There are some common problems such as recurrent symptoms and poor compliance among patients with chronic diseases. Although scientific knowledge and skills have been learned from traditional health education, patients with chronic diseases cannot improve their life style continuously. At present, many researches abroad have proved that health coaching contributes to setting feasible goals and encourages continuously behavior change of patients. In China, health coaching is in the stage of becoming familiar with its scientific definition, intervention effect and application characteristics. And health coaching also needs evidences from high-level evidence-based studies. Along with continuous improvement of intervention techniques on health management, health coaching will get further development and standardization.

Parathyroid hormone ( PTH) is an important hormone secreted by parathyroid cells , and regulates the metabolism of calcium and phosphorus in the body .In recent years , the toxic effect of PTH on myocardium has been re-ported.Calcium-sensing receptor (CaSR), a member of G protein-coupled receptor family, can feel the subtle change of extracellular calcium concentration and regulate intracellular calcium concentration through multifarious ways in order to control the secretion of PTH .The expression of CaSR is observed in parathyroid cells , renal tubular epithelial cells , myo-cardial cells, etc.Intracellular calcium, as a second messenger, participates in various cell functions , such as excitation-contraction coupling , fertilization and so on .The injury of myocardial cells is intimately linked with high concentrations of PTH and intracellular calcium , and high expression of CaSR .

Objective:To investigate and compare the influences of Ghrelin and growth hormone releasing peptide 6(GHRP-6) on the contractility of stomach smooth muscle in guinea pigs,and to study the related mechanism.Methods: The myenteric plexuses of gastric fundus and antrium in guinea pigs were stimulated with electrical field stimulation(EFS) to observe the influence of Ghrelin and GHRP-6 on the contractility of stomach smooth muscle.The influences of N-nitro-L-arginine(L-NNA) and L-Arginine(L-AA) on the effect of Ghrelin and GHRP-6 were studied to disclose the mechanism of the effects of Ghrelin and GHRP-6.Results: The circular muscle tissues of the gastric fundus generated on-relaxations and off-contractions when stimulating myenteric plexuses with 1-16 Hz electrical field;the on-responses induced relaxation could be reduced by L-NNA and the off-contractions induced contraction could be blocked by atropine and guanethidine.In fundic strips,ghrelin and GHRP-6 could decrease the on-response induced relaxation and increase off-response induced contraction of the muscle,with the effect of Ghrelin obviously stronger than that of GHRP-6.L-NNA could increase the effects of Ghrelin and GHRP-6-induced muscle contraction,and L-AA could decrease their effects.In the antral strips,electrical field stimulation of myenteric plexuses led to disappearance of relaxation wave,only leaving off-contractions.Both ghrelin and GHRP-6 could increase that contraction.Conclusion: Both ghrelin and GHRP-6 can promote the contractility of stomach smooth muscle in guinea pigs through stimulating myenteric plexuses of gastric fundus and antrium,which might be related to the NO pathway.

Objective To explore carotid atherosclerosis and its relative factors of maintenance peritoneal dialysis patients. Methods The general clinical conditions,hematobiochemical parameters and color ultrasound parameters of 27 maintenance peritoneal dialysis patients and 24 controll patients were collecled. General clinical conditions included body weight, height and BMI. Hematobiochemical paremeters included Hb, Alb, LP (a), TC, TG, HDL-C,LDL-C, CRP, plasma fibrinogen, C3, Apo-A 1, Apo-B, LP (a). Color ultrasound parameters included plaque incidence rate,thickness of vascularendothelium(IMT). Results Compared with the controll group,maintenance peritoneal dialysis patients: plaque incidence rate, thickness of vascularendothelium (IMT) increased significantly, Age, TC, TG,LDL-C,LP (a), dialysis time increased significantly in plaque-positive group(all p ＜ 0. 05), while Hb, Alb andPAB decreased significantly (all P ＜ 0.0 5) , CRP increased significantly (P ＜ 0.0 1) . Conclusions In maintenance peritoneal dialysis group,CRP,LP(a) had positive relationship with C-IMT. CRP had negative relationship with ALb. CRP had not relationship with age and dialysis time. There were relationships among malnutrition,inflammation and atherosclerosis in maintenance peritoneal dialysis patients. Interdiction of the relationship may played a very important role in ameliorating the prognosis of the maintenance peritoneal patients.

