China has entered the aging society , in urban communities and rural grassroots their are still many older people lack of health insurance , elderly patients with chronic diseases become the most difficult people to see a doctor, this needs to train more general practitioners to solve these problems .From a macroscopical view , general practitioners can bring substantial economic benefits and broad social benefits .From a microscopic view , they also can make effective use of family medical resources , bring convenient for old people going to a doctor and carry out an important role of health education .Improving the General Practitioner -Elderlyservice mode , the govern-ment needs to further improve the elderly medical service system and security system , vigorously promote grass -roots community health service institutions of medical conditions , develop specialized general medical personnel ac-cording to the needs of the elderly , implement contractual service relationships between general practitioners and the elderly.

Objective To establish an in vitro model of primnary osteoblasts fluorosis and to detect the influences of different doses of fluorosis on promoter methylation,transcription and expression of p16,then study the epigenetic effects of p16 gene on skeletal fluorosis.Methods Osteoblasts were isolated from Sprague-Dawley neonatal rats by enzyme digestion,and identified by morphology,alkaline phosphatasc staining and alizarin red staining.Osteoblast were treated with 0 (control group),200,400,800 and 1 600 μmol/L NaF for 72 h.The pl6 gene promoter region was amplified in the transcription initiation site-88-+ 143 region by bisulfatesequencing polymerase chain reaction (BSP).The mRNA transcription and the protein expression of p16 were detected by real-time quantitative PCR and Western blotting.Results Among the groups of osteohlasts treated with 200,400,800,1 600 μmol/L NaF,the positive rates of DNA methylation of promoter region in p16 gene of osteoblasts were 5.88％ (10/170),12.94％ (22/170),17.65％ (30/170) and 33.53％ (57/170),respectively.No DNA methylation was observed in the control group.There were significant differences between the control group and the NaF-treated osteoblasts groups (x2 =92.87,P ＜ 0.05).Average levels of p16 mRNA were 1.050 ± 0.073,0.869 ±0.037,1.065 ± 0.118 and 0.786 ± 0.148 in 200,400,800 and 1 600 μmol/L NaF-treated osteoblasts groups,compared with the control group (1.110 ± 0.315),there were significant differences among groups (all P ＜ 0.05) and 1 600 μmol/L NaF-treated osteoblasts group was much lower than other groups (P ＜ 0.05).Average levels of p16protein were 1.190 ± 0.050,1.214 ± 0.058,1.122 ± 0.123 and 0.320 ± 0.074 in 200,400,800 and 1 600 μmol/LNaF-treated osteoblasts groups,compared with the control group (1.115 ± 0.057),there were significant differences among groups (all P ＜ 0.05) and 1 600 μmol/L group was much lower than other groups.Conclusion NaF can cause hypermethylation in the promoter region of p16 gene,then suppress the expression of mRNA and protein,which might be one of the important mechanisms of cell proliferation change and cell cycle disorder in skeletal fluorosis.

Adolescent ; Age Factors ; Body Height ; drug effects ; Body Mass Index ; Child ; Child, Preschool ; Drug Administration Schedule ; Female ; Follow-Up Studies ; Growth Disorders ; drug therapy ; Human Growth Hormone ; administration & dosage ; therapeutic use ; Humans ; Male ; Recombinant Proteins ; therapeutic use ; Time Factors ; Treatment Outcome

Objective To discuss the application of Chinese version of Speech intelligibility rating (SIR) in e-valuating the speech intelligibility of Chinese children with hearing disorder ,and analyze its scorer reliability .Meth-ods 50 children with cochlear implants or hearing aids were interviewed using SRI Chinese version .Each child was rated by a parent and a speech and language therapist .The reliability of scores was analyzed with Spearman correla-tion coefficient ,Kendall's coefficient of concordance and Kappa coefficient .Results The complete agreement was foud in 34 cases(68% ) ,with a disagreement of one category in 14 cases(28% ) ,and a disagreement of 2 categories was found in 2 cases (4% ) .Spearman correlation coefficient was 0 .885 ,Kendall's coefficient of concordance was 0 .801 ,Kappa coeffi-cient was 0 .593 ,the result was statistically significant (P<0 .001) .Conclusion SRI Chinese version has good reliability and is helpful in evaluating Chinese speech producing ability of children with hearing disorder in everyday life .

Child ; Child, Preschool ; Enteral Nutrition ; adverse effects ; Female ; Humans ; Male ; Pancreatitis ; etiology ; Sodium Chloride

