The role of serotonergic system in vasovagal syncope (VVS) has been more concerned.Serotonin is a kind of neurotransmitter which is widely distributed in central nervous system.There are kinds of serotonergic receptors on postsynaptic membrane,among which 5-HT1A receptors participate in the mechanism of central blood pressure depression and promote the release of hormones such as prolactin and adrenocorticotrophic hormone.Acute administration of selective serotonin reuptake inhibitors (SSRIs) during head-up tilt test (HUT) blocks the reuptake of serotonin in the synapse space and thus increases stimulation of the serotonin receptors,which induces syncope episode.Long-term administration of SSRIs downregulates the postsynaptic serotonergic receptors,thus it weakens the reaction to the rapid change of serotonin concentration, which results in rapid depression of sympathic nerves and prevention of syncope episode.These demonstrate that central serotonergic system may participate in the pathogenesis of VVS and SSRIs are important for the diagnosis and treatment of VVS.

At present, oncology medical student in our country has many communication problems, such as communication awareness is not strong,the lack of communication,communication is not enough self-confidence and other issues.To improve the communication ability between doctors and patients for the oncology professional medical students:it is the necessary premise for correct implementation of diagnosis and treatment, an effective way to reduce medical disputes, adapt to the demand of the development of higher medical education.And pointed out the effective ways to improve the ability of doctor-patient communication:to set up the doctor-patient communi-cation and tumor department before the internship training course;establishlisten with your heart and professional guidancemode;with teacher actively guiding; learn to empathymode; adhere to the concept of taking pa-tients as the center.

Carcinoma, Hepatocellular ; pathology ; Drug Resistance, Multiple ; Humans ; Liver Neoplasms ; pathology

Animals ; Body Water ; Brain ; anatomy & histology ; Male ; Organ Size ; Rats ; Rats, Wistar ; Specific Gravity

The reform for medical insurance payment was the important method for standardizing medical service provider behavior,controlling costs and improving efficiency,which was also the important measurement for further improve and implement the reform of drug and health system.Since the new medical reform in 2009,the central and local government had paid more attention on the role of medical insurance payment reform.Local medical departments of different places implemented reform pilots.Through summarizing the foreign and domestic researches around capitation,bundle payment and global payment,the experiences and effectiveness of these pilots were evaluated so as to provide corresponding policy implications.

With the constant development of medical science and technology, great changes have taken place in the role of medico-technical departments. In light of the basic characteristics and development situation of medico-technical departments in modern hospitals, the paper proposes the following ways to step up their management: ①enhancing organizational management and raising the level of scientific management; ②reinforcing standardized management and improving the quality of diagnosis and treatment; ③tightening personnel management and bettering the quality of technical personnel; ④strengthening horizontal ties and coordinating relations with clinical departments; ⑤augmenting disciplinary integration and bringing into full play the role of advantaged specialty groups; ⑥giving full play to the “two initiatives” and setting up a highly efficient operational mechanism within the departments.

Objective To map the approximate transcription initiation site of STK11/LKB1 and identify its potential promoter region. Methods All reported transcripts of STK11/LKB1 were colllected through searching online database. The “first exon”, “first intron” and 5' UTR upstream gDNA sequence of STK11/LKB1 were analysed by MethPrimer and FiretEF to predict the CpG island and possible transcription initiation site, respectively. The STK11/LKB1 gDNA sequence was also analysed by softwares such as PromoterInspector to predict the probable promoter region. Results Among all the reported transcripts of STK11/LKB1, 5'UTR of BC007981 was the longest. STK11/LKB1 gene was a typical CpG island associated gene. There was no exon in the upstream region of the “first exon”, and 5'UTR in BC007981 was close to transcription initiation site. Promoters were predicted in the BC007981 5' upstream 200～400bp region. Conclusion The 5'UTR of STK11/LKB1 approaches the transcription initiation site. The transcription initiation site of STK11/LKB1 gene in several hundreds bp region of 5'UTR upstream may be indentified. The data will benefit further research on the trascriptional regulation of STK11/LKB1 through experimental methods.

