Based on experience on medical service drilling for many years,this paper analyses the hardship and complexity of medical service support in high & cold mountainous region.It also puts forward some suggestions in such aspects as integral design,focal points insurance,necessaries reinforcement,preach for popularization and mutual cure training.

The study was proceeded on the mRNA expression of the GULT1 and GLUT4 gene in the alloxan diabetic rats by the technique of dot-blot hybridization analysis. The results showed that the levels of the GLUT4 mRNA expression were reduced in diabetic rats while increased in insulin treated diabetic rats. This suggests that the reduced GLUT4 mRNA expression which could affect the quantity of its posttranslational products may be one of the causes of the insulin resistance.

Objective To evaluate the effect of amniotic products after transcervical resection of uterine adhesions (TCRA). Methods This study was carried out in 57 patients with intensive degree of intrauterine adhesions (IUA) who had been treated by TCRA between Jun. 2013 to Jun. 2014. These patients were devided into two groups randomly. In group amnion, 29 patients were placed amniontic scaffold balloon after TCRA;in group balloon, 28 patients were placed Foley′s balloon after TCRA. The two groups′balloons were taken out after TCRA 7 days. All patients were taken artificial cycle treatment. The uterine cavity form and the menstruation of 2 groups were observed in 3 months after TCRA. Results In group amnion, IUA score dropped from 10.1±0.5 preoperatively to 3.2±1.5 postoperative (P<0.01), in group balloon, IUA score dropped from 10.1 ± 0.5 preoperatively to 6.3 ± 2.5 postoperative (P<0.01). In group amnion, the menstrual score increased from 13.3 ± 4.4 preoperatively to 32.6 ± 5.5 postoperative (P<0.01), in group balloon, the menstrual score increased from 11.1±5.8 to 26.5±5.6 (P<0.01). The menstrual improvement of group amnion was better than that of group balloon significantly (P=0.002). In group amnion, the recurrence rate of adhesion was 21%(6/29), in group balloon, the recurrence rate of adhesion was 36%(10/28). There was no significant difference (P=0.248). The pregnancy rate of group amnion was 28%(8/29), the pregnancy rate of group balloon was 21%(6/28). The difference of pregnancy rate in two groups was not significant (P=0.760). Conclusion This small sample observation indicate that amniotic products used in the treatment of intensive IUA could improve menstrual, reduce the recurrence of adhesion, but the impovement of the pregnancy rate should be confirmed by large sample observation.

Objective To understand the significance of urinary protein components in children with different pathological types of glomerular diseases ,to explore the significance to diagnosis and treatment of disease .Methods Totally 120 children with glomerular diseases ,from November 2010 to July 2012 in the First Affiliated Hospital of Zhengzhou University were collected ,in which 6 children with acute glomerulo nephritis(AGN) ,35 children with minimal change disease(MCD) ,9 children with focal seg‐mental glomerulosclerosis(FSGS) ,44 children with Nephritis of Schonlein‐Henoch Purpura(HSPN) ,17 children with IgA nephrop‐athy(IgAN) and 9 children with hemolytic uremic syndrome(HUS) .Urine protein electrophoresis and urineβ2‐microglobulin(β2‐MG)levels were investigated in different glomerular diseases .Results Significant difference was detected inβ2‐microglobulin ,lyso‐zyme ,retinol‐binding protein ,free light chain ,α1‐microglobulin ,light chain dimmer ,albumin and transferring levels in different glo‐merular diseases(P=0 .016 ,P=0 .017 ,P=0 .017 ,P=0 .023 ,P=0 .004 ,P=0 .025 ,P=0 .049 ,P<0 .01) .A significant correlation was detected between low molecular weight protein and urineβ2‐microglobulin levels(r=0 .243 ,P=0 .025) .Conclusion It is sig‐nificant for diagnosis and treatment of glomerular diseases to the combination of urine protein electrophoresis and renal pathology .Urinary protein profiles are different in different pathological types .Proteomics may be significant for the mechanism of glomerular diseases .

Objective To assess the efficacy,compliance and safety of ketogenic diet (KD) for children with infantile spasms,thus to provide an effective basis for the treatment of infantile spasms.Methods Twenty-five patients with infantile spasms were treated with KD.The gas chromatography-mass spectrometry and high performance liquid chromatography-mass spectrometry (HPLC-MS/MS) were used,except for metabolic diseases,to detect the blood routine,urine,stool,blood Iipids,liver function,as well as electrocardiogram (ECG),electroencephalograph (EEG),ultrasound of the urinary system and other related checks of all patients.The KD antiepileptic drug therapy was given after all children were admitted to hospital,and KD started directly in all patients without fasting.The efficacy compliance and safety were followed up in this study.Results KD maintenance therapy for 1 month,3 mouths,6 months were given to 25 cases (100％,25/25 cases),to 22 cases (88％,22/25 cases),and to 10 cases (40％,10/25 cases),respectively.Among them 7 patients (28％,7/25 cases) were in complete control of seizures within 1 month.Up to Class Ⅱ,Ⅲ efficacy level accounted for 32％ (8/25 cases),12％ (3/25 cases),respectively.Thirteen cases of children had varying digestive symptoms,10 cases of them developed asymptomatic hypoglycemia,and 9 cases of children had sleep trouble during KD treatment,but after symptomatic treatment,children's adverse reactions almost subsided.Only 4 cases of children discontinued treatment due to adverse reactions.All children's seizures were fully controlled.Conclusions The effect of KD is sure in the treatment of infantile spasms.Although KD has some adverse reactions,but it can be tolerated;serious body organ dysfunction treated by KD + antiepileptic drugs combination therapy for 1 to 6 months is not found yet,so the therapy is worthy of promotion clinically.

