The Kingdom of Sweden is the biggest country on the Scandinavian Peninsula.It has developed an exlent welfare system called 'cradle-to-grave'.As the key of its welfare system,health care system is of an unique one that provides people with leading quality and lower cost care in Sweden.

This paper introduces some experiences on how to perform teaching reformation of reproductive medicine.

Developing countries are facing a big challenge of how to promote sexual and reproductive healthe Poverty erasion.reproductive health service promotion,schools and communities intervention,discussion between children and their parents encouragment are helpful to solve the sexual and reproductive problems with the adolescents

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is still the only cure method for acquired severe aplastic anemia. How to select patients for treatment has become a research hotspot in recent years. OBJECTIVE: To review the progress of allogeneic hematopoietic stem cell transplantation from three aspects: HLA full-phase matched unrelated donor hematopoietic stem cell transplantation (MUD-HSCT), unrelated cord blood transplantation (UCBT) and haploidentical hematopoietic stem cell transplantation (HID-HSCT). METHODS: Literatures on allogeneic hematopoietic stem cell transplantation for severe aplastic anemia collected in PubMed, CNKI full-text database and WanFang database from 2000 to 2018 were retrieved with the keywords “unrelated donor; haploidentical; unrelated cord blood; severe aplastic anemia” in Chinese and English. RESULTS AND CONCLUSION: MSD-HSCT is the first-line treatment for severe aplastic anemia, but in view of China’s special national conditions, HLA matched donor is not easy to find. As an important alternative treatment, MUD-HSCT is close to MSD-HSCT. However, the incidence of graft versus host disease and severe infection after MUD-HSCT is still higher than that after MSD-HSCT. It is still necessary to consider multiple factors when choosing MUD-HSCT treatment. Umbilical cord blood hematopoietic stem cells are widely used because of their abundant sources and high match success rate. The probability of UCBT is very high when the amount of pre-frozen total nucleated cells is more than 3.9×107/kg. However, in view of the delay of UCBT and immune function reconstruction, unless other transplantation methods are not feasible in clinical treatment of severe aplastic anemia and immunosuppressive therapy fails in the first course of treatment, UCBT should not be considered. HID-HSCT has the advantages of easy access and good compliance of donors and is close to full-matched transplantation. It has become an important alternative to transplantation. The use of baliximab and/or antithymocyte globulin is expected to reduce the incidence of graft versus host disease and expand the clinical application of HID-HSCT.

The myelodysplastic syndromes (MDS) are collectively the most common myeloid neoplasms,and the clonal hematopoiesis presented in MDS results in bone marrow failure.An understanding of the MDS gene mutation profile can help to understand the biological significance of MDS and can be used for early diagnosis of disease,precise risk stratification,interpretation of pathogenesis,and improvement of treatment options.As the pathological features of MDS are gradually elucidated,individualized and effective treatment options are improved,and the targeted drug therapy may improve the prognosis of MDS patients.This article introduces the progress of MDS gene mutations and targeted therapy in the 60th American Society of Hematology (ASH) Annual Meeting.

Myelodysplastic syndromes (MDS) are clonal disorders characterized by the accumulation of complex genomic abnormalities that defined disease phenotype,prognosis,and the risk of transformation to acute myeloid leukemia.The clinical manifestations and prognosis of patients with different phenotypes arevary different,and the overall survival varies from several months to several years.Prognostic scoring systems are important staging tools that aided physicians in their treatment recommendations and decision-making and could help patients understand their disease trajectory and expectations.These models and others use mainly clinical variables that are obtained from bone marrow biopsy and peripheral blood measurements.Adding gene mutation data into current models might improve the total predictive power.The search for an optimal way to merge the clinical and genomic data in a sophisticated and highly accurate model remains a work in progress.A comprehensive geno-clinical model that could translate the use of genomic data into clinical practice would finally be established.This paper mainly introduces the progress of the gene mutations and prognosis models of MDS in the 60th American Society of Hematology (ASH) Annual Meetings were reviewed.

Clonal hematopoiesis is a common aging_associated biological state. The incidence of malignant neoplasms for the patients with clonal hematopoiesis of indeterminate potential (CHIP) is 0.5%-1% every year. Potential factors of clonal progression in hematopoietic cells have been summarized, including disordered endogenous immunity caused by the augmentation of proliferative pressure, chromosomal instability caused by telomeres short; the amplification of clonal stem cells, acquisition of new mutations, and aging_associated changes in hematopoietic stem cells, including altered DNA damage response, an altered transcriptional program and epigenetic alterations while failing to support healthy hematopoiesis. CHIP is a vascular risk factor driven by interactions between clonal monocytes_macrophages and the endothelium, as well as a neoplastic progression risk factor driven by the acquisition of additional somatic mutations in the context of many other influences on hematopoiesis and clonal balance. Strategies to reduce the clonal burden associated with CHIP and to inhibit the key inflammatory pathways leading to atherosclerosis could improve the prognosis of the patients.

