Objective:To investigate the impact of social determinants of health on the inequality of child health and health care utilization.Methods:Information of 1 118 children aged 0 to 16 is extracted from the Chinese Family Panel Studies(CFPS)year 2008 cross sectional survey data for the analysis.Age standardized concentration curves and concentration indices are employed to assess the inequalities for incidence of low birth weight,self reported good health,adequate timing of breast feeding,health insurance coverage and incidence of catastrophic health expenditures for these children.Concentration indices are decomposed to four levels of social determinants of health(community,family,mother and individual level)to understand their contributions to health inequality respectively.Results:There are health inequalities existing in the investigated children,among which social factors at mother and family level have the largest contribution.Conclusion:To respond to the call by the WHO to achieve health equity through action on the social determinants of health in a generation,the inequalities of health and health care utilization amongst Chinese children should be put on the policy agenda,and social policies should intervene from multiple social dimensions,especially from family and mother levels.

Objective To investigate the elinicopathologic features of atypical endometriosis(AEM) and to discuss the relationship between AEM and tumors. Methods A retrospective analysis was performed of 163 cases of AEM, which were retrieved from the Department of Pathology files at the Tianjin Central Obstetrics and Gynecology Hospital between Jan 2004 and Dec 2006. The pathologic changes of AEM including its glandular epithelium, stroma, background and the conditions coexisting with tumor were observed. Results The AEM accounted for 4.38% (163/3724) of the endometriosis (EM) eases. Of 172 AEM foei of 163 patients, 168 were in the ovary, and the other 4 were in the fallopian tube, cervix and uterine serosa respectively. The rate of ovarian AEM was 6.81% of endometriosis. AEM associated with tumour was found in 26 cases (15.95% )and among 27 of ovarian AEM, 15 were malignant, 9 borderline and 3 benign. The AEM epithelia were mainly arranged in the form of surface epithelium. They present with characteristic features of moderate to marked pleomorphism, epithelial tufting and bud structures by microscopy. The walls of AEM cyst were presented with three layers of epithelium, endometrioid stroma and fibrosis-collngen. The endometrioid stroma were usually thin in contrast to the fibre-collagen tissue, which was often thick with scarred background. The transformation from AEM to tumor was found in most of the malignant tumors( 14/15,93% ). Conclusions AEM lesions hold some features of both EM and tumor, which may have a relatively higher potential for tumorigenesis and cancerafion. The process of damage and repair in EM foci during a long course may play a role in the development of EM into AEM and finally into tumor.

Objective To investigate the effect of three kinds of low molecular weight heparin combined with methylprednisolone on the high coagulation state and renal function in patients with refractory nephrotic syndrome.Methods 140 cases of refractory nephrotic syndrome were divided into four groups, 35 cases in each group.The control group were treated with methylprednisolone.Small, medium, and large dose group in the control group on the basis of the treatment, were given low molecular weight heparin on once every other day, once daily, twice daily treatment, 3075 AxaIU per times.The improvement of renal function and high coagulation state were compared between the four groups before and after treatment.In the course of treatment, the occurrence of adverse reactions was recorded.Results Remission rate in large, medium and small dose group remission rate was higher than the control group(χ2 =4.375,P<0.05); there was no significant difference in remission rate of three different dose groups.The 24h urine protein and ALB of the four groups after treatment were significantly increased, BUN and SCr were significantly lower(P<0.05).The 24h urine protein, ALB, BUN, SCr of improvement of large, medium and small dose group were significantly better than the control group( P<0.05).The 24 h urine protein, ALB, BUN, SCr in large dose group improved significantly better than those in small dose group(P<0.05).The APTT, PT in large, medium and small dose groups after treatment increased significantly, FIB decreased significantly(P<0.05).The improvement of FIB, APTT, PT in large, medium and small dose group were significantly better than the control group after treatment ( P <0.05 ).The FIB, APTT, PT in large dose group improved significantly better than those in medium and small dose group ( P <0.05 ) .Conclusion The low molecular weight heparin combined with methylprednisolone can significantly improve hypercoagulable state and renal function in the patients with refractory nephrotic syndrome, and the large dose of low molecular weight heparin effect is the best, and no significant adverse reactions occurred.

