There is a long path to go on the course of Chinese medical supply reform program.With the development of medicare system,the use of Internet + to promote Chinese medical supply reform program and to provide usefulsolutions to the present medicare problems in China could be very difficult.

Repeated calcium depletion and repletion of short term duration Ca2+ preconditioning CPC is hypothesized to protect the heart from lethal injury after exposing it to the Ca2+ paradox (Ca2+ PD). Hearts were preconditioned with five cycles of Ca2+ depletion (1 minute) and Ca2+ repletion (5 minutes). These hearts were then subjected to Ca2+ PD,ie,one cycle of Ca2+ depletion (ten minutes) and Ca2+ repletion (ten minutes). Hearts subjected to the Ca2+ PD underwent rapid and severely injury. CPC showed remarkable protection against the Ca2+ PD injury. Protein release from the perfusated heart was significantly reduced in CPC hearts compared with nopreconditioned Ca2+ PD hearts (0. 56 + 0. 10 and 1. 23 + 0. 10 mg/ml respectively ,P

OBJECTIVE:The pathophysiology of myocardial fibrosis during hypertension is complicated.Recently,it has been shown that inflammatory response plays an important role in the pathophysiology of myocardial fibrosis.This review describes the relationships among hemodynamic stress,hormonal factors and inflammatory factors,and emphasizes the important position of inflammation during the progress of myocardial fibrosis.DATA SOURCES:Using the terms of "hypertension,myocardial fibrosis,inflammatory response,angiotensin,cytokines" in English and Chinese respectively,we searched Medline database,Chinese Biological Medicine Database (CBM) and CNKI to identify English and Chinese articles of clinical researches and experiments related to the effects of inflammatory response on myocardial fibrosis during hypertension published from January 1991 to May 2007.STUDY SELECTION:The articles were primarily checked.Only articles that reported inflammatory response and myocardial fibrosis were included.The repeated researches and experiments and Meta analysis were deleted.DATA EXTRACTION:A total of 641 articles have been selected.The titles of all the articles and most of the abstracts have been read,and 162 articles met the inclusive criteria whereas the other 479 articles were deleted.42 articles have been analyzed.DATA SYNTHESIS:During hypertension,the extracellular matrix expands because of reactive and reparative fibrosis,which at last results in myocardial fibrosis.Previous clinical and experimental studies showed that hemodynamic stress and hormonal factors affected the progress of myocardial fibrosis.While recently,there are growing evidences indicating that the immune system.related with hemodynamic stress and hormonal factors is activated during hypertension in the progress of myocardial fibrosis.Then the recruitment of inflammatory cells and factors,including chemoattractant proteins,adhesion molecules and cytokines,informing cytokines cascade response,in turn accelerate the progress of myocardial fibrosis.CONCLUSION:Inflammatory response may play an important role in the pathophysiology of myocardial fibrosis during hypertension and then accelerate the progress of heart failure.

OBJECTIVE To evaluate the benefits,if any, of thyroidectomy using the harmonic scalpel versus conventional thyroidectomy. METHODS The clinical data of 34 consecutive patients underwent thyroid nodule enucleation or lobectomy in one year using the harmonic scalpel were recorded. The results were compared with that of the 34 case-control patients in the same period using conventional techniques. RESULTS The average incision length for those underwent thyroidectomy with the harmonic scalpel and conventional techniques was 3.8cm and 6.9cm respectively. Drains were not used in the harmonic scalpel group compared with average of 47ml drainage in the control group. The average inpatient cost was 7205 RMB for the harmonic scalpel group versus 8054 RMB for the control group(P=0.137). The average postoperative length of hospitalization was 3.5 days for the harmonic scalpel group versus 4.1 days for the control group (P=0.228). The average time of anesthesia was 95 minutes for the harmonic scalpel group compare with 81 minutes for the control group (P=0.018). One postoperative hoarseness occurred in each group. Two patients had mild skin burn in the harmonic scalpel group. No other complications were enumerated(x2=0.273,P=0.602). CONCLUSION The harmonic scalpel is a safe alternative for thyroidectomy. Compare with conventional thyroid surgery, this technique offers cosmetic benefit and less trauma for patient with thyroid nodules.

