OBJECTIVE: To summarize the advances in the genetic susceptibility to coronary artery disease (CAD) and explore the heritable basis of the disease.DATA SOURCES:Related articles in English from January 1990 to June 2006 were searched in Pubmed and EMCC databases with the terms "gene, coronary artery disease and myocardial infarction". Meanwhile, the CMCC database was searched for the relevant articles published between January 2000 and June 2006 in Chinese.STUDY SELECTrON: After the preliminary selection,relevant literatures on genetics of CAD and myocardial infarction(MI)were selected, and those with obvious indifferent contents or with less correlation were excluded.DATA EXTRACTION: Data of 49 articles were mainly extracted from the selected literatures providing solid evidence to elucidate the genetic susceptibility to CAD or MI.DATA SYNTHESIS: The involved 49 articles showed that CAD is a complex multifactorial disorder which is believed to result from the interplay between a person's genetic makeup and various environmental factors. The heritable basis is increasingly recognized as a crucial component in the development of CAD. Recent work in the field of genetics has lead to determining key genes associated with the susceptibility for CAD and MI through genome-wide linkage scans and large-scale gene-association studies as core human genetics approaches These susceptibility genes involve diverse functions, including dyslipidemia, vascular homeostasis, endothelial dysfunction, inflammation and immunity.CONCLUSION: The identification of genes that predispose to or directly cause CAD provides new insights into the pathogenesis of this disorder. However, the precise role of genetic factor in the CAD or MI events and the personalized gene-specific therapy await further investigation.

Objective To investigate the relationship among social anxiety,fear of negative evaluation and self-esteem and supply reference for psychological health education.Methods We adopted Social Avoidance and Distress Scale(SAD),Fear of Negative Evaluation Scale(FNE)and self-esteem(SES)scale to investigate nursing students in a certain university and college.Then we analyzed the investigation results. Results The scores of SAD and SES of nursing students with different education background were distinctly different(P<0.05).The score of SAD was positively correlated with that of SES(r=0.483,P<0.05)and FNE(r=0.316,P<0.01).Conclusion We should strengthen the cuhivation of serf-esteem for nursing students and help them to get rid of fear of negative evaluation and conquer social anxiety.

The purpose of the review was to explore the effects of nutritional supplements in children with HIV/AIDS.Nutritional supplements were found to have both positive and negative effects in HIV/AIDS children.It was found that selenium helps to boost immunity.Vitamin D supplementation was found to delay mother to child transmission (MTCT) of HIV and to reduce stunted growth associated with persistent diarrhea.Vitamins B,C,and E were found to delay HIV disease progression,reduce oxidative stress and HIV viral load.Multivitamin supplementation was found to be more effective in delaying HIV disease progression.Protein nutrition was found to improve cognitive and motor developments of children as well as helping HIV-positive children achieve 100％ weight for height.Some nutrient supplements,however,were found to have negative effects on HIV/AIDS children.Vitamin A was found to double the risk of mortality of HIV/AIDS in infants exposed to HIV via breastfeeding.Zinc was found to have a positive effect on production of infectious virus through its action on reverse transcriptase.Some micronutrional interact with each other leading to harmful side effects such as diarrhea.Some nutritional supplements interact with antiretroviral drugs leading to treatment failure.It is important for children to be given right doses of nutritional supplements and that their immune system should be closely monitored.

Neuropsychiatric systemic lupus erythematosus (NP-SLE) is more common in young woman but not yet in people over 75 years old.We report a case of NP-SLE in an old woman,who complained of tremor,hypermyotonia and gatism.The lab examinations showed strong positive (1∶3200) ANA,decreased levels of CH50,C3,C4,WBC,RBC,PLT,anti-ds-DNA(+),anti-Sm(+),SSA(+),PO(+),RO-52(+),urine blood (+) and protein (+).The proteins,MBPand IgGin CSF were increased.Head MRI scan showed many demyelination in bilateral intra ventricular and multiple patchy irregular long T1 and T2 signal under right parietal subcortical.The patient was immediately given methylprednisolone hormone therapy,combined with gamma globulin and hydroxychloroquine.After 4 days of treatment,most symptoms such as tremor and hypermyotonia disappeared.Laboratory tests showed that all immune markers changed better in three weeks.The patient was discharged in 4 weeks.it must be identified with cerebrovascular disease,Parkinson's disease and other common diseases in elderly people.It can be improved if the diagnosis and treatment of NP-SLE is immediately and the illness is well controlled.

