Medical assistance systems are an integral part of the health security system and they represent the integrity and adequacy of health risk protection. The overwhelming majority of developed countries have already es-tablished medical assistance systems to improve the accessibility of healthcare services and provide catastrophic pro-tection for families, especially for the poor. The paper conducts a comparative study of typical foreign medical assis-tance systems, where in the general method by which developed countries embed catastrophe protection mechanisms into public healthcare security systems and provide tilt protection to the needy is described. Medical assistance is pro-vided on a means-test basis and the development of private health insurance is encouraged to alleviate pressure on the public side. Corresponding implications for China are also warranted, including the provision of tilt protection to the needy, to re-define objects and standards of medical assistance, and enhance the coordination of different medical se-curity systems.

Objective To detect plasma K-ras gene mutation by using CED-RFLP/PCR to diagnose pancreatic cancer. Methods CED-RFLP/PCR technique was used to detect K-ras gene mutation in the plasma specimens of pancreatic cancer patients, patients with benign pancreatic diseases and healthy subjects. Results In pancreatic cancer patients the positive rate of plasma K-ras gene mutation was 73%, without false positivity, and higher than that in the pancreatic juice and duodenal juice, but lower than that in the fine-needle aspirates. Plasma K-ras gene mutation was not found in patients with benign pancreatic disease and healthy subjects. Conclusion The detection of plasma K-ras gene mutation by CED-RFLP/PCR is simple and effective, and could avoid the faults of other detection methods. It is helpful for the diagnosis and identification of pancreatic cancer.

Thirty-three patients with bone tumor(malignant in 10 cases and benign in 23 cases)selected from Department of Bone Tumor,the Second Affiliated Hospital of Mongolian Medical College from October 1999 to August 2006 underwent special prostheric replacement at neoplastic segment.The prosthesis was made of stainless steel, alloy of cobalt-chrome-molybdenum,or titanium alloy,which are provided by Beijing Lidakang Technology Company Limited.All patients provided the conftrmed consent.In the follow-up of 6-70 menths,one patient with giant cell tumor of haunch bone,two patients with malignant synovioma,and one patient with malignant fibrous histiocytoma died due to pulITlonary metastasis.In all those patients who survived,none have local recidivation,transferring,or fracture.Among them,one patient had postoperative infection and rigor at knee joint.Three patients had ache at middle part of thigh(junction between prosthesis and femoral bone)after knee joint replacement.According to the Ennekhag scores after reconstruction of surgical oncology,fineness rate of upper limbs was 80%,and that of lower limbs was 86.4%.Odynolysis rate of shoulder ioint was 90%.Active movement was increased and activity of femoral articulation Was generally normal.Extension and flexion of knee joint ranged from 0 to 100 degree.Rejection occurred in stainless steel prosthesis of knee joint in one patient.Junction between prosthesis and femoral bone Was looge in two cases.All other prostheses had great biocompatibillty to tissues.

Objective To investigate whether arsenic trioxide(As2O3)with different density is capable of affecting the invasiveness of neuroblastoma(NB)cells,and to give grounds for NB therapy with As2O3.Methods 1.Well-developed NB cells were selected and exposed to 0.75 ?mol/L,1.50 ?mol/L,3.0 ?mol/L As2O3 for 24 h;2.Collect the adherence cells,count the number and float them in nutrient medium again,add them into the transwell polycarbonate membrane plate that was covered by matrigel,there were 2?104 NB cells in each well;3.After 24 h,take off the membrane,fix the cells which cross the membrane with mehanol and dye them with hematoxylin;4.Observe the NB cells and count them,so the capability of invasion of LA-N-5 was evaluated by transwell chamber assay.Results After 24 h with the different density As2O3,the number of invading LA-N-5 cells was significantly lower in As2O3 group than that in control group(the number of invading cells of the As2O3 group was 28.0?4.0,19.33?4.16,6.33?1.53,respectively,the cell number of the control group was 46.33?6.11)(P=0.013,0.003,0);among the experiment groups,there was no difference between 0.75 ?mol/L and 1.50 ?mol/L(P=0.06),and it was significantly different between 0.75 ?mol/L and 3.0 ?mol/L,1.50 ?mol/L and 3.0 ?mol/L(P=0,0.007),the number of invading LA-N-5 cells of 3.0 ?mol/L As2O3 was the least.Conclusions As2O3 could inhibit the invasive potential of NB cells;the inhibitory action of 3.0 ?mol/L As2O3 is the most.

Child, Preschool ; Chromosomes, Human, Pair 11 ; Female ; Humans ; Kidney Neoplasms ; genetics ; Ring Chromosomes ; Wilms Tumor ; genetics

Objective To evaluate the efficacy and security of splenic artery ligation for severe hypersplenism during liver transplantation.Method Thirty-two liver transplant patients with preoperative hypersplenism were selected,including 17 cases (ligation group) treated by splenic artery ligation during liver transplantation,and rest 15 patients as non-ligation group.The fluctuation of white blood cells,platelets and volume of spleen were compared between these two groups.At the same time,splenic infarction,postoperative infection,recurrent gastrointestinal bleeding,splenic artery steal syndrome and other complications were observed in these two groups.Result All recipients were followed up for over 6 months.One recipient in ligation group died of multiple organ dysfunction caused by delayed recovery of liver donor with the survival rate being 94.1％ (16/17).The survival rate in non-ligation group was 93.3 ％ (14/15) (one recipient died of respiratory failure caused by pulmonary infection).There was no statistically significant difference in survival rate between these two groups (P＞0.05).Splenic necrosis wasn't detected in the ligation group.The splenic volume in ligation group was significantly less than that in non-ligation group (P＜0.01).The products of splenic maximum length and wide diameter shrunk 33.17-± 8.26 cm2 and 22.47 ± 7.25 cm2 in ligation group and non-ligation group,respectively.The platelet counts of ligation group were significantly greater than those of non-ligation group in all the observation points within 6 postoperative months (P＜0.01).The white blood cell counts of ligation group were greater than those of non-ligation group at the first week postoperatively (P＜0.01),whereas,there was no statistically significant difference between these two groups from then on (P＞0.05).The infection incidence of ligation group was lower than that of non-ligation group within 6 postoperative months (P ＜0.05).Statistically significant differences in recurrent gastrointestinal bleeding and splenic artery steal syndrome weren't found between these two groups (P＞0.05).Conclusion Splenic artery ligation in liver transplantation is safe and effective.It can rapidly increase the counts of platelet and white blood cell in the earlier postoperative time,which is beneficial to patient's recovery.Besides,it adds no correlative complication.

