Objective: During the five years period from 2006 to 2010, the Chinese government had increased the special funding for primary maternal and child health enterprise to analyze the total amount and constitution of the special funding respectively. Methods: From the perspective of special funding investment in the eastern, central and western regions with different levels of economic development, to perform the comparative analysis. Results and Conclusion:The government’s overall investment on maternal and child special funds is in increasing trend, the average per capita amount of special funds invested in west region is higher than the eastern and central region; in the aspect of investment constitution , the central government special funds for women and children is the main source, which accounts for more than 85% of total investment, the reducing and eliminating items in eastern and western regions and the inpatient childbirth subsidy items constitute the major component of special funding for primary maternal and child health in corresponding region. Based on the analysis of investment on the condition of primary maternal and child health , policy recommendations for further development of the cause of women and children are provided.

AIM: To investigate the involvement of calcineruin (CaN) signal pathway mediated by angiotension Ⅱ (Ang Ⅱ) in the myocardial remodeling mechanism in patients with congestive heart failure (CHF). METHODS: 39 patients of mitral valve disease with CHF were randomly selected and 30 cases of healthy persons were included as controls. Cardiac function parameters were measured by echocardiography. Concentration of Ang Ⅱ in plasma and myocardial tissues were determined by radioimmunoassay. Immunoprecitipation was used to assay the protein expression and phosphorylation CaN, nuclear factor of activated T cells (NFAT_3),zinc finger transcription factor (GATA_4) in myocardial tissues. The mRNA expression of ?-myosin heavy chain (?-MHC) was measured by RT-PCR. RESULTS: The Ang Ⅱ concentrations in patients with CHF were positively correlated with the parameters of the cardiac dialtion respectively, but negatively correlated with the paremeters of cardiac function. Compared to the control group, protein of CaN and GATA_4, phosphorylation of CaN, and ?-MHC mRNA expression in myocardial tissues in CHF groups were highly expressed and their expression were positively correlated to the levels of CHF, but the phosphorylation of NFAT_3 was negatively correlated with the levels of CHF. CONCLUSION: CaN signal pathway may play important roles in the myocardial remodeling in CHF.

OBJECTIVETo observe the origins and insertions of Pitanguy ligament,in order to find the anatomically theoretical basis for the treatment of nasal deformity such as drooping nose, short columella, gingival show.

METHODS15 cadaveric heads fixed by 10% formalin were used. 12 specimens underwent nasal anatomic study. The skin was incised, along the nasal midline to expose the Pitanguy ligament. The origin of Pitanguy ligament and its relationship with surrounding tissue were studied. Then the Pitanguy ligament was taken out for HE staining. Longitudinal section along the ligament was observed. 3 specimens underwent harvesting of full-thickness nasal tissue from skin to periosteal membrane. Then the samples were used for HE staining to show histologic study of ligament at horizontal section.

RESULTSPitanguy ligament originates in the midline of lower third of the nasal superficial musculoaponeurotic system, extends down to the tip along the midline of the nasal dorsum and then turns backwards at the nasal tip, and runs between the medial crura of the lower lateral cartilages, inserts into the base of columella. Its muscle is connected with the orbicularis oris muscle and the depressor septi nasi muscle. HE staining showed the ligament consists of fibrous connective tissue, muscle tissue and other ingredients, but without cartilage.

CONCLUSIONSPitanguy ligament exists with complex histological composition, so its name is still controversial. Because it has multiple connection with the orbicularis oris muscle and the depressor septi nasi muscle, so cutting or shortened the Pitanguy ligament can treat deformity of nose and lip by adjustment of nasolabial angles and the nasal length.

Cadaver ; Cartilage ; anatomy & histology ; Facial Muscles ; anatomy & histology ; Humans ; Ligaments ; anatomy & histology ; Lip ; anatomy & histology ; Nasal Septum ; anatomy & histology ; Nose ; anatomy & histology ; Nose Deformities, Acquired ; pathology ; surgery ; Subcutaneous Tissue ; anatomy & histology

Objective To introduce the techniques and specification of complete-block radical gastrectomy, and to compare with traditional radical gastrectomy in the operative time, surgical costs and postoperative complications. Methods Thirty gastric cancer patients meet the criteria were randomly divided into 2 groups. Group A: complete-block radical gastrectomy;group B: radical gastrectomy. Analysis and comparison were made on tumor site, time consuming of block, the proportion of gastrointestinal reconstruction, operative time, cost of block, pathological TNM stage, length of stay, postoperative complications and postoperative chemotherapy. Results Group A has longer operative time than group B (P<0.05). However, there was no significant statistical difference in the other indicators between these 2 groups. Conclusions Complete-block technology can separate cancer more completely during operation with the advantage of simplicity, low-cost, little effect on the subsequent operation. The incidence of postoperative complications and length of stay with the traditional surgery there was no significant difference.

