China's participation in global governance,inspired by the 17 United Nations Sustainable Development Goals,is driven by the guiding principle of "Building a Community of Shared Future for Mankind".China has been promoting the Belt and Road Initiative and South-South Cooperation and has made significant contributions to the prosperity of human beings.Along with the opportunities that globalization brought about such as the World Health Organization and the boom in the economy,global health challenges also emerged.This resulted in certain obstacles for China when it sought to advocate the Belt and Road Initiative and when it attempted to carry out its strategy to address global health issues.What are the emerging challenges for global health? What can China do for global health? Why does global health need China? We tried to address these questions as China's global engagement continues to expand in the new era.This article makes the case for Chinese approaches,including getting involved in public health,being consistent in addressing local conditions,and sharing China's experience with handling health services and staying in the lead through government action while being guided by relative policies.China has a lot to offer in the promotion of global health and in overcoming the challenges and risks that this goal currently faces.Thus,China should be considered an inseparable part of global health governance and bilateral health development cooperation.

Objective To evaluate the clinical significance of cortical laminar necrosis (CLN) on diffusion-weighted imaging at acute stage of cerebral infarction.Methods 41 patients were retrospectively investigated who were diagnosed acute cerebral infarction in area of middle cerebral artery,and they got diffusion weighted imaging ( DWI ),magnetic resonance angiography ( MRA ) and colored ultrasonic inspection of cervical arteries within 48 hours after onset,with exclusion of cardioembolism,and 5 patients also had digital subtraction angiography (DSA).The patients were classified into CLN positive group or negative group.The stenosis or occlusion of ipsolateral MCA,intracranial and extracranial ICA were compared between the two groups.Results 9 patients'DWI had CLN,among whom 7 patients present moderate or more severe stenosis of feeding artery,and 5 patients who only had CLN signal presented severe stenosis or occlusion.32 patients'DWI had not CLN,among whom 12 patients present moderate or more severe stenosis of feeding artery.The CLN positive group had a high incidence of ipsilateral intracranial ICA and(or) MCA moderate or severe stenosis or occlusion(55.6％ vs 21.9％,x2 =3.85,P ＜ 0.05 ).The 5 patients who only had CLN signal had ipsilateral feeding artery severe stenosis.A positive correlation was found between CLN and moderate or severe stenosis or occlusion of ipsilateral intracranial ICA and(or) MCA(OR:4.5,95％ CI:1.0 ～ 20.2).Conclusion Patients with acute cerebral infarction and CLN on DWI were more likely to suffer from moderate or severe stenosis or occlusion of feeding large artery,and these patients should be evaluated vessel condition.

Abstract?AIM: To observe the effect of acute angle closure glaucoma with cataract patients treated with glaucoma trabeculectomy combined two incision phacoemulsification and intraocular lens ( IOL ) implantation ( two incision triple surgery) .?METHODS: Patients admitted in our hospital during Jan.2013 to Jan.2016.The acute angle closure glaucoma with cataract patients in 40 cases ( 58 eyes ) were randomly divided into two groups:the observation group of 20 cases ( 29 eyes ) with two incision triple surgery treatment, and the control group of 20 cases ( 29 eyes ) with single incision triple after treatment.Visual acuity, intraocular pressure, bleb, corneal endothelial cell density, the area at 1mo before and after surgery, and postoperative complications of two groups were analyzed.?RESULTS: Postoperative visual acuity of two groups were significantly improved, but there was no significant difference between groups ( P >0.05 ); postoperative intraocular pressure, bleb formation rate of the observation group were 14.41 ±1.38mmHg, 90%, and the control group 14.40 ±1.40mmHg, 86% without statistical significance ( P>0.05 ), corneal endothelial cell density and area of observation group after 1mo were 1696.6±300. 8/mm2 , 540.8±71.6μm2 , and control group 1410.6±288.5/mm2 and 594.3 ±72.8μm2 with significant differences ( P<0.05).The incidence rate of compli-cation was 17%in the observation group, and 21%in control group (P>0.05).?CONCLUSION: For patients with acute angle closure glaucoma and cataract given two incision triple surgery and single incision triple surgery treatment can get good outcomes, but the effect of double incision on corneal endothelial cell injury is less.

