Objective: Our purpose was to study the predictive factors of interferon(IFN) therapeutic effectiveness. Methods:Genotypes of HCV, HCV RNA quantities, β2 microglobulin, 2′- 5′oligoadenylate synthetase, and peripheral blood lymohocyte subgroup were detected by using specific primer PCR assay, energy transference technique of signal primer, sheet chromatography, radioimmunoassay, and APAAP immunoenzyme bridge technique respectively in 20 blood samples of patients with chronic hepatitis C. Results:(1)The patients who had lower level of HCV RNA before treatment and had continuing decreased HCV RNA level after treatment had good response to IFN treatment in follow-up survey. (2)The patients with HCV-Ⅲ type had complete response much more than those with HCV-Ⅱ type (P＜0.05).(3)The patients with lower level of 2′- 5′oligoadenylate synthetase before treatment might have good response to IFN treatment. (4) There was no significant change in β2 microglobulin level before and after treatment and in different response groups before treatment.(5) The CD+3, CD+4, and CD+4/CD+8 in peripheral blood increased after treatment. The patients in complete response group had higher level CD+3, CD+4, and CD+4/CD+8 than those in part response and non-response groups, but there was no significance in statisitcs. Conclusion:The HCV RNA quantities, HCV genotypes, 2′- 5′oligoadenylate synthetase level before treatment were predictive factors of IFN therapeutic effectiveness. The changes of HCV RNA level in treatment and follow-up survey had important significance in therapeutic evaluation, β2 microglobulin level, and lymphocyte subgroup before treatment were not used as predictive factors for IFN therapeutic effectiveness.

According to the target-model of the health care system and characteristics of the health financing system,it is proposed in the paper that the charges of medical services should be the main revenue of public hospital compensation.Efforts should be made to adjust health care service prices and strengthen pharmaceutical management simultaneously so as to rebuild the structure of medical service charge.Medical insurance should make the majority in the compensation to cover most the medical expenses,with government subsidies supporting development.Both government financial investment and medical insurance should join their efforts for planning-guidance and performance-guidance.The authors also suggested to improve a graded and normative diagnoses and treatment system,regulate medical behaviors of public hospitals and their cost standards,justifying the total compensation and standard verification of such hospitals.

The paper summarized the explorations of public hospital pilots in the compensation mechanism and identified the following findings.For example,by means of fiscal support of public hospital infrastructure and development spending,cancellation of drug markup,higher service prices, and reformed payment mode of medical insurance,these hospitals have made initial changes at their business operating mechanism, motivation-guidance of compensation, and their makeup of medical revenue.In addition,such hospitals are found with lower cost of medical care per visit,and higher income of medical workers.The authors also pointed out such problems as inflated drug pricing and expenses,lack of scientific pricing mechanism for medical services,vague definition of policy-related losses,and old-fashioned practice of government investment and health insurance payment.Based on such findings,the paper advised to adjust health care prices by stages and to improve the management of health insurance and the coherence of compensation mechanism.

Calcium Channel Blockers ; pharmacology ; Cell Survival ; drug effects ; Drug Antagonism ; Humans ; Kidney ; cytology ; drug effects ; Lead ; toxicity

Objective To analyze the mutations of GATA4 gene in Han Chinese patients with atrioventricular septal defect(AVSD)and investigate the association between GATA4 gene and pathogenesis. Methods Ninety-four Han Chinese patients with AVSD were recruited,including 23 patients with Down syndrome and 71 patients without. One hundred healthy age-matched Han children were used as the control. Blood samples were drawn. Encoding region and flanking introns of GATA4 gene were amplified using polymerase chain reaction. The mutations were detected by DNA fragment sequences analysis. Results Three novel missense mutations(c.106C ＞ G,p.P36A;c.259C ＞ T, p.P87S;c.504C ＞ A,p.D168E)of the GATA4 gene were identified in three patients with complete AVSD without Down syndrome,and a fourth novel missense mutation(c.1079A ＞ G,p.E360G)was noted in a patient with complete AVSD and Down syndrome. A polymorphism of the GATA4 gene(c.G99T,p.A33A)from six patients was detected. Conclusions The GATA4 gene might be involved in the etiology of AVSD by functional changes resulting from gene mutation. The low incidence of GATA4 gene mutations in patients with AVSD with or without Down syndrome might suggest that AVSD is a polygenetic disorder.

Objective To observe the dynamic changes of NO,NOS in serum and CSF in patients with CNS infection and lay an experimental basis for discrimination of CNS infection due to different agents.Methods The method of nitrate redutase and the method of chromometry were employed to measure NO,NOS in serum and CSF at different time.The dynamic changes of NO,NOS in serum were observed on admission,on 3,5,9,14 day after admission.The dynamic changes of NO,NOS in CSF before treatment and two weeks after treatment were ob- served,too.Results There were no difference between the the concentration of NO and the vigor of total NOS in serum and in CSF of viral meningitis,bacterial meningitis and tubercular meningitis patients due to different agents. Conclusion The changes of the concentration of NO in serum and CSF,the vigor of total NOS in serum and CSF could not he seen as laboratory basis for discrimination of CNS infection due to different agents.

Objective To improve the patients' satisfaction to the nursing work through implementing the humanistic concern in nursing work. Methods We held some activities to provide the humanistic concern in nursing work, developed the educations to improve the professional quality of the nurses, constructed the criterion of civilized srvice, and strengthened the construction of nursing culture in the service demonstration ward. Meanwhile, we intensified the service ideas to create the harmonious patient-nurse relationships, the harmonious working settings, the harmonious treatment surroundings and the harmonious humanistic environment. Results The whole quality of the nurses was improved. especially the consciousness of active service. The relationship between nurses and patients was more harmonious, and the nursing quality and the degree of patients' satisfaction were elevated. Conclusions to implement the humanistic concern in nursing work is not only the base of building the harmonious relationships between patients and nurses. but also the guarantee of elevating the nursing quality and the degree of patients' satisfaction.