Objective To explore the relationship of the severity of coronary-artery stenosis with plasma levels of brain natriuretic peptide (BNP) and Meprin-α.Methods Totally 237 patients in our hospital were divided into control group (CON group), stable angina group (SA group) and acute coronary syndrome group (ACS group), according to coronary artery angiography.Patients with acute coronary syndrome were divided into 3 subgroups: unstable angina (UA) group, non-ST segment elevation myocardial infarction (NSTEMI) group and ST segment elevation myocardial infarction (STEMI) group.Patients with coronary artery disease (CAD) were divided into 3 subgroups: low-score, medium-score and high-score groups, according to coronary angiography and Syntax score.BNP and Meprin-α levels were determined in patients with coronary artery disease, and the degree of coronary artery stenosis was evaluated.The differences in above indexes were analyzed and compared among the three groups.Results Plasma levels of BNP and Meprin-α were higher in ACS group than in CON group [(233.16± 78.22)ng/L vs.(33.48 ± 13.71)ng/L, (26.89 ± 6.45) nmol/L vs.(12.83±0.66)nmol/L, both P＜0.05].Compared with UA group, plasma levels of BNP and Meprin-α were increased in NSTEMI and STEMI groups (all P＜0.05).Compared with the control group, plasma levels of BNP and Meprin-α in the Syntax scores-divided subgroups were increased (all P＜ 0.05).The plasma levels of BNP and Meprin-α in CAD patients were significantly increased along with the increase of Syntax Score.Spearman correlation analysis showed that low density lipoprotein cholesterol, glucose, BNP and Meprin-α levels had positive correlations with the occurrence of coronary heart disease, while high density lipoprotein level was negatively correlated with the occurrence of coronary heart disease (all P＜0.05).Conclusions BNP and Meprin-α levels in peripheral blood are significantly elevated in patients with coronary heart disease, and they are correlated with Syntax score.The risk of ACS is increased along with the increased BNP and Meprinα levels.

Objective To study the expressions of RhoC and MMP-2 proteins in epithelial ovarian cancer and their clinical significances in order to provid the basis for assessing the biological behaviour of epithelial ovarian cancer.Methods Immunohistochemistry was used to detect the expressions of RhoC and MMP-2 proteins in 10 cases of normal ovarian tissues,12 cases of epithelial benign ovarian tumor and 91 cases of epithelial ovarian cancer,and the relationship with the clinical features was analyzed.Results The RhoC and MMP-2 proteins positive expression rates in ovarian benign tumor and ovarian normal tissues were 0 respectively; the positive expression rates of RhoC and MMP-2 proteins in epithelial ovarian cancer were 37.3% and 68.1%.The expressions of RhoC and MMP-2 proteins in ovarian cancer were significantly higher than those in ovarian benign tumor and ovarian normal tissues.The positive expression rates of RhoC and MMP-2 in moderately and poorly differentiated cancer were significantly higher than those in well differentiated cancer(P

OBJECTIVE: To realize the application of nasal obstruction symptom evaluation (NOSE) and Epworth sleep score (ESS) before and after nasal cavity ventilation expansion techniques. METHOD: Forty-two OSAHS patients with nasal obstructive symptoms were diagnosed by clinical symptoms and polysomnography. Nasal cavity ventilation expansion technique was performed. Before and after the surgery, the NOSE and ESS were used to compare the difference. Postoperative data were obtained at least 3 months later. RESULT: Compared the data before and after operation, the NOSE and ESS were significantly decreased respectively (P<0. 05), there is no significant difference between 3 groups (P>0. 05). CONCLUSION The result suggest that OSAHS patients taking nasal cavity ventilation expansion operations showed improvement in severity of nasal obstructive symptoms and daily sleepy.
Humans ; Nasal Cavity ; surgery ; Nasal Obstruction ; physiopathology ; surgery ; Nasal Surgical Procedures ; Paranasal Sinuses ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; physiopathology ; surgery ; Surveys and Questionnaires ; Symptom Assessment ; methods

Objective To investigate the infiltration of inflammatory cells and the pathogenesis of nasal polyps. Methods the nasal polyps were obtained from 42 patients undergoing nasal operations. The tissues from each patient were stained with HE and Toluidine Blue for eosiophils, lymphocyte, plasma cell and mast cell and observed under the light microscope. A mean number of the above cells were counted. All data were analyzed with the Ttest. Results Eosinophils were found predominantly in 12 polyps(28.57％). Lymphocyte infiltration was shown in the other 30 polyps (71.43％). Furthermore, many mast cells with only a few eosinophils were found in the lymphocyte infiltration polyps; the number of mast cells in these polyps were much more than those in eosinophil accumulation polyps with a very significant difference(P＜0.01). Conclusion The accumulation of eosinophils in the nasal polyps does not appear to be related to the presence of mast cells and allergy. The disorder of immunity may play an important role in the formation of nasal polyps.

Fourteen compounds were isolated from 95% ethanol extract by silica gel, MCI, and ODS column chromatography. These compounds were respectively identified as quercetin (1), kaempferol (2), (+)-catechin (3), fraxin (4), protocatechuic acid (5), gallic acid (6), methyl gallate (7), ethyl gallate (8), apocynol A (9), baccatin (10), cerevisterol (11), ellagic acid (12), 3, 3',4'-tri-0-methylellagic acid(13) and N-benzoyl-L-phenylalaninyl-N-benzoyl-L-phenylalaninate(14) by analyzing their spectral data and comparing with the previously reported literatures. Except for gallic acid (6), all other compounds were isolated from this plant for the first time. Compounds 1, 2 and 6 showed moderate anti-proliferation activities on tumor cells.
Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; chemistry ; toxicity ; Euphorbiaceae ; chemistry ; Humans ; Plants, Medicinal ; chemistry ; Spectrometry, Mass, Electrospray Ionization