OBJECTIVE:To provide suggestions for China in dealing with the drug shortage problem by drawing experiences from USA.METHODS:The study was done by reiviewing literature and cases study.RESULTS:The FDA in USA has established procedures for the Center of Drug Evaluation and Organization of Regulation Affairs to resolve all kinds of drug shortage problems.CONCLUSIONS:A specific department should be set up to be responsible for resolving drug shortage problems in China with an emphasis on the shortage of medical necessary drugs,and it is urgent to get the information of drug shortage.

Objective To summarize our preliminary experience of selective fetieide with bipolar coagulation in complicated monochorionie twins(MCT),and discuss the clinical application of feticide in discordant MCT.Methods Three MCT with one twin anomaly.in which 2 had severe twin-twin transfusion syndrome(TTTS),stage Ⅳ ,and 1 had acardiac twin,were identified in the second trimester of pregnancy.To terminate the abnormal twin and isolate the co-twin's circulation completely.selective feticide was performed by umbilical cord occlusion with bipolar coagulation under guidance of ultrasound and fetoscopy.After each invasive procedure,serial monitoring was performed,including procedural complications,Doppler of fetal middle cerebral artery and umbilical artery.Pregnancies were followed up every 2 weeks for fetal growth until delivery.After birth the placentas and the terminated fetuses were examined.Result Cord occlusion was successfully accomplished in all 3 targeted fetuses,at 21,22 and 24 weeks of gestation respectively.One case with TTTS was complicated with rupture of the membrane in the terminated fetus at the 7th day after the procedure.and a healthy baby was born at 32 weeks.The other case with TTTS delivered a boy by cesarean section at 38 weeks.The third case with TRAP is at 35 weeks of gestations and under regular follow-up.Monochorionicity was confirmed by placental examination after delivery.and the effects of bipolar coagulation were observed at the,cord of terminated fetuses.Conclusions Umbilical cord occlusion witll bipolar coagulation is an effective procedure for selective feticide in MCT with one twin anomaly.The outcome of normal fetus can be favorable.

BACKGROUND:In allogene hematopoietic stem cell transplantation,the choice of preconditioning scheme is an important link of the success of hematopoietic stem cell transplantation,and a major research direction of stem cell transplantation.The myeloablative pretreatment scheme has great toxicity,and pretreatment related death rate is high.Thus,it is necessary to explore an ideal pretreatment scheme to expect a decrease in side effects and relapse.OBJECTIVE:To observe the effect of modified Bu/CY pretreatment regimen for treating hematologic malignancies.METHODS:The 8 patients were selected at the Department of Hematology,Haikou Municipal People's Hospital Affiliated to Xiangya School of Medicine,Central South University from November 2003 to March 2008,and received modified Bu/CY pretreatment:cytarabine 2.0-3.0 g/(m2·d)×2 d,intravenous drip,for 24 consecutive hours;myleran 4 mg/(kg·d)×3 d;cyclophosphamide 50 mg/(kg·d)×2 d;methyl-cyclohexyl nitrosourea 25 mg/(m2·d)×1 d;antithymocyte globulin 25 mg/(kg·d)×4 d. We have increased the arabinosylcytosin dose twice,and changed to a 24-hour infusion via intravenous drip,so that pretreatment strength was increased and promote lasting implantation of hematopoietic stem cells,based on the modified program.Graft-versus-host disease(GVHD)prevention:cyclosporin A and mycophenolate mofetil would be used advanced to minus 7 days (one day before stem cell transfusion is minus 1)based on the classic methotrexate regimen.The ABO blood group changes and DNA were tested in patients before and after ransplantation.RESULTS AND CONCLUSION:①The detection of hematopoietic reconstitution after transplantation:All patients have received hematopoietic reconstitution,with no pretreatment-related death.The white blood cells reduced to 0 after-3- +7 days of hematopoietic stem cell transplantation,and continues to(3-22)days,+10- +21 days white blood cells ＞ 1.0×109/L,+11- +51 days,platelets ＞ 20x109/L.②Incidence of GVHD:of 8 patients,there were GVHD Ⅳ grade(intestinal)in 1 case,acute graft-versus-host disease grade Ⅰ-Ⅱ in 3 cases.Above-mentioned results indicated that the further modification of BU/CTX2 regimen may be an effective pretreatment program,with a few side effects,which is better than the classic total-body irradiation/CY regimen.What's more,it is simple accurate,reliable rote of anti-leukemia and will be a safe and effective method for treating hematologic malignancies.

