Summarized in the paper are the experiences of Zhejiang University and its affiliated hospitals in developing medical consortiums based on two emphases of primary ends. The authors found that a sustainable ecosystem of medical services can be built upon quality resources of the university and its hospitals if the missions, components and roadmap are clarified.

Objective To evaluate the application of osteoporosis self-assessment tool for Asians (OSTA) in screening of osteoporosis for postmenopausal women in community.Methods Total 793 postmenopausal women were included.OSTA were calculated and bone mineral density (BMD)was measured by dual energy X-ray absorptiometry (DXA).The correlation of OSTA index with DXA results was analyzed.Results The prevalence of osteoporosis and osteopenia was 18.3％ (145/793) and 47.7％(378/793) respectively,the remaining 270 women had normal bone mass (34.0％).According to OSTA index the rate of low-risk,medium-risk,high-risk osteoporosis groups were 61.9％ (491/793),29.5％(234/793) and 8.6％ (68/793),respectively.The BMD measured by DXA was positively correlated with OSTA index(r =0.559,P =0.000).The area under receiver operating characteristic curve (ROC) of OSTA for diagnosing osteoporosis was 0.736.Taking-1 as cut off value,the sensitivity and specificity of OSTA in diagnosis of osteoporosis was 73.1％ (106/145) and 69.8％ (452/648),respectively.Conclusion OSTA can be used as an effective index for screening of osteoporosis in postmenopausal women in community.

Objective To investigate the biological characteristics of neural stem cells from the striatum of human embryos. Methods Neural stem cells were isolated from the striatum of 16-20 weeks human embryos.These cells were cultured to proliferate and then differentiate without mitogens or inductive factors.At various time points the progeny of neural stem cells differentiation were analyzed.Using immunocytochemistry stainings,the biological characteristics of neural stem cells were examined. Results Neural stem cells in the striatum of 16-20 weeks human embryos proliferated rapidly in vitro within the first one month of culture at an average doubling time of 3-4 days.Upon mitogen withdrawal,the differentiation of neural stem cells to neurons exceeded 50%.After 8 weeks in culture,however,the proliferation speed of neural stem cells lowered significantly.The proportion of neurons induced by mitogen removal was under 20%.There were about 20% of cells within neurosphere continue to divide.Conclusion The proliferation and self-renewal ability of neural stem cells in the striatum of 16-20 weeks human embryo is robust.In vitro,the rate of proliferation went down with time,and the ability of differentiation to multiple neural cells varied.The different mitogen factors in media have different effects on neural stem cell.Within neurospheres,neural stem cells are not homogenous,as only a portion of cells can divide.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Cystadenocarcinoma, Papillary ; pathology ; Dactinomycin ; therapeutic use ; Diagnosis, Differential ; Ependymoma ; drug therapy ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Hysterectomy ; Ovarian Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Ovariectomy ; Teratoma ; pathology ; Vimentin ; metabolism ; Vincristine ; therapeutic use

A systematic review was undertaken, including studies that evaluated the incidence of the blood system adverse events of Tripterygium wilfordii (TWP). Medline, Embase and the Cochrane library were searched for relevant studies, including RCT, cohort studies and case series, of patients treated with TWP published in English and Chinese from inception up until May 25th, 2013 with the keywords including "Tripterygium wilfordii", "toxicity", "reproductive", "side effect", "adverse", "safety" and "tolerability". Relevant information was extracted and the incidence of the blood system adverse events was pooled with MetaAnalyst software. Besides, subgroup and sensitivity analyses were performed based on age, mode of medicine, observation time and disease system. According to inclusion and exclusion criteria, a total of 49 articles were included in the meta-analysis, they were split into 54 researches incorporated in the analysis. There is a large degree of heterogeneity among the studies, so data was analyzed using random-effects model and the summary estimates of incidence of the blood system adverse events was 6.1%. The weighted combined incidence of three major blood system adverse events were white-blood cells decreasing 5.6% (95% CI, 4.3% - 7.3%), hemoglobin decreasing 1.7% (95% CI, 0.5% - 5.0%) and platelet decreasing 1.8% (95% CI, 1.0% - 3.1%), respectively . Sensitivity analyses based on 45 studies with high quality showed the combined value was close to the summary estimate of total 54 studies. The current evidence indicates that the incidence of the blood system adverse events induced by TWP was high; attentions should be paid on to the prevention and treatment of the blood system adverse events.
Blood Cells ; drug effects ; Hemoglobins ; analysis ; Humans ; Tripterygium ; adverse effects

