Five medicines for prevention and treatment of osteoporotic fractures were introduced.They are bisphosphonates,calcitonin,selective estrogen-receptor modulator,estrogen and active vitamin D.The pharmacologic effects,safety,application and causions were explained according to principles of evidence-based medicine.

With the development of molecular biology and molecular genetics,more attention has been taken to the advanced techniques which can be used to detect minority mutations.In recent years,many techniques such as amplification refractory mutation system,PCR clamping,pyrophosphorolysis-activated polymerization,co-amplification at lower denaturation temperature-PCR and digital PCR have been developed,which will make the hereditary disease diagnosis,cancer detection,noninvasive antenatal diagnosis step into a new stage in the near future.This review presents an overview of the principles,aoolications,advantages and disadvantages of these techniques.

With the rapid advancement of immunology and molecular biology,many new revelations and ideas were drew for clinical immunology in laboratory medicine.In the current circumstances of application of clinical pathway management and individual medical care,how to accurately grasp these changes to build perfect quality system for clinical immunology laboratory,clarify the immunology laboratory pathway and integrate that into clinical pathway management,make solid progress for the promotion and application of individual diagnosis and evaluate the diagnostic value of new technique and item for clinical immunology laboratory accurately might be worth pondering for every people working in clinical immunology laboratory.In this paper,the status quo and reflection of clinical immunology is reviewed.

Hypertension is a common chronic disease which can lead to cardiac, cerebrovascular and renal damage; it is seriously harmful to human health. Cardiovascular disease caused by hypertension has become the first cause of death of residents in our country, the burden of disease has become more and more serious, how to manage hypertension has become an important public health issue in our country. In this review, the development and current situation of the community health management of hypertension at home and abroad are described and analyzed, the experience and practice worthy of learning are summarized to provide evidence for the prevention and control of hypertension in community.

Objective To observe the distribution of cornea Q value in adult myopia,and its relationship with age,sex,eye and refraction.Design Prospective case series.Participants Consecutive 510 patients (1020 eyes) of myopia of adults.Methods Cornea Q values were obtained with OrbscanⅡz Anterior Segment Analysis System in all subjects of adult myopia.Normal distribution test of Q value and correlation analysis with sphere,cylinder,sex,and age were performed.Main Outcome Measures Q value of cornea,corre- lation coefficient.Results In 1020 eyes of adult myopia,the mean Q value was-0.27?0.16 (range from-0.86 to 0.25) with near nor- mal distribution.The difference of Q value between right eyes and left eye was not statistically significant (P=0.675).The Q value be- tween male (-0.26?0.15) and female(-0.27?0.17) was not statistically difference(P=0.697).No significant relation was found Q value with either sphere (r=0.057,P=0.068) or cylinder (r=0.044,P=0.156).Mean Q value of below 20 years old was maximal,-0.24,while over 40 years old was minimal,-0.36,and the difference were statistically significant (P=0.000).Conclusions Q value of cornea has negative shift with the increase of age,especially in over 40 years old.Q value of cornea has no relationship with left or right eyes,sex and refraction,but it is highly customized.

