Hospitals are currently confronted with many problems, including distribution according to the division of administrative areas and jurisdiction; construction with complete sets of facilities on the part of all hospitals,big or small; and worsening of the unbalanced allocation of health resources due to the to assumption by big hospitals of many tasks of bssic-level hospitals. Besides, the excessively speedy incresse of expenses for outpatient and inpatient services as a result of hospitals' introduction of high technologies has inhibited some people's demands for medical services and competition among hospitals will become particularly fierce. Thus, ways out for hospitals lie in clarifion of their respective functions and development according to regional planning; regrouping of health resources by the government through measures of shutting down,stopping down, sopping production, merging, changing products or moving to other sites; structural readjustment and implementation of the system of responsibility by hospital directors within hospitals;bringing into play the initiatives of middle-level cadres; establishment of a scientific mechanism for personnel employmennt and selection; giving priority to efficiency and consideration to fairness in distribution; improvement of service quality; and making a good job of rational charging.

Objective To investigate human papilloma virus(HPV) infection in normal endometrium, atypi-cal hyperplasia of endometrium and endometrial carcinoma. Methods By the nucleic acid hybridization,we detected 28 pairs of endometrial carcinomas, 21 pairs of atypical hyperplasia of endometrium. Normal endometrium from 16 pa-tients with uterine myomas were as control. Results HPV16/18 DNA was detected in 25 endometrial carcinoma and 2 atypical hyperplasia of endometrium and 1 normal endometrium. Conclusions Endometrial carcinoma HPV16/18 DNA were significantly higher than those infected with atypical endometrial hyperplasia and normal endometrium. Note the occurrence of endometrial cancer,the development may be associated with HPV infection.

Objective To investigate apoptosis and bcl-2 expression of dust cells in human bronchopulmonary lymph nodes and murine peritoneal macrophages treated with carbon particles and study the relation of apoptosis of dust-laden macrophages and structural changes of the lymph nodes. Methods Distribution of dust particles, apoptotic cells and structural changes of the lymph nodes were viewed on paraffin sections and ultrathin sections. Apoptosis and bcl-2 expression of dust cells in human bronchopulmonary lymph nodes and macrophages treated with carbon particles were observed with TUNEL staining and bcl-2 antibody labeling. Results In the bronchopulmonary lymph nodes of the adult group, dust particles were deposited significantly in macrophages, the lymphatic tissue decreased, collagen fibres and density of blood vessels increased. In ultrathin section, the nucleus condensed and contained vacuoles. There were TUNEL-positive cells and bcl-2 labeling positive cells in dust cells of the lymph nodes and macrophages 24*!h after phagocytizing carbon particles. Bcl-2 was expressed strongly in the active macrophages decomposing dust particles or carbon particles. Conclusion Deposition of dust particles induces apoptosis and overexpression of antiapoptotic gene bcl-2 of macrophages in human bronchopulmonary lymph nodes. Structural changes of the bronchopulmonary lymph nodes in adult may relate to apoptosis of dust-laden macrophages.

Objective To examine location of hyaluronan(HA) in macrophages and effects of HA on adhesion and migration of macrophages and explore regulating mechanism of HA. Methods HA of macrophages was labeled with aggrecan.Location of intracellular and extracellular HA of the cells was viewed using optic microscope and confocal laser scanning microscope.Effects of HA on adhesion and migration of macrophages were examined by adhesion assay and migration assay. Results Macrophage synthesized HA.HA located mainly on the membrane and in premeter and perinuclear area of the quiescent cells.In the moving cells,most of intracellular HA located in pseudopodia,tail and perinuclear area.HA was rich on the surface of the pseudopodia and tail of the cells.HA on the surface of macrophages and HA substratum increased cell adhesion and migration,addition of free HA into the medium decreased cell adhesion.Conclusion There are characteristics of HA distribution in macrophages.HA synthesized by macrophages and HA substratum promoted adhesion and migration of macrophage,while free HA reduces cell adhesion.