Objective To investigate the clinical manifestation and diagnosis of osteitis deformans. Methods Three male patients with characteristic manifestations of osteitis deformans were reviewed in this study. The ages of the patients were 51, 49 and 43 respectively. Two patients with pelvic lesions on X ray films presented symptomatic pain and malaise localized in hip, one complained of tibial bowing deformity. The typical radiographic characteristics were bone enlarged size, increased bone mineral density with uneven distribution; the bone trabeculae were usually coarse and arrayed irregularly like a grid. All patients underwent the diagnostic biopsy. Under microscopic observation, the bone structures were arranged disorderly, the trabeculae were thickened and enriched with osteoclasts and osteoblasts, irregular blue cement line were also seen in thickened trabeculae, the bone marrow were replaced by the fibrovascular connective tissue. All patients were given calcitonin and diphosphonates as medical treament. Results In the follow up period of an average of 16 months(range 3-26 months), one patients had pain relief at lesioned hip but functional limitation remained, the others did not have any sign of malignant progression. The serum alkaline decreased dramatically and the involved bone did not present with deteriorated change. They were working as usual. Conclusion Osteitis deformans is a disorder of bone architecture resulting from disturbance in the rate of bone turnover; typical radiographic and pathologic feature is the important points for definite diagnosis of osteitis deformans.

To introduce the approaches and procedures of neurologic erectile dysfunction (ED) assessment in our institute, and evaluate the neurologic investigation by making an analysis of 58 cases. Diagnostic criteria of neurologic ED: nervous system injuries or diseases, abnormal clinical symptoms and signs, electrophysiological abnormalities of nervous system, abnormal results of nocturnal penile tumescence and rigidity (NPTR) (penis rigidity <60% and lasting time <10 minutes). In the group of 20 patients with the injuries of the brain, spinal cord or spinal root nerves, pudendal cortical somatic evoked potential (PCSEP), sacral reflex latency (SRL), pudendal-to-cortical motor evoked potential (PCMEP), penile sym- pathetic skin responses (PSSR) and NPTR showed abnormality by 45%, 20%, 20%, 85% and 85%, re- spectively. In 38 patients with the injuries of pelvic fracture with urethra break, PCSEP, SRL, PCMEP, PSSR and NPTR showed abnormality by 24%, 5%, 20%, 92% and 66%, respectively. In the former, 35% were identified to have severe ED, and 50%, moderate ED; in the latter, 21%, to have severe ED, 13%, medium ED, and 37%, light ED. The approaches and procedures were proved to possess excellent specificity and reliability in the assessment of neurological ED.
Erectile Dysfunction/physiopathology* ; Evoked Potentials, Motor ; Fractures, Bone/complications* ; Humans ; Male ; Pelvic Bones/injuries* ; Penile Erection ; Penis/physiopathology* ; Reproducibility of Results ; Sensitivity and Specificity ; Spinal Cord Injuries/complications*

Angioplasty, Balloon, Coronary ; psychology ; rehabilitation ; Coronary Disease ; psychology ; rehabilitation ; surgery ; Humans ; Postoperative Period

Objective To observe the effects of tuina on muscle atrophy after denervation and on muscle satellite cell proliferation.Methods Ninety male rabbits with denervated skeletal muscles were randomly divided into a normal group,a control group,and a treatment group.Tuina was applied daily to the right gastrocnemius muscles beginning one day after the modeling.Changes in muscle wet weight ratio and the amount of skeletal muscle satellite cells (SCs) were observed 1,2 and 3 weeks and 1,2,4 and 6 months post-modeling.Results The muscle wet weight ratios of both the treatment group and the control group were lower than those of the normal group.The weight ratio in the treatment group was significantly different from that in the control group after 2 months (0.578 ±0.163 vs 0.470 ±0.062),4 months (0.575 ±0.110 vs 0.453 ±0.101) and 6 months (0.559 ±0.083 vs 0.446 ±0.048).The amount of SCs was also significantly different in the treatment and control groups after 1 week (16.83 ±5.31 vs8.67±2.58),2 weeks (51.83±7.94 vs32.00±6.93) and4 months (11.17±3.49 vs 17.67±4.18).Conclusion Tuina therapy can promote proliferation of satellite cells and delay the atrophy of denervated skeletal muscles.

