Objective To evaluate the association of fetal total bile acid (TBA) concentration with fetal adrenocortical dysfunction in intrahepatic cholestasis of pregnancy(ICP). Methods The concentration of TBA, cortisol and DHEA-S in the cord blood were measured in 20 fetuses with maternal ICP (ICP group) and 22 fetuses of normogravidas (control group) after elective cesarean section. The cord blood TBA concentration was investigated by enzyme method and the cord concentration of cortisol and DHEA-S by radioimmunoassay. Results The cord TBA concentration in ICP group was significantly higher than that of controls [(8.93?3.16)mmol/L vs (4.33?1.51)mmol/L, P0.05)]. The cord blood level of cortisol,DHEA-S and the ratio of DHEA-S over cortisol were correlated with the cord blood TBA concentration (r 1= 0.87,r 2=-0.88,r 3=-0.84,P

Objective To summarize the experience of liver retransplantation, as well as the factors i nfluencing the surgical effects. Methods The clinical data of 8 patients who received liver retransplantation in our cent er were analyzed retrospectively. Results Among 8 cases, complications of biliary tract occurred in 5 cases, chronic rejec tions in 2 cases, embolism in hepatic artery in one case. Infections occurred in 7 cases before engraftment. Case 1 had develope d renal function failure before the surgery, and he died of severe infections an d multi-organ failure after transplantation. Case 4 had massive hemorrhage duri ng the operation and also died of multi-organ failure after transplantation. Case 7 developed in tracanial hemorrhage and abdominal infection and died early after transplantatio n. Other 5 cases has recovered and left hospital. Conclusions Liver retransplantation is the only measure that can be taken to save the lives of patients whose liver allograft fails to function. It's very important that the indications and time of retransplantation should be carefully selected. Factors that may lead to harmful effects on liver retranspl antation include bad preoperative condition of the recipient, tough and long ope ration, massive hemorrhage during the operation, and severe complications after the surgery.

This paper analyzed the 15-year exploration and practice in Zhenjiang City on the reforms of the healthcare reform From the perspectives of the role and impact exerted by medical insurance in hospitals,as well as main challenges and countermeasures or recommendatioas of this regard,the paper discussed the development relationship among public hospitals,healthcare system reform and medical insurance.Main points include the following:orchestrated development between hospitals and medical insurance;establishment of an equal negotiation mechanism between hospitals and medical insurance;establishment of a beneficary system adaptable to medical insurance capacity;establishment of a scientific and feasible pattern of fees settlement and payment;hospitals are expected to deepen the reform and better management,playing the role of providing quality medical services and reasonably controlling medical costs.

Objective: To develop a grinding intrument for removing the remaining bonding material and polishing the dental enamel after orthodontic treatment. Methods: A dental griding instrument was made based on ultrasonic principle with the frequency of 25～45 kHz. 60 premolars extracted for orthodontic purpose were used in the experiment, before treatment the surface roughness was measured and recorded as Ra 1. Brackets were adhered to the premolars, and then debonded. The surface enamel of 30 teeth were polished by the ultrasonic grinding instrument (group of GI), that of another 30 by conventional technique(group of CT) , the roughness was measured and recorded as Ra 2. Results: In group GI Ra 1 and Ra 2 were 0.846 6?0.428 2 and 0.740 5?0.372 1(P0.05), respectively. After treatment Ra 2 in group GI was smaller than that in group CT(P

Objective To assess the academic influence of research on blood pressure in the world and its frontiers. Methods Papers on blood pressure published from 2004 to 2008 and from 2009 to 2013 in China and foreign coun-tries were retrieved from Web of Science. Their academic influencing power was assessed and their evolution in the past 10 years was displayed by Citespace. Results The world outputs in research on blood pressure increased steadily from 2004 to 2014. The competitive force of the USA-led developed Western countries was strong and stable. The out-puts in research on blood pressure in China increased rapidly, but its influencing power was relatively low. Although progress was made at micro and macro levels,greater advances were achieved at gene,molecular and big data levels in the past 10 years. Conclusion The USA and European countries-led development in research on blood pressure is steady, and it is urgent for China to reduce its gap with USA and European countries.