Objective To investigate the effect of the balance between helper T lymphocyte (Th) 1 cytokines and Th2 cytokines in the serum of hepatic fibrosis rats induced by CCl4 on the expression of β-catenin in their livers. Methods Seventy-five rats were divided into control group,treatment group and model group. Hepatic fibrosis models were built by subcutaneous injection of CCl4in male Wistar rats, then rats in treatment group were treated with pentoxifylline(PTX) by intragastric administration. The model rats without PTX treatment served as treatment control. The serum levels of Th1 cytokines(interferon-γ, IFN-γ; tumor necrosis factor-α, TNF-α), Th2 cytokines (interleukin-4,IL-4;interleukin-6,IL-6) and type Ⅳ collagen were measured by enzyme-linked immunosorbent assay (ELISA). The expression and distribution of β-catenin in liver tissue and the percentage of area of type Ⅳ collagen accounted in the liver were analyzed by immunohistochemical analyses. The changes in serum cytokines were depicted by using One-way ANOVA, and the correlation between β-catenin expression and cytokines levels or hepatic fibrosis development was elucidated by Bivariate.Results The serum levels of Th2 cytokines in model group were significantly higher than those in treatment group, and even higher than those in control group (F=71. 260,91. 732, all P＜0.05).However, the levels of Th1 cytokines in model group were significantly lower than in treatment group while even lower than those in control group(F= 50. 420,10. 625, all P＜0.05). Serum cytokines came out to be Th2 polarized. Meanwhile, the percentage of type Ⅳ collagen area accounted in the liver,which was corresponding to the degree of liver fibrosis, was lower in the treatment group than the model group and even lower in control group (F=3 000,both P<0.05). β-catenin expression in the liver of model group was stronger than that in the treatment group, and even stronger than that in normal group (F=92. 030, both P＜0. 05). According to β-catenin immunohistochemical analyses based on patho-photos, livers from the model group showed dark color in both cell cytoplasm and nucleus, while the liver from the treatment group only showed weak color in cytoplasm and no straining color in nucleus and the liver from normal group showed colors neither in cytoplasm nor in the nucleus.The expression of β-eatenin had a positive correlation with either the level of Th2 cytokines in serum of rats (r=0. 560,P＜0.01) or the percentage of area of type Ⅳ collagen accounted in the liver of rats (r=0. 757, P＜0. 01). Conclusions Th2 polarization in serum cytokines can aggravate the development of liver fibrosis by inducing the expression of β-catenin, which in the livers of rats is a reflection of the degree of the liver fibrosis.

Autophagy is a metabolic pathway that widely presents in eukaryotic cells through the lysosomal mechanism to degrade its components. Autophagy regulates cell death not only by activating classic autophagosomal-lysosomal pathway, but also by influencing the occurrence and development of apoptosis and necrosis. Currently, the effect of autophagy in neuronal injury after acute cerebral ischemia/hypoxia and its specific mechanisms remain unclear. Studies have demonstrated that the autophagy after ischemia/hypoxia has a neuroprotective effect, such as maintaining neuronal homeostasis and reducing neuronal death; but other studies have also suggested that autophagy may aggravate neuronal injury after ischemia/hypoxia by activating multiple pathways, and even induce neuronal death.

Objective To explore the effect of subcutaneous composite flaps by crossed filling and supporting within areola combined with continuous distraction on moderate and severe inverted nipple.Methods 33 patients with 59 moderate and severe inverted nipples were involved in this study.The bilateral subcutaneous triangular composite tissue flaps pedicled with the base of the nipple were harvested within areola,the two triangular composite tissue flaps were revolved and advanced either horizontally to the opposite pedicle through the tunnel beneath the nipple and fixed as supporting.After the operation,the continuous distraction of the nipple lasted for two to four weeks,clinical effect and complications were analyzed.Results None of these 59 nipples appeared blood circulation disorder after operation.Postoperative follow-up for 6 months to 3 years showed that 54 inverted nipples were corrected completely without complications,such as nipple and areola necrosis,and there were no recurrence.The patients and doctors were satisfied with the appearance of the nipples.Conclusions Correcting the moderate and severe inverted nipple with subcutaneous composite flaps by crossed filling and supporting within areola combined with continuous distraction is simple,microinvasive,effective,and the incision scar is invisible,and it therefore is an ideal method for correcting the inverted nipple.

Objective To investigate the related demographic and obstetrical factors of postpartum depressive symptoms.Methods The study was carried out in four hospitals selected by stratified sampling in Changsha city.The 320 nullipara women who met the designed including criteria at 6 weeks postpartum were recruited by cluster sampling from the four hospital.Three hundred and twenty nullipara women were assessed by using Edinburgh Postpartum Depression Scale(EPDS),self-designed demographic and obstetrical factors questionnaires.Results The study showed that the careers like cadre and clerisy were demographic risk factors(P=0.011,OR=0.886).There were four obstetrical risk factors,including assisted reproductive technology(ART)(P=0.005,OR=4.585),the time of the first stage of labor(P=0.024,OR=2.269),instrumental delivery(P=0.000,OR=49.767),and birth defect(P=0.000,OR=28.386).The normal delivery was a protective factor(P=0.003,OR=0.151).Conclusion Multiple factors are involved in the incidence of postpartum depression.Preventive intervention should be taken actively to prevent against postpartum depression.

Objective: To study the subjective of well-being and influential factors of medical chronic inpatients. Methods: 322 chronic pulmonary heart disease, diabetes, hypertension and coronary atherosclerotic heart disease' inpatients were tested by Index of Well-Being, SAS, T-AI and SDS. Results: ①The sense of Well-Being of these patients was obviously higher than the healthy people, and the sense of well- being of hypertension and coronary atherosclerotic heart disease' inpatients was better than other groups. ② By multi-variable stepwise regression analysis, the T-AI was the most powerful negative influential factor on the Subjective Well-being of the chronic patients. Furthermore, it was also closely related to the patients' SDS, the kind of disease and SAS. Conclusions: Since the patients have lower sense of Well-being, and it can be improved by reducing their negative emotions such as anxiety and depression, therefore, the nurses should pay attention to the psychological support of the patients so that their metal status can be improved and also the quality of nursing can be enhanced.

Objective To get rid of the toxins from the blood when the blood pass through the hemoperfusion apparatus. Methods The circuit of the rejected hemodialysis machine was modified to make its monitoring unit and blood pump available. The blood was drawn from the body, and then the hemoperfution apparatus substituted as the dialyser. Results The application to 130 cases proved that the apparatus behaved well. Conclusion The modified machine can meet the desired requirements.