OBJECTIVE:Bone morphogenetic protein (BMP) plays a vital role in the prevention and treatment of skeleton diseases, recently researches on the molecular mechanism of sheep prolific FecB gene indicated that BMP and its receptors have important influence on animal follicular development. In this study the influence of different type BMPs andits receptors on the follicular development was reviewed in order to explore effective modulation on animal reproduction.DATA SOURCES: Computer was applied to retrieve Medline database on the related literatures from January 1998 to June 2005. The retrieval words were "BMP" and "BMPR" that combined respectively. Language in the articles was limited to English. Simultaneously related articles were also computer searched in China periodical full text database and Wanfang databases from January 1996 to December 2005 with the retrieval words of "BMP, BMPR", that limiting the article language to Chinese.STUDY SELECTION: At first, the document was retrieved, altogether 200 studies on BMP and its receptors were enrolled including 140 Chinese literatures and 60 English literatures.DATA EXTRACTION: these literatures were screened and 30 were included for relating to the BMP characteristic, as well as the influence of BMP and its receptors on follicular development and reproductive endocrine.DATA SYNTHESIS: Of the 30 literatures, 18 experiments discussed the function of BMP and its receptors and its signal transduction mechanism,12 were about the influence of different BMP on reproductive cell secretion, as well as receptor mutation on ovulation.CONCLUSION: BMPs family plays vital role in animal reproductive modulation, current experiments prove that the changes of signal transduction due to BMP receptor gene mutation has made breakthrough for the exploration of the prolific mechanism in sheep. Moreover studies on follicular development modulation and ovulation mechanism are liable to provide theoretical reference for the prolific modulation in sheep or other species.

OBJECTIVETo observe the therapeutic effects of steel plate fixation after the failure of arthrodesis of ankle by screw fixation.

METHODSFrom August 2001 to October 2011, 15 patients were with steel plate fixation after failure of arthrodesis of ankle by screw fixation. Among patients, 9 cases were males and 6 cases were females,ranging age from 40 to 65 years old with the average of 56 years old. Ten cases were in left and 5 cases were in right. Screws were removed and steel plate was fixed intraoperatively, and plaster external fixation for postoperation. Clincal effect were evaluated according to AOFAS scoring system from pain, waliking ability and aligment before and after operation, and X-ray was used to evaluate joint fusion after operation.

RESULTSAll patients were followed up, and the duration ranged from 4 months to 4 years with an average of 2 years. The incison were healed in stage I. No ankle pain,injury of blood vessel and nerve,infection and farilure of internal fixation occuerred. The AOFAS score increased from 36.86 +/- 8.32 preoperatively to 85.09 +/- 4.65 (t = -26.366, P = 0.000).

CONCLUSIONSteel plate fixation after the failure of ankle arthrodesis of screw fixation has the advantages of rigid stability, simple manipulation and high success rate, less pain, perfect recovery.

Adult ; Aged ; Ankle Joint ; diagnostic imaging ; surgery ; Arthrodesis ; Bone Plates ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Steel ; Tomography, X-Ray Computed ; Treatment Failure

Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; complications ; Coronary Vessels ; Humans ; Syphilis, Cardiovascular ; complications

BACKGROUND: Myelin sheath related inhibitors have been found to have great impact on microenvironment of axon regeneration. Traditional Chinese medicine is gradual y becoming a research hotspot on improving microenvironment of nerve regeneration with its advantage on multiple factors and targets.
OBJECTIVE: To clarify the effect of Jisuikang on Nogo-66 receptor NgR expression after spinal cord injury.
METHODS: 144 rats were randomly divided into six groups: sham surgery group, model group, prednisone group, high-, moderate- and low-dose Jisuikang groups (n=24). Animal models of spinal cord injury were established by the modified Allen’s method in the later five groups. Rats in the prednisone group were daily given 0.06 g/kg prednisone acetate by lavage, once a day. Rats in the high-, moderate- and low-dose Jisuikang groups were daily intragastrically given 12.5, 25 and 50 g/kg Jisuikang, once a day. Rats in the sham surgery and model groups were intragastrically daily given 20 mL of saline, once a day. Rats in each group were administered drugs until death.
RESULTS AND CONCLUSION: Compared with the model group, NgR protein and mRNA expression levels were significantly lower in the prednisone, moderate-and low-dose Jisuikang groups. These data suggested that Jisuikang can improve the recovery of neurological function after spinal cord injury and effectively inhibit NgR protein expression at the site of injury so as to suppress the microenvironment factors harmful to nerve regeneration and further improve the microenvironment of nerve regeneration. Subject headings: Drugs, Chinese Herbal; Spinal Cord Injuries; Axons; Tissue Engineering

Diabetic nephropathy is a complication of diabete and its incidence is increasing obviously these years. The pathogenic mechanisms of DN are complex, with multiple factors involved such as the glycometabolism disorders , hemodynamic changes, aldose reductase pathway activation, alterations in cytokines, oxidative stress, protein kinase C activation, lipid metabolism disorders and genetic susceptibility etc, which are not completely clear yet. Thus, the research progress of DN pathogenesis is to be reviewed.