Objective To study the effect of the levels of serum gonadal hormone and plasma calcitonin gene-related peptide(CGRP) on the hot flushes symptom of perimenopausal women. Methods 65 perimenopausal women (35 with hot flushes and 30 without hot flushes) and 25 healthy fertile women were enrolled. The subjects were analyzed for serum estradiol (E2), follicle-stimulating hormone (FSH) ,luteinizing hormone (LH) and plasma calcitonin gene-related peptide (CGRP). Results. ① There were no significant differences of the E2 levels between the perimenopausal women with and without hot flushes (P>0.05). The levels of FSH and LH were significantly higher in the women with hot flushes than women without hot flushes and fertile women(P<0.05),② The levels of plasma CGRP were significantly higher in the women with hot flushes than women without hot flushes (P<0.05), and significantly lower than fertile women,③The levels of plasma CGRP were significantly higher in severe hot flu-shes group than that in the mild hot flushes group and moderate hot flushes group(P<0.05), the severity of hot flu-shes was positively related to the level of plasma CGRP(rs=0.823, P<0.01), but there was no relationship be-tween serum E2 and the severity of hot flushes (P>0.05). Conclusion The occurrence of perimenopansal hot flu-shes might be closely related to the decline and fluctuation of serum E2,increase of FSH and LH and the concentra-tion variety of plasma CGRP.

OBJECTIVETo study the effect of treatment of renal anemia by combination of Bushen Jianpi Recipe (BJR, a Chinese experience recipe for supplementing Shen and supporting Pi) and low dosage erythropoietin (EPO), and the influence of treatment on change of serum tumor necrosis factor alpha (TNF-alpha) so as to explore the possible mechanism of integrative Chinese and western medicine (ICWM) in treating renal anemia.

METHODSPatients with renal anemia were randomly divided into two groups, the ICWM group and the control group, symptomatic and supporting treatment such as dialysis, supplementing of ferrous, foliac acid and vitamin B12, was given to both groups. Additionally, to the ICWM group, 50 IU/kg of EPO subcutaneous injection for twice every week, and oral intake of BJR, one dose per day taken in two parts, were given, and to the control group, EPO alone, 50 IU/kg by subcutaneous injecting, 3 times per week, was given. The therapeutic course for two groups was 3 months. Blood levels of hemoglobin (Hb), hematocrit (Hct), TNF-alpha were measured before treatment and the therapeutic effect was observed.

RESULTSAfter treatment, the levels of Hb and Hct increased significantly in both groups (P < 0.01), comparison between the two groups in Hb and Hct after being treated for 3 months showed significant difference (P < 0.05). The serum level of TNF-alpha was markedly higher than normal range in both groups before treatment, it significantly lowered after treatment in the ICWM group (P < 0.05), but unchanged in the control group.

CONCLUSIONCombination of BJR and EPO could significantly inhibit the production of TNF-alpha, this may be an important factor for ICWM in effectively improving sensitivity to EPO.

Adult ; Anemia ; blood ; drug therapy ; etiology ; Chronic Disease ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Erythropoiesis ; drug effects ; Erythropoietin ; therapeutic use ; Female ; Glomerulonephritis ; blood ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Recombinant Proteins ; Tumor Necrosis Factor-alpha ; metabolism

AIM: To explore the changes in extracellular regulated protein kinase (ERK1/2) in the hypertrophic myocardium induced by pressure overload at the different time courses and to determine the molecular mechanism in the myocardium from hypertrophy to heart failure. METHODS: C57/BL mice, aged 12 week old, were subjected to sham-operation (SH) or transversing aortic constriction (TAC) to establish left ventricular hypertrophy. Echocardiographic assessments, hemodynamic determination, organ weight measurement, morphological and histological examination were performed at 1, 4, 8, 12 and 16 weeks after surgery. Meanwhile mRNA levels of atrial natriuretic peptide (ANP), α-myosin heavy chain (α-MHC), bcl-2 and bax were measured by RT-PCR, and ERK1/2 levels were detected by Western blotting. The animals in SH group were performed the same tests then sacrificed at 16 weeks. RESULTS: (1) Compared to SH group, LVESd, LVEDd, Awsth, Awdth, Pwsth and Pwdth progressively increased after TAC. Meanwhile, ejection fraction (EF%) significantly decreased at 16th week (P<0.05). LVSP, dp/dt_(max) and dp/dt_(min) in TAC group were progressively increased after 4 weeks. From 8-12 weeks these parameters maintained stable and then sharply decreased at 16th week (all P<0.05). However, LVEDP was statistically increased at 8th week. These echocardiographic and hemodynamic changes indicated a development of LVH and eventually progressing towards to heart failure. (2) Histologically, cardiac collagen measured by percentage of Sirius red positive stained area and apoptosis index showed progressive increases from 4 to 16 weeks. (3) Compared to SH group, mRNA levels of ANP was time-dependently increased while α-MHC and Bcl-2 were time-dependently decreased. The ratio of Bcl-2 /Bax was decreased. Phosphorylation of ERK1/2 was increased at 4th week, then decreased with age of TAC (all P<0.05). CONCLUSION: Pressure-overload induced by TAC results in a development of LVH from early concentric hypertrophy to late eccentric hypertrophy, and eventually toward cardiac dysfunction or heart failure. Those changes are associated with increase in cell size and cardiac fibrosis. ERK1/2 signaling pathway may involve in the regulation of myocardial cell apoptosis in hypertrophic and failure heart.