It has been shown that two pathways of signal transduction are activated under the stimulation of cytokines , such as IL-1?TNF-? ?EGF?TGF-? ?PDGF?IGF-1, secreted by fibroblast-like synoviocytes with rheumatoid arthritis. They are receptor tyrosine kinases-Ras-MAPK pathway and non- receptor tyrosine kinases-JAK-STAT pathway. The former activation plays an important role in chronic synovitis of rheumatoid arthritis. More researches are expected to focus on G-protein-AC-cAMP signal transduction pathway and the internal relations of all kinds of pathways.

To stury the pharmacokinetie of tramadol and aeetaminophen in healthy volunteers. Methods Totally 20 healthy adult male volunteers participated in the study were randomly assigned to 2 treatment groups and were given respectively the dose of one and two pills by oral administration. Serum was separated and the concentrations of tramadol and acetaminophen in human serum were determined by HPLC using fluorescence and UV detector. The values of concentration were directly detected, and AUC was calculated by linear trapezoid method. Results The main pharmacokinetie parameters of tramadol and acetaminophen of 2 dosages groups were as follow: Tramadol: AUC_(0-24h)(ng · h· mL~(-1)) were 2 724. 89 ± 1 016.54 and 1 361.61 + 441. 79; AUC_(0-∞)(ng·h·mL~(-1)) were3 065.49±1 190.66 and 1 555.04±582.51; t_(max)(h) were 1.8±0.75 and 1.9±0.57; t_(t/2)(h) were 7.34±1.39and7.63±2.02; Kel(h~(-1)) were 0. 098±0. 019 and 0. 097± 0.027; Cl_r(mL · min~(-1)) were 31.84±13.65 and 30.03 ± 9.20; MRT(h) were 7.62 ± 1.07 and 7.77 ± 0.75. Acetaminophen. AUC_(0-24h)(μg · h · mL~(-1)) were 40.28 ± 10.36 and 18.37 ± 3.84 ; AUC_(0-∞)(μg · h · mL~(-1)) were 41.63 ± 10. 96 and 18. 81 ± 4.06; t_(max)(h) were 0. 9 ± 0.46 and 0. 9 ± 0. 39; t_(t/2)(h) were5.39 ± 1. 16 and 4. 96 ± 1.03; Kel(h~(-1)) were 0. 13 ± 0. 03 and 0. 15 ± 0. 03; Clr (mL · min~(-1)) were 17.17 ± 4.57 and 18.42 ± 3.89; MRT(h) were 4.86 ± 0.48 and 4.50 ± 0.53. Conclusions No significant difference in pharmacokinetic parameters, such as t_(max), t_(t/2), Ke,Cl, MRT,AUC_(0-t)/dose, AUC_(0-∞)/dose and C_(max)/dose are shown between these two dose groups and a linear pharmacokinetic is featured.

With the diversified development in training clinical students, an impeccable system in clinical on - job postgraduates training has been established. lt has been being an important problem for colleges and tutors to improve the quality in the postgraduates training program in the specialty of ophthalmology. This paper analyzed the problems in the training of clinical postgraduates and explored the ways to resolve the problems.

As a harmless detecting measurement, cardiopulmonary exercise testing(CPET) can effectively assess exercise strength. So it can conduct to write out an exercise prescription, direct heart rehabilitation and evaluate the clinical effects of medications. The results of CPET are reliable, and it can be performed repetitively. Therefore, CPET has better prospects in coronary artery diseases rehabilitation.

Objective To learn the hotspots of study in ischemic optic neuropathy (ION).Methods Literature on ION published in January 2000 to July 2012 was identified in Pubmed database.MeSH terms that frequently appeared were identified and co-word analysis was carried out by cluster analysis.Then a network was drawn using social network analysis.Results A total of 1045 papers were included.The United States,England,Germany,France and Netherlands together accounted for 71.53％ (748) of the articles.There were 28 high-frequency MeSH terms and hot topics clustered into four fields.The appearance frequency of MeSH showed that most research focused on:(1)postoperative or arteritic ION;(2) epidemiology,pathology and diagnosis of ION ; (3) pathophysiology and therapy of ION ; (4) chemically induced ION.Conclusion The international main research focus of ION includes four fields,which may provide reference or scholars both in scientific research and clinical research.

