BACKGROUND: Beta-adrenergic activation can enhance signal-transduction pathway of endothelial nitric oxide (NO). Vascular endothelial NO production in response to β -adrenergic activation is important in the normal control of vessel tone by the sympatheadrenal system. Previous trials have demonstrated that endothelial nitric oxide synthase (eNOS) activated by isoprenaline, β -adrenergic agonist, may be correlated with phosphorylation of eNOS. OBJECTIVE: To investigate the possible protein kinase involved in the signal transduction of the eNOS activation by β -adrenoceptor (β AR) stimulation in human vascular endothelium. DESIGN: Comparative observation. SETTING: Department of Geriatrics, First Affiliated Hospital of Zhengzhou University. MATERIALS: The experiment was performed at the Open Key Clinic Medical Experimental Laboratory of University of Henan Province between September 2006 and June 2007. Fresh umbilical cords were obtained following delivery of healthy babies to healthy normotensive mothers, either by vaginal delivery or by elective Caesarean section. The written informed consent was obtained from all donors. Approval was granted by the Affiliated Hospital of Zhengzhou University. Isoprenaline, H-89, Wortmannin, [3H]-L-arginine were from Sigma, USA. METHODS: Blank control group, H-89 group (protein kinase inhibitor), Wortmannin group (phosphatidylinositol 3-kinase inhibitor) and H-89+Wortmannin group were set up, and isoprenaline subgroup and blank subgroup were subdivided with 3 tubes in each group. Human umbilical vein endothelial cells (HUVECs) were cultured with H-89 and Wortmannin, separately for 10 minutes, then agonist isoprenaline or vehicle was added and the incubation continued for another 30 minutes, eNOS activity was determined by the conversion of [3H]-L-arginine to [3H]-L-citrulline. The results were corrected by protein concentration in the corresponding cellular extracts. MAIN OUTCOME MEASURES: Changes in eNOS activity of each group. RESULTS: ①Basal [3H]-L-citrulline production was (3 085.62±272.72) mBq per 1 μ g protein, lsoprenaline increased [3H]-L-citrulline formation by (30.72 ± 3.91 )% compared with the control group (P < 0.001 ). H-89 or Wortmannin alone did not alter eNOS activity [(0.44± 1.00)%, (0.36±1.47)%, P > 0.051. ②The increase of eNOS activity by isoprenaline wassignificantly inhibited by pretreatment of H-89 and Wortmannin [(4.73±2.19)%, (17.35±3.72)%, P < 0.001]. ③The inhibition of protein kinase and phosphatidylinositol 3-kinase to isoprenaline-induced increase in eNOS activity [(4.92± 0.99)%] was similar to protein kinase alone, but not in an additive effect (P > 0.05). CONCLUSION: Protein kinase and phosphatidylinositol 3-kinase are involved in the signal transduction of β- adrenoceptors mediated eNOS activation.

From members in this local district from January 2011 to December 2013,a total of 150 patients with malignant cancer and chronic disease patients of lost of functions and their carers were recruited.A self-tailored interview was conducted via face-to-face communications.And according to 112 (74.7％) carers,as compared to hospitalization,the patients were more likely willing to be looked after at home.The 95 (63.3 ％) carers had a lack of professional caring knowledge and their caring techniques were insufficient.And 97 (64.7％) carers were willing receive professional training in nursing and protecting dying patients.In-house terminal care is indeed required by the patients.However its service is best supported by the following aspects.The supports from local medical services and resources; professional training organized by a local social (neighborhood) committee and providing the guidance of in-house caring techniques and information of the relevant disease management.Building up a mutual terminal care group and finalizing the caring standards as soon as possible are essentials.

[Objective] To discuss the efficacy of Telbivudine treating chronic hepatitis B.[Method] Randomly divide 164 cases into treatment group 85 and control one 79,respectively taking Telbivudine and Ramivudine for anti virus for 48 w,then observe their efficacy.[Result] The ALT normalization and HbeAg positive rates were separately 87.50% and 71.15% for both groups; HBV DNA reduction rates and HbeAg postive-5.3 and-4.2log10 copies/ml,negative-6.6 and-5.5 log10 copies/ml;HbeAg negative rates respectively 28.57% and 23.08%;HbeAg serum conversion rates 23.21% and 15.38%;resistance rates of HbeAg positive 3.57% and 11.53%,negative 3.45% and 14.81%;the difference was very obvious(P

Young women affected by education and career delay the childbearing period,which results in reduced fertility.With the two-child policy completely opening,more and more elderly women have demands for pregnancy and the need of assisted reproductive technology (ART) increases day by day.However,the ART treatment faces with a series of medical and ethical problems.For example,the pregnancy rate of aged women is low but the abortion rate is high;and the incidence of pregnancy complications and fetal chromosomal abnormality increases significantly.In this regard,it can solve these problems through limiting the women's age,choosing the donated eggs,strengthening the counseling for elderly infertile women before ART treatment,paying attention to the psychological problems and applying the genetic screening technology before implantation.

