Differentiated cells can be induced into pluripotent stem cell by reprogramming with defined fators. The new method of stem cell technology marks a major breathrough. This paper reviews the establishment, identification and research progress about induction of pluripotent stem cell.

Objective To observe the efficacy and safety of fondaparinux sodium prolonged treatment in patients with acute myocardial infarction underwent primary percutaneous coronary intervention (PCI).Methods A total of 121 patients with acute ST segment elevation myocardial infarction (STEMI) underwent primary PCI from February 2011 to April 2012 were divided into three groups by random digits table method:40 patients in fondaparinux sodium general treatment group (A group),41 patients in fondaparinux sodium prolonged treatment group (B group) and 40 patients in enoxaparin group (C group).The basic treatment was similar among three groups.The patients in A group were given fondaparinux sodium 2.5 mg/d for 5-7 d,and the averaged time was 6.02 d.The patients in B group were given fondaparinux sodium 2.5 mg/d for 10-15 d,and the averaged time was 12.61 d.The patients in C group were given enoxaparin 5000 U/12 h for 5-7 d,and the averaged time was 6.21 d.Main outcome indexes including re-myocardial ischemia,new-myocardial infarction,death and bleeding were observed within 15 d after treatment.Results The incidence of death,re-myocardial ischemia,new-myocardial infarction and overall cardiovascular events in B group [4.9％(2/41),0,0,4.9％(2/41)] were significantly lower than those in A group [25.0％(10/40),12.5％(5/40),10.0％(4/40),47.5％(19/40)] and C group [27.5％(11/40),15.0％(6/40),12.5％ (5/40),55.0％ (22/40)],and there were significant differences among three groups (P ＜ 0.05or ＜0.01).The incidence of mild bleeding,severe bleeding and overall bleeding in C group [32.5％(13/40),15.0％ (6/40),47.5％ (19/40)] were significantly higher than those in A group [10.0％ (4/40),2.5％(1/40),12.5％(5/40)] and B group [14.6％(6/41),2.4％(1/41),17.1％(7/41)],and there were significant differences among three groups (P ＜ 0.05 or ＜ 0.01).Conclusions Fondaparinux sodium prolonged anticoagulation treatment can significantly reduce overall cardiovascular events in patients with STEMI underwent primary PCI,and does not increase bleeding.It is safe and effective.

The health care alliance in county was the vertical integration of medical service system,which was conductive to improve the overall efficiency of the county medical service,achieve tiered health care system,optimize regional health resources and enhance the capacity of primary health care services.It took Tianchang County,Anhui as a case study.It investigated and analyzed how the local took measures to carry out the health care alliance reform in organization structure,interest distribution,health human resources construction,information construction,division and coordination mechanism,medical service pattern,etc.,so as to provide references for implementing county medical alliance reform in other regions.

Objective To evaluate the pain control, general condition and well-being of the patients with advanced cancer treated with transdermal fentanyl as well as the effects of transdermal fentanyl on heart rate variability (HRV) and endocrine function. Methods This open prospective study included 40 patients with advanced cancer. The direct conversion ratio from oral morphine to transdermal fentanyl system (TFS) was 100:1 daily. In patients who had never received any opioid before the initial dose of TFS was 25?g/h. The transdermal system was changed every 72h and the dosage was adjusted to the need of the patients according to the VAS scores and the requirement of morphine. 8 hospitalized patients were monitored by 24h Holter for changes in HRV. Blood samples were taken before transdermal fentanyl patch when pain was severe and 24h after TFS for determination of ACTH,?-endorphin, growth hormone(GH) and insulin levels.Results Pain relief during treatment with transdermal fentanyl was significant accoring to VAS scores. Well-being scores showed that patients' quality of life including appetite, sleep, mental state and daily activities was significantly improved after two weeks treatment. The ratio of LF vs HF, which is one of HRV frequency indices, was obviously reduced at 24h after transdermal fentanyl patch as compared with that before TFS (P

12-O-tetradecanoylphorbol-13-acetate (TPA) is an activator of protein kinase C (PKC)extracted from the croton oil, it is one of the most powerful inducers of differentiation as well as a powerful tumor promoter. It is used by the study of induction and differentiation generally, because of it can induce the differentiation of tumor cell and promote the lymphocyte transformation and secrete of lymphokine, meanwhile,it is able to induce many kinds of cell of leukemic cell strain like HL-60, HEL and so on, Some literature reported that TPA had the function of differentiation of primary leukemic cell. The article mainly explains the induction and differentiation of leukemic cell by phorbol ester as well as its mechanisms, which to provide the theory evidence for prevention and cure of leukemia.

Objective To observe the effect of Zhixuebao particles combined with Marvelon in the treatment of dysfunctional uterine bleeding in adolescent.Methods69 cases from October 2013 to March 2015 were randomly divided into observation group with 34 cases and control group with 35 patients.The control group was treated with Marvelon and observation group was another treated with Zhixuebao particles.Related indicators of two groups were compared.ResultsEndometrial thickness, menstrual volume and menstrual period of observation group were lower than that of control group(P<0.05).The bleeding time, stop bleeding time of observation group were shorter than that of control group (P<0.05).After treatment,hormone LH, FSH, P levels of observation group were lower than that of control group(P<0.05);Total effective rate of bservation group was 94.12%, higher than control group 74.29%(P<0.05).ConclusionZhixuebao particles combined with Marvelon is effective in treating dysfunctional uterine bleeding in adolescent, can improve hormone levels and it is worthy of further research and application.

