Wuhu City has been exploring,since 2007,an innovative health and medical system featuring both the reform of public hospitals and that of the primary care system.This reform aims at strengthening the public health service system,improving the basic medical service system,speeding up the construction of the medical security system,and improving the drug supply system.It is characteristic of a core,two wings,and four-wheel drive,which tells the essence of Wuhu' s reform practices and outcomes.

Objective To summarize the main results and characters of the research literature by reviewing systematically and comprehensively,we get an overall awareness of the current status of the nursing needs of the aged at home and discover the deficiency.Consequently,we provide evidence to improve the nursing services for the aged at home.Methods We systematically searched CNKI (1979-2014.5),CBM (1978-2014.5)and VIP (1989-2014.5).According to the including criteria and excluding criteria,we screened the literature twice.Main results and characters of the literature were described.Results A total of 975 articles were included.The first literature were published in 1986.From 2006,the amount of the literature increased annually.42.36％ (413/975)of the research types were descriptive research.The contents of the literature mainly focused on the need of comprehensive nursing services,such as community nursing services [37.44％(365/975)];home care [20.10％(196/975)];long-term care [10.26％(100/975)].The overall quality of the hterature was not high.Experimental research and descriptive research were implemented mostly in developed areas.The 46.97％(458/975) of the first authors worked in hospitals.Conclusions There is a small quantity of literature published with low quality.Questionnaire with comprehensive items describing needs demanded by the aged are required.We should put an eye on the aged living in undeveloped areas or with recognition impairment.Meanwhile,depending on the general hospital,we should carry out high-quality experimental research,as well as exploring multidisciplinary model.

ObjectiveTo investigate the expression and significance of CDX2,Ki-67 in adenoma and colorectal adenocarcinoma,and the correlation between CDX2 and Ki-67.MethodsThe expression of CDX2 and Ki-67 was evaluated in the colorectal adenocarcinoma,adenoma and normal colorectal mucosa as control subjects by immunohistochemistry.ResultsThe magnitude of CDX2 were negatively correlated with the level of dysplasia in adenoma(rs=-0.38,P =0.02),and negatively correlated with differentiation,lymph node metastasis,diversion and Dukes stage of cancer in colorectal adenocarcinoma(rs=-0.49,rs=-0.37,rs =- 0.38,rs =-0.37,P =0.01).The expression and relativity of Ki-67 in the samples were contrary to the CDX2.The levels of CDX2 and Ki-67 expression had significant difference between the adenoma and adenocarcinoma,and showed negatively correlation in this two type tissues (rs=-0.69,P =0.00; rs =-0.40,P =0.00).ConclusionsCDX2 may be used as an effective marker to evaluate malignancy degree and prognosis of large bowel neoplasm patient.The levels of Ki-67 expression in colorectal adenocarcinoma are correlated with malignancy degree and clinical stage.The expression of CDX2 is negatively correlated with Ki-67.Combined detection of CDX2 and Ki-67 may be helpful for the judgment of colorectal tumor biological characters.

Objective To determine the frequency of the cholesteryl ester transfer protein (CETP)-TaqIB polymorphism and investigate its relationship with plasma lipid levels and coronary hert disease(CHD). Methods Two hundred and thirty-eight patients with CHD (CHD group) and 203 age-matched controls( control group) were selected, the CETp-TaqIB mutation was detected by restriction fragment length polymorphism of the CETP gene. Results In the total subjects, the frequency of B1 and B2 alleles were 59.4%(262/441 ) and 40.6%( 179/441 ) respectively. Compared with that in control group, the frequency of CETP genotype BIBI was higher in CHD group [39.9%(95/238) vs 29.6% ( 60/203 ), P<0.05], and the frequency of B1B2 was lower in CHD group [44.1%(105/238) vs 53.7%(109/203), P< 0.05]. Compared with that in the B2 homozygotes, high density lipoprotein cholesterol (HDL-C) and apolipoprotein (apo)A I level were significantly lower in the B1 homozygotes [(1.19±0.36) mmol/L vs (1.38±0.39) retool/L,( 1.17±0.33 ) g/L vs ( 1.30±0.31 ) g/L, P<0.05]. The B 1 homozygotes was associated with higher degree of cononary stenosis than the B2 carriers (P<0.05 ). There was no significant association between CETP-TaqIB genotype and the risk of CHD (P=0.147). Conclusions CETP-TaqIB polymorphism affects the concentrations of lipaproteins. There are significant associations between the B1 homozygotes and lowerHDL-C and apo A I levels. The B1 allele is not an independent risk factor for CHD.