Objective To explore a medical insurance model for rare diseases and orphan drugs applicable in China.Methods Eleven rare diseases from six disease systems and thirty-five orphan drugs covered were pinpointed for comparative analysis of their present coverage in various medical insurance systems in China.Results The coverage of 35 orphan drugs in the national essential drug list(2009)and the national essential drug list(2012)is 0 and 37.1％ respectively; the coverage in the national essential insurance medicine list is 54.3％ (19 types),and the average coverage in the medicine list for the New Rural Cooperative Medical Insurance Scheme is 33.6％.The study found insufficient rare diseases included in the Basic Medical Insurance Schemes in general.Conclusion The coverage of basic medical insurance for rare disease patients is low in China.In this regard,such measures should be taken to mitigate the economic burden for these patients,namely expanding the coverage of reimbursement list of orphan drugs,building the special reimbursement system of rare diseases and orphan drugs and improving the medical rescue system for rare diseases in China and their medical care level.

Genes, Recessive ; Humans ; Nephritis, Hereditary ; diagnosis ; Nephrotic Syndrome ; diagnosis

Objective To explore the outpatients′experience of caring and provide references for improving their experience of medical care.Methods The phenomenology research method was adopted in this study,and twenty-one outpatients were subject to an in-depth interview to learn their outpatient experiences.Results Ten themes of experience with caring were extracted as follows:passionate and patient,careful and considerate,respect for others,offers to help,encouraging and comforting,apologies and courteously,humor,truthful considerations,conscientious and responsible,and a caring environment setup.Five themes of experience without caring were extracted as follows:impatient communication, careless seeing of outpatients,delayed service,passive reminders,and facilities without enough details. Conclusions The outpatients may have abundant experiences of caring at the outpatient clinic,also lack of caring sometimes as well.Outpatient managers should keep an eye on outpatients′needs and satisfaction of caring from time to time,to improve the quality of outpatient service.

By expounding the definition and application status quo of egg freezing with non-medical factors, this paper ethically analyzed the conflict between egg freezing with non-medical factors and assisted reproductive technology standard management. After systematic evaluation on effectiveness, safety, economy and ethics, it sug-gested that the egg freezing with non-medical factors required careful consideration.

Purpose:To prove that electroacupuncture pudendal nerve stimulation(EPNS)can exactly excites the pudendal nerve.by simultaneous measurements of pelvic floor muscle (PFM) movements(perineal ultrasound),vaginal pressure and pelvic floor surface myoelectricity.Methods:Long needles(acupuncture needles)were deeply inserted into four sacral points and electrifled to stimulate the Pudendal nerves.When EPNS Was performed.perineal ultrasound B-mode images of PFM movements(contractions),M-mode PFM movement curves;vaginal pressure and pelvic floor surface electromyogram were recorded simultaneously by use of an urodynamic instrument with video suite(Medtronic Duet Encompass).Simultaneous records were also obmined under three conditions in the process of the nerve stimulation:1) pausing electric stimulation;2)reducing the intensity of electric stimulation(to about 2/7 of the original);3)drawing back the two lower needles to make the tips 1-2 cm away from the original position.Results:Thirty-five female patients with stress incontinence(aged 54.9±9.81 received EPNS and the simultaneous measurements.When EPNS was performed correctly,the patient felt rhythmic and cephalad PFM contractions with the urethra as the center.Simultaneous records showed the following:1) cranio-caudal PFM movements on the B.mode image;2)the M-mode curves indicating the PFM contractions (amplitude:about 1 mm,n=31,14 cases≥1 mm and 17 cases＜1 mm);3)A sawtooth curve of changes in vaginal pressure[amplitude:2.61±1.69(0.7-5.6)cmH2O,n=34];4)pelvic floor myoelectric waves[amplitude:23.9±25.3(5-96)μV,n=34].The amplitude of a PFM movement curve conformed basically to that of a vaginal pressure curve.If the electric current was stopped or its intensity was reduced to about 2/7 of the original or during the process of the nerve stimulation the two lower needles were gradually drawn back until the tips were 1-2 cm away from the original positions,then B-mode PFM movements,M-mode curves and sawtooth changes in vaginal pressure disappeared.Conclusion:Electroacupuncture pudendal nerve stimulation can exactly excites the pudendal nerve and effectively contract the pelvic floor muscles.

Objective To evaluate the open-set auditory speech perception abilities, to characterize the auditory speech development of children with cochlear implants.Methods 27 congenitally deafened children with cochlear implants were evaluated with Mandarin monosyllable and disyllable lexical neighborhood test(M-LNT-Monosyllable & M-LNT-Disyllable) and Mandarin hearing in noise test for children(MHINT-C) according to the order from M-MLNT easy test,M-MLNT hard test, M-LNT easy test ,M-LNT hard test, MHINT-C quiet condition, MHINT-C noise front condition, MHINT-C noise non-implant side condition to MHINT-C noise implant side condition in sound field.Results 27 CI children have completed M-LNT/M-MLNT, 9 of them could be tested in quiet condition with MHINT, and 7 could be tested in noise with MHINT. There were significant differences between scores of easy and hard words lists of M-LNT and M-MLNT(P