The author of the article makes all-around expectation of continuous medical education development in our country from the ten aspects such as its role in medical reform and medical development,perfecting its construction,intensifing the demand-orientation,making scientific and informationized management.improving the quality of education and modernization of its means,conducting theoretical and practical study to generalize new theory and methods and promoting the international communication and cooperation.

Objective To evaluate the osteogenic potential of selected exercises and determine which one has the greatest value for the elderly.Methods Twenty healthy old subjects were recruited in the study.Each subject performed the following four exercises in random order:stepping onto a 4-in riser (STEP),sit-to-stand (STS),jumping (JUMP) and marching (MARCH).The subjects performed successively each of the 4 exercises for 1 minute,with an interval of 3 minutes between each.The Vicon action capture system was used to record the peak ground reaction of the subjects during their exercises.The osteogenic index (OI) was calculated by the formula:OI=peak GRF/ (body weight×9.8) × In (number of loading cycles±1).Results JUMP and MARCH had superior OI value (7.52 ±2.06,6.51 ±1.59) than STEP (5.22 ±0.63) among the4 exercises (P＜0.05).STS was found to have the lowest OI (2.23 ± 0.42) in the elderly.There was no significant correlation between the height and OI in JUMP and MARCH (P ＞0.05).Conclusion STEP and MARCH had the higher OI value and could be deemed as the better ways to induce positive effects on bone health in the elderly population.

Neovascularization plays an essential role in the process of renovation in tissue damage,tumor growth, and hormones action. Parathyroid hormone (PTH) is one of the basic hormones that regulate the serum calcium, phosphorus, and bone metabolism. In recent years, studies involving the neovascularization-mediated effects of PTH on metabolism are becoming more and more popular and wider. Based on recent researches, the purpose of this paper is to summarize the changes of angiogenesis while PTH interacts with its target organs, especially interacts with osseous tissue.

Agriculture ; Humans ; Occupational Exposure ; adverse effects ; analysis ; Radiation Dosage ; Radon ; adverse effects ; analysis ; Seasons

BACKGROUND: A good many researches believe that the gene polymorphism of vascular endothelia nitric oxide synthase(eNOS) correlate with diseases of heart, brain and kidney. However, it is still not clear whether eNOS Glu298Asp correlates with myocardial infarction in the elderly Chinese.OBJECTIVE: To investigate the distribution of Glu298Asp polymorphism of vascular eNOS in the elderly as well as correlation between Glu298Asp polymorphism of eNOS and myocardial infarction in the elderly Chinese.DESIGN: A case-controled study based on diagnosis.SETTING, PARTICIPANTS and METHODS: A total of 37 patients with myocardial infarction were selected into case group, which all of them were patients from either outpatient department or inpatient department of the First Affiliated Hospital of Nanjing Medical University. Thereinto, 20 cases without hypertensive history were allocated into case subgroup. Totally 172 subjects selected from the re-testees of physical checkup of our hospital were assigned into control group, of which 92 cases without hypertensive history were allocated into control subgroup. Indices like height, body mass and fasting blood sugar were detected respectively in all participants of all groups. The polymorphism of Glu298Asp of eNOS gene was assayed by polymerase chain reaction(PCR), and restriction fragment length polymorphism (RELP).MAIN OUTCOME MEASURES: The polymorphism of Glu298Asp of eNOS gene as well as the allelic frequency of 298Asp in the elderly of four groups.RESULTS: Genotype of Glu/Asp of the case group was higher than that of the control group(32.43% and 18.02% respectively) . The genotype composition of Glu298Asp polymorphism had significant difference between the case group and the control group(x2 = 3.87, P < 0. 05) . Between normotensive subgroups, Genotype Glu/Asp of the case subgroup was higher than that of the control subgroup(35.00% and 10. 87% respectively) . The genotype composition of Glu298Asp polymorphism of the eNOS gene also had significant difference between the case subgroup and the control subgroup (x2 = 7.43, P < 0.01) . The allelic frequency of 298Asp of the case group was higher than that of the control group without statistical significance (16. 22% and 9.01% respectively, P > 0. 05) . Between normotensive subgroups, the allelic frequency of 298Asp of the case subgroup was significantly higher than that of the control subgroup(17.50% and 5.43% respectively, x2 = 6.82, P < 0.01 ) ).CONCLUSION: Glu298.Asp polymorphism of the eNOS gene exists in the elderly Chinese. The genotype of Glu/Asp and allelic frequency of 298Asp might be a genetic susceptible marker of myocardial infarction in the elderly Chinese.

Objective To discuss influence of early rehabilitation nursing on rehabilitation effect of patients after heart valve replacement.Methods 60 patients with heart valve replacement were divided into the rehabilitation group and the control group with 30 patients in each group.The control group was given normal nursing and self-exercise ad libitum.Based upon the above,the rehabilitation group was given systemic and normative rehabilitation nursing according to programs established for each individual.The incidence of complications,guardianship time and hospitalization time were compared between the two groups.Results The incidence of complications of the patients in the rehabilitation group was much lower than the patients in the control group.And the time of the patients in the rehabilitation group in ICU and hospitalization time was shorter than the patients in the control group.Conclusions Early rehabilitation care can effectively reduce the incidence of complications after cardiac surgery,promote recovery of cardiac function,also can improve the quality of life of patients.

