The puberty and reproduction are regulated by the hypothalamic-pituitary-gonadal axis. The activation of hypothalamic gonadotropin-releasing hormone (GnRH) neurons and an increase in GnRH is critical for the initiation of puberty. The mechanism of GnRH regulation for neurons activity is complicated, because many different factors can affect the secretion of GnRH. Glutamate is the main excitatory neurotransmitter, which can promote the secretion of GnRH through a variety of pathways. In recent years, relevant studies showed that NELL2 may influence the secretion of GnRH by regulating the secretion of glutamate or through other pathways,thereby affecting the onset of puberty. So NELL2 plays an important role in promoting neuronal growth,differentiation, neuronal plasticity maintenance and synapse transportation etc.

Objective To investigate the status of post traumatic growth and role reinforcement in elder patients with cerebral infarction accepting the treatment of rehabilitation, and to explore the effect of role reinforcement on post traumatic growth. Methods Totally 303 patients with cerebral infarction accepting the treatment of rehabilitation were investigated by the Post Traumatic Growth Rating Scale and the Role Reinforcement Scale. Results The post traumatic growth and role reinforcement scores of the patients were (61.50 ± 7.19), (63.51 ± 9.28) points. The scores of each dimension of post traumatic growth were significantly positively correlated with the role reinforcement (r =-0.794--0.123, P < 0.05 or 0.01). Stepwise regression analysis showed that the influence factors on the post traumatic growth of the patients were the cultural level, age and each dimension of role reinforcement (P < 0.05). Conclusions For the patients with cerebral infarction accepting the treatment of rehabilitation, the level of post traumatic growth is in a moderate level, and the role reinforcement is in a strong level, and role reinforcement is the influencing factor of post traumatic growth.

The cerebral salt wasting syndrome and syndrome of inappropriate antidiuretic hormone secretion are frequent in hyponatremia in patients with intracranial disorders.There is a major problem about the incidence,diagnosis,and differentiation of cerebral salt wasting syndrome and syndrome of inappropriate secretion of antidiuretic hormone in patients with acute central nervous system disorders.Clinical presentation of cerebral salt wasting syndrome is similar to syndrome of inappropriate antidiuretic hormone secretion,but the therapy is different.So differential diagnosis is essential for appropriate management.This paper differentiate two kinds of diseases from the pathogenesis,diagnosis and treatment.

Objective To explore the possible mechanism for KiSSI gene in control gonadotropin - releasing hormone(GnRH)secretion participating in sexual development onset and normal reproduction regulation by investigating the changes in expression of KiSS1,GnRH in hypothalamus and luteinizing hormone(LH),follicle stimulating hormone (FSH),and estradiol(E2 )in serum by using RNA interference mediated by lentivirus - based vectors,after interfering expression of KiSSI. Methods Ninety female Sprague - Dawley rats of 21 days were randomly divided into 3 groups:interference virus group receiving intracerebroventricular injection of KiSSI - microRNA interference lentivirus;lentivi-rus - control group given intracerebroventricular injection of lentivirus without interference effect;9 g/ L saline control group given intracerebroventricular injection of 9 g/ L saline. Ten rats in each group and the animals were sacrificed at 30 - day - old,35 - day - old,45 - day - old,respectively. Then the expressions of KiSSI and GnRH mRNA were detec-ted in the rat hypothalamus with real - time PCR,the LH,FSH,and E2 in serum was examined with chemiluminescence method. Results The levels of KiSSI mRNA in interference virus group were significantly reduced after being infected with recombinant lentivirus compared with those of 9 g/ L saline control group( at 30 d:0. 106 ± 0. 018;at 35 d:0. 218 ± 0. 025;at 45 d:0. 215 ± 0. 033,all P = 0. 000). The level of GnRH mRNA in interference virus group was sig-nificantly reduced after being infected with recombinant lentivirus compared with that of 9 g/ L saline control group(at 30 d:0. 230 ± 0. 040;at 35 d:0. 407 ± 0. 030,all P = 0. 000). The level of LH in interference virus group was lower than the other 2 groups at 35 d[(0. 101 ± 0. 004)IU/ L,P = 0. 467]. The level of FSH in the interference virus group was lower than that of the other 2 groups at 35 d[(0. 235 ± 0. 014)IU/ L,P = 0. 015]. The level of E2 in the interfe-rence virus group was lower than that of the other 2 groups at 35 d and 45 d[at 35 d:(171. 750 ± 11. 050)nmol/ L, P = 0. 000;at 45 d:(192. 310 ± 13. 100)nmol/ L,P = 0. 010]. Conclusions Lentivirus with KiSSI - microRNA can affect the expression of GnRH mRNA and the levels of sex hormone. Lateral cerebral ventricle microinjection of KiSSI -microRNA lentivirus can delay sexual development of Sprague - Dawley female rats.

