The discovery of cell-free fetal DNA ( cffDNA) in maternal plasma provides a new idea for noninvasive prenatal testing( NIPT).Though some studies to date have shown several fetal DNA markers, how to accurately distinguish cffDNA from the pool of maternal plasma free DNA is still a challenge.So far, NIPT based on cffDNA has been used for detection and study of a variety of diseases, along with the advance and development of technology, it will have a more broad application prospects.This article will make a review for the research status from the biological characteristics and the markers of cffDNA, the clinical applications and the existing issues and development prospects of NIPT based on cffDNA.

Pancreatic adenocarcinoma is a highly malignant tumor and its prognosis is poor. The key factors for cure and prolonged survival are early detection, adequate evaluation of resectability and surgical resection with microscopic tumor clearance. Surgeons should pay attention to standardize operative procedures to increase the R0 resection rate. Whipple specimens should be inked and examined carefully. Postoperative adjuvant radiotherapy and chemotherapy are beneficial in the prevention of local tumor recurrence and distant metastasis. Inter-disciplinary cooperation and multimodality treatment are helpful to improve the prognosis and quality of life of patients with pancreatic cancer.

It's a new financial management system that our country implemented the management of separating the income and expenditure in the community health services.Beijing is one of the former pilot cities which carried on the management of separating the income and expenditure.To know the effectiveness of the implementations and its influence to the health services,this article analyses the status of community health services,the financial investment and the performance results in Beijing.Considering the above,this paper also provides policy recommendations on the development of health services in Beijing to improve the new urban medical service system which based on the community health services.

Pancreatic cancer is highly malignant with a poor prognosis. The resectability and prognosis of early pancreatic cancer are much better than the advanced, so early diagnosis is crucial for saving patients' lives. Because the symptoms of pancreatic cancer are non-specific, most of the patients are misdiagnosed as gastrointestinal or hepatobiliary diseases. Early diagnosis rate of pancreatic cancer can be greatly improved by combined application of tumor marker detection, endoscopic ultrasound, computed tomography, positron emission tomo-graphy, and etc. Early screening of high-risk population has been advocated by the experts, and its value in early diagnosis of pancreatic cancer has been confirmed by relevant studies. The colaboration of multiple pancreatic surgery centers in conducting prospective studies and setting gnidlines for the pancreatic cancer diagnosis, and relevant fundamental reseaches should also be emphasized.

Farnesoid X receptor(FXR), a member of the metabolic nuclear receptor superfamily, plays key roles in maintaining bile acid and lipid homeostasis.FXR is highly expressed in the entero-hepatic system where it transcriptionally regulates bile acid metabolism, intestinal barrier function and liver regeneration, etc.Loss or down regulation of FXR expression can lead to a lot of diseases, such as cholecystolithiasis, biliary cirrhosis,primary hepatic carcinoma, colon carcinoma, etc.Activation of FXR may protect against or provide a pharmacological target for these diseases.

Objective To investigate the surgical indicatin and outcome of recurrent gastric carcinoma.Methods Review the clinical data of 56 cases with recurrent gastric carcinoma underwent reoperation from 1990 to 2000.The operative indication, surgical method and complications were analized.Results In 25 cases the recurrent tumor were resected (44.6%),in 10 cases adjacent organs were resected.NO operative motality was observed.Conclusions More aggressive radical resection of the gastric cancer is the key to prevent recurrence.Laparotomy should be performed without delay once there is a suspicion of recurrence.

In order to compare differences of effects of complex prescription for reinforcing the kidney on osteoblast (OB) and osteoclast (OC), MTT method was used to determine proliferous capability of OB, bone lacuna count was used for quantitative assessment of absorbent activity of OC. Results showed that the mean influencing rate of Jin Gui Shen Qi Pill, Bu Shen Yi Jing Prescription, Zhi Bai Di Huang Pill, and Western medicine Premarin tablet for proliferous capability of OB was 159. 2%, 121. 5%, 21. 6% and 75. 7% respectively; the mean influencing rate for bone lacuna count was 50. 2%, 21. 0%, 19. 8% and 38. 1% respectively, suggesting that the drug for even reinforcing Yin and Yang can improve proliferation of OB and inhibit activity of OC, and increase of the drug for warming Yang can strengthen the promoting action on proliferation of OB, but increase of the drug for nourishing Yin had opposed action, the drugs for nourishing Yin plus the drugs for purging the pathologic fire can inhibit activity of OC and proliferation of OB.

Has 80% medical trouble dispute and the medical trouble communication in the modern medical trouble dispute does not arrive related,Then 20% case and the medical technology concern.Obviously communicates in the solution medicine trouble relations is playing the very important role.

Objective To assess effects of cerebral ischemic postconditioning(IPost)on neuronal apoptosis and phosphated glycogen synthase kinase-3β(GSK-3β)after cerebral ischemic/reperfusion.Methods The experiment was conducted at the center for animal experiment of Renmin Hospital,Wuhan University.Thirty male Wistar rats were randomly divided into three groups:sham operation(S),ischemic/reperfusion(I/R)and ischemic postconditioning(IPost).Each group contained ten rats.Global brain ischemia was produced with four-VO method.Animals were killed after two days.Apoptosis in neurons in the cortex region were detected by TUNEL assay; infarct areas were detected by TTC ; activity of p-GSK-3β was detected by spectrum assay; Statistical software SPSS13.0 was applicated to perform one-way ANOVA Student-Newman-Keul test; correlation was detected by linear regression.Results Compared with group S,TUNEL-positive cells and infarct areas increased(P ＜0.01),the activity of p-GSK-3β decreased in I/R and IPost groups(P ＜ 0.01).Compared with group I/R,TUNEL-positive cells and infarct areas significantly decreased(P ＜ 0.01),the activity of p-GSK-3β increased in group IPost(P ＜ 0.01).The activity of p-GSK-3β and TUNEL-positive cells had highly correlation,so as infarct areas(P ＜ 0.01).Conclusions IPost can lessen the ischemic/reperfusion injury of Cortex,through increas the activity of p-GSK-3[β and decreasing neuronal apoptosis.

Thyroid hormones play major roles in the regulation of a wide range of metabolie and physiologic processes.Serum thyroid-stimulating hormone( TSH ) concentration,a sensitive barometer of thyroid function,shows significant individual difference in which genetic variation is a major factor.After using traditional genetic linkage studies and candidate gene association studies to explore the suseeptibility genes of serum TSH,many progresses have been made and new susceptibility genes have been identified by genome-wide association study (GWAS).In this review,we focus on the susceptibility genes of serum TSH levels and also the future prospect that may be obtained from these studies.