Objective: During the five years period from 2006 to 2010, the Chinese government had increased the special funding for primary maternal and child health enterprise to analyze the total amount and constitution of the special funding respectively. Methods: From the perspective of special funding investment in the eastern, central and western regions with different levels of economic development, to perform the comparative analysis. Results and Conclusion:The government’s overall investment on maternal and child special funds is in increasing trend, the average per capita amount of special funds invested in west region is higher than the eastern and central region; in the aspect of investment constitution , the central government special funds for women and children is the main source, which accounts for more than 85% of total investment, the reducing and eliminating items in eastern and western regions and the inpatient childbirth subsidy items constitute the major component of special funding for primary maternal and child health in corresponding region. Based on the analysis of investment on the condition of primary maternal and child health , policy recommendations for further development of the cause of women and children are provided.

OBJECTIVETo observe the origins and insertions of Pitanguy ligament,in order to find the anatomically theoretical basis for the treatment of nasal deformity such as drooping nose, short columella, gingival show.

METHODS15 cadaveric heads fixed by 10% formalin were used. 12 specimens underwent nasal anatomic study. The skin was incised, along the nasal midline to expose the Pitanguy ligament. The origin of Pitanguy ligament and its relationship with surrounding tissue were studied. Then the Pitanguy ligament was taken out for HE staining. Longitudinal section along the ligament was observed. 3 specimens underwent harvesting of full-thickness nasal tissue from skin to periosteal membrane. Then the samples were used for HE staining to show histologic study of ligament at horizontal section.

RESULTSPitanguy ligament originates in the midline of lower third of the nasal superficial musculoaponeurotic system, extends down to the tip along the midline of the nasal dorsum and then turns backwards at the nasal tip, and runs between the medial crura of the lower lateral cartilages, inserts into the base of columella. Its muscle is connected with the orbicularis oris muscle and the depressor septi nasi muscle. HE staining showed the ligament consists of fibrous connective tissue, muscle tissue and other ingredients, but without cartilage.

CONCLUSIONSPitanguy ligament exists with complex histological composition, so its name is still controversial. Because it has multiple connection with the orbicularis oris muscle and the depressor septi nasi muscle, so cutting or shortened the Pitanguy ligament can treat deformity of nose and lip by adjustment of nasolabial angles and the nasal length.

Cadaver ; Cartilage ; anatomy & histology ; Facial Muscles ; anatomy & histology ; Humans ; Ligaments ; anatomy & histology ; Lip ; anatomy & histology ; Nasal Septum ; anatomy & histology ; Nose ; anatomy & histology ; Nose Deformities, Acquired ; pathology ; surgery ; Subcutaneous Tissue ; anatomy & histology

AIM: To investigate the involvement of calcineruin (CaN) signal pathway mediated by angiotension Ⅱ (Ang Ⅱ) in the myocardial remodeling mechanism in patients with congestive heart failure (CHF). METHODS: 39 patients of mitral valve disease with CHF were randomly selected and 30 cases of healthy persons were included as controls. Cardiac function parameters were measured by echocardiography. Concentration of Ang Ⅱ in plasma and myocardial tissues were determined by radioimmunoassay. Immunoprecitipation was used to assay the protein expression and phosphorylation CaN, nuclear factor of activated T cells (NFAT_3),zinc finger transcription factor (GATA_4) in myocardial tissues. The mRNA expression of ?-myosin heavy chain (?-MHC) was measured by RT-PCR. RESULTS: The Ang Ⅱ concentrations in patients with CHF were positively correlated with the parameters of the cardiac dialtion respectively, but negatively correlated with the paremeters of cardiac function. Compared to the control group, protein of CaN and GATA_4, phosphorylation of CaN, and ?-MHC mRNA expression in myocardial tissues in CHF groups were highly expressed and their expression were positively correlated to the levels of CHF, but the phosphorylation of NFAT_3 was negatively correlated with the levels of CHF. CONCLUSION: CaN signal pathway may play important roles in the myocardial remodeling in CHF.

OBJECTIVE:To provide suggestions for China in dealing with the drug shortage problem by drawing experiences from USA.METHODS:The study was done by reiviewing literature and cases study.RESULTS:The FDA in USA has established procedures for the Center of Drug Evaluation and Organization of Regulation Affairs to resolve all kinds of drug shortage problems.CONCLUSIONS:A specific department should be set up to be responsible for resolving drug shortage problems in China with an emphasis on the shortage of medical necessary drugs,and it is urgent to get the information of drug shortage.