Objective To investigate the expression of low molecular mass polypeptide-2 (LMP2)and protein phosphatase 1A (PPM1A) in gestational trophoblastic disease and elucidate their predictive value in malignant transformation of hydatidiform mole. Methods The expressions of LMP2 and PPM1A protein in 196 complete hydatidiform moles (in which 28 cases with malignant transformation) , 7 invasive moles, 5 choriocarcinomas and 20 normal chorionic villus were detected with the method of En Vision immunohistochemistry. Their clinicopathologic data were retrospectively analyzed. Results LMP2 and PPM1A protein expressed in cytotrophocytes, syncytiotrophoblast and extravillous trophoblast. The level of LMP2 expression in deteriorative hydatidiform mole was significantly higher than that in non-deteriorative hydatidiform mole or normal chorionic villus (6. 79 ±2. 38, 5.26 ±2.63 and 3. 10 ±1.65, all P <0. 01),while there were no difference compared with gestational trophoblastic neoplasms (6. 42 ±2. 68, P=0. 113).The level of PPM1A expression was highest in normal chorionic villus, and decreased gradually in hydatidiform mole (non-deteriorative and deteriorative) and gestational trophoblastic neoplasms (6. 30 ±2. 98, 4. 93 ± 2. 50, 4. 43 ± 2. 04 and 3. 33 ± 2. 06, all P < 0. 01); the level of PPM1A expression in deteriorative hydatidiform mole was significantly lower than that in non-deteriorative hydatidiform mole (P=0.001). The expression of LMP2 protein was correlated to theca lutein ovarian cyst, the expression of PPM1A protein was related with uterine size (P < 0. 05) . While, there was no correlation between the expressions of the two proteins (P >0. 05). Conclusions High expression of LMP2 and low expression of PPM1A might play an important role in the motility and invasiveness of trophohlast cells and malignant transformation of hydatidiform mole. Testing the expression of LMP2 and PPM1A in hydatidiform mole tissues of initial uterine evacuation might be have some reference significance in judging outcomes of hydatidiform mole.

Objective To study the antitumor activity of extract from Salvia plebeia and investigate whether the extract induce apoptosis of K562 cells. Methods The aqueous, petroleum ether, dichloromethane (CH2Cl2), ethyl acetate, and butanol extracts were prepared from the aerial parts of 5. plebeia. Taking fluorouracil as reference, the cytotoxic activities of these extracts on HeLa, A549, SGC-7901, HCT-116, K562, LoVo, DU-145, and HepG2 cells were evaluated. To clarify the apoptosis of K562 cells induced by CH2Cl2 extract, the methods of Hoechst 33258 staining, flow cytometry assay, and DNA ladder assay were investigated. Results The CH2Cl2 extract showed the most potent cytotoxic effect against K562 cells, with an IC50 < 15 μg/mL for 3 d treatment. The characteristic apoptotic symptoms such as DNA fragmentation and chromatin condensation were also observed in the K562 cells. Conclusion The CH2Cl2 extract from S. plebeia may inhibit the cancer cell proliferation by inducing cell apoptosis.