Objective To investigate the relationship of plasma homocysteine with the genotype distribution of MTHFR and MTRR among Chinese Han women in Xiangtan. Methods MTHFR C677T, A1298C and MTRR A66G geno?typing was analyzed to detect the distribution of gene polymorphisms among 1 701 women from Xiangtan city then the data were compared with the rest of the Han women in Zibo, Zhengzhou, Yantai, Zhenjiang, Songzi, Huizhou, Qionghai. Plasma Hcy levels from 110 patients were measured and analyzed the correlation with gene polymorphisms. Results The frequency of MTHFR C677T genotype and allele frequencies in Xiangtan is 12.6%which is higher than Huizhou (10.9%) and Qionghai (6.1%) but lower than Zibo (43.6%), Zhengzhou (36.8%), Yantai (32.2%), Zhenjiang (21.8%) with statistically significant dif?ference (P<0.05). There is no significant different in MTHFR C677T between Xiangtan and Songzi. The frequency of MTH?FR A1298C genotype and allele frequencies in Xiangtan is 4.8%which is lower than Qionghai(7.1%)but higher than Zibo (1.4%),Zhengzhou(2.4%), Yantai(1.8%), Zhenjiang(3.5%)and Songzi(2.6%)with statistically significant difference. The frenquency of MTRR A66G genotype and allele frequencies in Xiangtan is 6.8%which is higher than Zibo (4.8%) but lower than Qionghai (9.3%) with statistically signifcant difference. Plasma Hcy concentration correlate with MTHFR C677T, Hcy concentration in TT population is higher than that in CT and CC population(μmol/L:8.52±2.01 vs 5.94±1.47 vs 5.71± 0.18);Plasma Hcy concentration also correlate with MTHFR A1298C and Hcy concentration in CC population is higher than AA and AC population(μmol/L:9.83 ± 2.26 vs 6.35 ± 2.13 vs 5.55 ± 1.75);Plasma Hcy concentration does not correlate with MTRR A66G. Conclusion The gene polymorphism of MTHFR C677T, A1298C and MTRR A66G among the Han women in Xiangtan was statistically different from other selected regions of China. Mutation in MTHFR C 677T and A1298C were associated with elevated plasma levels of Hcy.

According to the alanine aminotransferase (ALT)level, 4 509 patients were assigned into group A (n=449, with raised ALT)and group B (n=4 060, normal ALT). Between the patients of group A and B, differences existed in age [(48.5 ± 11.3 vs 55.7 ± 11.4) years, P＜0.01], duration of diabetes [( 36.8 ±45.0 vs 56.2±58.8 ) months, P＜0. 01], body mass index[BMI, (27.7±3.9 vs 25.8±3.4) kg/m2, P＜0.01], waist-tohip ratio (0.95±0.06 vs 0. 93±0.07, P＜0. 01 ), diastolic blood pressure [( 78± 10 vs 75± 10) mm Hg, 1 mm Hg=0. 133 kPa, P＜0. 01], fasting blood glucose [(9.04±2.91 vs 8.63 ±3.05 ) mmol/L, P = 0. 008], 2 h blood glucose after meal[( 13.85±4.67 vs 13.07 ± 4. 92 ) mmol/L, P=0. 002], HbA1c(8. 11% ± 1.82% vs 7.74% ±1.96%, P＜0. 01 ), fasting serum insulin[( 10.59±7.31 vs 7.97±7.18) mU/L, P＜0. 01], postprandial insulin [(48.96±43.80 vs 35.25 ±32.37 ) mU/L, P＜0. 01], homeostasis model assessment for insulin resistance ( HOMA-IR, 4.11±-2.85 vs 3.00 ± 2.92, P＜ 0. 01 )、 triglycerides [( 2.77 ± 2.50 vs 2. 19 ± 2.99 ) mmol/L, P＜0. 01], and high-density lipoprotein-cholesterol [HDL-C, ( 1.20 ± 0. 30 vs 1.29 ± 0. 83 ) mmol/L, P = 0. 01].Logistic regression analysis showed that HbA1C, postprandial insulin, and HOMA-IR, uric acid and urinary albumin were positively, and HDL-C negatively related with the ALT level. It suggests that raised ALT seems to be an index related to the clustering of cardiovascular risk factors, insulin resistance, and earlier onset of type 2 diabetes.