Objective To investigate the effect of regulatory dendritic cells treated by extracorporeal photochemotherapy on T cell proliferation. Methods Human peripheral blood mononuclear cells (PBMCs) were obtained and the immature dendritic cells (imDCs) were induced by recombinant human granulocyte and macrophage colony stimulating factors. SPDCs were obtained by PUVA treatment, and ECDCs were co-cultured with imDCs and PUVA-SP to obtain immunoprecipitated dendritic cells. In vitro, imDCs were co-cultured with SPDCs to obtain SPDCs; imDCs were added to 10ng/ml of LPS, and cultured for 1 day to obtain DCs. The expressions of CD11c, CD83 and CD86 on the surface of the cells were detected. The effect of imDCs on the proliferation of recipient T cells was detected by mixed lymphocyte culture method. Results The early apoptosis rate of PUVA-treated cells was 91.33%. The positive expression rates of CD83 and CD86 in ecpDCs were 22.83%±5.26% and 22.06%±4.37%, respectively, which were similar to those of imDCs (15.06%±0.59%, 15.19%±1.83% (P<0.01), but significantly lower than those in DCs (99.79%±0.36%, 99.85%±0.19%, respectively), the difference was statistically significant (P<0.01). The recipient imDC cells phagocyting the appoptotic splenic lymphocytes from the donor significantly inhibited the proliferation of recipient T cells. Conclusion Apoptosis of splenic lymphocytes induced by extracorporeal photochemotherapy can inhibit the maturation of dendritic cells and inhibit the proliferation of T lymphocytes.

Objective To dynamically monitor the changes of peripheral blood lymphocyte subsets of renal transplant recipients and investigate the relationship between lymphocyte subsets with infection and rejection.Methods The clinical data of allogenic kidney transplantation recipients and living relative donors in the Department of Kidney Transplantation of the First Affiliated Hospital of Zhengzhou University were prospectively collected from June 2015 to December 2016.The data of lymphocyte subsets and other related indexes were obtained from renal transplant recipients and relatives of the same period.Results Sixty-four cases of living-relative donors and 351 cases of renal transplant recipients were enrolled in this study,and the recipients were divided into 3 groups:infection group (67 cases),acute rejection group (46 cases),and stable group (238 cases),according to the diagnostic criteria.There was significant difference in the concentration distribution of lymphocytes between the stable group and the control group (P<0.05).The stable frequency distribution range of the stable group was as follows (cells/μL):Lym (1 000-1 500),T (<1 500),CD4+ (<1 000),CD8+ (<1 000),B (<300),NK (100-300),CD4+/CD8+ (0.5-1.0).The number of Lym,T,CD4+,CD8+,NK and B cells in the preoperative patients was less than that in the healthy population (P<0.05);The number of Lym,T,CD4+, CD8+,B and NK cells was gradually decreased in the postoperative infection group,which was less than that in the stable group (P<0.05).After treatment the indicators gradually restored to the level in the stable group level;the number of T,CD4+,CD8+,B cells was highly correlated with infection.The number of T and CD4+ cells,and CD4+/CD8+ ratio were significantly increased in acute rejection group as compared with the stable group,and gradually decreased after the rejection was reversed.The number of T,CD4+,CD8+ cells was highly correlated with rejection.Lymphocyte subsets had a predictive effect on infection and rejection of recipients,and CD4+ cell count and CD4+/CD8+ ratio were independent risk factors.Conclusion The monitoring of lymphocyte subsets has an important clinical value in the evaluation of immune status and individual treatment of renal recipients.

Objective To explore the factors of high level of serum estradiol(E2)in infant with hemangiomas and its relationship with tumors' proliferation.Methods The levels of serumal estradiol of 25 proliferative hemangiomas and 15 oblique inguinal hernias with same ages 1 day preoperation and 3 days postoperation were tested by chemiluminescence enzymatic immune method.The expressions of estrogen receptors(ER)in 25 tumors and 15 normal skin tissue were tested by immunohistochemical method.Results The levels of E2 of preoperation were ob-viously higher than that of postoperation in hemangiomas and control group(Pa0.05).The expression of ER in tumors was significantly higher than that in normal skin tissue(P

0.05).In addition,in different medication intervals and the same total dosage(200 mg),there was no difference in the number of patients who reached ASAS20,ASAS50 anti BASDAI50 in both groups.The changes of other parameters were not observed.Conclusion Two dosages and different medication interval of rhTNFR-Fc have similiar efficacy onset time and maintenee period.Mean- while,at the same total dosage,there is no signifieant difference in therapeutic effect in the two dosage groups. However,50 mg(1/7 d)regimen has better compliance than 25 mg(1/3 d).