Objective To explore clinical characteristics of chronic total occlusion(CTO) in population with routine coronary angiography,and to cumulate therapeutic experience.Methods Retrospective analysis was performed on clinical data of 57 cases with CTO selected from 825 patients undergone coronary angiography.Results Among 57 cases,the percentage of male,myocaridial infarction,diabetes mellitus,hyperlipidermia and left ventricular dysfunction was 73.7%,84.2%,22.8%,73.7% and 22.8%,respectively.The types of lesions included single branch(n=11),double branches(n=29) and three branches(n=17).Of 70 branches lesion vessels,44 were TIMI 0 of blood flow classification and 26 were TIMI1.The position of lesions occurred at left anterior descending branch(n=32),left circumflex branch(n=16),right coronary artery(n=22).The occlusion time was less than three months(n=41) and more than three months(n=29).The lengths of lesion was divided into less than 20 mm(n=43) and more than 20 mm(n=27).The shapes of terminal lesion looked like rat-tail(n=42) and blaze knife-edge(n=28).The coronary stents were performed at 57 lesions among 70 branches and the successful rate of operation was 82.9%.Conclusions Timely coronary angiography and selecting suitable treatment on different kinds of lesions for male patients with myocardial infraction,especially complicated with diabetes mellitus,might play important roles in prevention of CTO and in improvement of the successful rate of percutanous coronary intervention for the complex lesion.

[Objective]To explore a method for isolating and culturing bone marrow mesenchymal stem cell(BMSCs) in vitro,and improve the cellular conglutination ability of biomaterial poly-lactide-co-glycolic acid(PLGA),and observer the adhesion of BMSCs cultured on PLGA modified with Ⅱ collagen.[Method]BMSCs were isolated and cultured in vitro.The cell exterior antigen,cell livingness and cell cycle were analyzed by flow cytometry method,and cellular configuration was observed continually under invertd phase-contrast microscope.PLGA was made by phase separation,and was modified with Ⅱ collagen.The third era BMSCs were cultured on PLGA,and its adhesion with biomaterial was observed scan electron microscope.[Result]BMSCs could be isolated and cultured in vitro,and express CD29,CD44,CD106,but not express CD34,CD45.The cell livingness was 88.96%,cells in G0-Glperiod are 90.32%.The cell morphology was spindle.The average diameter of PLGA modified with Ⅱ collagen was 100 ?m,and PLGA has good adhesion with BMSCs.[Conclusion]BMSCs could be cultured stability in vitro for long time,and is good seminal cell of tissue engineering.Ⅱ collagen can improve the cellular adhesion of PLGA,PLGA modified with Ⅱ collagen is the good biomaterial of tissue engineering.

Objective To evaluate the significance of laparoscopy in the diagnosis and treatment of unexplained acute right lower abdominal pain in women. Methods Clinical data of 52 women with unexplained acute right lower abdominal pain from April 1999 to April 2004 were retrospectively analyzed. Results Diagnosis was clarified under laparoscope in all the 52 patients, including 28 cases of acute appendicitis, 18 cases of acute pelvic inflammatory disease, 3 cases of ovarian cyst pediculotorsion, 2 cases of right tubal pregnancy, and 1 case of Crohn’s disease with iliac perforation. With exception of a conversion to open surgery in 3 patients, laparoscopic treatment was successfully completed in the remaining 49 patients. No surgical complications occurred. The patients were discharged from the hospital 2~6 days postoperatively. Conclusions Laparoscopy is a timely, safe and effective alternative for the diagnosis and treatment of unexplained acute lower right abdominal pain in women.

Protein arginine methyltransferases ( PRMTs) play crucial roles in the methylation of a series pro-tein substrates.PRMT5 is a type Ⅱ methyltransferase that symmetrically methylates arginine residues of histone and non-histone substrates, thereby regulating a variety of cellular processes through epigenetic control of target gene expression or post-translational modification of signaling molecules.Recently, accumulated evidence has suggested that PRMT5 may function as an oncogene.This review is aimed to summarize the oncogenic role of PRMT5 and its regulatory mechanisms in tumors.

The protein of BRCC36 is a kind of enzyme specifically hydrolyzing K 63-linked poly-ubiquitin chain and widely found in a variety of eukaryotic cells .BRCC36 recognizes diverse substrate proteins , and participates in various kinds of pathophysiological responses such as DNA damage repair , cell signal transduction and cell cycle control .It plays an important role in the process of cancer , angiogenesis and cardiac injury .This review discusses the progress in the inves-tigation on BRCC36 protein to provide the necessary information for searching new therapeutic targets of many diseases .

After mice given Ammoniun Glycyrrhizanate orally, the spleen weight, the number of leukocytes in peripheral circulation and carbon particle cleaning index increased significantly. Rat spleen lymphocytes exposed to 8 x10-7M and 8 x10-10M of Ammoniun Glycyrrhizanate produced levels of PGE that were 1 - 2 -fold greater than that of the control lymphocytes cultured in medium alone. We also found that the levels of PGE2 and cAMP in mice spleen increased significantly after P.O. Ammoninn Glycyrrhizanate, which we suggested might be the mechanisms of immane regulatory functions of Ammoniun Glycyr rhizanate.