Issues of Chinese medical health reform are analyzed and approached associated with the US federal medical health system. We made the suggestions that establish the public health service system covering both urban and country residents, push on the reform of medical insurance, drug circulation and medical system. We advocate that implement the scientific development view and hold the opportunity, impel the medical health reform in general.

Angiogenesis is one of the important pathological characteristics in the development of tumor growth. Hence ,an?ti-angiogenes is has become a hot topic in the field of cancer research. The current strategy for anti-angiogenesis therapy is to restore the angiogenic balance which is broken in the tumor via either block of proangiogenic factorsor application of angiogenic inhibitors. Endogenous angiogenic inhibitors show more promising prospects compared with proangiogenic factor antagonists. However ,the un?derlying mechanisms for the angiogenic inhibitors remain to be thoroughly elucidated. There are two kinds of endogenous angiogenic inhibitors,one is the hydrolyzed fragments of precursor protein,such as plasminogen Kringle 5(K5),angiostatin/kringle 1~4,end?ostatin,etc;the other is cell secreted proteins,such as pigment epithelium-derived factor(PEDF),kallikrein-binding protein (KBP/kallistatin),antithrombin,etc. Here we summarized the research progresses on the biological functions,underlying mecha?nisms of tumor angiogenesis and application prospects of K5,PEDF,and KBP,so as to provide insights into the antiangiogenic ther?apies of tumor in the future.

Triple negative breast cancer (TNBC) is characterized by lack of expression of the estrogen (ER)and progesterone receptors (PRs) and the human epidermal growth factor receptor (HER-2) that are commonly observed in other breast cancer subtypes.Treatment options are limited since the hormonal receptor and HER-2 antagonists are ineffective for TNBC.In contrast to non-TNBC,TNBC is more aggressive with higher recurrence,metastatic,and mortality rates.Besides further studies on cytotoxic drugs and chemotherapy regimens,More studies on potential targeted molecular treatment of TNBC should be strengthened.For the moment,potential targeted molecular treatment of TNBC including antiangiogenic agents,epidermal growth factor receptor (EGFR) inhibitors and poly (adenosine diphosphate ribose) polymerase (PARP).In contrast to their surprising anti-tumor effectivness in basic experiments,these targeted molecular agents show no promising results in clinical trials by now.This article aims to review advancements of targeted molecular treatment of TNBC in recent years.

Objective To discuss the indication and safety of vaginal birth after cesarean .Methods Prospective analysis was clone the 63 cases of successful vaginal delivery from scarred uterus during Jan 2009 to Dec 2012 in this hospital .Results Intensive observation revealed 21 successful cases of vaginal delivery without occurrence of uterus rupture or neonatal suffocation .Postpartum hemorrhage occurred only once .Conclusion Vaginal birth after cesarean is safe as long as its indication is strictly controlled .

Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Multiple System Atrophy ; therapy

Objective To retrospectively study histopathologic features of ulcerous colitis (UC) and Crohn's disease (CD) by endoscopic biopsy. Methods Data of age, gender and intestinal involvement of 106 cases of CD and 180 cases of UC confirmed by pathology were reviewed. Mucosal architecture, chronic inflammation, acute inflammation and epithelial features were evaluated based on histopathological criteria.These features were compared between the two groups. Results Compared with CD cases, UC showed significantly higher percentage of architectural disorders ( P ＜ 0. 05 ), lower percentage of discontinuous chronic inflammation ( P ＜ 0. 05 ) and higher incidence of cryptitis, crypt abscesses and polymorph cells in lamina propria (P ＜0. 05 ), and higher rate of epithelium damage, flattened and less mucous cell as well. Granuloma, pseudo pylorus glands metaplasia and narrow ulcer only occurred in CD cases. Lesions of 90% (162/180) cases of UC were limited to colon, while those of 28% (30/106) of CD cases to ileocecum, and those of 56% (59/106) CD cases involved different parts of gastrointestinal tract. Conclusion Diagnosis of CD and UC needs comprehensive analysis. Diagnostic evidence for CD includes focal involvement of ileocecum, the multifocal involvement in gastrointestinal tract, granuloma, discontinuous inflammation, pyloric gland metaplasia, while that for UC includes mucosal damage limited to colon, continuous chronic inflammation, architectural disorders, or epithelial damage.

