ObjectiveTo identify the main problems and provide information for making plans on medical resources allocation by analyzing the dynamic trends of medical resources allocation and service efficiency in Guangzhou after reform and opening-up. MethodsDescriptive analysis, Ascend and Descend Trends Test and ratio analysis were used to compare medical resource allocation and utilization efficiency at different development phases. ResultsCurrently health resources per capita in Guangzhou are close to those in developed countries or areas, but relative shortage derived from demand-driven increase still exists. There is a central tendency toward big comprehensive hospitals, the quality of medical resources is rather low, and efficiency of medical services tends to descend. ConclusionIt showed that when the government making plans on medical resources allocation, strict entry regulation should be reinforced, the standard of medical resource quality should be improved, appropriate space should be left for further development. Medical resources should be directed to reallocate to communities and rural areas in a right way, medical service efficiency and accessibility should be improved.

BACKGROUND:It is controversial to treat sacroiliac joint fracture.Some scholars advocated expectant treatment,and some others advocated surgery therapy.Pelvic stability was responsible for the scheme selection.Sacroiliac joint fracture-dislocation destroys pelvic stability,which easily induces instability and bone nonunion,resulting in sacroiliac joint pain,unequal size of lower limbs,sitting pain and dysfunction.Thus,prognosis of mental implant is significantly better than expectant treatment in treatment of unstable pelvic fracture.OBJECTIVE:To summarize the treatment of unstable pelvic fractures and their clinical application using various internal and external fixation of metal implants.METHODS:The computer-based research was done in Pubmed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang database (http://www.wanfangdata.com.cn) for articles published from January 1991 to December 2009 with the key words of "Pelvic fractures,instability,surgical treatment" by the first author.A total of 115 articles were retrieved,and those concerning characteristics and clinical application of implants in the treatment of unstable pelvic fracture.Articles addressing old and repetitive contents were excluded.Literatures of the same fields published in recent years or in authorized journals were selected.Finally,30 articles were included.RESULTS AND CONCLUSION:Sacroiliac joint fracture-dislocation is a severe,high-energy trauma,has been paid great attention in the therapy,particularly in unstable sacroiliac joint fracture-dislocation.A stable type of fracture and dislocation of the sacroiliac joint received a conservative treatment of unstable sacroiliac joint fracture-dislocation appropriate line of external fixation,internal fixation for reconstruction of pelvic stability and internal fixation treatment varied,but the therapeutic effect of internal fixation needs to be improved.What are bio-mechanical characteristics of various internal fixation methods,and how the timing of weight-bearing activities following various internal fixations require further basic and clinical studies.An unstable sacroiliac joint fracture-dislocation fixation has many ways,including the anterior and posterior fixed-fixed.Minim ally invasive therapy such as posterior CT guided sacroiliac joint lag screw is the developmental trend.

