Acquired Immunodeficiency Syndrome ; prevention & control ; Humans

Reform on medial service compensation mechanism,as a key point in the heahhcare system reform,runs through the entire reform process.It plays a key role for the establishment and improvement of urban medical care system,medical service system,medical management system and operating system,for its guidance and regulation effects.Such a refonn to build a scientific and perfect compensation model and mechanism will be highly significant for the smooth progress of the new round of healthcare reform and its success in the end.

Acquired Immunodeficiency Syndrome ; prevention & control ; therapy ; Communicable Disease Control ; Humans

Transient receptor potential (TRP) is a kind of novel Ca2+ permeant channel.It is later found that TRP channels are expressed broadly in many organisms,tissues and cell types.It is involved in the regulation of sensory conduction and cell signal transduction.Further studies are required to assess which TRPC6(a member of TRPC subfamily) is associated with the cytosolic Ca2+ levels,development and progression of cancer and tumor cell cycle.TRPC6 may be regarded as new targets for the treatment of cancer.

Objective To evaluate the clinical features,diagnostic methods and treatment of venous thromboembolic disease (VTE) during pregnancy.Methods From June 2006 to June 2011,a total of 20 pregnant women were diagnosed VTE at the Department of Obsterics and Gynaecology,Qilu Hospital of Shandong University.Clinical data of these patients were analyzed retrospectively.Results (1) Characteristics of patients:the symptoms of all the 20 patients commenced in pregnancy.Of these,6 (30％) happened in the first trimester,7 (35％) in the second trimester,and 7 (35％) in the third trimester.Twelve (60％) patients went to hospital in one week after they had symptoms,while 8(40％ ) went to hospital after one week.(2)Clinical manifestation:18 patients were diagnosed deep venous thrombosis (DVT),one was diagnosed pulmonary embolism (PE).One patient was diagnosed DVT and PE simultaneously.Among the 19 DVT patients,16 (16/19)were on the left side,3 (3/19)were on the other.They all came with sudden swelling and pain of the affected lower extremity.In 17(17/19) patients,the circumference differences between two legs were beyond (4.0 ±0.5) cm.In all the 20 patients,12 (60％) had elevated plasma level of D-dimmer.The diagnosis of DVT was made mainly by a Doppler ultrasound.Among the 19 DVT events,7 (7/19) were proximal DVT,2 (2/19) were distal,and 10( 10/ 19) were mixed type.(3)Anticoagulant therapy:patients with VTE during pregnancy were treated with low molecular weight heparin (LMWH) (enoxaparin,once 1 mg/kg subcutaneous,twice a day).After delivery,patients were treated with subcutaneous LMWH and warfarin simultaneously for at least 5 days,until the prothrombin time-international normalized ratio ( PT-INR ) was ＞ 2.0 for 24 hours.( 4 ) Thrombolytic therapy:for most patients with VTE,we are against the routine use of thrombolytic therapy,especially before delivery.For patients with acute massive PE,urokinase of 600 000 units intravenously daily was recommended for 3 days.For those patients with DVT whose standard anticoagulation therapy was ＜ 30 days,an inferior vena cava filter(IVCF) placement was recommended before delivery or abortion.If it was ≥30 days,IVCF was not recommended as a routine,and anticoagulant therapy was used 24 hours after delivery.If there was no recurrent DVT or PE,IVCF was retrieved routinely in 12 days.(5)Outcome:among patients treated with LMWH (95％,19/20).Three received IVCF placement,which was retrieved successfully in 12 days,with no interventional complication.All patients recovered well after 2 weeks,and the circumference differences between two legs were within (2.0 ± 0.3 ) cm.Of the 18 patients maintained to the third trimester,17 received anticoagulant therapy,and no abnormal findings were found during antenatal examination.Ten patients received cesarean section (50％,10/20),while 8 had vaginal delivery (40％,8/ 20).Neither neonatal asphyxia nor malformation was observed.The patients were followed-up for 1 - 24 months,no venous thrombus extension was found in 17 cases by Doppler ultrasound,thrombus disappeared in 2 cases of distal DVT after 4 weeks and 8 weeks respectively.By echocardiography,the pulmonary arterial pressure of the 2 patients with PE was found normal 3 months after hospital discharge.There was no maternal death during the study,no recurrent PE or bleeding occured.Conclusions LMWH is safe and effective for VTE during pregnancy.Routine use of thrombolytic therapy is not recommended.VTE in pregnancy is not the absolute indication of termination of pregnancy.The indication of an IVCF placement should be stricter,and a retrievable suprarenal IVCF is recommended under certain circumstances.

Taking the modern occupation education concept as the guide,oriented by adapting to the demand of occupation post,we established a new open education mechanism of medical occupation education to promote the reform of personnel training mode,curriculum and teaching content to explore the effective way of the sustainable development of local medical occupation education.

Objective To study the effect of CsA in a therapeutic dose on the hepatic ultrastructure in rats.Methods Twenty-four SD rats were divided into 3 groups.The control group was orally administered olive oil,and the other 2 groups were orally given CsA 25 mg/kg and 50 mg/kg daily respectively.After 2 weeks.the liver samples were taken for ultrathin sections.The stereological method was used to quantify some hepatic ultrastructural parameters including volume density (Vv),surface density(Sv),numerical density(Nv) and specific surface(δ).Results CsA caused an increases of Vv and Sv and a decrease of δ in endoplasmic reticulum;a decreases of Vv and Nv in microbody;decreases of Vv in Golgi complex and glycogen inclusions;an increases of Vv and Nv in lipid inclusions.Conclusion CsA in a therapeutic dose could cause the change of hepatic ultrastructure of rat.

Carbon monoxide(CO)has a significant anti-inflammatory action.Carbon monoxide releasing molecule(CORM),as a new donor of CO,is used widely in biological study.The article reviewed the antiinflammatory action of CO and the progress of CORM.

Objective　To study radiotherapy in the treatment of uterine sarcomas and response to radiation in primary or recurrent uterine sarcomas. Methods　A total of 102 uterine sarcomas treated in the Cancer Hospital from May 1960 to June 1999. A retrospective review of 45 patients receiving surgery alone, 29 patients for postoperative radiotherapy, 4 radiotherapy alone, 24 recurrent sarcomas receiving radiotherapy. Results　The 5-year overall survival for 45 patients treated with surgery alone and 29 patients managed by postoperative radiotherapy were 56.7% and 58.6% respectively (P>0.05). The addition of radiotherapy significantly reduced the local recurrence rate from 42.2% to 20.7% （P<0.05）. The tumor was disappeared completely by treatment of radiotherapy alone in 3 patients of primary uterine cervix sarcomas. 1 patient was free of disease at 36 months. Other 2 patients died 9 and 11 months later because of distant metastases. The complete and partial response rate of radiotherapy was 50.0% for recurrent tumors. The radiotherapetic sensibility of endometrial stromal sarcomas, mixed mesodermal sarcomas and leiomyosarcomas was downward tendency in turn.Couclusions　The postoperation adjuvant radiotherapy reduced the pelvic recurrent significantly. Radiotherapy should be used in the treatment of uterine sarcomas as an important part of combination therapy.

Acquired Immunodeficiency Syndrome ; prevention & control ; China ; Humans