OBJECTIVETocompare the effects of different waveforms and parameters of electrical stimulation to elicit a blink, and construct a functional electrical stimulation (FES) system to restore synchronous blink in unilateral facial nerve palsy (FNP).

METHODSFirstly, twenty-four rabbits were surgically induced unilateral FNP and were divided into three groups, who received square, sine and triangle pulse wareforms, respectirely. Both the healthy and the paralysis eyelids of the rabbits received pulse train stimulation to produce a blink in both eyes. For each rabbit, twenty-seven combinations of frequencies (25 Hz, 50 Hz and 100 Hz) and nine pulse widths (1-9 ms) were stimulated. The threshold amplitude and electric charge to elicit a blink was compared between different waveforms and different parameters. Secondly, a FES system was constructed to treat six surgically induced unilateral FNP rabbit chosen in the twenty-four rabbits, it consisted by an electromyogram (EMG) amplifier module which record the EMG of the healthy muscle, and a stimulator which received the EMG input and output a pulse train stimulation when triggered by the EMG.

RESULTSWhen the carrier frequency of the pulse train was 25 Hz, it was not able to induce a smooth blink. However, when the carrier frequencies were 50 Hz and 100 Hz, a smooth blink could be induced. The voltage required by 100 Hz was lower than 50 Hz, but it cost more electric charge. The amplitude that square waveforms required was far lower than sine and triangle, but the electric charge between the three waveforms was similar. Synchronous blink could be restored in the six unilateral FNP rabbits with the FES system.

CONCLUSIONSTo elicit a blink, square pulse train delivered in 50 Hz is a preferable option. The motion of the healthy eyelids as a source of information for stimulation of the paralyzed sides can restore the synchronous blink in unilateral FNP rabbits.

Animals ; Blinking ; Electric Stimulation ; Electric Stimulation Therapy ; methods ; Electromyography ; Eyelids ; Facial Nerve ; Facial Paralysis ; therapy ; Rabbits

OBJECTIVETo study the expression of Toll-like receptors (TLRs) mRNA in human trophoblast HTR-8/SVneo cells and the changes in indoleamine 2,3-dioxygenase (IDO) mRNA expression in response to TLR ligand stimulation.

METHODSThe expressions of TLRs and IDO mRNA in human HTR-8/SVneo cells were tested by RT-PCR, and the changes in IDO mRNA levels after exposure to TLR3, TLR4, TLR7/8, and TLR9 ligands were quantitatively analyzed with real-time PCR.

RESULTSIDO and TLR1-10 mRNAs were expressed in HTR-8/SVneo cells. As the cell culture time extended, IDO mRNA expression level tended to increase within 48 h. After stimulation with the TLR ligands, the expression of TLR-3 mRNA was down-regulated while the expression of TLR-4, 7, 8, and 9 mRNA up-regulated. Stimulation of the cells with poly(I:C) lowered the expression of IDO mRNA while IFN-γ increased its expression.

CONCLUSIONSThe expression of IDO mRNA is associated with the nutrition of the maternal-fetal interface. Stimulation with the TLR ligands affects the expression of IDO and TLR mRNA expressions in the cells, which verifies the functional activity of TLRs and suggests a role of IDO in TLR pathway-dependent antiviral immunity.

Cell Line ; Female ; Humans ; Indoleamine-Pyrrole 2,3,-Dioxygenase ; genetics ; metabolism ; Interferon-gamma ; pharmacology ; Ligands ; Poly I-C ; pharmacology ; RNA, Messenger ; metabolism ; Toll-Like Receptors ; genetics ; metabolism ; Trophoblasts ; cytology ; metabolism

Objective:To monitor the cerebral vascular blood flow parameters in the early stage of simulated acute exposure to high altitude hypoxia by transcranial color Doppler (TCCD), and to evaluate the change trend of cerebral hemodynamics and cerebrovascular reactivity.Methods:Sixty-four healthy volunteers were selected to observe the changes of peak systolic flow velocity(Vs), end diastolic flow velocity(Vd), mean flow velocity(Vm), resistance index (RI) and pulsatility index (PI) of middle cerebral artery (MCA) 30 minutes after they quickly entered the simulated altitude of 4 500 meters. Combined with breath holding test, breath holding index (BHI) was used to evaluate cerebrovascular reactivity (CVR), and subjects were divided into ≤30 years old group and >30 years old group, and the changes of CVR after hypoxia of the two groups were compared.Results:In the early stage of hypoxic environment, compared with baseline, SpO 2 decreased, heart rate increased, and blood flow velocity of middle cerebral artery(Vs, Vd, Vm) increased significantly, BHI showed a decreasing trend (all P<0.01). After hypoxia, the BHI rate of change in >30 years old was lower than that of the subjects ≤30 years old ( P<0.05). After breath holding, cerebral blood flow velocity increased significantly, PI and RI decreased significantly (all P<0.01). Conclusions:Cerebral blood flow is very sensitive to hypoxia. The application of TCCD technology can evaluate the trend of cerebral blood flow dynamics and cerebrovascular reserve capacity in real time and accurately, which is helpful to provide objective basis and research basis for the prevention and treatment of high altitude hypoxia.