Objective To introduce the techniques and specification of complete-block radical gastrectomy, and to compare with traditional radical gastrectomy in the operative time, surgical costs and postoperative complications. Methods Thirty gastric cancer patients meet the criteria were randomly divided into 2 groups. Group A: complete-block radical gastrectomy;group B: radical gastrectomy. Analysis and comparison were made on tumor site, time consuming of block, the proportion of gastrointestinal reconstruction, operative time, cost of block, pathological TNM stage, length of stay, postoperative complications and postoperative chemotherapy. Results Group A has longer operative time than group B (P<0.05). However, there was no significant statistical difference in the other indicators between these 2 groups. Conclusions Complete-block technology can separate cancer more completely during operation with the advantage of simplicity, low-cost, little effect on the subsequent operation. The incidence of postoperative complications and length of stay with the traditional surgery there was no significant difference.

BACKGROUND:In allogene hematopoietic stem cell transplantation,the choice of preconditioning scheme is an important link of the success of hematopoietic stem cell transplantation,and a major research direction of stem cell transplantation.The myeloablative pretreatment scheme has great toxicity,and pretreatment related death rate is high.Thus,it is necessary to explore an ideal pretreatment scheme to expect a decrease in side effects and relapse.OBJECTIVE:To observe the effect of modified Bu/CY pretreatment regimen for treating hematologic malignancies.METHODS:The 8 patients were selected at the Department of Hematology,Haikou Municipal People's Hospital Affiliated to Xiangya School of Medicine,Central South University from November 2003 to March 2008,and received modified Bu/CY pretreatment:cytarabine 2.0-3.0 g/(m2·d)×2 d,intravenous drip,for 24 consecutive hours;myleran 4 mg/(kg·d)×3 d;cyclophosphamide 50 mg/(kg·d)×2 d;methyl-cyclohexyl nitrosourea 25 mg/(m2·d)×1 d;antithymocyte globulin 25 mg/(kg·d)×4 d. We have increased the arabinosylcytosin dose twice,and changed to a 24-hour infusion via intravenous drip,so that pretreatment strength was increased and promote lasting implantation of hematopoietic stem cells,based on the modified program.Graft-versus-host disease(GVHD)prevention:cyclosporin A and mycophenolate mofetil would be used advanced to minus 7 days (one day before stem cell transfusion is minus 1)based on the classic methotrexate regimen.The ABO blood group changes and DNA were tested in patients before and after ransplantation.RESULTS AND CONCLUSION:①The detection of hematopoietic reconstitution after transplantation:All patients have received hematopoietic reconstitution,with no pretreatment-related death.The white blood cells reduced to 0 after-3- +7 days of hematopoietic stem cell transplantation,and continues to(3-22)days,+10- +21 days white blood cells ＞ 1.0×109/L,+11- +51 days,platelets ＞ 20x109/L.②Incidence of GVHD:of 8 patients,there were GVHD Ⅳ grade(intestinal)in 1 case,acute graft-versus-host disease grade Ⅰ-Ⅱ in 3 cases.Above-mentioned results indicated that the further modification of BU/CTX2 regimen may be an effective pretreatment program,with a few side effects,which is better than the classic total-body irradiation/CY regimen.What's more,it is simple accurate,reliable rote of anti-leukemia and will be a safe and effective method for treating hematologic malignancies.

BACKGROUND: Effective mobilization and collection of hemopoietic stem cells are initial factors for peripheral stem cell transplantation, while they make sure a permanent reconstruction of hemopoiesis. Mobilization and collection have been developed; however, the collection is more, and the yield of hemopoietic stem cells is various. OBJECTIVE: To investigate the best time of mobilization and collection of peripheral blood stem cells from healthy donors. METHODS: A total of 16 donors who were selected from Haikou People's Hospital between January 2003 and December 2008 were randomly divided mobilization group (A, n=6) and mobilization + collection group (B, n=10). A group was subcutaneously injected with 5.0-10.0 μg/(kg·d) recombinant human granulocyte colony-stimulating factor (rhG-CSF) (Filgrastim), and B group was treated with rhG-CSF and intravenously injected with 10 mg dexamethasone. Peripheral stem cells were collected twice in each group. The two groups were collected at the fourth and 5~(th) day of mobilization after the second or 4th hour subcutaneous injection of rhG-CSF. The collection was 4.0-5.0 mL, the manhandled volume was 3.0-5.0 mL, and the total blood volume was 6.7-10.1 L. RESULTS AND CONCLUSION: Number of mononuclear cells was (4.0-8.0)×10~8 kg~(-1) in the two groups. The cell concentration of fourth hour was higher than the second hour after rhG-CSF treatment (P < 0.05). The mononuclear cell concentration of fourth hour was higher than the second hour after the fourth and 5~(th) day of rhG-CSF treatment. Our research showed that we could collect sufficient amount of cells (to a high concentration) by one time, which had reasonable collection time - value-effectiveness relationship, when the cycle blood volume was 1.8-2.2 times of circulating blood volume.