Objective To systematically evaluate the effectiveness of Chinese medicine(CM) combined with chemotherapy in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis. Methods Databases of PubMed, EMBase, Cochrane Library, China National Knowledge Information(CNKI), VIP Database, Wanfang Database, and SinoMed were retrieved to collect randomized controlled trials(RCTs) of CM combined with chemotherapy in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis. And then the quality of the included RCTs was evaluated systematically. Results Seven RCTs involving 700 cases of stageⅡ-Ⅲ colorectal cancer patients were included, 355 patients in treatment group were treated with CM combined with chemotherapy, and 345 patients in control group were treated with chemotherapy alone. The results of Meta-analysis showed that treatment group was superior to the control group in preventing the recurrence and metastasis of colorectal cancer one , 2 and 3 year(s) after the radical surgery, showing statistically significant differences(P < 0.05), while the difference of five-year recurrence and metastasis rate was not statistically significant between the two groups(P > 0.05). At the same time, CM combined with chemotherapy had better effect than chemotherapy alone on prolonging the time for recurrence and metastasis, improving performance status and relieving the symptoms, the difference being significant(P<0.05). Conclusion CM combined with chemotherapy exerts better effect than chemotherapy alone in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis and onimproving the quality of life of the patients. However, for the low methodological quality of the included trials, the conclusion still needs more large-size sample, multiple-center, and high-quality clinical trials to be confirmed.

SUMMARY To describe the first case of leiomyosarcoma of the tibia with multiple skeletal metastases in China. A 31-year-old woman was referred to Peking University People’s Hospital for evaluation of a lesion on the proximal left tibia. The radiographic examination showed the lesion had a moth-eaten destructive appearance with ill-defined border and soft tissue extension. The tumor is isointense to muscle on T1-weighed images and heterogeneous and of high signal on T2-weighed images. Technetium-99m bone scintigraphy demonstrated multiple markedly increased skeletal radioisotope uptake. The tibia lesion was surgically removed. Microscopically, tumor cells consisted of spindle shaped cells, arranged in bundles, with cigar-shaped and blunt-ended nuclei. Immunohistochemistry revealed that the tumor cells were positive for smooth muscle antigen (SMA) and caldesmon. It should be cautious to make the diagnosis of leiomyosarcoma arising in bone. After excluding metastasizing leiomyosarcoma of gastrointestinal tract, urinary system and uterus, the final diagnosis relies on immunohistochemical analysis, however, other spindle cell sarcomas have to be differentially diagnosed.

AIM: To investigate the function and the mechanism of transplanting bone marrow derived peripheral blood mesenchymal stem cells(PBMSCs) on restenosis after carotid balloon angioplasty in the model of carotid atherosclerosis rabbits,and to determine if the functions of PBMSCs are enhanced after hypoxia preconditioning.METHODS: Bone marrow cells were mobilized by granulocyte colony-stimulating factor(G-CSF),and PBMSCs were collected through density gradient centrifugation and adherent culture,labeled with enhancement type green fluorescent protein(EGFP) genes.All animals with carotid atherosclerosis stenosis were randomly divided into three groups: hypoxia preconditioning group(n=24,received intravenous transplantation of PBMSCs with hypoxia preconditioning),non-hypoxia preconditioning group(n=24,received normal culture of PBMSCs) and control group(n=24,only received equal-volume of culture medium).Vascular endothelial growth factor(VEGF) was determined by enzyme linked immunosorbent assay(ELISA) at 7 d,14 d and 28 d post-angioplasty,respectively.The vessel morphology,the homing of MSCs and the reendothelialization were analyzed with Weigert staining and immunohistochemistry.RESULTS: Compared to control group,the level of VEGF significantly increased in both hypoxia preconditioning group and non-hypoxia preconditioning group at all time points(P