BACKGROUND: Using low-intensity pulsed ultrasound (LIPU) to promote the repair of articular cartilage injury is very common,and we also have more options to choose the cytoskeleton, but the application conditions of LIPU and the appropriate cytoskeleton have not reached any consensus yet.OBJECTIVE: To investigate the feasibility of establishing tissue-engineered cartilage by cell-free allograft demineralized bone matrix (CFDBM) co-cultured with rabbit cartilage cells and bone marrow mesenchymal stem cells (BMSCs) in vitro, and to investigate the effect of LIPU on the cells in CFDBM.DESIGN, TIME AND SETTING: Multiple sample observation was performed at the Institute of Biomedical Engineering, Second Military Medical University of Chinese PLAfrom May to August 2009.MATERIALS: The CFDBM was prepared as modified Urist's method; the cartilage cells were obtained using mechanical disintegration and enzyme digestion; the BMSCs were separated using whole bone marrow rinsing method, purified, and amplified layer by layer.METHODS: As CFDBM With a composite of different cellular components, and whether applying LIPU stimulation, the samples were divided into four groups: chondrocyte group, BMSCs group, compound group (CFDBM was compounded with chondrocytes,BMSCs, and chondrocytes/BMSCs, respectively, without LIPU stimulation), and LIPU group (CFDBM was compounded with chondrocytes/BMSCs, and then the samples were stimulated with LIPU on the second day, 1.0 MHz frequency, 10 mW/cm~2 transient spatial intension, 20 min/d).MAIN OUTCOME MEASURES: ① the 2~(nd)-generation of cartilage cells and BMSCs were examined by immunohistochemical method; ② The CFDBM prepared as modified Urist's method was examined as HE staining; ③ The samples of four groups were examined by collagen II immunohistochemical staining on the 21~(st) day.RESULTS: ① The collagen II immunohistochemical staining of the second generation of the articular cartilage cells showed that the morphostructure was polygon, star or round, and pseudopodia extended, and the cells were rich in cytoplasm; the cytoplasm was brownish yellow, and the cell nuclear was round. ② The result of immunohistochemical staining of BMSCs showed that,CD34 was negative, CD44 and CD105 were positive. ③ In the center of CFDBM prepared as modified Urist's method, there was no obvious cell-like structure and the gap size was uniform. ④ On the 21~(st) day after combining CFDBM with cells, collagen II immunohistochemical staining demonstrated that BMSCs group was negative, chondrocyte group was weak positive, compoundgroup was positive, and the LIPU group was strongly positive.CONCLUSION: ① Biological property of the 1~(st)-3~(rd)-passage chondrocytes and BMSCs was similar to primary-cultured cells. ②Both chondrocytes and BMSCs had a highly proliferative ability in CFDBM. ③ 10 mW/cm~2 LIPU could not affect activity of BMSCs but could promote differentiation Into articular cartilage cells, and it also could not promote celt proliferation.

Objective:To fabricate and to study the surface morphology and biological safety of a novel coating on microarc-oxidized titanium.Methods:The novel functional coating was fabricated by cross-linking the double-layer nanoparticles loading rhBMP-2 and SDF-1 with gelatin on microarc-oxidation coating on titanium implant surface.The surface topography was observed and optimized,and the biological safety of the novel coating was primarily evaluated by cell toxicity test,oral mucosa stimulation test and hemolysis test in vitro.Results:The novel functional coating possesses excellent morphology.The coating showed the cytotoxicity of score 1 and no mucous membrane irritation,the hemolytic rate of the coating was 4.6％.Conclusion:The coating possesses good morphology and biological safety.

BACKGROUND:The aid treatment of aphasia is mainly achieved through computer training system, and the applied software of the market at present is mainly Chinese aphasia training system software. The software for a native Uighur aphasia patient does not apply and no research of Uygur language aphasia training software has been reported. OBJECTIVE:To design a clinic oriented training software for Uighur aphasia, based on training specifications of rehabilitative therapist in the treatment of Uighur aphasia patients. METHODS:The experiment was conducted from January 2013 to December 2013 in South and North areas of Xinjiang Uygur Autonomous Region, deeply researching the common and familiar life material of the Uyghur’s and combining the life custom of the Uyghur’s, to screen the relevant materials of the speech rehabilitation training, preliminary build up the living language material database of the Uyghur’s. Basing on this database, we designed the computer-assisted application software which has the Uygur and Chinese double interface. The software is designed by the software research and development personnel in accordance with the requirements of the members of our group, with Uygur and Chinese double interface speech rehabilitation training software. 30 Uygur aphasiac patients after stroke in Xinjiang were screened for clinical trials and evaluation, the software after many corrections, detailed recorded the valuable dates and the problems existing in the experimental stage. And we constantly communicate with the software designers so as to repeatedly revise the wrong in the process of training, and eventualy developing a set of basic mature Uygur language aphasia and training software. RESULTS AND CONCLUSION:A set of basic mature Uygur aphasia training software was designed. With the research and development of the Uighur aphasia training software, speech therapists of Xinjiang get a fuly functional, easy operation, flexible extension training tool, which help to reduce the workload of speech therapists and improve the clinical efficiency.

