requirement of morphine. 8 hospitalized patients were monitored by 24h Holter for changes in HRV. Blood samples were taken before transdermal fentanyl patch when pain was severe and 24h after TFS for determination of ACTH,?-endorphin, growth hormone(GH) and insulin levels.Results Pain relief during treatment with transdermal fentanyl was significant accoring to VAS scores. Well-being scores showed that patients' quality of life including appetite, sleep, mental state and daily activities was significantly improved after two weeks treatment. The ratio of LF vs HF, which is one of HRV frequency indices, was obviously reduced at 24h after transdermal fentanyl patch as compared with that before TFS (P