Based on experience on medical service drilling for many years,this paper analyses the hardship and complexity of medical service support in high & cold mountainous region.It also puts forward some suggestions in such aspects as integral design,focal points insurance,necessaries reinforcement,preach for popularization and mutual cure training.

The study was proceeded on the mRNA expression of the GULT1 and GLUT4 gene in the alloxan diabetic rats by the technique of dot-blot hybridization analysis. The results showed that the levels of the GLUT4 mRNA expression were reduced in diabetic rats while increased in insulin treated diabetic rats. This suggests that the reduced GLUT4 mRNA expression which could affect the quantity of its posttranslational products may be one of the causes of the insulin resistance.

Mobile internet terminals were connected to the pharmacy of the hospital to improve the outpatient pharmacy process, building an internet-based pharmacy service model for general tertiary hospitals. This model covered the entire outpatient service, ranging from registration, payment and dispensary at the hospital. It significantly enhanced the efficiency, namely 80. 8% less time for payment, not to mention the free delivery and no waiting time for dispensary.

Objective]To introduce professor YU Jingmao’s experience in treament of children with adenoid vegetation. [Methods]To select 3 effective cases of adenoid vegetation diseases, clarify professor YU Jingmao’s features of treatment based on syndrome differentiation, stage therapy and drug characteristics, and then analyze and expound the clinical experiences of professor Yu Jingmao. [Result]Professor YU Jingmao in infantile adenoid vegetation body therapy, treats in three stages:the early cure dispelling wind pathogens to clear heat reducing swelling;medium-term plans to raise Yin and moisture lung, promoting blood circulation to remove blood stasis;late to invigorate qi for consolidating superficies, nourish yin to clear away heat,often obtains better effect. [Conclussion]Professor YU Jingmao’s dialectical claim of in treatment of adenoid vegetation,stage therapeutics,purgation-tonifying and cultivste vital qi are worth learning.

5-fluorouracil (5-Fu) as an antimetabolite drug,has been widely used in the treatment of various solid tumors.However, due to the heterogeneity of tumor and the impact of the individual, some patients still have drug resistance or serious lethal toxicity reaction.The text focuses on the research progress of pharmacogenomics and pharmacogenetics of some forecast elements which affect the efficacy and toxicity of 5-Fu,and discussed their guiding role on the choice of chemotherapy drugs.

OBJECTIVE: To summarize the data about endemic fluorosis, and investigate its prevalence and the effects of prevention and cure, so as to suggest more effective measures for the prevention and cure in the future. DATA SOURCES: A computer-based online search of China National Knowledge Infrastructure (CNKI) and VIP Chinese database was undertaken to identify articles about the distribution, monitoring and effects of prevention and cure of endemic fluorosis published in Chinese from January 1995 to March 2006 by using the keywords of "endemic fluorosis, monitor". STUDY SELECTION: Literatures about endemic fluorosis, including mainly brief introduction, practice in prevention and cure, summary of meeting, etc., the repetitive studies were excluded, and only one of them published the latest was involved. DATA EXTRACTION: Totally 25 relevant literatures were collected, and 18 of them were involved, the others were excluded. DATA SYNTHESIS: The monitoring results showed that until the end of the 2004, 44.51％ of the villages, in the drinking water type disease areas with endemic fluorosis, had executed the low-fluorine treatment of water, and 194 villages had been controlled basically; In the coal pollution type disease areas, 24 villages had been controlled basically,25.42％ of the families had reformed the stoves to prevent the coal pollution. The fluorine in water and air had been obviously declined after the improvement, some place had reached the standard of government.The morbidity rate of dental fluorosis in children of 8 to 12 years old was lower than before; The improving condition was good in most disease areas, and part of them had reached the control line; Meanwhile,the problems also existed that the measures of prevention could not befulfilled completely for the short of money, and the role of decreasing fluorine could not be acted completely because of the ill-management after the changed project.CONCLUSION: After the continuous efforts for tens of years, great progress has been obtained in the prevention and cure of endemic fluorosis,and the prevalence rates of dental fluorosis and skeletal fluorosis have reduced obviously, but many problems also exist at the same time. Therefore,the prevention and cure should be reinforced to restrain its prevalence more effectively.

Objective To investigate the protective effect of Niacin on blood-retina barrier (BRB) in diabetic rats and related mechanism.Methods The male Wistar rats (60) were divided into control (CON) group,diabetes (DM) group and Niacin-treated (NA) group,20 rats in each group.Rats diabetes models were induced with streptozotocin injection.Niacin (40 mg/kg · d) was administrated orally everyday in Niacin-treated group until sacrificed after 3 months.Pathological outcomes,total cholesterol (TC) and highdensity lipoprotein (HDL) were evaluated at month 3.Optical microscopy was used to observe the retinal structure.The integrity of BRB and the vascular permeability was quantified by analyzing albumin leakage using Evans blue (EB) method.The relative expressions of Claudin-5,Occludin,zonula occluden (ZO)-1 and GPR109A mRNA in rat retinas were detected by reverse transcription PCR (RT-PCR) and relative expression of GPR109A,tumor necrosis factor (TNF)-α and interleukin (IL)-6 by Western blot.Results Compared to CON group,the TC content was increased and HDL content was decreased in DM group (t=4.034,5.831;P＜0.05).Compared to DM group,the TC content was decreased and HDL content was increased in NA group (t=6.868,3.369;P＜0.05).The retinal structure of CON group was normal.Pathological changes were found in the DM group,such as tumescent nuclei and disorganized structures.The retinal structure of NA group was similar to the control group.Evans blue dye that the microvascular leakage in DM group was increased compared with CON group (t=24.712,P＜0.05),while in NA group was decreased compared with DM group (t =16.414,P＜ 0.05).The mRNA expression of Occludin,Claudin-5,ZO-1 in DM group were decreased compared with CON group (t=11.422,12.638,12.060;P＜ 0.05),while in NA group were increased compared with DM group (t=5.278,3.952,8.030;P＜0.05).The mRNA expression of GPR109A in NA group were increased compared with DM group (t=5.053,P＜ 0.05).The protein expression of GPR109A,IL-6,TNF-αin DM group were increased compared with CON group (t=4.915,11.106,6.582;P＜0.05).Compared to DM group,the protein expression of GPR109A was increased (t=5.806,P＜0.05),while the protein expression of IL-6 and TNF-α were decreased (t=10.131,5.017;P＜0.05).Conclusion Niacin has the protective effect for BRB by up-regulating GPR109A expression which may suppress inflammation.

