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.

Objective To study the effect of anti-hypertensive therapy on the characteristics of platelet in essential hypertension(EH) patients. Methods Thirty-two healthy people(CT) and 37 patients with primary hypertension (gradeⅠ) were recruited . Blood pressure and 4 platelet parameters: platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet hematocrit (PCT) were determined by whole blood automatic analysis apparatus. Results The 4 platelet parameters were increased in hypertension patients compared with healthy people and decreased after anti-hypertensive therapy[PLT:(before 201.8?72.9 vs after 187.1?68.6 )10~ 9 L+{-1}; MPV:(before 10.3?1.9 vs after 10.0?1.9)fL, PDW:(before 15.5?1.1 vs after 15.2?1.0)fL; PCT:(before 0.198%?0.047% vs after 0.187%?0.036%)](P

OBJECTIVE To investigate the resistance of Staphylococcus to erythromycin and clindamycin and detect the percentage and gene for inducible resistance in Tai'an.METHODS The susceptibilities of Staphylococcus to erythromycin and clindamycin were examined by Kirby-Bauer disc agar diffusion test and the inducible erythromycin resistance to clindamycin was checked by D-test according to the standards of NCCLS,and the resistance genes msrA,Vgb,sat4,ermA,ermB and ermC were detected by using PCR technology.RESULTS Among the 326 strains,162(44.12%)were all resistant to erythromycin and clindamycin;68(20.86%)were resistant to erythromycin and sensitive to clindamycin but they were positive in D-test;42(12.88%)were resistant to erythromycin and sensitive to clindamycin but they were negative in D-test.The rates of inducible resistance of MRSA,MSSA,MRCNS and MSCNS to clindamycin were 40.00%,56.25%,63.38% and 66.67%,respectively among the Staphylococcus which were resistant to erythromycin and sensitive to clindamycin.The gene ermC was the main one for inducible erythromycin resistance to clindamycin.The percentage of gene ermC was 85.29% and that of ermC and sat4 either was 7.35%;all the others were negative.CONCLUSIONS The rate of inducible erythromycin resistance to clindamycin in our area is relatively high,and D-test in clinical microbiology laboratory should be done so that the physicians can select the reasonable MLSB antimicrobial agents.

BACKGROUND:Preterm premature rupture of the membrane is a frequent complication during gestational period. Three-dimensional culture can help damaged tissue restore anatomical integrality,being worth for clinical application. OBJECTIVE:To explore biological characteristics of human amniotic cells three-dimensionally cultured by fibrin scaffold,study the possibility of cell/scaffold composite material for repairing preterm premature rupture of the membrane,and to compare with normal monolayer culture. DESIGN,TIME AND SETTING:An in vitro cell/scaffold study was performed at the Basic Institute of Chongqing University of Medical Science between December 2007 and November 2008. MATERIALS:Amnion tissue derived from uterine-incision delivery women was provided by the Department of Obstetrics and Gynecology,the First Affiliated Hospital,Chongqing University of Medical Sciences;fibrinogen was provided by Sigma,USA. METHODS:Either epithelial cells or mesenchymal cells,being isolated from human amniotic membrane,were cultivated using enzyme digestion and repeated adherence methods. Fibrinogen was conglomerated,and epithelial cells of logarithmic growth were plated onto the surface of fibrin scaffold to simulate a three-dimensional culture in vitro. Before conglomerating fibrinogen,mesenchymal cells of logarithmic growth were mixed with fibrin solution to simulate a three-dimensional culture in vivo. In addition,either epithelial cells or mesenchymal cells were incubated onto 24-well plate for normal monolayer culture. MAIN OUTCOME MEASURES:Cell morphology using inverted microscopy,proliferation of mesenchymal cells,and interaction between mesenchymal cells and scaffold under different culture environments. RESULTS:Epithelial cells were round and smooth on the surface of fibrin scaffold,pseudopodia were stretched out,and microvillus were rich. Mesenchymal cells in fibrin glue were fusiform in shape and stretched out along scaffold. Cells formed net structure at different surfaces. By three-dimensional culture,proliferation of mesenchymal cells was stable but slow compared to monolayer culture. By in vivo three-dimensional culture,fibrin glue gradually shrank and gel thickness gradually decreased. On the 5th day,the gel thickness was only 40% for the initial thickness,and on the 15th day,gel thickness was 10%. CONCLUSION:Both epithelial cells and mesenchymal cells can sterically grow on fibrin scaffold,and the proliferation is stable. Fibrin glue gradually shrinks in cell/fibrin composite scaffold,suggesting that amniotic cells/fibrin composite scaffold can simulate body tissues to repair preterm premature rupture of the membrane.