Objective To investigate the changes of waist muscle density and area in the subjects with spiral CT scan examination,and through the quantitative analysis of different age and gender to get the degree of lumbar muscle degeneration.Methods 240 cases of lumbar CT scan reconstruction images (including the patients suffering from low back pain)were collected.According to the age,20 - 29 years old group,30 - 39 years old group,40 -49 years old group,50-59 years old group,60-69 years old group,and 70-79 years old group were set up.The lumbar transverse psoas muscle,lumbar side muscle,erector spinae cross-sectional areas (CSA)and mean CT values were measured at different levels.Scanning equipment:Toshiba Activion 16-slice spiral CT scanners, acquisition range from the waist 1 to S1.Results ①Compared between the measurement results of the same age groups (except 70-79 years old group),the average CSA of the male at the same level waist was higher than the female (P <0.05).②Compared between the same level groups of 20-29 years,30-39 years and 40-49 years, there were no significant differences (P >0.05).Compared between the same level groups of 50-59 years,60-69 years and 70-79 years,there was no significant difference (P >0.05).③Compared the CSA of man’s erector spinae muscle between 40-49 years group and 50-59 years group,there were significant differences (P <0.05).④Compared the same level CSA of female between 20-29 years,30-39 years,40-49 years,50-59 years,60-69 years,70-79 years groups,and the adjacent groups,there were no significant differences (P >0.05).⑤The same level average density of erector spinae muscle was lowest compared with the psoas major muscle and quadratus lumborum muscle,and falling faster,the psoas major muscle was relatively higher.The same level average density of female’s erector spinae muscle was lower than man’s,specially in 70-79 years group.Conclusion Multi-slice spiral CT can be used to diagnose the lumbar degenerative conditions.

The B-cell lymphoma gene 2 (Bcl-2) is considered as the most important inhibiting cell apoptosis control gene,and its expression is up-regulated in asthma.Drug intervention against Bcl-2 affects signal pathways,down-regulates the Bcl-2 expression,and induces programmed cell death.It may become the target of asthma treatment.This article reviews the structure characteristics of the Bcl-2,the mechanism of regulating apoptosis,and its role in asthma.

Objective To study the ways of obstetrics and gynecology noviciate on how to increase medical students' practical ability in eight-year program. Methods The three aspect studies ,such as experimental technology teaching on gynecology, clinical observation and thought of emergency and ward practice,and simulation teaching of clinical skill,has been accomplished in 50 students of eight-year program in the grade of 2004. Results Teaching achievements has been made in three aspects,such as the settlement of the difficulties in obstetrics and gynecology teaching, the increase of clinical skill and enhancement of practical chance in obstetrics and gynecology. Conclusions The studies of obstetrics and gynecology noviciate provide referenced teaching modes for increase medical students' practical ability in eight-year program.

Objective To study the feasibility of regional network platform for wound care technical training.Methods Micro-letter pubic number and internet technologies were used to develop a regional network platform of wound care which has one center with multiple branches,training nurses how to take care of wound by the educational column.Results There were 383 nurses had browsed the web site and took part in the learning since regional network platform was working 3 months,931 nurses paid close at-tention to Micro-letter pubic number.Performance examination was improved obviously after training,the percent of pass was 17.8% before training and 80.7% after training,the difference was with statistical significance (χ2=303.629,P<0.01).Conclu-sion The regional network platform of wound care based on micro-letter and internet technologies has a promising application.

Liver transplantation has been taken as one of the most effective therapies for patients with end-stage liver disease. However. 10%-40% patients develop biliary complications (BO after transplantation and 6%-13% patients have to receive liver retransplantation, with the mortality being around 19%. BC is one of the major risk factors for the prognosis of liver transplantation. This review summarizes the etiology and the mechanism(s) of biliary complications after liver transplantation.