Objective By collecting rheumatoid arthritis (RA) periodontal parameters,analyzing the general information and clinical indicators to understand the relationship between RA and periodontitis.Methods From December 2014 to May 2016,132 cases of RA,50 cases of the periodontitis group were enrolled.Their periodontal parameters,general data and clinical indicators were analyzed and the measurement data were compared with t test.Counting data was compared by Chi square or Fisher's exact test for statistical analysis.Results The prevalence rate of periodontal disease in patients with rheumatoid arthritis was high (73％).When the RA complicated with periodontitis group and RA without periodontitis group were compared,the C-reactive protein (CRP) [(43±33) mg/L,(30±27) mg/L,t=2.213,P＜0.05],erythrocyte sedimentation rate (ESR) [(50±30) mm/1 h,(38±25) mm/1 h,t=2.263,P＜0.05],rheumatoid factor (RF) [(319±368) U/ml,(174±228) U/ml,t=2.783,P＜0.05],anti-cyclic citrullinated peptide (CCP) [(511 ±700) AU/ml,(262±429)AU/ml,t=2.535,P＜0.05],the positive rate of anti-CCP [80 (83％),17 (47％),x2=17.522,P＜0.001],health assessment questionnaire (HAQ) (2.5±0.8),(2.2±0.8),t=2.011,P＜0.05) of the RA complicated periodontitis group was statistically significantly different,but disease activity score (DAS)28 (5.5±0.7,5.3±0.7,t=1.970,P＞0.05) was not statistically significantly different.The anti-CCP positive group and anti-CCP negative group were compared in the number of patients with missing teeth [22 (23％),15 (43％),x2=5.19,P＜0.05],missing teeth number (3.5±1.5,2.5±1.4,t=2.004,P＞0.05),probingdepth (PD) (5.3±1.4) mm,(5.0±1.4) mm,t=1.094,P＞0.05),clinicalattachmentLevel (CAL) (5.2±1.4) mm,(4.9±1.5) mm,t=0.946,P＞0.05),bleedingon-probing (BOP) [17 (18％),7 (20％),x2=0.106,P＞0.05) was not statistically significant.Periodontitis with RA group and periodontitis group were compared with the number of patients with missing teeth [21(42％),5(10％),x2=4.11,P＜0.05],number of missing teeth (1.10±0.29,1.20±0.40,t=0.638,P＞0.05),PD [(4.3±1.7) mm,(3.2±1.4) mm,t=4.902,P＜0.05],CAL [(3.9±2.0) mm,(3.4±1.7) mm,t=2.18,P＜0.05],BOP [18(36％),9(18％),x2=13.306,P＜0.05] and CRP [(30±26) mg/L,(20±16) mg/L,t=3.820,P＜0.05],ESR [(45±21) mm/1 h,(32±18) mm/1 h,t=3.047,P＜0.05],was statistically significantly different.Conclusion The incidence of periodontitis in patients with RA is high;periodontitis may have a certain promoting effect on RA,and RA may also have some promoting effects on periodontitis.

Objective To investigate the relationship between vaginal and intestinal Candida in patients with vulvovaginal candidiasis by using microbiological and molecular methods. Methods The samples of vaginal discharge and anal swabs were collected from 148 cases with vulvovaginal candidiasis,followed by fungal culture, identification, purification and genome DNA extraction. The genome sequences from respective locations were aligned and typed according to their homology analyzed by internal transcribed spacer (ITS) PCR and random amplified polymorphic DNA (RAPD) PCR. Patients with vulvovaginal infection or those with infections in intestine and vulvovagina were pooled respectively, while the recurrent incidences after local anti-fungal treatments were analyzed. Results Candida albicans is the dominant pathogen in 148 cases with vulvovaginal candidiasis (91.9% , 136/148) ; 33. 1% (49/148) of patients with vulvovaginal candidiasis were infected in both intestine and vulvovagina. While 92% (22/24) of patients with intestinal and vaginal Candida infection showed high homology. The recurrent rate of patients with vulvovaginal candidiasis complicated with concurrent intestinal Candida infection (7/14) was significantly higher than that of solo vaginal infected patients [21% (6/29)] after vaginal treatment (P < 0. 05) . Conclusions The infection of vulvovaginal candidiasis is highly associated with the concurrent infection of intestinal Candida. The recurrent rate is high in patients with vulvovaginal candidiasis with concurrent infection of intestinal Candida after vaginal treatment. The general management to those patients infected by both vulvovaginal and intestinal Candida is necessary in reducing the recurrence of the disease.

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.

Objective To observe conditioned enhancement of antibody production against influenza vaccine. Methods 36 female BALB/c mice were injected with 3 μg/mouse influenza virus hemagglutinin (HA) as the unconditioned stimulus (UCS),and camphor odor was served as the conditioned stimulus (CS). After a CS/UCS pairing was made,animals were re-exposed to the CS at Weeks 6. Results Through one conditioned stimulus,the optical density of anti-HA antibody of the conditioned group (Weeks 9:0.68±0.06; Weeks 10:0.60±0.06)was significantly increased compared with the unconditioned group (Weeks 9:0.53±0.06; Weeks 10:0.48±0.04) ( P <0.01). The level of anti-HA antibody of the conditioned group was also significantly greater than other controlled groups( P <0.05). Conclusion Through a single exposure to camphor odor which was paired with immunization of influenza virus HA in a single trial learning protocol,a significant conditioned anti-HA IgG production occurred.