Three fresh lungs removed from three male adult dogs were injected with ABS. This material was injected into each lobe of the lung through the pulmonary artery and bronchus simultaneously. The pressure was maintained between 200～280 mmHg. The injected specimens were digested in 20～50％ HCl and peptic solutions for 7～10 days. A part of the cast replicas of the lungs was taken off and gilded with EIKO IB-3. Under SEM (HITACHIS～450) the specimens thus prepared were observed. The chief findings were as follows:Scanning electron micrographs of the injected vascular system presented a clear, three-dimensional picture of extensive capillary networks around the individual alveoli. In the septa between alveoli the capillary networks appeared to be a single layer. These networks looked like pentagonal or hexagonal rings; the meshes in between them were smaller than the vessels themselves.The capillaries observed here in the scanning stereopicture belonged to the category of the alvioli cappilary of the subpleura; the meshes of which were larger than those of other parts.Because the numerous alveoli and capillary networks surrounding the alveoli were filled with the ABS, the position and the shape of the capillary networks can be seen very clearly.The lumen of the alveoli were polyhedron in shape, various in sizes and smooth in contour. Many imprints of the alveolar type Ⅱ cell nuclei existed on the surface. The bridge formation between alveoli were really interalveolar pores; their number and diameter varied. The function of the interalveolar pores was briefly considered in this paper.

The architecture of the alveolus and its capillaries of human lung injected withsolution of ABS in methyl ethyl ketone was studied under the SEM.The results wereoutlined as follows:1.The alveolar casts were observed from the subpleural and intralobular septu-lar surfaces.The human alveolus is irregular polygon in appearance.The size ofthe alveolus is variable,its surface is smooth,there are many depressions of the topof type Ⅱ cells.The bridge-like structure between two adjacent alveoli are thecasts of the alveolar pores.They are variable both in size and number,and ofround or oval shapes with smooth surface.2.Capillaries of the subpleural space and interlobular septulum are transitional,and identical in appearance.Meshes of the capillary network are larger than thoseof other parts,but more closer in density compared with those in dog.Each capil-lary is branched from the metaarteriole.3.Capillaries in the alveolar septum is a single layer of dense network,theirdiameter are larger than those of the mesh hole.They originate mainly from thecapillaries of subpleural space and interlobular septulum.