Objective To evaluate the effect of amniotic products after transcervical resection of uterine adhesions (TCRA). Methods This study was carried out in 57 patients with intensive degree of intrauterine adhesions (IUA) who had been treated by TCRA between Jun. 2013 to Jun. 2014. These patients were devided into two groups randomly. In group amnion, 29 patients were placed amniontic scaffold balloon after TCRA;in group balloon, 28 patients were placed Foley′s balloon after TCRA. The two groups′balloons were taken out after TCRA 7 days. All patients were taken artificial cycle treatment. The uterine cavity form and the menstruation of 2 groups were observed in 3 months after TCRA. Results In group amnion, IUA score dropped from 10.1±0.5 preoperatively to 3.2±1.5 postoperative (P<0.01), in group balloon, IUA score dropped from 10.1 ± 0.5 preoperatively to 6.3 ± 2.5 postoperative (P<0.01). In group amnion, the menstrual score increased from 13.3 ± 4.4 preoperatively to 32.6 ± 5.5 postoperative (P<0.01), in group balloon, the menstrual score increased from 11.1±5.8 to 26.5±5.6 (P<0.01). The menstrual improvement of group amnion was better than that of group balloon significantly (P=0.002). In group amnion, the recurrence rate of adhesion was 21%(6/29), in group balloon, the recurrence rate of adhesion was 36%(10/28). There was no significant difference (P=0.248). The pregnancy rate of group amnion was 28%(8/29), the pregnancy rate of group balloon was 21%(6/28). The difference of pregnancy rate in two groups was not significant (P=0.760). Conclusion This small sample observation indicate that amniotic products used in the treatment of intensive IUA could improve menstrual, reduce the recurrence of adhesion, but the impovement of the pregnancy rate should be confirmed by large sample observation.

Objective To understand the significance of urinary protein components in children with different pathological types of glomerular diseases ,to explore the significance to diagnosis and treatment of disease .Methods Totally 120 children with glomerular diseases ,from November 2010 to July 2012 in the First Affiliated Hospital of Zhengzhou University were collected ,in which 6 children with acute glomerulo nephritis(AGN) ,35 children with minimal change disease(MCD) ,9 children with focal seg‐mental glomerulosclerosis(FSGS) ,44 children with Nephritis of Schonlein‐Henoch Purpura(HSPN) ,17 children with IgA nephrop‐athy(IgAN) and 9 children with hemolytic uremic syndrome(HUS) .Urine protein electrophoresis and urineβ2‐microglobulin(β2‐MG)levels were investigated in different glomerular diseases .Results Significant difference was detected inβ2‐microglobulin ,lyso‐zyme ,retinol‐binding protein ,free light chain ,α1‐microglobulin ,light chain dimmer ,albumin and transferring levels in different glo‐merular diseases(P=0 .016 ,P=0 .017 ,P=0 .017 ,P=0 .023 ,P=0 .004 ,P=0 .025 ,P=0 .049 ,P<0 .01) .A significant correlation was detected between low molecular weight protein and urineβ2‐microglobulin levels(r=0 .243 ,P=0 .025) .Conclusion It is sig‐nificant for diagnosis and treatment of glomerular diseases to the combination of urine protein electrophoresis and renal pathology .Urinary protein profiles are different in different pathological types .Proteomics may be significant for the mechanism of glomerular diseases .

OBJECTIVE:To determine residual citrinin in Zhibituo tablet by solid phase extraction-UPLC-MS/MS. METH-ODS:The sample was processed preliminary by solid extraction. The determination was performed on Zorbax Eclipse Plus C18 col-umn with mobile phase consisting of water (0.1% formic acid)-acetonitrile (70:30,V/V,gradient elution) at the follow rate of 0.30 mL/min. The column temperature was 40 ℃,and analysis time was 7 min,the sample size was 2 μL. Ionization mode was positive ion mode. The ion source temperature was 150 ℃,drying gas velocity was 15 L/min,sheath gas temperature was 350 ℃, sheath gas flow rate was 12 L/min,capillary voltage was 3500 V,atomization device pressure was 40 psi,atomization voltage was 0 V. The acquisition mode was MRM mode. RESULTS:The linear range of citrinin was 0.1-20 ng/mL(r=0.9994);the limits of quantitation and detection were 0.05 and 0.01 ng/mL. RSDs of precision,stability and repeatability tests were all lower than 2.0%;recoveries were 98.868%-103.160%(RSD=1.5%,n=6). CONCLUSIONS:The method is rapid,sensitive,accurate and suitable for the determination of residual citrinin in Zhibituo tablet.