ObjectiveTo analysis the current conditions of the main chronic disease,satisfaction,reactive and trust,then to make the control policy in community health management base in China.Method Using the questionnaire by oneself,which the contents include prevalence,understand rate,management rate,behavior correct rate,control rate,medicine obey and satisfaction,reactive and trust of 2009 the chronic disease in 2009.ResultsThe total investigate people was 1 189 456.The hypertension prevalence is 8.01％,the diabetes prevalence is 4.41％.To compare with Shanghai and Jilin in 6 aspects,the prevalence,understand rate,management rate,control rate,medicine obey rate is higher in Shanghai.But behavior correct rate is lower in Jilin.Survey of hypertension prevalence rate was decreased,awareness,management,rates,rates of behavior modification,medication compliance rates and control rates of growth from 2009 to 2010.Satisfaction,responsiveness and trust indicators investigated a total of 2268 people,the process of service satisfaction to 93.43％,93.78％ overall satisfaction; to have the privacy of reactivity to 94.41％ of the basic amenities and clean comfortable response of the 90.45％ ; of treatment services for the 92.59％confidence,the confidence of the cost for the 93.98％ of the overall trust in institutions is 92.76％.ConclusionsThe government must take main principle in chronic disease control.We must enhance base construct of community health management and increase management level of chronic disease.We must enhance practitioner's culture ang increase knowledge of chronic disease management.

Objective: To explore the clinical efficacy of positive airway pressure biphasic (BiPAP) non-invasive ventilation for treating the patients with severe pre-eclampsia combining acute heart failure (AHF).
Methods: A total of 84 patients with severe pre-eclampsia combining AHF treated in our hospital from 2008-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups: Control group, the patients received routine treatment for pre-eclampsia and AHF,n=41 and Observation group, based on routine treatment, the patients received assistant BiPAP ventilation,n=43. The changes at before and 3h after treatment of cyanosis, dyspnea, pulmonary rales, heart rate (HR), respiratory rate (RR), arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2), arterial carbon dioxide partial pressure (PaCO2), pH value and plasma levels of BNP were compared between 2 groups.
Results:①Comparison of before vs after treatment in both groups: HR (times/min) in Control group (90±8 vs 110±14) and Observation group (80±6 vs 112±12); RR (times/min) in Control group (24±5 vs 33±8) and Observation group (18±4 vs 35±7); PaCO2 (mmHg) in Control group (41.3±4.3 vs 48.4±5.6) and Observation group (29.7±5.4 vs 47.8±3.9); BNP (ng/L) in Control group (87.50±8.00 vs 133.00±8.00) and Observation group (69.50±8.30 vs 138.00±6.92); SaO2 (%) in Control group (93.0±3.7 vs 80.5±4.7) and Observation group (97.1±3.4 vs 81.2±4.2); PaO2 (mmHg) in Control group (80.3±5.8 vs 80.5±4.7) and Observation group (89.1±6.2 vs 53.2±5.4), allP<0.05.②After treatment, compared with Control group, Observation group presented obviously decreased HR, RR, PaCO2 and BNP; signiifcantly increased SaO2 and PaO2, allP<0.05. PH was similar between 2 groups,P>0.05.
Conclusion: Assistant BiPAP ventilation may treat the patients with severe pre-eclampsia combining AHF, it could improve HF symptom and hypoxia. The clinical signiifcance should be conifrmed by further investigation.

Cerebral Infarction ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Neurology ; Parkinson Disease ; drug therapy ; Peripheral Nervous System Diseases ; drug therapy ; Phytotherapy

Anemia, Hemolytic ; chemically induced ; therapy ; Female ; Humans ; Paraquat ; poisoning ; Poisoning ; therapy ; Young Adult

Actins ; metabolism ; Animals ; Antigens, CD ; metabolism ; Cadherins ; metabolism ; Carotid Artery Injuries ; metabolism ; pathology ; Endothelium, Vascular ; metabolism ; ultrastructure ; Fluorescent Antibody Technique ; Microscopy, Confocal ; Rats ; Troponin ; metabolism

This paper reviewed and analyzed the management and performance of 43 key clinical pmjeets in recent ten years in Fudan University(the clinical part of original Shanghai Medical University).It was found that hardware equipments of clinic,the ability of disease prevention,diagnosis and treatment obviously improved,the talent training and personnel structure received outstanding outcome,the academic level of basic researches got obvious promotion,the preponderant disciplines established gradually and consolidated,and the center radiation effect showed preliminary success under the aid of key project fund.Constructing the key clinical projects should boost actively amalgamation of medicine and sciences and pay a great attention to develop the medicine auxiliary discipline to further enlarge the clinical research achievements and fully display the guidance function for the development of our country~clinical medicine discipline under the new situation.

