A picture of great market potential and mismatch of supply and demand in Anhui was drawn in the paper,with five challenges analyzed for the industry in general.The authors proposed to integrate medical resources and aging care resources,to build a diversified and tiered health care and aging care supply system,an integrated administrative coordination mechanism,and enhance fiscal support among other policy suggestions.These proposals were designed to encourage the development of the aging care industry featuring a combination of medical resources and aging care.

ObjectiveTo observe the effect and adverse reaction of Reduning injection in the treatment of epidemic hemorrhagic fever.Methods98 patients with epidemic hemorrhagic fever were randonly divided into 2 groups,the treatment group was given Reduning injection ;The control group was given ribavirin injection;The efficacy and prognosis and adverse reaction were compared between two groups.ResultsThe antipyretic effect of the treatment group was better than that of the control group ( x2 =6.41,P ＜ 0.05 ),and the fever clearance time,oliguria time,the total duration was significantly shortened( t =2.356,2.071,5.125,all P ＜ 0.05 ).There were no obvious adverse reaction in the two groups.ConclusionReduning injection in the treatment of epidemic hemorrhagic fever had good curative effect,safety,and it was worthy of popularization and application.

Objective To investigate the clinical effect of aspirin and ursodeoxycholic acid on treating intrahepatic cholestasis of pregnancy (ICP).Methods Seventy-one ICP patients were divided by random digits table method into observation group (36 cases) and contol group (35 cases).Observation group was treated with aspirin and ursodeoxycholic acid.Control group was given unsodeoxycholic acid.The biochemical indicators,itching score and pregnancy outcomes of two groups were observed.Results Total bile acid (TBA),total bilirubin (TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and itching score of two groups after treatment were all significantly lower than those before treatment (P ＜0.05 ).TBA,TBIL,ALT and itching score of observation group[ (31.7 ± 8.3 ) μ mol/L,(33.9 ± 5.8 ) μ mol/L,(53.1 ± 8.4) U/L,(0.48 ± 0.06) scores] were obviously lower than those of control group [(76.2 ±9.2)μ mol/L,(56.9 ± 8.2) μmol/L,(80.8 ± 10.6) U/L,(0.81 ±0.04) scores] (P ＜0.05).The incidences of amniotic fluid contamination,premature delivery and neonatal asphyxia of observation group were significantly lower than those of control group [38.9％(14/36) vs.71.4％(25/35),11.1％(4/36) vs.31.4％( 11/35 ),5.6％ ( 2/36 ) vs.22.9％ ( 8/35 ),P ＜ 0.05 ].Conclusions The combined application of aspirin and ursodeoxycholic acid can improve the biochemical indicators,itching symptom and pregnancy outcomes.

In order to explore the relationship between the expression of TGF ? 1,its receptor and the wound age during the healing process of rats skin incision wound,a preliminary study were performed on the vital skin wound 0 5～168h after injury by using the immunohistochemical and the molecular biological methods.The results were then compared with those of the postmortem skin injury.The results revealed that the expression of the cytokine TGF ? 1 in the epithelial cells were enhanced 0 5h after the antemortem skin incision and the strongest reactions were seen at 24～96h post injury.The expression of TGF ? 1 was also found in the macrophages and the fibroblasts in the granulation tissues.Analysis of the immunoblotting(Western blot)results showed that the peak value of the TGF ? 1 protein was appeared at 168h after the antemortem skin incision and peaked at 96h.TGF ? 1 was detected 0 5～3h after postmorten skin injury by using the immunohistochemical method.No expression of mRNA was found.It is suggested that some regular and characteristic expression of TGF ? 1 in the incised skin wounds were related with the wound age.It might be used for timing of skin wound on rat.