Adult ; Female ; Humans ; Laryngeal Diseases ; microbiology ; Male ; Middle Aged ; Mycosis Fungoides ; Retrospective Studies

To evaluate the effect of dexmedetomidine on prognosis after cardiac surgery with cardiopulmonary bypass (CPB) in the patients.For this retrospective study,753 patients of both sexes,aged 18-84 yr,who underwent cardiac surgery with CPB from September 2013 to May 2015,were divided into 2 groups depending on whether or not dexmedetomidine was used during surgical procedures:control group (group C,n=548) and dexmedetomidine group (group D,n =205).Propensity score matching analysis with preset caliper width was used.A total of 197 matched pairs were selected from the patients.The development of postoperative arrhythmia,in-hospital mortality,pulmonary infection after operation,and acute renal injury,length of intensive care unit stay,length of hospital stay and 30-day readmission to the hospital were collected.Compared with group C,the incidence of postoperative tachyarrhythmia and inhospital mortality rate were significantly decreased (P＜0.05),and no significant changes were found in the incidence of postoperative bradyarrhythmia,pulmonary infection after operation and postoperative acute renal injury,length of intensive care unit stay,length of hospital stay and rate of 30-day readmission to the hospital in group D (P＞0.05).Dexmedetomidine can effectively improve prognosis after cardiac surgery with CPB in the patients.

OBJECTIVE:To explore the effects of inhaled budesonide on the efficacy and related indexes of patients with acute bronchitis. METHODS:102 patients with acute bronchitis were randomly divided into control group and observation group. Control group was given 100 mg/(kg·d) Cefotaxime sodium injection,adding into 150 ml 0.9% Sodium chloride injection intravenously by 2 times,as well as sedation,oxygen inhalation,rehydration,correcting acid-base balance and other conventional treatment;ob-servation group was additionally given 2 ml Inhaled budesonide suspension,twice a day. The treatment course for both groups was 7 d. Clinical efficacy,erythrocyte immune complex rosette(E-ICR),high-sensitivity C-reactive protein(hs-CRP),peak expiratory flow rate(PEF),forced vital capacity(FVC),1 second forced exhaled volume(FEV1),time of body temperature returned to nor-mal,cough disappearance time,rale disappearance time before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,time of body temperature returned to normal, cough disappearance time and rale disappearance time were significantly shorter than control group,the differences were statistically significant(P<0.05). Before treatment,there were no significant differences in the E-ICR and hs-CRP levels,PEF,FVC and FEV1 between 2 groups(P>0.05). After treatment,E-ICR and hs-CRP levels were significant-ly lower than before,and observation group was lower than control group,PEF,FVC and FEV1 were significantly higher than be-fore,and observation group was higher than control group,the differences were statistically significant(P<0.05). And there were no adverse reactions during treatment. CONCLUSIONS:Based on conventional treatment,inhaled budesonide has obvious efficacy in the treatment of acute bronchitis,and it can reduce E-ICR and hs-CRP,improve pulmonary functions,with good safety.