Objective To investigate the relationship between serum uric acid ( SUA) concentration and urinary albumin excretion rate ( UAER) and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitua (T2DM). Methods The clinical data of 372 patients with T2DM. including 184 males and 188 females, were collected. The correlations between SUA and the other clinical indexes were analysed by Pearson method, and multiple regression analysis was employed to examine the effects of various factors on UAER and CIMT. Results SUA concentration was higher in males than in females with T2DM (P <0. 01). and was positively correlated with UAER both in males and females with T2DM, even after adjustment for the creatinine clearance (r = 0.24, P < 0.01 for males; r = 0. 29, P < 0.01 for females). Positive correlation was found between SUA concentration and CIMT in females (r =0. 29, P < 0. 01). Multiple regression analysis demonstrated that SUA concentration was an independent determinant of UAER for males as well as females (β=0.16, P<0.05 for males; β=0. 20, P < 0. 05 for females), and was also an independent determinant of CIMT for females (β =0.16, P <0.05). Conclusion SUA plays an important role in the progression of diabetic nephropathy and cardiovascular diseases in patients with T2DM. SUA control may provide a novel approach for the treatment of diabetic nephropathy and vascular complications.

Objective To investigate the different expression pattern of Src-homology2 domain phosphatase (SHP)-1 and SHP-2 in human papiilomavirus (HPV)6/11 infected condyloma acuminatum (CA) and the significance of the difference. Methods HPV6/11 related CA cases were diagnosed by in situ hybridization. The expression and distribution of SHP-1 and SHP-2 were examined by SP immunohistochemistry technique in skin samples from 40 HPV 6/11 positive CA cases and 20 healthy control (foreskins). Results The positive rates of SHP-1 and SHP-2 were 80% and 85% respectively in CA, which were significantly higher than those in healthy control cases (only 35% and 30%, respectively, X2=11.87,P<0.01; X2 =18. 15,P<0. 01) . The SHP-1 and/or SHP-2 positive cells in CA skin lesions were mainly distributed in prickle layer, showing as brown yellow, with the positive staining located in cytoplasm. Contrastively, the SHP-1 and/or SHP-2 positive cells in healthy controls were rare and mainly distributed in basal layer, showing as pale yellow with the positive staining located in cytoplasm. There was no significant correlation between the expression of SHP-1 and SHP-2 in CA( rs = 1.0, P>0.05 ). Conclusion The expressions of SHP-1 and SHP-2 increase in HPV6/11 positive CA, which suggest that with the infection of HPV6/11, SHP-1 and SHP-2 may play a regulatory role in the proliferation of keratinocytes.

Objective To explore the association of Glu298Asp polymorphism of the endothelial nitric oxide synthase gene (eNOS) with myocardial infarction in Chinese aged people based on a case-control study. Methods Thirty-seven patients with myocardial infarction and 172 sex- and age-matched healthy control subjects were enrolled. Their height, weight and blood pressure were measured and the fasting plasma lipid concentrations were examined. Glu298Asp polymorphisms of the eNOS gene were examined using PCR and RFLP methods. Results Genotype Glu/Asp in the patient group was higher than that in the control group (32.4% vs 18.0%). The genotype composition of Glu298Asp polymorphism showed significant difference between the patient group and the control group ( =3.87, P 0.05). Among the normotensive subgroup, the allelic frequencies of 298Asp in the patient subgroup was higher than that in the control subgroup (17.5% vs 5.4%). The allelic frequencies of 298Asp had significant difference between the patient subgroup and the control subgroup ( =6.82, P

Objective:To compare the therapeutic and adverse effects of concurrent raltitrexed plus oxaliplatin and radiotherapy with those of PF synchronous radiotherapy in the treatment of advanced esophageal cancer. Methods:A total of 84 pathologically con-firmed patients with advanced esophageal carcinoma were randomly distributed to the concurrent raltitrexed plus oxaliplatin and ra-diotherapy group (experimental group, n=40) and to the PF synchronous radiotherapy group (control group, n=44). All patients were treated with 3DCRT at a total dose of 60 Gy/30f. The chemotherapy in the experimental group consists of raltitrexed at 2.5 mg/m2, d1, plus oxaliplatin at 130 mg/m2, d2. The chemotherapy of the control group consists of DDP at 25 mg/m2, Dd1-3, plus 5-FU 500 mg/m2, d1-5. Two cycles of concurrent chemotherapy were administered during radiotherapy on d1 and d29. The comparison results were used to estimate the therapeutic and adverse effects of the two groups. Results:The rerponse rate, complete response, and one-year overall survival rate of the experimental group were higher than those of the control group [(87.50%vs. 79.54%, P=0.3293), (32.50%vs. 18.18%, P=0.13), and (82.50%vs. 79.50%, P=0.701)], but the difference was not statistically significant. The incidence rates of nau-sea and vomiting, appetite degression, leucopenia, radiation-induced esophagitis, and cardiotoxicity were significantly lower (P<0.05) in the experimental group than in the control group. Other adverse effects of the two groups were similar (P>0.05). Conclusion:Simi-lar to PF chemotherapy and radiotherapy, the concurrent raltitrexed plus oxaliplatin and radiotherapy achieved a similar short-term therapeutic effect but lower adverse effects on patients with esophageal cancer.