Transient receptor potential(TRP)channels as an important non-selective cation channels family mainly permeate Ca2 + ,Na + and other cations. TRPC channel is a subtribe of TRP family which regu-lates the second messenger of Ca2 + concentration and variety of protease activity,and which can directly or in-directly affect the biological behavior of cells. Recently,more and more evidences have certificated the TRPC channels affect the tumorigenesis and development,such as regulation of proliferation,differentiation,migra-tion,apoptosis and resistance of chemotherapeutic agents during cancer progression.

[Summary] There are a variety of treatment methods for stress urinary incontinence ( SUI) .Surgery is effective but has high risks, only to adapt to the limited population .Conservative treatment has a high recurrence rate and poor long-term results.Local injection of stem cell has been proposed as a new minimally invasive therapy of SUI .Stem cells, with the ability to transform into muscle cell , secrete various growth factors , promote local nerve and muscle tissue regeneration , and repair sphincter dysfunction .This article reviewed on therapy of skeletal muscle-derived stem cells and the associated risks of treatment .

The ethics review for clinical trials pertaining to human body highly emphasizes human subjects protection.This study discussed how to balance the relationship between the rights,safety and health of the subjects and interests of the science and the community,how to review the damage compensation provisions and insurance provisions in the informed consent,how to scientifically define the human subject biomedical trials involving vulnerable groups,and how to conduct trials on vulnerable groups,as well as other sensitive issues in ethics review.

Objective To investigate the value of the levels of urinary NT-proBNP whether is similar with the levels of blood NT-proBNP for the diagnosis of chronic heart failure.Methods 79 patients with chronic heart failure (NYHA Ⅰ~Ⅳ)as a research group,and 53 healthy people as a control group,the levels of urinary and blood NT-proBNP on two groups were measured respectively by Roche cobas h 232 cardiac markers detector and compared the difference of the levels of urinary NT-proBNP and blood NT-proBNP between the two groups.Results The levels of urinary and blood NT-proBNP in pa-tients with chronic heart failure were much higher than those in healthy subjects,respectively (P <0.01).The concentration of urinary NT-proBNP increased gradually with more severe symptoms.The level of urinary NT-proBNP was positively cor-related with the levels of blood NT-proBNP.Conclusion The levels of urinary NT-proBNP is a new candidate marker for the diagnosis of chronic heart failures and it provides a similar accuracy with the levels of blood.

Objective To investigate the protective effect of Niacin on blood-retina barrier (BRB) in diabetic rats and related mechanism.Methods The male Wistar rats (60) were divided into control (CON) group,diabetes (DM) group and Niacin-treated (NA) group,20 rats in each group.Rats diabetes models were induced with streptozotocin injection.Niacin (40 mg/kg · d) was administrated orally everyday in Niacin-treated group until sacrificed after 3 months.Pathological outcomes,total cholesterol (TC) and highdensity lipoprotein (HDL) were evaluated at month 3.Optical microscopy was used to observe the retinal structure.The integrity of BRB and the vascular permeability was quantified by analyzing albumin leakage using Evans blue (EB) method.The relative expressions of Claudin-5,Occludin,zonula occluden (ZO)-1 and GPR109A mRNA in rat retinas were detected by reverse transcription PCR (RT-PCR) and relative expression of GPR109A,tumor necrosis factor (TNF)-α and interleukin (IL)-6 by Western blot.Results Compared to CON group,the TC content was increased and HDL content was decreased in DM group (t=4.034,5.831;P＜0.05).Compared to DM group,the TC content was decreased and HDL content was increased in NA group (t=6.868,3.369;P＜0.05).The retinal structure of CON group was normal.Pathological changes were found in the DM group,such as tumescent nuclei and disorganized structures.The retinal structure of NA group was similar to the control group.Evans blue dye that the microvascular leakage in DM group was increased compared with CON group (t=24.712,P＜0.05),while in NA group was decreased compared with DM group (t =16.414,P＜ 0.05).The mRNA expression of Occludin,Claudin-5,ZO-1 in DM group were decreased compared with CON group (t=11.422,12.638,12.060;P＜ 0.05),while in NA group were increased compared with DM group (t=5.278,3.952,8.030;P＜0.05).The mRNA expression of GPR109A in NA group were increased compared with DM group (t=5.053,P＜ 0.05).The protein expression of GPR109A,IL-6,TNF-αin DM group were increased compared with CON group (t=4.915,11.106,6.582;P＜0.05).Compared to DM group,the protein expression of GPR109A was increased (t=5.806,P＜0.05),while the protein expression of IL-6 and TNF-α were decreased (t=10.131,5.017;P＜0.05).Conclusion Niacin has the protective effect for BRB by up-regulating GPR109A expression which may suppress inflammation.