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

ObjectiveTo investigate the influence of transverse and longitudinal lower segment caesarean section on the outcome of newborn, postpartum haemorrhage and ratio of complications in placenta previa. MethodsPlacenta previa with lower segment transverse caesarean section( 117 cases) were taken as control group, meanwhile, the lower segment with longitudinal section (142 cases ) as experimental group. Their operational complications, amount of bleeding during and after operation and outcome of the perinatal period were analysed.Results No significant difference in age, parities, gestational weeks, the types of the placenta praevia and the locus of placenta between the two groups were found( P>0.05), while there were significant difference in the amount of bleeding during and after operation, the need of using gauze ribbon to stop bleeding, section splitting and rate of hysterectomy after caesarean section(P<0.01). ConelusionLower segment longitudinal caesarean section in placenta praevia not only shows less bleeding during operation and lower rate of postpartum haemorrhage, but also avoids using gauzes to stop bleeding and causes lower rate of hysterectomy after caesarean section, so it can be the first choice when determining the style of section in placenta praevia.

Objective To investigate the resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides and its resistance genes.Methods The minimal inhibitory concentrations (MICs) of seven antimicrobials (gentamicin, amikacin, tobramycine, netilmicin, neomycin, streptomycin and kanamycin) against 20 strains of multi-drug resistant Acinetobacter baumannii were detected by agar dilution method. Meanwhile, two resistance genes of aminoglycoside nucleotidyltransferase were amplified by PCR and vertified by DNA sequencer.Results It was found that MIC50 and MIC90 of gentamicin, amikacin, streptomycin and kanamycin in 20 strains of Acinetobacter baumannii were all above 1 024 mg/L, and their resistant rates were 95%, 95%, 100% and 90% respectively, while the resistant rates of tobramycin, netilmicin and neomycin were 85%, 90% and 40% respectively. Two aminoglycoside-modification genes ant(2″)-Ⅰ and ant(3″)-Ⅰ were detected in 20 strains, with 55% and 80% of positive rate respectively. The double positive rate of two resistance genes was 50%.Conclusion The resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides was closely associated with ant(2″)-Ⅰ and ant(3″)-Ⅰ genes.

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.

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.

ObjectiveTo determine the possibility of r eal-time perfusion imaging in the quantitative evaluation of myocardial perfusion in various segments of left ventricle. MethodsImages of ten anesthetized dogs were obtained at the mid-papillary muscle short-axis view with a real-time imaging system. Mechanical index (MI) was adjusted to 0.1 , 0.2 and 0.4 respectively, and frame rate was set at 20 Hz. Optison was infused intravenously at a rate of 0.1 , 0.2 and 0.5 ml/min, respectively. Images were recorded for 150 real-time frames commencing immediately after a couple of Doppler bursts. Myocardial opacification was assessed both visually and quantitatively for six segments of left ventricle (antero- and infero-septum, inferior, posterior, lateral and anterior wall). Myocardial signal intensity versus real-time frame curves were made and fitted to an exponential function: Y=A(1-e -?t ). ResultsUsing low MI (MI= 0.1 or 0.2 ) and with continuously infusion of Optison at a rate of 0.2 or 0.5 ml/min, real-time imaging resulted in sufficient myocardial opacification and left ventricular endocardial border definition, and displayed myocardial thickening and wall motion simultaneously. ConclusionsReal-time imaging has a potential in the quantitative assessment of myocardial perfusion, and allows simultaneous assessment of perfusion and myocardial function.

Objective To study the relationship of fatty acid binding protein-2(FABP2)and apolipoprotein E(ApoE)with coronary heart disease(CHD)in type-2 diabetes mellitus(T2DM)patients.Methods FABP2 and ApoE gene polymorphisms were detected by PCR-RFLP.At the same time all CHD in T2DM patients' serum triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol were(HDLC),low-density lipoprotein cholesterol(LDLC)were detected.Results The T-allele frequencies of FABP2 were higher(P

In recent years, scientists paid close attention to the studies of 3D printing in cardiovascular tissue engineer-ing, which has made some advances.But how to promote cardiovascular tissue engineering for clinical application still needs deeper research.Here we discussed from three cardiovascular tissues ( myocardial tissue, heart valves, coronary) , which at-tempted to retrospect the current progress of 3 D printing in cardiovascular tissue engineering and provided a guidance of further investigations.