Objective To evaluate the safety of conscious venous anesthesia with fentanyl and propofol in elderly patients over 70 during gastrointestinal endoscopy. Methods Clinical data of 826 elderly patients over 70, who underwent gastrointestinal endoscopy with venous anesthesia, were retrospectively analyzed. The patients were divided into 2 groups according to their ages, with 618 patients aging from 70 to 80 in group A, in which 342 received endoscopy and 276 underwent colonoscopy, and 208 patients older than 80 in group B, in which 112 underwent endoscopy and 96 had colonoscopy. Another cohort of 600 patients younger than 70, who underwent venous anesthetic endoscopy during the same time period, was randomly selected as the control group, in which 400 patients received endoscopy and 200 had colonoscopy. Blood pressure, heart rate, peripheral oxygen saturation (SpO2) and adverse reaction were monitored in each patient during the procedure and compared among different groups. Results No procedure-related perforation or sedation-related mortality was observed, and no procedure was terminated clue to sedation complication. The average dosages of propofol used in procedure of endoscopy in groups A, B and control were 54.22±21.36 mg, 40.22±12.46 mg, and 86.44±34.26 mg, respectively. The average dosages of propofol in colonoscopy were 82.56±40.64 mg, 45.36±15.44 mg and 102.23±46.32 mg, respectively. With same procedure, there was no significant difference in heart rate and blood pressure among different groups, nor was there any difference in these variables before and after the procedure in each group (P>0.05). Sedation exerted more influence on SpO<,2> in elderly patients. A total of 18 cases in groups A and B experienced SpO<,2> <90%, which was mainly due to aspiration of saliva and relieved by oxygen inhalation. Conclusion Under appropriate monitor, it is safe and feasible to give conscious sedation to elderly patients over 70 during gastroimestinal endoscopy.

To support the ongoing health reform in China,Chongqing municipal government made the decision in 2008 "Building Healthy Chongqing" ,and pinpointed for the first time regional development as a key goal.In line with this situation,the hospital proposed such hypothesis changes as from "disease hypothesis to "health hypothesis",from "illness oriented" to "capability oriented",and from "shaping development" to "adaptive development",as well as from one-sided efforts of medical staff to minimize casualty to joint efforts with patients to safeguard life and health.Focusing on these four strategic shifts,the hospital works in developing its "technical attraction,service capacity,innovation capacity,and emergency assurance capability,and management soft power",aiming at building a sustainable hospital in its development.

Objective To evaluate the clinical significance of phural effusion and/or ascites and their prognostic role in patients with acute pancreatitis.Methods The clinical data of 312 patients with acute pancreatitis were collected and analyzed retrospectively.Results Pieural effusion was found in 47 patients and ascites in 18.of 47 cases with pleural effusion,there were 31 cases(65.9%)of severe pancreatitis(P＜0.01)and 27 cases (57.4%)complicated by pseudocyst(P＜0.01).Among 18 cases with ascites,there were 14 cases(77.7%)of severe pancreatitis(P＜0.01).6 cases with pleural effusion and/or ascites died of multiple organs failure.Conclusion Pleural effusion and/or aseites is closely associated with severe pancreatitis.

Objective: To explore the effect of health education and supportive therapy on neuroses. Methods: Fifty six subjects were assigned into two groups according to the sequence of hospitalization. Both groups received the same drug treatment, average dosage: in experiment group fluoxetine 20～30mg/d (9 cases), Amitriptyline 75～150mg/d(8 case), Alprazolam 1.6～ 2.8mg/d(13 cases), received the health education and supportive therapy for 38 to 60 days in addition to drug treatment. In control group, fluoxetine 20～30mg/d(11 case), Amitriptyline 75～200mg/d(5 cases), Alprazolam 1.2～2.8mg/d(10 cases) were used. The Symptom Checklist 90 was used for assessment before and after treatment and cure rate was evaluated by clinical standard at discharge in both groups. Results: Cure rate was higher in the experimental group (94%) than control group (71%, P<0.05). The total score of the Symptom Checklist 90 and main factors were lower in the experimental group than the control group (P<0.01). Conclussion: Early health education and supportive therapy can improve the treatment outcome of patients with neuroses.

Syncope is a common pediatric emergency event,which can be caused by various metabolic disorders different from other illness. The major metabolic anomalies include hypoglycemia, hyperventilation,electrolytes imbalance,hypoxemia and others, in which hypoglycemia is caused by hyperinsulinemia,pituitary and adrenal disease, diabetes, ketotic hypoglycemia, inherited metabolic disorders of sugar, organic acids and amino-acids,etc. This article introduced the common metabolic anomalies and their causes,diagnosis and therapy.

Objective:To investigate the effects of thyroid motilin(MTL) on migrating motor complex(MMC) in fasting rats.Methods: The distribution and quantitative expression of motilin in the thyroids were detected by immunohistochemistry and radioimmunoassay.We also observed the effect of thyriod motilin on the MMC by recording the gastrointestinal motility in conscious rats.Results: Tail vein injection of MTL increased MMC in antrum and duodenum in a dose-dependent manner,as manifested by increased contraction frequency and amplitude(P