Objective To investigate the risk factors of acute kidney injury (AKI) in patients undergoing cardiac valve surgery with cardiopulmonary bypass (CPB).Methods A retrospective cohort database study was conducted, involving 1 349 patients undergoing heart valve surgery with CPB technique.Logistic regression was used to screen out the risk factors of AKI after the surgery.Results Of the 1 349 patients, the incidence of AKI in valve surgery was 28.4%.One year older (OR=1.05, 95%CI 1.03-1.06, P<0.001), diabetes (OR=2.11, 95%CI 1.22-3.68, P=0.008), anemia (OR=1.50, 95%CI 1.05-2.21, P=0.026), each additional basic serum creatinine of 1 mg/dl (OR=1.01, 95%CI 1.01-1.02, P=0.001), each additional operation time of 1 hour (OR=1.28, 95%CI 1.15-1.41, P<0.001), plasma transfusion during surgery (OR=1.50, 95%CI 1.14-1.97, P=0.004) were the independent risk factors for AKI in multivariate logistic regression model.Conclusion AKI is a common and serious complication following cardiac valve surgery.More attention should be paid to the patients with elder age, anemia, prolonged operation time, diabetes, increased basic serum creatinine and requirement of plasma transfusion during surgery.

Objective The incidence of cardiovascular and cerebrovascular diseases in postmenopausal women with type 2 diabetes is grim.The study was designed to explore the effect of ω-3 polyunsaturated fatty acids (PUFA) on endothelial function in postmenopausal women with type 2 diabetes. Methods 50 patients admitted to Dingli Medical College of Wenzhou Medical Univer-sity from March 2014 to October 2014 were divided into group A and Group B by random number table .Cross-design of two stages ( I, II) was applied in the investigation .At stage I(3 months ahead of the experiment ), Group A took oral ω-3 PUFA while Group B took placebo .At stage II ( 3 months after the experiment ) , Group B was given oral ω-3 PUFA, while Group A was given placebo .T1 and T3 time was the beginning of the stage I and stage II experiment , while T2 and T4 time was the end of stage I and stage II experiment .At the beginning and end of each stage , detection was made on LDL-C, TG, IL-6, plasminogen activator inhibitor-1 (PAI-1) and endothelium-dependent flow-mediated vasodilation (FMD). Results After the intervention on Group A at stage I , FDM at T2 time was significantly increased compared with that at T 1 time([7.23 ±3.28]% vs [3.62 ±2.13]%, P<0.05), while all the other indexes at T2 time decreased significantly in comparison with T1 time: LDL-C ([2.85 ±0.47]mmol/L vs [3.36 ±0.57] mmol/L), TG([2.41 ±1.06]mmol/L vs [2.96 ±1.12] mmol/L), IL-6([2.83 ± 0.30]ng/L vs [3.42 ±0.32]ng/L), PAI-1 ([7.23 ±3.28]ng/L vs [3.62 ±2.13]ng/L) (P<0.05).After receiving ω-3 PUFA intervention on Group B at stage II , FDM at T4 time was significantly increased compared with that at T 3 time([6.88 ±2.06]% vs [3.60 ±2.18]%, P<0.05), while all the other indexes at T4 time decreased significantly in comparison with T3 time: LDL-C ([3.26 ±0.77]mmol/L vs [3.63 ±0.73] mmol/L), TG([2.28 ±0.94]mmol/L vs [2.77 ±1.25] mmol/L), IL-6([2.91 ± 0.48]ng/L vs [3.30 ±0.52]ng/L), PAI-1 ([45.7 ±24.4]ng/L vs [56.3 ±24.4]ng/L) (P<0.05).Two-period crossover design analysis of variance showed that there was significant difference effect on LDL -C(F=2.754, P=0.019), TG(F=3.115, P=0.011), IL-6(F=1.825, P=0.032), PAI-1(F=2.324, P=0.023) and FMD(F=3.784, P=0.006)between ω-3 PUFA and placebo . Conclusion ω-3 PUFA can improve endothelial function in postmenopausal women with type 2 diabetes , which is of great significance for the primary prevention of cardiovascular disease .