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.

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.

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.

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.

The effect of artrial natriuretic polypeptides on the intracellular free. calcium concentration of immune cells of spontaneously hypertensive rats has been investigated. It was found that artrial natriuretic polypeptides could raise directly the intracellular free calcium concentration of thymocytes, splenocytes and lymphonode cell, or cooperate with Con A in increasing the intracellular free calcium concentration of rat lymphocytes and T lymphocytes except for B cells. It was also found that artrial natriuretic polypeptides could cooperate with IL-2 in increasing the intracellular free calcium concentration of rat lymphoblast induced by Con A. The extent of increased intracellular free calcium concentration induced by artrial natriuretic polypeptides in immune cells of spontaneously hypertensive rats was lower than that of WKA rats.

Objective To study the effect of probiotics on the change of intestinal permeability and inflammatory reaction after surgery of colorectal cancer.Methods Sixty patients who underwent colonic surgery were randomly divided into two groups:probiotic group and control group,with 30 cases in each group.Each group received nutritional support of the same nitrogen and calorie from day 3 to day 7 after operation.The patients in probiotic group were orally administrated probiotic(2 g/d)from the first day after surgery for 7 days.Every patient's body temperature and heart rate were observed after operation,and white blood cell counts were observed before operation and on day 1,5,8 after operation.The levels of microbial DNA in whole blood and plasma D-lactate,and urine lactulose/mannito(L/M)ratio were measured before operation and on day 1 and day 8 after operation,respectively.In addition,the occurrence of postoperative systemic inflammatory response syndrome(SIRS)and complications of inflammation were closely observed.Results The average heart rate in postoperative 5 days was significantly lower in probiotics group than that in control group(P0.05).Conclusion Probiotics can decrease intestinal permeability and maintain the intestinal barrier function after operation.It may be helpful for the recovery of patients with early inflammatory response after surgery of colorectal cancer.

Objective To investigate the effect of continued nursing education manual on surgical nursing education.Methods A continued nursing education manual was designed and applied to surgical nursing education.The effects were assessed by comparing the nursing training results before and after intervention by the manual in terms of nursing theory test,nursing techniques test.Results After the application of manual,the training coverage rate increased from 94.59%to 100.00%(P<0.05),the pass rate of theory test increased from 87.57%to 94.21%(P<0.05),and the pass rate of nursing skills test increased from 90.27%to 96.14%(P<0.05). Conclusion The continued nursing education manual is effective in improving the educational effect of surgical nursing.

Along with the mediated society,there are the problems in students'current media literacy,such as the alienation of media using,inability to distinguish'media reality'and'objective reality',lacking of media ethics and consciousness of self-discipline.Based on the analysis of these problems,in combination with the actual college education,we put forward the realization ways and the corresponding strategies to improve the students'media literacy.

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 .