Objective To study the changes of insulin resistance due to severe short-term fluctuations of body mass in simple obese patients. Methods 94 women with simple obesity, were treated by low caloric and high protein diet for two months. A series of examinations were taken before and after the treatment. Results After two months, weight, body mass index (BMI), waist, hip, fasting serum insulin and HOMA-IR reduced significantly ( P <0. 01 or P < 0.05 ). But after 6 months follow-up,these data began to regain. After 12 months ,these data were not significantly different. Fasting serum insulin and HOMA-IR increased ( P < 0. 05). Conclusions The low caloric and high protein diet combined acupuncture or cupping could reduce weight. But 44% patients weight rebound, and HOMA-IR increased.

Objective To analysis the progress in prevention and control of iodine deficiency disorders (IDD) in Dalian and to provide a scientific basis for further prevention and control of the disease.Methods From 2006 to 2010,5 or 9 townships were randomly sampled from each county in Dalian,4 villages were sampled from each selected townships and 15 or 8 households were sampled from each selected villages for collecting salt samples and salt iodine level was determined by direct titration method.Sixty daytime urine samples from pregnant women,breast feeding women,infants and young children were collected,respectively,every year to detect urinary iodine level.From 2007 to 2009,2 to 11 counties were sampled and from each selected county one school was sampled to collect 100 daytime urine samples of children aged 8-10 and iodine content was determined.From 2006 to 2009,2 to 5 counties were sampled,from each selected county 2 to 5 schools were sampled and 100 children aged 8 to 10 in each selected school were sampled to detect intelligence quotient level and the thyroid volume.Results From 2006 to 2010,16 012 copies of households' edible salt samples were monitored; the average iodine content was ranged 29.68-31.51 mg/kg,the rate of qualified iodized salt in household ranged from 97.24％ to 98.42％.A total of 1398 copies of urine samples of pregnant women,486 breast feeding women,473 infants and 502 young children were monitored,and the median value of urinary iodine was 129.3-189.6,114.6-190.6,148.5-298.5 and 144.4-187.3 μg/L,respectively.A total of 1657 urine samples were monitored,1264 intelligence quotient level and 1197 thyroid volume of school-age children were determined,the median urinary iodine,thyroid goiter rate and intelligence quotient level was 217.9-266.7 μg/L,0-3.29％ and 110.4-117.2 μg/L,respectively.Conclusions From 2006 to 2010,the city's households qualified iodized salt coverage rate has reached the national standard for elimination of iodine deficiency disorders.The iodine nutrition of key population and school-age children has reached adequate level,the thyroid goiter rate is less than 5％,and the level of intelligence quotient has increased every year.But the iodine nutrition of breast feeding women in 2009 and 2010,pregnant women in 2010 is inadequate,so iodine nutrition surveillance and health education in pregnant and breast feeding women need to be strengthened in the future.

AIM To explore the effects of Sini Decoction (Aconiti lateralis Radix Praeparata,Zingiberis Rhizoma,Glycyrrhizae Radix et Rhizoma) on rat myocardial fibrosis induced by isoproterenol.METHODS Forty SD rats were randomly divided into blank,model,captopril [100 mg/(kg · d)] and Sini Decoction [3.8 g/(kg · d)] groups,with ten rats in each group.Except for the blank group,the rest rats were given subcutaneous injection of isoproterenol [5 rg/(kg · d)] to prepare myocardial fibrosis model,and successive administration lasted for four weeks.At 20 h after the last administration,hemodynamics changes of heart were detected;heart weight indexes were calculated;the changes of myocardial pathological morphology were observed by HE and Masson staining;NO level in serum was measured by nitrale reduetase;SOD activity in serum was measured by xanthinoxidase method;MDA level in serum was measured by thiobarbituric acid method;the protein expressions of RhoA,ROCK1 and eNOS in myocardial tissue were detected by Western blot method.RESULTS Compared with the model group,the cardiac function of rats was significantly improved;the myocardial collagen content was significantly decreased;the MDA level in serum was obviously decreased;the NO level and SOD activity were significantly increased;the protein expressions of RhoA and ROCK1 in myocardium tissue were significantly reduced,and the protein expression of eNOS was markedly increased in the Sini Decoction group.CONCLUSION Sini Decoction can improve the isoproterenol-induced myocardial fibrosis in rats,and its mechanism may be related to inhibiting the RhoA/ ROCK signaling pathway,in turn,raising the expression of eNOS,which leads to reduced oxidative stress.