Objective To evaluate the academic level and the popularity of Chinese Journal of Orthopaedics from the point view of citation. Methods According to the information of Chinese Medical Citation Index (CMCI), the amount and distribution of the original articles in Chinese Journal of Orthopaedics cited by the journals included by CMCI were statistically analyzed. The data analysis included the percentage of cited articles, the number of citation of a single article, authors of most cited articles, geological regions of cited articles, citing journals, the self citing rate and years of citation. Results The percentage of cited papers (663 articles, 3728 times) in all published 1 182 articles in Chinese Journal of Orthopaedics from 2005 to 2009 was an average of 56.09%. The average time of original articles cited by other researchers was 5.62. The highest one was citated by 104 times. 210 articles (31.68% of total papers) were cited 5 or more times, and the all cited times from them were 2835 (76.04% of total cited times). 663 cited articles were written by 485 authors from different countries. The most frequently cited author wrote 12 papers. The number of authors with one paper cited was 386 (79.58% of total authors). The cited authors are from the mainland, HongKong, and Taiwan in China, as well as USA, Canada, France. Beijing, Shanghai and Tianjin are leading cities in orthopaedic research. Beijing was the first place (32.16% of total authors). There were 445 citing journals. There was 217 items self cited; the self- citing rate is 0.058. Conclusion Chinese Journal of Orthopaedics has provided high quality articles and has a strong influence in the field of medical research. It has been become an important resource for orthopaedic researchers and a vital medical journal in China.

Objective To investigate vascular endothelial growth factor(VEGF) and TNF-α levels in the serum of patients with primary hepatocellur carcinoma(HCC),and to evaluate their relevance with the development and metastasis of HCC.Methods VEGF and TNF-α levels in serum were examined by enzyme linked immunosorbent assay(ELISA) technology in 87 patients with HCC and 10 healthy individuals.Results Serum VEGF and TNF-α,levels in HCC patients were significantly higher than that in the contorl group.In addition,HCC patients infected with hepatitis virus(including HBV and HCV) showed a remarkable elevation in serum VEGF and TNF-α levels.The VEGF and TNF-α levels in HCC with metastasis were also higher than those without metastasis.Conclusion The serum VEGF and TNF-α levels in HCC patients might serve as the pivotal biological indices that could reflect HCC progressien and metastasis.

Cognitive behavior therapy (CBT) has been proved to be an effective psychological treatment method for depression,especially for mild-to-moderate depression,however,due to the influence of various factors,its application in patients with depression is limited.Studies abroad have confirmed self-help intervention based on CBT has good effects on patients with depression.By reviewing efficacy of self-help interventions based on CBT on depression,it can be known that most of the literatures support that self-help interventions based on CBT has good effects on depression.Related researches abroad have been more mature,but few similar studies have been conducted in our country.So self-help CBT for depression has broad prospects in our country,which can play an important role in the prevention and therapy of depression,alleviating the shortage of medical resources,and reducing the patients' medical expenses,etc.Based on bibliotherapy (a major form of self-help interventions based on CBT),future studies need to learn from foreign practice to expand the audience to the clinic,community and non-clinical patients,in order to provide advice for interventions for depression in China.

Chronic kidney disease-mineral and bone disorder (CKD-MBD) refers to a series of clinical symptoms and biochemical and imaging abnormalities caused by minerals and calcium phosphorus metabolic disorder,which is associated with chronic kidney disease (CKD).Since 2006 ,the concept of CKD-MBD was put forward for the first time,doctors are increasingly paying more attention to it.This review introduces the epidemiological characteristics, clinical manifestation, examination methods, diagnostic criteria and the research progress of treatment and prevention of CKD-MBD.