Joint -Up Community is crucial to the community health services. Joint - Up is an kind of co -operation, but it is neither the co - operation of bureaucracy nor that of the market model. The new relationship of Joint - Up is based neither on responsibility nor on contract, but on equal partnership. It is vital to solve the ethical plight of health services in country.

Accumulation and infiltration of polymorphonuclear leukocytes are pivotal factors in accelerating cell apoptosis and death in ischemia/reperfusion(I/R) injury, however, adhesion molecules play an important role in its rolling，latching and infiltrating. The goal of the review is to explore the effect and significance of intercellular adhesion molecule-1(ICAM-1) in ischemia/reperfusion.

Dystonia is common in children with cerebral palsy. It can cause motor dysfunction, and is frequently associated with altered speech articulation, abnormal swallowing, and excessive drooling. Although trihexyphenidyl (Artane) is an anticholinergic agent with a long history of use in the management of dystonia in adults, information is limited regarding the use of trihexyphenidyl in children. This study reviewed the clinical experience of the use of trihexyphenidyl in children with cerebral palsy for dystonia, with special emphasis on benefits and tolerability.

BACKGROUND:Nitric oxide can interfere with the function of mitochondria, and accelerate the intervertebral disc damage and degeneration by interfering with the release of inflammatory cytokines. Nitric oxide is an important inflammatory cel medium leading to degeneration of intervertebral disc induced by pressure and other external factors.
OBJECTIVE:To investigate the regulatory effect of nitric oxide and nitric oxide synthase inhibitor niacinamide on mitochondrial function and its association with biological behavior of rabbit nucleus pulposus.
METHODS:Cultured nucleus pulposus cel s of rabbit lumbar intervertebral disc were randomly divided into six groups:normal blank control group, 10μmol/L sodium nitroprusside group, 100μmol/L sodium nitroprusside group, 200μmol/L sodium nitroprusside group, 0.05 g/L nicotinamide group (100μmol/L sodium nitroprusside+0.05g/L nicotinamide), and 0.5 g/L nicotinamide group (100μmol/L sodium nitroprusside and 0.5 g/L nicotinamide). Different doses of nitric oxide donor sodium nitroprusside and nicotinamide were added in the medium of each group. Three days after intervention, cel proliferation activity, intracel ular ATP concentration, cel nitric oxide synthase activity, cel ular reactive oxygen species level, and mitochondrial membrane potential were detected respectively.
RESULTS AND CONCLUSION:(1) After 3 days of rabbit nucleus pulposus cel s intervened by different concentrations of sodium nitroprusside, intracel ular nitric oxide synthase content increased with sodium nitroprusside volume increase, and ATP concentration decreased along with sodium nitroprusside volume increase;there were significantly differences between the normal control group and sodium nitroprusside groups (P<0.01). (2) Reactive oxygen species could be increased in the sodium nitroprusside group. Niacinamide groups indicated a dose-dependent manner to improve the increase of cel ular reactive oxygen species levels with sodium nitroprusside intervention (P<0.01). (3) In the sodium nitroprusside groups, nucleus pulposus cel membrane potential decreased. In the niacinamide groups, sodium nitroprusside-induced decline in mitochondrial membrane potential was reduced (P<0.01). (4) Niacinamide groups also indicated a dose-dependent manner to improve the proliferative activity of nucleus pulposus cel s as compared with sodium nitroprusside groups (P<0.01). Significant differences were determined between the two groups (P<0.01). (5) Results suggest that the excess nitric oxide can damage mitochondrial metabolic function of rabbit nucleus pulposus cel s and cause cel energy metabolism. Niacinamide can reverse these damages by inhibiting nitric oxide synthesis, thereby contributing to the prevention against intervertebral disc degeneration.

Objective To evaluate the efficacy of epidural block combined with general anesthesia for elderly upper abdominal surgery Methods Thirty-four elderly patients ,scheduled for elective upper abdominal surgery, ASA grade Ⅰ-Ⅱ, were divided randomly into study group (groupⅠ) and control group (group Ⅱ) In both groups anesthesia was induced with introvenous diazepam 0 1mg?kg -1, fentanyl 5?g?kg -1, etomidate 3mg?kg -1, atracurium 0 2 mg?kg -1 and succinylcholine 2 mg?kg -1, and was maintained with intravenous infusion of propofol 4-10ml/h and/or inhalation of 1% isoflurane and intermittent bolus of atracurium In groupⅠ epidural block was performed before induction Hemodynamics was measured with impendence cardiography and electroencephagram were monitored and intraoperative awareness, postoperative restlessness and anesthetic dosage were recorded, also the concentrations of plasma vasopressin and blood glucose were determined at pre-operation, incision and the end of surgery Results In group Ⅰ MAP,CO,HR incresed slightly during intubation, incision and extubation, and systemic vascular resistance (SVR) decreased during operation , but SVR was increased abruptly after extubation in group Ⅱ There were unsignificant changes in thoracic fluid index(TFI), stroke volume(SV), ejection volume index(EVI), EVI/TFI ratio in both groups during whole procedures SEF was recovered more earlier in group Ⅰthan that of in group Ⅱ after extubation The vasopressin and glucose levels increased significantly after-extubation compared with those before operation in group Ⅱ Conclusions The epidural block combined with general anesthesia can be more effectvely and safely applied to elderly upper abdominal surgery