ObjectiveTo investigate and analyze the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients.MethodsA retrospective review is presented of patients less than 30 years with surgical treatment of bronchogenic carcinoma between 1969 and 2008.There were59 patients (36 male and 23 female).Mean age was 23 years ( range 8-29 ) .The ratio of men to women patients was 1.7∶1.Forty-nine cases ( 83.0% ) were symptomatic at presentation and 18 cases(30.5% )were misdiagnosed as other diseases.Surgical procedures included radical resection in 46 cases,palliative resection in 3 cases,thoracotomy only for unresectable disease in 7 cases and VATS biopsy in 3 cases.The histological types were 18 adenocarcinomas,13 carcinoids,9 mucoepidermoid carcinoma,5 squamous cell carcimomas,4 small cell lung cancer,3 adenosquamous carcinoma and 4 others.On TNM staging,8 cases in stage Ⅰa,3 cases in stage Ⅰb,9 cases in stage Ⅱ a,12 cases in stage Ⅱb,15 cases in stage Ⅲa,8 cases in stage Ⅲb,4 cases in stageⅣ.ResultsThere were no operative death in radical group.Post-operative atelectasis in 3 cases.One case died from postoperative respiratory failure in explosive group,the postoperative five year survival rate was 27.0%.radical resection group 5-year survival was 35%.Univariate analysis identified TNM stage and surgical procedures as predictors of survival( P <0.05).factors that had no significant effect on overall survival included gender,histologic sbutype and postoperative chemotherapy (P > 0.05).The 5 year survival in stage Ⅰ,Ⅱ,Ⅲa,Ⅲb + Ⅳ were 75.0%,33.3%,14.3% and 0,respectively.The 5 year survival in lobectomy,pneumonectomy and exporsive were 43.0%,18.2% and O,respectively.On multivariate analysis,TNM stage of disease was the only independent predictor of survival ( P =0.000) .ConclusionWe should pay attention to adolescent lung cancer and improve the diagnosis rate avoiding of delaying surgical treatment.The five year survival rate of radical resection for adolescent lung cancer was good.They should be treated with aggressive multimodality therapy and surgical resection is the first-line treatment for them.

BACKGROUND:Cataract is not the necessary symptom for myotonic dystrophy(DM).But it may be the early and even only clinical symptom of DM.Molecular diagnosis can provide the important evidence for the diagnosis of DM.OBJECTIVE:To explore the characteristics of cataract in 26 patients with myotonic dystrophy of 3 pedigrees from Shanghai Songjiang area.DESIGN:Analysis on the Genealogy of Pedigree.SETTING:Department of Neurology,Shanghai Changhai Hospital.PARTICIPANTS:Twenty-six patients of 3 pedigrees,aged 7 to 71 years old,which were preliminarily diagnosed as DM patients or were suspicious DM patients,admitted to Department of Neurology,Shanghai Changhai Hospital between May 2001 and August 2003,were recruited in this study.Among the involved patients,13 corresponded to the clinical diagnosis standard from Practical Neurology,and the other 13 patients have adverse symptoms and (or) body signs of partial or mild DM,suspecting with DM patients.METHODS:①Peripheral blood of 1 mL was taken and genome DNA was extracted.By using a thermocycler,a polymerase chain reaction (PCR) was carried out to examine the CTG repeats according to criteria of molecular diagnosis (CTG repeats from 80-3350).②In addition,slit-lamp examination for specific lens opacity was carried out and the association between DM and cataract was analyzed.MAIN OUTCOME MEASURES:①CTG trinucleotide repeat numbers.②Association between DM and cataract.RESULTS:Of the 26 patients,25 participated in the final analysis except 1 who suffered from sterility clinically.①25 patients were consistent with the molecular diagnostic criteria of DM (CTG repeats from 80-3 350).The remaining 1 with CTG repeats of 13 was clinically sterility and therefore belonged to the normal individual.The (CTG)n triplet repeats of 17 patients with cataract were 2380±80,while 8 patients with cataract were 2298±105(P＞0.05).②Cataract was characterized as iridescent lens opacity or blue posterior cortical lens opacity in 17 patients.Among the 17 patients,cataract in 8 patients was the only early clinical sign whose(CTG) n triplet repeats were higher than the normal ones.CONCLUSION:In the pedigrees with DM patients,characteristic cataract,as a main and even only early clinical sign,will provide important clinical evidence for the early diagnosis of DM.

BACKGROUND:Human embryonic stem cels are able to self-renew indefinitely and have the capacity to differentiate into al three germ layers (ectoderm, endoderm and mesoderm). These properties imply great potential in the basic research and clinical application, including regenerative medicine, drug screening and toxins, early human embryo, cel transplantation, gene therapy,etc. However, it is a substantial chalenge to develop efficient techniques for their large-scale culture under defined conditions, and for controling and directing their differentiation. For therapeutic purposes, many scholars are trying to establish methods for maintaining pluripotency in defined xeno-free conditions and scalable culture systems. OBJECTIVE:To discuss the progress of serum-free culture systems in human embryonic stem cel research reported in recent years and to highlight the chalenges and advances being made towards the development of serum-free and xeno-free culture systems suitable for therapeutic applications. METHODS:A computer-based search of CNKI and PubMed academic database was performed for articles addressing serum-free culture systems of human embryonic stem cels published from 2008 to 2015. Repetitive and old articles were excluded. Finaly, 58 articles were summarized. RESULTS AND CONCLUSION:Several groups have attempted to exclude individual animal components by using feeder-free matrices, feeder cels of human origin, or defined xeno-free media, aiming to select a suitable matrix and medium that can minimize or not use heterologous components, in order to obtain cel lines at clinical level. However, the current cel products are far from clinical application. There are stil many problems to be solved, such as standardization, normalization and individualization of cel products. With the normative development of stem cel research and industry, human embryonic stem cel products are expected to be widely used in clinic.