Objective: To investigate the effect of Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina on scapulohumeral periarthritis (SP). Methods: A total of 30 cases with SP were randomized into an observation group and a control group. Those in the observation group practiced Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina therapy; whereas those in the control group received only tuina therapy. Tuina therapy was conducted every other day, 20 min every time for 1 month and Yi Jin Jing (Sinew-transforming Qigong Exercises) was conducted once a day for 1 month. The therapeutic effects were assessed by visual analogue scale (VAS) and Constant-Murley scale. Results: After treatment, the VAS score and Constant-Murley scale were substantially improved, showing statistical significances (P<0.01); the Constant-Murley scale in the observation group was better than that in the control group, showing a statistical significance (P<0.01); the effective rate in the observation group was higher than that in the control group, between-group comparison showed a statistical significance (P<0.01). Conclusion: Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina and tuina alone have a verified effect in treating SP, and the former can achieve a better effect than the later.

Objective:To investigate the effects of rituximab on lymphocytes and immunoglobulin in the treatment of focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD).Methods:The subjects were FSGS and MCD patients admitted to Ruijin Hospital affiliated to Shanghai Jiaotong University on July 1, 2014 and July 1, 2019. All the enrolled patients were confirmed by clinical examination and renal biopsy, and received rituximab treatment (4 infusions of 375 mg/m 2 with the interval of 7-14 d). The levels of immunoglobulin IgA, IgG, IgM, and lymphocytes of CD19 +, CD20 +, CD3 +, CD3 +CD4 +, CD3 +CD8 + and natural killer cells (CD56 +CD16 +) were compared between baseline and the third month, the sixth month, the ninth month and the twelfth month after treatment. Results:Ninety-six patients with FSGS or MCD were enrolled in this study. The midian age was 28 years old (14-77 years old). The ratio of men to woman was 1.8∶1. There were 65 cases of MCD and 31 cases of FSGS. After rituximab treatment, the 24 h-proteinuria was significantly lower than that before treatment, and the serum albumin level was increased (both P<0.05). After rituximab treatment of 3 months, 6 months, 9 months and 12 months, CD19 + and CD20 + lymphocyte counts were significantly decreased (all P<0.01), and gradually recovered after 6 months. Compared with baseline, at 3, 6, 9, 12 months after rituximab treatment, the level of blood IgG was significantly increased ( P=0.004,<0.001,<0.001,<0.001, respectively), and the level of blood IgM was significantly decreased ( P<0.001, =0.008, =0.005,<0.001, respectively) but the median level still within the normal range (400-3 450 mg/L). The level of blood IgA was not significantly changed (all P<0.05). T lymphocytes (CD3 +, CD3 +CD4 + and CD3 +CD8 +) and natural killer cells (CD56 +CD16 +) showed no significant difference from baseline (all P>0.05). Conclusions:Rituximab can effectively eliminate CD19 + and CD20 + lymphocytes, and has little influence on peripheral blood lymphocyte count and immunoglobulin level except CD19 + and CD20 + lymphocytes. The standard administration of rituximab is safe for patients with FSGS and MCD.

Single-cell RNA sequencing (scRNA-seq) is an emerging technology that observes transcriptomes' differences between individual cells at the cellular level.The basic strategy is to capture single cells and lysis the cells to get mRNA, then amplify them after reversing transcriptions, finally cDNA is used to build sequencing libraries.At present, this technology has been widely used in many subject areas.Visual system includes retina, lateral geniculate nucleus, and visual cortex, etc.It's responsible for the acquisition and processing of visual information and the formation of vision.Visual information accounts for more than 70% of all sensory information.Therefore, the study of the visual system is particularly important.With the rapid development of science and technology, there are more and more research results on scRNA-seq.This technology is gradually becoming an important tool for guiding clinical practice, and has provided a bridge for basic research transforming to clinical research.In this review, we introduce the main technical routes and methods of scRNA-seq and detail its application in visual system.