Objective To observe the clinical effects of treating acute upper gastrointestinal bleeding(AUGIB) with freezing Zidi mixture lavage. Method 183 UGIB patients from the First Affiliated Hospital to Guanzhou University of TCM in August 2013 were randomly recruited into a control group with 91cases and a treatment group with 92 cases. The treatment group was treated with intragastric administration of freezing Zidi mixture, while the control group was treated with intragastric administration of cryohydrate and norepinephrine. The changes of clinical effects, blood pressure, hemoglobin, blood urea nitrogen, pulse and dark stool were observed and the bad emotions as anxiety, depression and fear were evaluated. Results ① On therapeutic effect, the total effective rate was 96.7% and 85.7% in the treatment group and the control group respectively, with statistical difference(χ2=2.943,P<0.05). ② On the time of symptom disappearance:the disappearing time of vomiting, dark stools and occult blood test in the treatment group was obviously shorter than the control group after the treatment(t=6.628、14.052、21.706,P<0.05 or 0.01). ③ On body symptom changes: after the treatment, the systolic pressure, heart rate, hemoglobin, and blood urea nitrogen [(114.3±12.1)mmHg,(78.6±11.4)/min,(98.1±10.5)g/L,(5.9±1.1)mmol/L] in the treatment group were all obviously improved than those [(106.3±11.2)mmHg, (88.7±12.1)/min,(88.2±11.7)g/L,(6.9±1.4)mmol/L] in the control group;body temperature returned to normal in both groups, and there was no statistical difference score was either in or between groups(P>0.05). ④ On changes of anxiety, depression and fear:the treatment group [the(42.5±9.4), (41.6±9.7), (26.3±5.4)for each]was obviously improved after the treatment than the control group[the score was(51.2±10.1),(50.4±11.5),(30.4±6.9)for each],P<0.05. Conclusion Freezing Zidi mixture lavage can obviously elevate systolic pressure, decrease heart rate, enhance hemoglobin, decrease blood urea nitrogen, relieve body stress reaction and other clinical symptoms. Its effects were better than intragastric administration of cryohydrate and norepinephrine in treating AUGIB.

Objective To investigate the effect of treatment with transplanted bone marrow mononuclear cells under different transplant paths on neovascularization in ischemic cerebral infarction rats. Methods The MCAO models were established by intraluminal vascular suture method. All the successful models were randomly divided into control group, intravenous transplantation group and subarachnoid transplantation group according to the random number table. The Extraction,isolation and culture of bone marrow mononuclear cells were extracted,i?solated and cultured. The models in the control group were injected 200μl PBS through the femoral vein. The mod?els in the intravenous transplantation group were injected 200μl containing 2×107 bone marrow mononuclear cells through the femoral vein. The models in the subarachnoid transplantation group were injected 200μl containing 2× 107 bone marrow mononuclear cells through the subarachnoid. The VEGF levels in cerebrospinal fluid of rats were detected using quantitative ELISA method. The vascular regenerations in the infarct area were observed by using quantitative immunofluorescence. Results After transplantation of bone marrow mononuclear cells 7 d,14 d and 28 d,the VEGF levels of rat cerebrospinal fluid in subarachnoid transplantation group were (207.4±8.9)pg/ml, (171.2±10.3)pg/ml and (143.8±13.8)pg/ml,respectively,which were all higher than the VEGF levels in intra?venous transplantation group,the differences were all statistically significant (P<0.05). After transplantation 14 d and 28 d,the BrdU?positive cells in subarachnoid transplantation group were ( 2043. 8 ± 514. 2) and ( 1834. 8 ± 307.4) ,respectively,which were higher than the intravenous transplantation group,the differences were all statisti?cally significant (P<0.05). The microvessel counts in subarachnoid transplantation group were (384.6±45.1) and (514.8±51.3),respectively,which were higher than that in the intravenous transplantation group,and the differ?ences were all statistically significant (P<0.05) . Conclusions Bone marrow mononuclear cells transplantation can increase VEGF secretion,and promote angiogenesis infarct. The effect of subarachnoid transplantation is better.

Objective To put forward a reform assumption of physician payment model based on review of physician payment models abroad. Methods Literature review and expert interview. Results Physician payment model and its reform patterns overseas were discussed. Problems of current physician payment model in Chinese public hospitals were analyzed. Conclusions The physician payment reform in public hospitals should focus on raising physician salary. The investment of resources and technology of medical service projects should be measured reasonably. Setting up responsibility center , saving health care costs and improve the quality of health care are the most important three aspects of physician payment model reform in Chinese public hospitals.