Objective To investigate the effect of atorvastatin on the expressions of solubility P-selectin(sP-selectin) and high sensitive C reactive protein(hs-CRP) in patients with percutaneous coronary intervention (PCI),and to explore the protective effect of atorvastatin on myocardium.Methods A total of 100 acute coronary syndrome patients having underwent successful PCI were enrolled in this study.All patients were divided into 3 groups by random digits table method:standard treatment group (group A,30 patients,atorvastatin 20 mg),low-dose atorvastatin pretreatment group (group B,35 patients,preoperative 12 h and 2 h atorvastatin 40 mg and 20 mg,respectively) and high-dose atorvastatin pretreatment group (group C,35 patients,preoperative 12 h and 2 h atorvastatin 80 mg and 40 mg,respectively).The level of sP-selectin was measured with ELISA.The level of hs-CRP was measured with latex enhanced immunoturbidimetry.Results Before operation,the levels of sP-selectin in group A,B,C were (2.32 ±0.40),(2.51 ± 0.33),(2.47 ± 0.28) μ g/L.After 6 and 12 h of operation,the levels of sP-selectin in group A,B,C were (4.12 ± 0.75),(3.34 ± 0.42),(3.31 ± 0.46) μ g/L and (5.64 ± 1.07),(4.08 ± 0.74),(3.84 ±0.48) μg/L.The levels of sP-selectin in group A,B,C after operation were significantly higher than that before operation (P ＜ 0.05).At the same time point,the levels of sP-selectin in group B,C after operation were significantly lower than that in group A (P＜ 0.05).Before operation,the levels of hs-CRP in group A,B,C were (4.32 ±0.51),(4.46 ±0.57),(4.29 ±0.43) mg/L,after 6 and 12 h of operation,the levels of hs-CRP in group A,B,C were (8.91 ± 1.34),(7.44 ± 1.06),(7.28 ±0.95) mg/L and (13.66 ± 1.49),(8.08 ± 1.14),(7.92 ± 1.04) mg/L.The levels of hs-CRP in group A,B,C after operation were significantly higher than that before operation (P＜ 0.05).At the same time point,the levels of hs-CRP in group B,C after operation were significantly lower than that in group A (P ＜ 0.05).The analysis of Pearson correlation showed,the level of sP-selectin was positively related with hs-CRP (r =0.753,P ＜0.01).The incidence of perioperative myocardial infarction was 23.3％ (7/30),5.7％ (2/35) and 2.9％ (1/35) in group A,B and C,respectively.The incidence in group A was significantly higher than that in group B and C (P ＜ 0.05).But there was no significant difference between group B and group C (P＞ 0.05).Conclusion The atorvastatin pretreatment can decrease the levels of sP-selectin and hs-CRP in patients after PCI,which play an important role in myocardium protection.

Objective To investigate the diagnostic value of T-SPOT.TB in patients with fever.Methods T-SPOT.TB was carried out in 456 febrile patients who had no determined reason for fever or who could not be excluded from infection with Mycobacterium tuberculosis.These patients were followed up for their final clinical diagnosis and the diagnostic value of T-SPOT.TB was evaluated using the receiver operating characteristic (ROC) curve.Results In the present study,85 patients were clinically diagnosed with tuberculosis (TB) (including 34 cases of pulmonary TB,24 cases of TB infection defined as T-SPOT.TB positive without TB lesion,but effective with anti-TB treatment,10 cases of tuberculous pleurisy and 17 cases of other extrapulmonary TB) and 371 patients had no definite evidence of Mycobacterium tuberculosis infection (including 42 cases of suspected TB and 329 cases of other diseases).T-SPOT.TB had a high sensitivity of 84.3％ in TB patients and a high negative predictive value of 94.2 ％,but the specificity was 68.1％ and the positive predictive value was 41.4 ％.The Kappa value was 0.380 and the area under ROC curve was 0.762 (95％CI:0.707-0.817).T-SPOT.TB had a higher sensitivity in extrapulmonary TB than in pulmonary TB (88.2 ％ vs 78.1 ％),with the negative predictive values of 95.3 ％ and 92.6 ％,Kappa values of 0.438 and 0.299,and the areas under ROC of 0.791 (95 ％ CI:0.724-0.857) and 0.719 (95％CI:0.623-0.815),respectively.Ninety-nine cases were T-SPOT.TB positive out of 329 patients diagnosed with other diseases.Conclusions T-SPOT.TB test can be used as a method for TB diagnosis in patients without obvious TB lesions.Due to its relatively high negative predictive value,T-SPOT.TB can be used to rule out infection with Mycobacterium tuberculosis.