Aim To investigate the effect of 8-bromo-7-methoxychrysin(BrMChR) on apoptosis of human gastric carcinoma SGC-7901 cell line.Methods SGC-7901 cells were cultured and the inhibitory effect of BrMChR on the proliferation of SGC-7901 cell line was measured by MTT assay.The apoptosis of SGC-7901 cells induced by BrMChR was analyzed using flow cytometry (FCM) with PI staining.DNA ladder bands were observed by DNA agarose gel electrophoresis.Results MTT assay suggested that BrMChR markedly inhibited the proliferation of SGC-7901 cells in a concentration-dependent manner,its IC50 was 2.6 ?mol?L-1,the potency of BrMChR was 8 times more than that of lead compound,chrysin (ChR,IC50 was 16.5 ?mol?L-1),and was 3 times more than that of 5-fluorouracil (5-FU,IC50 was 7.7 ?mol?L-1). FCM with PI staining indicated the apoptotic rate of SGC-7901 cell line treated with BrMChR (1.25,5.00,20.00 ?mol?L-1) for 48 h was (19.8%?0.2%),(36.8%?1.9%) and (45.5%?3.5%) respectively and the rate treated with BrMChR (1.25 ?mol?L-1) was higher than that treated with ChR (20.00 ?mol?L-1,12.9%?1.5%). DNA agarose gel electrophoresis showed that when treated with BrMChR(20.00 ?mol?L-1) for 48 h,the gene DNA of SGC-7901 cells presented typical DNA ladder bands which could attenuated by the effect of pre-incubation of GW9662(10.00 ?mol?L-1),a blocker of PPAR?.Conclusion BrMChR might induce apoptosis of SGC-7901 cell line partially by activating PPAR?.

The distribution of serotonin(5-HT), phenylethanolamine-N-methyltransferase (PNMT), substance P(SP) and leu-enkephalin(L-ENK) immunoreactive neurons in the rostral ventrolateral medulla (RVL) of the cat was studied with the immunohistochemical ABC technique, and the projection of 5-HT, SP and L-ENK positive neurons of the RVL into the thoracic cord was preliminarily investigated by a combined fluorescent retrograde transport and immunofluorescence method. The results indicate that 5-HT, PNMT, SP and L-ENK immunoreactive neurons mentioned above were localized primarily in the caudal part of nucleus paragigantocellularis lateralis and the rostral part of nucleus lateralis reticularis. SP positive cell bodies in the reticular formation close ventrolateral to nucleus ambiguus were also found. Some 5-HT, SP and L-ENK positive cells were situated in the area near the pia mater. In the most area of the RVL, 5-HT, PNMT, SP and L-ENK immunoreactive cell bodies had an overlapping distribution. 5-HT or PNMT or L-ENK positive neurons crowded, intertwined each other with their processes in the region at the levels 1.0-3.5mm caudal to trapezoid body, about 3.3mm lateral to the midline and about 0.8mm from the ventral surface of the medulla, and formed a longer or shorter continuous cell column which ran in the rostrocaudal direction. These three columns nearly coincided with each other at the level 1.5-2.5mm caudal to trapezoid body. Part of 5-HT, SP and L-ENK positive neurons in the RVL projected into the thoracic cord. The functional significance of these substances in the RVL was also discussed.

Aim To explore the role of a peroxisome proliferators-activated receptor gamma ligand,Rosiglitazone,in angiogenesis in human lung adenocarcinoma cells with reference to the regulation of vascular endothelial growth factor(VEGF).Methods Human lung adenocarcinoma A549 cell line was cultured in vitro.Expression of PPAR? and VEGF in A549 lung adenocarcinoma cells treated with different concentrations of Rosiglitazone was examined by semi-quantitative RT-PCR and immunohistochemical staining.Results PPAR? protein levels were higher in cultured A549 cells.RT-PCR and immunohistochemical staining showed that PPAR? mRNA and protein were enhanced in cells treated with Rosiglitazone in a dose-dependent manner,compared with those of untreated cells.Rosiglitazone had a potent inhibitory effect on the expression of VEGF in A549 cells dose-dependently in a range of concentrations.The effect was maximal with 10 ?mol?L~(-1) RSG and weaken over 20 ?mol?L~(-1) RSG,whereas 100 ?mol?L~(-1) RSG didnot have this down-regulation.GW9662,a PPAR? antagonist,partially blocked this effect of Rosiglitazone.Conclusions Activation of PPAR? suppresses angiogenesis in human lung adenocarcinoma.This action is probably associated with the down-regulation of angiogenic factor,VEGF,which may be modulated by PPAR?.These results suggest that PPAR? might be a novel molecular target for angiogenesis lung adenocarcinoma.

Aim To investigate the molecular mechanism of Rosiglitazone on the expression of integrin ?1 in lung pulmonary carcinoma A549 cell line. Methods RT-PCR and flow cytometry methods were used to examine the expression of mRNA and cell total protein of PPAR? and integrin ?1 subunit. Results The expression of PPAR? mRNA and integrin ?1 mRNA had dose-dependent regulating action by Rosiglitazone,using PPAR? inhibitor GW9662 and ERK pathway inhibitor PD98059 could abolish the inhibition of PPAR? on the expression of integrin ?1. Conclusion The effect of PPAR? ligand Rosiglitazone on integrin ?1 expression is mediated through PPAR?-dependent signaling parthway. The mechanism may be partly involved in ERK pathway.