Background and purpose: Triple negative breast cancer (TNBC) is a high risk breast cancer characterized by the negative expression of estrogen receptor(ER), progesterone receptor (PR) and Her-2 that have no specific therapy. This study was to analyze clinical pathological characteristics, survival, and prognostic factors of patients with TNBC. Methods: Clinical and pathological as well as follow-up data of TNBC, treated at the Cancer Centre of Sun Yat-sen University from Jan. 2000 to Dec. 2003, were collected and analyzed. Results: A total number of 128 women were identified as having triple negative breast cancer. The median age of these patients was 46 years, and 60.9% of them had stage Ⅰ or Ⅱ disease. The majority of pathological types were invasive ductal carcinomas, and 78.1% of tumors were staged T1 or T2. And 48.4% of these patients were involved in lymph node. Event-free survival, local replase-free survival, distant metastasis-free survival and overall survival at five years were 71.1%, 84.3%, 75.8% and 83.6% respectively. Though lymph node metastasis, tumor masses, stage and lymph-vascular invasion were all found to be related to overall survival, however, only lymph node metastasis and tumor masses affected the overall survival as revealed by the Cox proportional hazard model analysis. Conclusion: Triple negative breast cancer has distinct clinical and pathological characteristics. The patients are usually young, with large masses, lymph node metastasis, family history of breast cancer and poor prognosis; lymph node metastasis and tumor mass are important prognostic factors.

Objective To analyze the clinical characteristics of twin reversed arterial perfusion sequence (TRAP),and investigate its prenatal evaluation and clinical management.Methods Karyotype results and ultrasound data of 25 TRAP cases were retrospectively reviewed,including estimated weight and umbilical blood flow of acardiac twin,cardiac function and middle cerebral artery peak systolic velocity of pump twin.Various managements and the outcomes were analyzed.Results (1) Karyotype of amniotie fluid were tested in 16 pump twins.Mosaicism was found in 1 case (46,XX[36]/46,XY [14]).(2) According to the ultrasound evaluation,large acardia accounted for 87.0％ (20/23) cases.Abundant blood perfusion (inter-twin difference of umbilical resistance index ≤0.20) was indicated in 86.4％ (19/22) cases.Decompensation of cardiac function was suggested in 66.7％ (10/15) pump twins.Fetal anemia of pump twin indicated by middle cerebral artery peak systolic velocity＞1.5 multiples of the median was diagnosed in 75.0％ (12/16) cases.(3) The acardiac twin with abundant blood perfusion was more likely to be a large acardia than those without [94.7％(18/19) vs 1/3,Fisher exact test,P=0.04]; More pump twin with large acardia tended to have cardiac decompensation than non-large acardia pump twins [83.3 ％ (10/12) vs 0/3,Fisher exact test,P=0.02].(4) Eleven patients chose to terminate their pregnancies after being diagnosed.In 14 cases who continue the pregnancies,the survival rate of pump twin was 64.3％ (9/14).In 3 cases of non-large acardia without cardiac decompensation of pump twin,the patients selected conservative observation resulting in 2 term deliveries and 1 termination of pregnancy due to for exacerbation.Among 11 cases with large acardia,which the pump twins were complicated by cardiac decompensation or anemia,five cases selected conservative observation.One ended in spontaneous abortion; three exacerbated (one termination and two cesarean section before term with living births) ; one was stable until delivery.Another 6 cases received bipolar cord coagulation,and successful interruptions of acardiac blood flow were achieved in 5 cases among which 4 pump twins survived.Conclusions Prenatal diagnosis,cardiac function and fetal anemia of pump twin,together with the growth and blood supply of acardia are important indexes for prenatal evaluation of TRAP,on which our prompt management should be based.