Objective:To investigate the protective effects of different concentrations of chloroquine on RGC in n-methyl-d-aspartate (NMDA) injured mice and its possible mechanisms.Methods:Fifty-four healthy male C57/BL6 mice were randomly divided into three groups, 18 in each group. The mice in low-dose chloroquine group were intraperitoneally injected with chloroquine solution at a dose of 10 mg/kg daily. Mice in high-dose chloroquine group were intraperitoneally injected with chloroquine solution at a dose of 100 mg/kg, and the mice in control group were intraperitoneally injected with the same volume of PBS. NMDA intravitreal injection was performed 2 days after intraperitoneal injection, 5 nmoles NMDA was injected into the left eye, and the same volume of PBS was injected into the right eye as a control. The RGC staining of retinal plaques were performed 7 days after NMDA injection, and the number of alive RGC was calculated. The visual acuity and electroretinogram were used to evaluate the electrophysiological functions of RGC at 9 and 10 days after modeling. Real-time quantitative PCR and retinal frozen sections and glial fibrillary acidic protein (GFAP) immunofluorescence staining were performed 11 days after NMDA injection to evaluate the glial activation of the retina. The density, visual acuity, and the amplitude of PhNR-wave of RGC between groups were compared by one-way analysis of variance.Results:At 7 days after NMDA injection, the density of RGC in retinal patch of low-dose chloroquine group was significantly higher than that of intraperitoneal injection of PBS control group ( F=54.41, P<0.01). The density of RGC in retinal patch of high-dose chloroquine group was lower than that of control group ( F=1.18, P>0.05). The visual acuity was higher than control group, and the difference was statistically significant ( F=9.10, P<0.05). The amplitude of PhNR-wave was significantly higher in low-dose chloroquine group than that of the control group ( F=17.60, P<0.01). The mRNA level of inflammatory factor and GFAP positive signal was also significantly lower than that of the control group ( F=23.66, P<0.05). The amplitude of PhNR-wave, the expression of GFAP ( F=110.20, P<0.01) and the mRNA level of inflammatory factors ( F=167.60, 17.78; P<0.01) in the high-dose chloroquine group were higher than the other two groups, and the differences were statistically significant. Conclusions:In NMDA injury retinal model, low-dose chloroquine significantly increased the survival and physiological function of RGC, and the mechanism may be related to the inhibition of glial activation and inflammatory response. High-dose of chloroquine would aggravate the apoptosis of RGC.

Objective To summarize our experience in robotic-assisted laparoscopic surgery for adrenal diseases Methods The clinical data of 243 patients with adrenal tumor treated by robotic-assisted laparoscopic surgery from March 2010 to February 2017 were retrospectively reviewed.There were 99 men and 144 women.The mean age was 51.6 years (range, 19-84).Tumors located at left adrenal in 140 cases, right in 97 cases,and both sides in 6 cases.The average diameter was 3.32 cm (range, 0.8-12 cm).However, there were 41 cases whose tumor diameter were greater than 5 cm.Results There were 2 cases of conversion during operation, 1 case converted to open surgery and the other to the traditional laparoscope surgery.The mean operative time was 35 min (range, 20-130 min).Estimated blood loss was 80 ml (range,20-1 200 ml).Blood transfusion was needed in 6 cases.The mean postoperative hospital stay was 5d (range, 3-20 d).The pathological diagnosis included 37 cases of pheochromocytoma, 149 cases of cortical adenoma, 3 cases of cortical carcinoma, 5 cases of metastatic tumor, 9 cases of adrenal myelolipoma, 3 cases of adrenal cyst, 2 cases of bronchogenic cyst, 25 cases of adrenal nodular hyperplasia,2 cases of angiomyolipomas, 1 case of mature teratoma, 1 case of diffuse large B-Cell lymphoma, 1 case of angioma, and 4 cases of neurofibromatosis.Conclusions Robotic-assisted laparoscopic adrenalectomy was safe and effective.Robotic-assisted laparoscopic surgery has the advantages over laparoscopic surgery in treatment of complicated adrenal tumor, such as large adrenal tumors, pheochromocytoma, bilateral adrenal diseases, overweight and obese patients with adrenal diseases.