Objective:To investigate the current status of prevention and treatment of esophagogastric variceal bleeding (EVB) in cirrhotic portal hypertension patients in Ningxia region.Methods:The retrospective and descriptive study was conducted. The clinical data of 820 cirrhotic portal hypertension patients who were admitted to 21 medical centers in Niangxia region from January 2018 to December 2020 were collected, including 85 cases in Ningxia Hui Autonomous Region People′s Hospital, 73 cases in the Fifth People′s Hospital of Ningxia Hui Autonomous Region, 59 cases in the Wuzhong People′s Hospital, 52 cases in the Qingtongxia People′s Hospital, 50 cases in the Guyuan People′s Hospital, 47 cases in the Yuanzhou District People′s Hospital of Guyuan City, 47 cases in the Yinchuan Second People′s Hospital, 40 cases in the General Hospital of Ningxia Medical University, 40 cases in the Tongxin People′s Hospital, 35 cases in the Yinchuan First People′s Hospital, 34 cases in the Third People′s Hospital of Ningxia Hui Autonomous Region, 32 cases in the Zhongwei People′s Hospital, 30 cases in the Lingwu People′s Hospital, 30 cases in the Wuzhong New District Hospital, 30 cases in the Yanchi People′s Hospital, 29 cases in the Ningxia Hui Autonomous Region Academy of Traditional Chinese Medicine, 28 cases in the Shizuishan Second People′s Hospital, 25 cases in the Shizuishan First People′s Hospital, 21 cases in the Haiyuan People′s Hospital, 20 cases in the Pengyang People′s Hospital, 13 cases in the Longde People′s Hospital. There were 538 males and 282 females, aged (56±13)years. Observation indicators: (1) clinical charac-teristics of cirrhotic portal hypertension patients; (2) overall prevention and treatment of EVB in cirrhotic portal hypertension patients; (3) prevention and treatment of EVB in cirrhotic portal hypertension patients from different grade hospitals. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Results:(1) Clinical characteristics of cirrhotic portal hypertension patients: of 820 cirrhotic portal hypertension patients, 271 cases were in compensated stage and 549 cases were in decompensated stage. Of the 271 cases in compensated stage, there were 183 maels and 88 females, aged (53±12)years. There were 185 Han people, 85 Hui people and 1 case of other ethic group. The etiological data of liver cirrhosis showed 211 cases of viral hepatitis B, 4 cases of alcoholic liver disease, 8 cases of viral hepatitis C, and 48 cases of other etiology. There were 235 cases of Child-Pugh grade A and 36 cases lack of data. Of the 549 cases in decompensated stage, there were 355 males and 194 females, aged (57±14) years. There were 373 Han people, 174 Hui people and 2 cases of other ethic group. The etiological data of liver cirrhosis showed 392 cases of viral hepatitis B, 33 cases of alcoholic liver disease, 10 cases of viral hepatitis C, and 114 cases of other etiology. There were 80 cases of Child-Pugh grade A, 289 cases of grade B, 170 cases of grade C and 10 cases lack of data. (2) Overall prevention and treatment of EVB in cirrhotic portal hypertension patients: of 271 patients in compensated stage, 38 cases received non-selective β-blocker (NSBB) therapy, 16 cases received endoscopic treatment, 6 cases received interventional therapy. Of 549 patients in decompensated stage, 68 cases received NSBB therapy, 46 cases received endoscopic treatment, 28 cases received interventional therapy. (3) Prevention and treatment of EVB in cirrhotic portal hypertension patients from different grade hospitals: of 271 patients in compensated stage, 181 cases came from tertiary hospitals, of which 28 cases received NSBB therapy, 15 cases received endoscopic treatment, 6 cases received interventional therapy. Ninety cases came from secondary hospitals, of which 10 cases received NSBB therapy, 1 cases received endoscopic treatment. There was no significant difference in NSBB for prevention of EVB between tertiary and secondary hospitals ( χ2=0.947, P>0.05), while there was a significant difference in endoscopic treatment for prevention of EVB between tertiary and secondary hospitals ( χ2=5.572, P<0.05). Of 549 patients in decompensated stage, 309 cases came from tertiary hospitals, of which 22 cases received NSBB therapy, 29 cases received endoscopic treatment, 22 cases received interventional therapy. Two hundreds and fourty cases came from secondary hospitals, of which 46 cases received NSBB therapy, 17 cases received endoscopic treatment, 6 cases received interven-tional therapy. There were significant differences in NSBB and interventional therapy for prevention of EVB between tertiary and secondary hospitals ( χ2=18.065, 5.956, P<0.05). Conclusions:The proportion of receiving EUB prevention in cirrhotic portal hypertension in Ningxia is relatively low. For patients with compensated liver cirrhosis, the proportion of NSBB therapy and endoscopic treatment in the secondary hospitals was lower than that in tertiary hospitals. For patients with decompensated liver cirrhosis, the proportion of interventional treatment in secondary hospitals is lower than that of tertiary hospitals, but the proportion of NSBB in secondary hospitals taking is higher than that of tertiary hospitals.

Adenosine 5'-monophosphate-activated protein activated protein kinase (AMPK), a heterotrimeric complex, is an important kinase to regulate glycolipid metabolism and energy balance involved in a variety physiological processes in human body. Many research indicated that the function and activity of AMPK were closely related to inflammation, diabetes and cancers. Recent reports show that inhibition of metformin (a first-line drug) on hepatic glucose in patients with hyperglycemia is associated with AMPK pathway, suggesting that targeting AMPK may be one of the effective strategies for the prevention and treatment of a variety of chronic diseases. Here, we review research progress on the structure, activation and regulation of AMPK in glycolipid metabolism to provide an insight into the basic and clinical research of diabetes therapy.
AMP-Activated Protein Kinases ; Adenosine ; Adenosine Monophosphate ; Energy Metabolism ; Enzyme Activation ; Glycolipids ; Humans