Objective To investigate the effect of ellagic acid on human epidermal melanocyte melanogenesis and melanin transfer, and the mechanism thereof. Methods The human melanocytes and and keratinocytes were co-cultured and purified. After passing the second generation, cells of 1∶10 ratio were inoculated into the small dish (3 cm × 3 cm). The changes of melanin content and tyrosinase activity in melanocytes were detected before and after intervention with ellagic acid (100, 10 and 1 mg/L) for 48 h. The melanin transfer in cultured cells was detected by flow cytometry method. The 10 nmol/L arbutin was used as the positive control. Results The tyrosinase activity was down-regulated by ellagic acid in a dose-dependent manner. The ellagic acid can reduce the melanin content except for the 1 mg/L of ellagic acid. The melanin transfer was also inhibited by ellagic acid in a dose-dependence manner. Conclusion Ellagic acid can be used for skin-whitening cosmetic and the depigmenting effect might be due to the down-regulation of melanogenesis and melanin transfer.

Objective To analyze the clinical characteristics of Hashimoto's disease(HD) accompanying with thyroid cancer,and to explore the experience of diagnosis and treatment.Methods Clinical data of 41 cases of HD accompanying with thyroid cancer were retrospectively analyzed.The patients were diagnosed by postoperative paraffin pathological examination from Jan.2002 to July 2011.Results 10 cases of HD,37cases of thyroid cancer,and 8 cases HD accompanying with thyroid cancer were diagnosed before operation.The rate of preoperative diagnosis was only 19.51％.All patients underwent surgical treatment,including 22 cases total thyroidectomy,14 cases subtotal thyroidectomy,and 5 cases lesion side lobe resection.24 cases underwent ipsilateral neck dissection,and 4 cases underwent bilateral neck dissection (ipsilateral radical resection,contralateral selective resection).Postoperative paraffin pathological examination proved that there were 39 cases of HD accompanying with thyroid cancer,1 case of focal cancer and 1 case of B-cell lymphoma of mucosa-associated thyroid.All patients were followed up.Conclusions The preoperative diagnosis rate of HD accompanying with thyroid cancer is low and great attention should be paid to its diagnosis.For HD patients,if carcinoma can not be excluded,surgical exploration is recommended.Appropriate surgical method should be chosen according to intraoperative frozen section results.Postoperative thyroid hormone treatment is usually taken.

Objective To study the epidemiological and clinical features of primary hyperthyroidism complicated with thyroid cancer.Methods Clinical data of 30 cases of hyperthyroidism complicated with thyroid cancer(hyperparathyroidism group)were retrospectively analyzed.They were chosen from the 365 cases of primary hyperparathyroidism treated by operation from Jan.2002 to Jun.2011.At the same time,30 cases of thyroid cancer without hyperparathyroidism were randomly taken out as the control group.Results The incidence of thyroid cancer in primary hyperparathyroidism was 8.22％ (30/365).The median course,preoperative diagnostic rate of thyroid cancer,and lymph nodes metastasis rate for hyperparathyroidism group and control group was 875.00 vs 120.00 days(z =-2.501,P ＜0.05),40.0％ (12/30) vs 66.7％ (20/30) (x2 =4.286,P ＜0.05),and 20.0％ (6/30) vs 46.7％ (14/30) (x2 =4.800,P ＜ 0.05) respectively.All patients were followed up with the average of 4.5 years,ranging from 1 month to 9 yeas and a half.1 case(3.3％)in hyperparathyroidism group recurred hyperthyroidism 5 years after surgery.1 case(3.3％)recurred thyroid cancer 1 year after surgery and received operation again,and 1 case(3.3％)died half a year after operation from respiratory failure caused by lung metastasis of thyroid cancer in the control group.Conclusions Hyperthyroidism complicated with thyroid cancer has the characteristics of high incidence rate of thyroid cancer in the hyperthyroidism patients,long course,high preoperative misdiagnosis rate,low lymph node metastasis rate,favorable prognosis and so on.