BACKGROUND: Macrophage colony-stimulating factor (M-CSF)/receptor activator of nudeer kappa B ligand (RANKL), two types of cytokines co-induce myeloid stem cells to form osteoclasts, is a kind of new method to harvest ostaoclasts with high purity and quantity, but there is lack of uniform cultivation standard. OBJECTIVE: To construct an effective M-CSF/RANKL induced mice myeloid stem cells inducing osteoclast differentiation cultivation system. METHODS: Myeloid stem cells ware obtained from ICR mice and then cultured for 24 hours in a-minimum essential medium containing M-CSF, at cell density of 10~7/L, 10~8/L, 10~9/L. Then 10 μg/L M-CSF and 20, 50, 100 μg/L RANKL were added into culture medium. Tartaric-resistant acid phosphatase stained was performed to observe the transition process from stem cell to osteoclast, as well as cell morphology and stain situation after culture, and positive stained osteoclasts were counted. We compared the influence of different induction conditions to the quantity of osteoclast. RESULTS AND CONCLUSION: A small quantity of osteoclasts contained many red positive beads in the intracytoplasm were observed at 3 days. There were positive beads with hypochromatic dikeryon in cells. A large amount of positively stained osteoclests were seen after 6-day cultudng, which maintained dikaryon. After 9-day culturing, positively stained colossal multinudear cells occurred, became larger and maintained three nuclei. At certain cell density, 100 μg/L RANKL could induce to form more osteoclasts compared with other 2 concentrations (P < 0.05); at certain RANKL concentration, the osteoclasts formation at cells density of 10~8/L was dramatically greater than other 2 cell densities (P < 0.05); the number of osteoclasts was the most when the concentration of RANKL was 100 μg/L and cell density of 10~8/L (P < 0.05). When osteoclasts are induced by M-CSF/RANKL from mudne myeloid stem cells, the best concentration of RANKL is 100 μg/L and cells density is 10~8/L.

Objective To discuss the surgical treatment of delayed acetabular fractures and factors that affect the clinical outcomes. Methods From February 2001 to July 2005, 37 cases of delayed acetabular fractures were surgically treated. There were 22 males and 15 females, with an average age of 36.8 years (17 to 58). 10 cases were simple fractures and 27 complicated ones. The interval between injury and surgery averaged 44.8 days (21 to 399 days). 6 cases were treated through Kocher- Langenbeck approach, 1 ilio- inguinal approach, 2 extended ilio- inguinal approach, and 28 combined approaches. The mean operation time was 226 min (120 to 490 min). The average blood loss was 1 798 mL. Results The mean follow- up period was 18.9 months (6 to 56 months). Evaluation was conducted with Matta' s reduction criteria and modified D’ Aubigne and Postel clinical scoring. Reduction was anatomical in 31 cases, unsatisfactory in 4 and poor in 2. Clinical outcomes were rated as excellent in 21, good in 9, fair in 5 and poor in 2. There was 1 case of femoral head necrosis. Heterotopic ossification developed in 11 cases. In addition, transient paralysis of the sciatic nerve happened in 4 patients. Conclusions In principle, combined or extended ilio- inguinal approach should be reserved for the delayed acetabular fractures with the exception of simple fractures of posterior wall or/and posterior column, anterior wall and anterior column which can be managed by a single approach. The occurrence of arthritis correlates with the severity of the fracture. No direct relation has been found in this series between femoral head necrosis and femoral head dislocation before operation. Severity of fracture, interval between injury and surgery, and skills of orthopedists determine the clinical outcome, operation duration, and perioperative blood loss.

Objective To investigate the combination appr oach used to treat the complex acetab ular fractures.Methods Form January 1998to August 2001,31c ases of acetabular fractures were tr eated through combination of Kocher-Langenbeck a nd ilioinguinal approaches.26case s of them resulted from traffic injur ies,and 5from fall injuries.The average interval from injure to operation wa s 17.6days.The average blood loss wa s1890ml.The average operative duration was 252minutes.According to the classification of Letournel and Jud et,associated fracture types accounte d for 27cases,and simple type 4cases.They were fixed by the reconstructi ve plates and /or plates +lag screws.Results The average follow-up was 20.2month s.According to criteria of Matta,of the 20cases who underwent a natomic reduction,10were satisfac tory while 1unsatisfactory.21case s had excellent and good clinic results,8fair,2poor.Conclusion Because of the advantages of excelle nt ex-posure,convenient reduction,rigid fixation and lower heterotopic ossification,the combination approach is good to treat the complex acetabular fractu res involved the two columns.[