The discovery of cell-free fetal DNA ( cffDNA) in maternal plasma provides a new idea for noninvasive prenatal testing( NIPT).Though some studies to date have shown several fetal DNA markers, how to accurately distinguish cffDNA from the pool of maternal plasma free DNA is still a challenge.So far, NIPT based on cffDNA has been used for detection and study of a variety of diseases, along with the advance and development of technology, it will have a more broad application prospects.This article will make a review for the research status from the biological characteristics and the markers of cffDNA, the clinical applications and the existing issues and development prospects of NIPT based on cffDNA.

Pancreatic adenocarcinoma is a highly malignant tumor and its prognosis is poor. The key factors for cure and prolonged survival are early detection, adequate evaluation of resectability and surgical resection with microscopic tumor clearance. Surgeons should pay attention to standardize operative procedures to increase the R0 resection rate. Whipple specimens should be inked and examined carefully. Postoperative adjuvant radiotherapy and chemotherapy are beneficial in the prevention of local tumor recurrence and distant metastasis. Inter-disciplinary cooperation and multimodality treatment are helpful to improve the prognosis and quality of life of patients with pancreatic cancer.

It's a new financial management system that our country implemented the management of separating the income and expenditure in the community health services.Beijing is one of the former pilot cities which carried on the management of separating the income and expenditure.To know the effectiveness of the implementations and its influence to the health services,this article analyses the status of community health services,the financial investment and the performance results in Beijing.Considering the above,this paper also provides policy recommendations on the development of health services in Beijing to improve the new urban medical service system which based on the community health services.

Thyroid hormones play major roles in the regulation of a wide range of metabolie and physiologic processes.Serum thyroid-stimulating hormone( TSH ) concentration,a sensitive barometer of thyroid function,shows significant individual difference in which genetic variation is a major factor.After using traditional genetic linkage studies and candidate gene association studies to explore the suseeptibility genes of serum TSH,many progresses have been made and new susceptibility genes have been identified by genome-wide association study (GWAS).In this review,we focus on the susceptibility genes of serum TSH levels and also the future prospect that may be obtained from these studies.

Myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Tregs) are important inhibitory immune cells.Research finds that MDSCs and Tregs increase in a large number under the conditions of inflammation,infection and tumor and they are able to suppress the immunity system and promote tumorigenesis and metastasis through multiple mechanisms.Finding the causes resulting in the increase of MDSCs and Tregs in tumor microenvironment and the eliminating methods have become new focuses in the field of antitumor immunotherapy.

Objective To assess effects of cerebral ischemic postconditioning(IPost)on neuronal apoptosis and phosphated glycogen synthase kinase-3β(GSK-3β)after cerebral ischemic/reperfusion.Methods The experiment was conducted at the center for animal experiment of Renmin Hospital,Wuhan University.Thirty male Wistar rats were randomly divided into three groups:sham operation(S),ischemic/reperfusion(I/R)and ischemic postconditioning(IPost).Each group contained ten rats.Global brain ischemia was produced with four-VO method.Animals were killed after two days.Apoptosis in neurons in the cortex region were detected by TUNEL assay; infarct areas were detected by TTC ; activity of p-GSK-3β was detected by spectrum assay; Statistical software SPSS13.0 was applicated to perform one-way ANOVA Student-Newman-Keul test; correlation was detected by linear regression.Results Compared with group S,TUNEL-positive cells and infarct areas increased(P ＜0.01),the activity of p-GSK-3β decreased in I/R and IPost groups(P ＜ 0.01).Compared with group I/R,TUNEL-positive cells and infarct areas significantly decreased(P ＜ 0.01),the activity of p-GSK-3β increased in group IPost(P ＜ 0.01).The activity of p-GSK-3β and TUNEL-positive cells had highly correlation,so as infarct areas(P ＜ 0.01).Conclusions IPost can lessen the ischemic/reperfusion injury of Cortex,through increas the activity of p-GSK-3[β and decreasing neuronal apoptosis.

Pancreatic cancer is highly malignant with a poor prognosis. The resectability and prognosis of early pancreatic cancer are much better than the advanced, so early diagnosis is crucial for saving patients' lives. Because the symptoms of pancreatic cancer are non-specific, most of the patients are misdiagnosed as gastrointestinal or hepatobiliary diseases. Early diagnosis rate of pancreatic cancer can be greatly improved by combined application of tumor marker detection, endoscopic ultrasound, computed tomography, positron emission tomo-graphy, and etc. Early screening of high-risk population has been advocated by the experts, and its value in early diagnosis of pancreatic cancer has been confirmed by relevant studies. The colaboration of multiple pancreatic surgery centers in conducting prospective studies and setting gnidlines for the pancreatic cancer diagnosis, and relevant fundamental reseaches should also be emphasized.

Farnesoid X receptor(FXR), a member of the metabolic nuclear receptor superfamily, plays key roles in maintaining bile acid and lipid homeostasis.FXR is highly expressed in the entero-hepatic system where it transcriptionally regulates bile acid metabolism, intestinal barrier function and liver regeneration, etc.Loss or down regulation of FXR expression can lead to a lot of diseases, such as cholecystolithiasis, biliary cirrhosis,primary hepatic carcinoma, colon carcinoma, etc.Activation of FXR may protect against or provide a pharmacological target for these diseases.

A 46-year-old female patient presented to our hospital with history of pharyngeal discomfort for 6 months. Physical examination showed that she had facial asymmetry, loss of the left nasolabial fold, rightward de- viation of uvula, swelling of the left soft palate. Magnetic resonance imaging revealed a bigger neoplasm in left pa- rapharyngeal space which invaded into left lateral skull base. The left internal carotid artery, vein and the styloid process was jostled backward. The primary clinical diagnosis is pleomorphic adenoma of the parapharyngeal space.
Adenoma, Pleomorphic ; surgery ; Carotid Artery, Internal ; Endoscopes ; Endoscopy ; Face ; abnormalities ; Facial Asymmetry ; congenital ; Female ; Humans ; Hyperplasia ; Magnetic Resonance Imaging ; Middle Aged ; Nasal Cavity ; Paranasal Sinuses ; Pharynx ; Skull Base Neoplasms ; surgery

Objective: To observe the effect of ovariectomized rat serum containing Bushen Yijing decoction (BYD) on the absorption function of osteoclast. Method: Fourty 10 - month - old female SD rats were randomly allocated to four groups, among which 30 rats were subjected to ovariectomy to establish the osteoporosis model, and 10 rats only received mimic operation. After 3 months, the model rats were given saline, BYD and estrogen respectively. Three months later, all the rats were killed to obtain the sera. Osteoclasts were isolated from the extremities of 1 - day SD rats and incultured on the ivory slices. The lacunar number formed after bone absorption was observed. Results: Compared with the mimic operation group, the number of lacurae of ovariectomized groups increased by 74. 1 % ,while that of the BYD group and estrogen group decreased by 65.7% and 59.3% respectively, showing significant differences with the mimic group (P