Objective To investigate the correlation of oxygen extraction rate (ERO2) with blood lactate clearance rate and cardiac output (CO) in the early stage of post-restoration of spontaneous circulation (ROSC) in patients resuscitated from cardiogenic cardiac arrest,and to analyze the relationship between the ERO2 and prognosis.Methods Fourteen patients successfully resuscitated from in-hospital cardiogenic cardiac arrest in the emergency ICU from October 2012 to January 2014 were retrospectively analyzed.These patients were assigned to survival group (n =5) or death group (n =9) as per the outcome at 72 h after ROSC.At admission (0 h),3,6 and 12 h after ROSC,arterial blood and venous blood were drawn to detect ERO2 and lactate clearance rate.Cardiac output (CO) was measured by thoracic impedance method,APACHE Ⅱ scores were assessed,and survival time was recorded.Results The patients in the death group died during the period of 12-72 hours after ROSC.The significantly decreased ERO2 at 6 h and 12 h after ROSC,and decreased blood lactate clearance rate and decreased CO at 3 h,6 h and 12 h after ROSC were found in the death group compared with the survival group (all P ＜ 0.05).The ERO2 at 6 h and 12 h after ROSC was significantly positively related to blood lactate clearance rate (r =0.857,r =0.947,both P ＜ 0.05) and CO (r =0.968,r =0.936,both P ＜ 0.05) at 3 h,6 h and 12 h after ROSC.The ERO2 at 6 h and 12 h after ROSC was significantly negatively related to APPACHE Ⅱ score (r =-0.970,r =-0.973,both P ＜ 0.05);APPACHE Ⅱ scores were significantly negatively correlated with blood lactate clearancerates (r=-0.880,r=-0.899,r=-0.850,all P＜0.05) and CO (r=-0.876,r=-0.922,r=-0.916,all P＜0.05) at 3 h,6 h and 12 h after ROSC.Conclusions The ERO2 at 6h after ROSC may be used to assess the severity and prognosis of patients resuscitated from cardiogenic cardiac arrest.

Objective To study the endogenous metabolites of liver-kidney deficiency syndrome in knee-joint osteoarthritis (KOA) and explore the metabolic profile of KOA liver-kidney deficiency syndrome. Methods Totally 50 cases of KOA with liver-kidney deficiency syndrome and 50 cases of KOA with non-liver-kidney deficiency syndrome were collected respectively, and 20 cases of healthy volunteers were collected as the normal group. The serum samples of subjects were collected after fasting for 8 h. Hydro-Nuclear Magnetic Resonance (1H-NMR) spectrometer was collected. Principal component analysis and partial least squares discrimination analysis were used to conduct multivariate statistical analysis. Results 1H-NMR could identify 23 kinds of metabolites, and there was statistical significance between KOA patients and healthy volunteers (P<0.05, P<0.01). There was statistical significance in cartilage matrix metabolism, energy metabolism, lipid metabolism, pain, inflammation-related metabolites in patients with KOA liver-kidney deficiency syndrome and patients with KOA non-liver-kidney deficiency syndrome (P<0.05). Conclusion Patients with KOA liver-kidney deficiency syndrome have a unique 1H-NMR metabolic profile, KOA syndrome has a metabolic material basis.

Objective:To analyze the concerning guarantee mechanisms during the transformation of the com-munity health service mode. Method:Purposive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou, and Chengdu, where the transformation of the community health service mode was pi-loted earlier and representative, were selected as the field survey sites. The qualitative method was used to collect da-ta accompanied by the quantitative method. Results: The guarantee mechanisms related to the transformation of the community health service mode could be concluded into four main types:collaboration mechanism, health profession-al training mechanism, incentive mechanism, and policy guarantee mechanism. All of the four mechanisms contribu-ted to the improvement of general teamwork, dual referral systems, and the development of contract and appointment services. Conclusion:During the transformation of the community health service mode, priority strategies include top-down design, health professional training mechanisms, and performance-based incentive mechanism, all of which should be implemented in the future.

Objective:To analyze the structure modes of general practice teams in community health care cen-ters in order to provide empirical evidence for the transformation of the community health service mode. Method:Pur-posive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou and Cheng-du, where the transformation of the community health service mode was piloted earlier and representative, were se-lected as the field survey sites. The qualitative method was used to collect the data accompanied by the quantitative method. Results:The structure models of general practice teams could be divided into four types:1) general practi-tioner+nurse+nurse assistant+pharmacist, 2) physician (general practitioner, herbalist physician) +nurse+com-munity volunteers, 3 ) physician ( general practitioner/herbalist physician ) +nurse +assistant +community volun-teers, and 4) general practitioner+nurse+assisting team (professionals of public health and maternal care, etc) +supportive team ( pharmacists, health technician, etc) . Conclusion:The paper verified the common sense conclusion that general practitioners should play an essential role in general practice teamwork. The four general practice team models analyzed above positively contributed to the improvement of efficiency and quality, the relationship between health professionals and patients, the promotion of community participation, and the combination between preventive care and clinical care.