Restenosis after interventional treatment is the major factor infheneing the result of percutaneous transluminal angioplasty, and it is a hot and difficult research in recent years. Endothelial progenitor cells are a class of proliferation and able to differentiate into vascular endothelial precursor cells, and take part in the repair and angiogenesis after endothelial injury-intimate. It is expected to play an important role in the prevention of vascular restenosis after interventional treatment. In this article, we reviewed the endothelial progenitor cell research overview and advances of prevention of restenosis after interventional therapy in recent years.

BACKGROUND: With wide application of biotechnological substitute materials, pelvic repair and reconstruction develop to a certain degree. Biomaterial patch is a major substitute for repairing injured pelvic fascia tissue, so it is widely used for pelvic reconstruction.OBJECTIVE: To investigate the feasibility, efficacy, and clinical value of biomaterial patch to pelvic reconstruction in the females.METHODS: Articles related to pelvic functional disorder, pelvic reconstruction, and application of patch implant were retrieved from PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and (http://www.wanfangdata.com.cn) with the key words of "reconstruction of whole pelvic floor, mesh, synthetic mesh implants" in both Chinese and English between 1990 and 2008. Duplication studies were excluded. A total of 54 articles were initially retrieved, and 17 ones were included in the final analysis.RESULTS AND CONCLUSION:Pelvic organ prohpse, which was a major symptom of pelvic disorder in the females, caused by defect of pelvic supporting structure, injury, and functional disorder. Traditional operation could not solve fundamental question.At present, substitute materials for pelvic repair and reconstruction mainly include biomaterial patch (self-substitute materials, homogeneity substitute materials, and heterogeneity substitute materials) and artificial patch. All of them could substitute the injured pelvic fascia tissue; therefore, they were major substitute materials of pelvic tissue and widely used for pelvic reconstruction. Patch which was used for pelvic reconstruction realized the recovery of anatomic structure and caused functional recovery, with simple and easy processing. Additionally, patch application did not prolong operative time and cause complication, but induced well tolerance, security and reliability, and remarkable short-term effect on patients. However, the long-term efficacy should be further studied. The modified pelvic reconstruction is clinically valuable for patients with varying prolapsed sites.

BACKGROUND:The essence of cell differentiation is a selectively intra-cellular gene expression,which results in specific proteinic synthesis and causes changes in biochemistry,structure and function.Thus,original proteomics and a single protein analysis can not meet the requirement in study.Proteomics technology provides a powerful tool due to the large scale,systemical study of protein transformation and interaction,which can be used for exploring molecular mechanism of bone mesenchymal stem cells(BMSCs)during directional differentiation.OBJECTIVE:To introduce proteomics,to summarize the research of proteomics in directional differentiation of BMSCs,and to forecast the development of proteomics research methods.METHODS:To search articles highly related with BMSCs,cell differentiation,and proteomics published on CNKI (www.cnki.net/index.htm),Sciencedirect(http://www.Sciencedirect.com),I.S.I(http://www.isiwebofknowledge.com)were searched,and the key achievements were included in the analysis.RESULTS AND CONCLUSION:A total of 29 documents were reviewed,and the experiences in the application of proteomics technology in the directional differentiation of BMSCs were summarized.With the innovation and development in methodology and technology,proteomics will become a powerful tool for us to study the potential mechanisms of BMSCs directional differentiation.

Objective To investigate the influence of plasmid spread and ampD mutation to Enterobacter cloacae that leads to the AmpC β-lactamase change from inducible type to constitutive type. Methods The Enterobacter cloacae were isolated from the patients with nosocomial infection. The inducible type isolations and their constitutive type changers were put into the same group. The plasmid ampC gene and chromatin ampD gene in pairs in each group were amplified, sequenced and compared. Results Of 195 patients infected by Enterobacter cloacae of inducible type, 25 (12.82%) were changed to the ones of constitutive high type. In these 25 changed groups, 10 were caused by plasmid spread, 10 by ampD mutation, 1 by both, and 4 by neither. Twelve changed constitutive type strains had ampD significant mutations, in which 7 were frame-shift mutations and 5 were spot mutations. Conclusions The change ratio of Enterobacter cloacae from inducible type to constitutive type is rather high. Both plasmid spread and ampD mutation are possibly the mechanism of such change. Plasmid mediated AmpC β-lactamase spreads among different species and interregionally. The mutation rate of chromatin ampD gene is also higher than the natural mutation rate. These two mechanisms should be considered in clinical treatment.

It is well known that the macrophages play an important defensive role in the innate immune system. During recent years, with the introduction of the concept of chronic low-grade inflammatory diseases and their further intensive study, the activation and balance of macrophage, as well as its inflammatory effects in chronic lowgrade inflammatory diseases, such as obesity, type 2 diabetes, atherosclerosis, and non-alcoholic fatty liver, are gradually becoming a hot topic of current research. The present article mainly gives an overview of the important role played by macrophages in the inflammatory effects in these diseases.