BACKGROUND: Effective mobilization and collection of hemopoietic stem cells are initial factors for peripheral stem cell transplantation, while they make sure a permanent reconstruction of hemopoiesis. Mobilization and collection have been developed; however, the collection is more, and the yield of hemopoietic stem cells is various. OBJECTIVE: To investigate the best time of mobilization and collection of peripheral blood stem cells from healthy donors. METHODS: A total of 16 donors who were selected from Haikou People's Hospital between January 2003 and December 2008 were randomly divided mobilization group (A, n=6) and mobilization + collection group (B, n=10). A group was subcutaneously injected with 5.0-10.0 μg/(kg·d) recombinant human granulocyte colony-stimulating factor (rhG-CSF) (Filgrastim), and B group was treated with rhG-CSF and intravenously injected with 10 mg dexamethasone. Peripheral stem cells were collected twice in each group. The two groups were collected at the fourth and 5~(th) day of mobilization after the second or 4th hour subcutaneous injection of rhG-CSF. The collection was 4.0-5.0 mL, the manhandled volume was 3.0-5.0 mL, and the total blood volume was 6.7-10.1 L. RESULTS AND CONCLUSION: Number of mononuclear cells was (4.0-8.0)×10~8 kg~(-1) in the two groups. The cell concentration of fourth hour was higher than the second hour after rhG-CSF treatment (P < 0.05). The mononuclear cell concentration of fourth hour was higher than the second hour after the fourth and 5~(th) day of rhG-CSF treatment. Our research showed that we could collect sufficient amount of cells (to a high concentration) by one time, which had reasonable collection time - value-effectiveness relationship, when the cycle blood volume was 1.8-2.2 times of circulating blood volume.

Objective To investigate the efficacy and safety of tirofiban in the treatment of aged patients with acute coronary syndrome (ACS) during primary percutaneous coronary intervention (PCI). Methods Two hundred and fifty-six patients with ACS who underwent primary PCI were randomly divided into two groups: tirofiban group (tirofiban + PCI treatment, n= 130) and control group (routine PCI treatment, n = 126). Tirofiban group was further divided into two subgroups according to the age: aged group(age ≥60 years, n= 68) and non-elderly group(age<60 years, n=62). At the end of PCI procedure, angiographic features such as thrombolysis in myocardial infarction (TIMI) flow grade, corrected TIMI frames count and TIMI myocardial perfusion grades (TMPG) were analyzed immediately. The incidence of major adverse cardiac events (MACE) was observed within 36 hours and 30 days after PCI, and the incidence rates of thrombocytopenia and bleeding were assessed. Results There was no significant difference between both the two study groups and the two subgroups in the basic clinical or angiographic characteristics before PCI (all P>0.05). There was no significant difference between two groups in TIMI 3 flow achievement rate in culprit vessels after PCI (93.6% vs. 91.3%, χ~2 = 1.02, P= 0.313). In tirofiban group, corrected TIMI frames count was significantly higher than that in control group (31.6±7.7 vs. 23.8±6.1, t = 2.49, P 0.026), and TMPG 3 achievement rate was also higher (83.1% vs. 67.5% ,χ~2=4.05, P=0.046). The incidence of MACE was significantly lower in tirofiban group than that in control group both within 36 hours and 30 days after procedure(6.9% vs. 19.0%, χ~2= 6.30, P= 0.013; 3.8% vs. 11.90%, χ~2= 5.82,P=0.018, respectively). No statistical difference was found in mild bleeding complications between the two groups (20.2% vs. 15.2%, χ~2 =3.65, P=0.065), but the incidence of mild bleeding was higher in aged group than that in the non-elderly group(25.0% vs. 14.5%,χ~2=4.98, P=0.026), and the incidences of serious bleeding and thrombocytopenia were similar between the two subgroups. Conclusions Intravenous tirofiban infusion is safe in aged ACS patients during primary PCI, and has favorable short-term outcomes compared with routine treatment, although there is a slight risk of mild bleeding.