BACKGROUND:3D printing, a rapid prototyping technology, is considered to be one of the symbols of the third industrial revolution. There are many kinds of 3D printed materials, which have a wide range of clinical applications.OBJECTIVE: To systematically introduce 3D printed biological materials, to summarize the application advances of 3D printing technology in the printing and production of bone, artificial limbs, dentures, skin, blood vessels, stent, implant prosthesis, and tumor models, as well as to investigate the performance conditions of 3D printed biomaterials based on the advantages and disadvantages of the currently used biomaterials, in order to provide reference for future research.METHODS:A computer-based search of CNKI, Wanfang, VIP, CBM, PubMed was performed to search relevant articles published from 2010 to 2016, using the keywords of three-dimensional printing/3D printing/3-D printing; biomaterials; clinical application in Chinese and English, respectively.RESULTS AND CONCLUSION: Great progress in 3D printed biomaterials has been made. However, there are some defects in the existing printed materials, such as high cost, low printing precision and poor biodegradability. Only if the problem of materials is solved, can we continue to develop 3D printing technology. New breakthroughs in 3D printing in the field of medicine have been made, and new technologies and new materials have been applied in clinical practice. Systemic summarization of these application achievements of 3D printing in the field of medicine can provide reference for future medical research.

Objective To observe the clinical effect of Jiawei Gegen Decoction on cervical spondylosis of sympathetic.Methods 54 patients with cervical spondylosis from June 2013 to June 2016 were divided into the control group and the study group by odd and even numbers,each 27 cases,the contrel group was treated with Flunarizine Hydrochloride, the study group was treated with Jiawei Gegen decoction,The treatment effect, symptom improvement and adverse reaction rate were evaluated between the two groups.Results Compared with the control group, the treatment effect of the patients in the study group and the improvement of symptoms after treatment were better than the control group,the incidence of adverse reactions was lower in the study group (P <0.05).Conclusion With Jiawei Gegen Decoction for the treatment of sympathetic cervical spondylosis patients, the treatment effect is prominent, at the same time, the symptoms of patients improved better, less adverse reactions, it is worthy of clinical trust.

Objective:To explore the effect of Shenfu Injection (SFI) on expression of Heme oxygenase-1 (HO-1) and iNOS (inducible nitric oxide synthase) in renal failure rats induced by intestinal ischemia-reperfusion (IR) and its possible mechanism. Methods:The model of intestinal ischemia-reperfusion was induced by clamping superior mesenteric artery for one hour and then releasing the arterial clamp for six hours. Wistar rats were randomized into three groups:IR+normal saline group,IR+SFI group and control group (C group). The serum creatinine and blood urea nitrogen were observed respectively. Expression of HO-1 and iNOS in rat kidney tissue was detected by immunohistochemitry and morphometry computer image analysis. The histological change of kidney was observed under light microscope. Results:①Compared with C group,expression of HO-1 and iNOS increased markedly in IR+ normal saline group (P

[Summary] Poorly controlled hyperglycemia is closely associated with adverse outcomes during pregnancy. As the prevalence of diabetes rapidly increases ,the management of diabetes during pregnancy has been a significant and urgent need in clinical practice. This article reviewed the hot spots in the research field of gestational diabetes mellitus (GDM ) and pregnancy with diabetes mellitus ,including progresses on the risk factors for GDM and the long term effects of diabetes during pregnancy on mothers and offspring. This was followed by a body of evidences on the clinical benefits of improved glycemic control during pregnancy ,current therapeutic strategy using insulin as the golden standard as well as the potential advantage of insulin determir due to its unique pharmacokinetic‐pharmacodynamic (PK‐PD ) profile in this therapeutic area. Finally ,the authors summarized data from clinical trials on the usage of insulin detemir in pregnancy and in particular went over the designs and results of two randomly controlled trials investigating the efficacy and safety of insulin detemir in pregnancy patients with T1DM. Currently available data proved that insulin detemir was effective in improving glycemic control with a good safety profile in diabetic pregnant patients ,which may serve as an ideal choice in the management of diabetes during pregnancy.

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.