Objective To study the role of homeobox A2(HOXA2) gene in cell growth,cellcycle and apoptosis of hepatoma cells, and discuss the feasibility that HOXA2 gene would be a potential therapy target of hepatoma. Methods Real-time quantitative polymerase chain reaction and revers transcriptional polymerase chain reaction were performed to examine HOXA2 expression in tumorous and non-tumorous tissue of patients was matched with liver cancer. siRNAs were chemically synthesized to interference HOXA2 in PLC/PRF/5 and MHCC-97L cells. Growth curve and soft-agar colony formation assay were performed to evaluate cell growth, and cell cycle and apop-tosis were analyzed by flow cytometry. Results HOXA2 was upregulated in HCC samples compared with matched non-tumor tissues(P<0.05). Two siRNAs against HOXA2 gene were designed and synthesized to specially knock-down HOXA2 in PLC/PRF/5 and MHCC-97L cells. HOXA2 knockdown inhibited cellular growth and soft-agar colony formation in PLC/PRF/5 and MHCC-97L cells. And Fowcytometry analysis revealed that HOXA2 knock-down by RNA interference could result in G1 arrest and S decrease and promoted cellular apoptosis. ConclusionHOXA2 gene has an important role in cell growth of hepatoma cells.

BACKGROUND: In order to improve the medication safety and remove export obstacles of Chinese preparations contained heavy metal and arsenide (cinnabar, realgar), it is necessary to carry on the evaluation on the efficacy and safety of cinnabar and realgar. At present, it has not been clear concerning to the pharmacodynamic mechanism of cinnabar and realgar in compound prescriptions yet.OBJECTIVE: To study the differences in cinnabar and realgar in angong niuhuang wan in the organism physiologically and pathologically so as to probe into those pharmacodynamic mechanism.DESIGN: A randomized and controlled trial.SETTING: Institute of Clinical Pharmacology of one university.MATERIALS: The experiment was performed in Institute of Clinical Pharmacology of Guangzhou University of Traditional Chinese Medicine in January 2003. Totally 51 male SD rats weighted varied from 250 g to 300 g were employed, provided by Experimental Animal Center of First Military Medical University of Chinese PLA.METHODS: SD rats were randomized into 6 groups(8-10 rats/group),named as normal group, normal & angong niuhuang san (integral recipe) group(278 mg/kg), normal & cinnabar and realgar omitted angong niuhuang san(disassembled recipe) group(222.7 mg/kg), cerebral edema model group(ligature on unilateral carotid artery by injection of pertussis bacilli (PB), 2 500 million/kg), model & integral recipe group (medication 278 mg/kg was done 1 hour before model preparation), model & disassembled recipe group(medication 222.7 mg/kg was done 1 hour before model preparation) . Five hours later after once medication(4 hours later after PB injection in model group), blood was collected and brain homogenate was prepared.MAIN OUTCOME MEASURES: Brain tissues, serum lactate dehydrogenase(LDH) activity and percentage enzyme activity of lactate dehydrogenase isoenzymes (LDH1-5).RESULTS: Compared with normal group, the general activity of LDH in normal & integral recipe group and normal & disassembled recipe group was significantly improved by 32.4% to 38.4% ( P ＜ 0.05); percentage enzyme activity of LDH1,2 was significantly increased( P ＜ 0.01 ), and that of LDH4, 5 was reduced( P ＜0.01) . Except LDH5, there were no significant differences in enzyme activity of isoenzymes in two groups. Compared with model group, the general activity of LDH in model & integral recipe group and model & disassembled recipe group was significantly improved by 23.4% to 38.5% ( P ＜ 0.01); percentage enzyme activity of LDH5 was significantly increased( P ＜ 0.01 ), there were no significant differences in two groups. In model & integral recipe group, percentage enzyme activity of LDH2,3 was significantly decreased( P ＜ 0.01), and that of LDH1,4 was no significant change. In model & disassemble recipe group, percentage enzyme activity of LDH1,4 was significantly reduced( P ＜ 0. 05, 0.01 ) and that of LDH2,3 was no significant change.CONCLUSION: In normal physiological state, angong niuhuang san produces a certain injuries on cardiac muscle and kidney. In pathological state of infectious cerebral edema, both integral and disassembled recipes inhibit LDH enzymes that have been over-activated, but the significant differences did not presented between both. Cinnabar and realgar in compound prescript provide the effects in various degrees on levels of LDH isoemzymas.