There is a significance of pregnancy thyroid hormone reference ranges establishment,because the consequences of thyroid dysfunction during pregnancy are terrible.This review will focus on meaning of pregnancy thyroid hormone reference range,importance of TPO antibody testing and current advances of methodology.

[Objective] To observe the therapeutic effect of kidney-tonifying herbal medicine for chronic aplastic anemia (CAA) and its effect in regulating immune function. [Methods] Twenty-nine cases of CAA were randomized into 2 groups: group A (n = 15) was treated with routine western medicine plus Huosui Tablets and kidney-tonifying decoction for oral use, and Huosui Ointment for external application; group B (n = 14) was treated with routine western medicine only. Three months constituted one treatment course and the two groups were treated for over 2 courses. After treatment, the therapeutic effect was assessed and the changes of peripheral blood counting and immune function indexes were compared with those before treatment. [Results] After treatment, the total effective rate was 80.0% in group A and 42.9% in group B, the difference being significant (P 0.05) . [Conclusion] Kidney-tonifying herbal medicine is effective for the treatment of CAA and its therapeutic effect may be related to the regulation of immune function.

Objective To perform the research on the domestic hospital marketing. Methods Through deep discussion,data analysis and marketing survey,we conducted a research on the market positioning and marketing strategies for Shanghai Ruijin-Harvard Heart Center which is a Sino-foreign joint venture. Results The demand is much bigger than the current supply in the market for cardiovascular diseases.The establishment of the center meets the demands of the market. Conclusion The center will focus on the adult patients in Shanghai and Yangtze Delta,and combine the external,internal and interactive marketing strategies.It may provide some useful experience for the Chinese hospital management,especially for hospital marketing.

Abstract?AlM:To study the thickness changes of retinal nerve fiber layer ( RNFL) in Parkinson's disease ( PD) .?METHODS:Fifteen eyes of 15 PD patients in early stage and 18 eyes of 18 controls were chosen to take RNFL examination by optical coherence tomography ( OCT ) . Circular scans were taken around the optic nerve head (diameter = 3. 46mm) to record the features of RNFL. Scanning areas included eight quadrants of the temporal, superior, nasal, inferior, inferior-temporal, superior-temporal, inferior-nasal and superior-nasal quadrant. RNFL thickness was comparatively analyzed in eight quadrants and the average level in two groups.?RESULTS: RNFL thickness in two groups in temporal, superior, nasal , inferior, temporal- inferior, temporal-superior, nasal-inferior, nasal-superior were: ( control/PD) 83. 2 ± 17. 5μm/68. 7 ± 13. 5μm, 132. 7 ± 17. 4μm/128. 1 ± 25. 3μm, 83. 7 ± 22. 3μm/76. 5 ± 17. 8μm, 141. 5 ± 15. 3μm/128. 6± 13. 2μm, 117. 9 ± 24. 5μm/103. 3 ± 14. 1μm, 120. 8 ± 21. 2μm /102. 6 ± 23. 7μm, 110. 2 ± 27. 7μm/96. 6 ± 15. 0μm, 109. 6 ± 20. 6μm/101. 2 ± 20. 9μm. The average RNFL thickness in controls was 109. 9 ± 8. 5μm while it showed 102. 3 ± 11. 9μm in PD group. RNFL thickness in inferior, temporal, inferior-temporal, superior-temporal and the average RNFL thickness were statistically different in two groups ( t= 2. 595, 2. 700, 2. 153, 2. 330, 2. 131;P= 0. 014, 0. 011,0. 040,0. 026,0. 041).?CONCLUSlON: RNFL thickness in inferior, temporal, inferior temporal, superior temporal and the average RNFL thickness are significantly thinner in mild PD than those in the controls.