By random sampling,we investigated 276 graduate students of Huazhong Normal University in Wuhan for their understandings on euthanasia.The survey data showed that only a few students have a clear recognition of euthanasia,and no more than 50% of the students investigated accepted active or passive euthanasia,while the acceptance of passive euthanasia was less than 25%.However,the students realized that individuals have the right for euthanasia since they considered euthanasia as a humanitarian behavior,and they hoped certain legislations would be soon available.The students with different backgrounds including genders,majorities,and origins of hometowns(from urban or suburban areas) all have influences on their understanding of euthanasia.Therefore,more extensive investigations are in great need for the future legislation of euthanasia.

Objective To observe the effect of Zhuang Jing mixture (ZJM ) on behavior of primary senile rat and monoamine neurotransmitters in it′s brain ,and to study its mechanism of anti‐aging .Methods Fifty senile female rates which average weight was(300 ± 20)g were randomized divided into 5 groups :blank control group ,low‐,mid‐and high‐dose group of ZJM ,positive control group ,with 10 rats in each group .After medication for 8 weeks ,Morris water maze test was used to evaluate the spatial learning and memory ability of primary senile rats .High performance liquid chromatography with fluorescence detection (HPLC‐FD) was used to detect the monoamine neurotransmitter content in rat′s cerebral cortex and hippocampus .Results Compared with blank control group ,high‐,middle‐dose group of ZJM and positive control group were improved the ability of learning and memory of pri‐mary senile rat ,as well as the cerebral cortex and hippocampus monoamine neurotransmitters levels .High‐dose group of ZJM had significant difference compared with positive control group in improving the ability of learning and memory(P<0 .05) ,and in im‐proving the cerebral cortex and hippocampus monoamine neurotransmitters(P<0 .05) .Conclusion ZJM could significantly improve the learning and memory abilities of primary senile rats ,and its mechanism may be related to adjust the monoamine neurotransmitter in brain .

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AIM:Xaf1-Saos inducible cell lines,which contain "gene switch" system were used to detect the effect of Xaf1 on tumor necrosis factor receptor(TNFR) signal pathway and to investigate the mechanism of cooperation between Xaf1 and TNF-? in inducing cell apoptosis.METHODS:Xaf1 on TNFR1 expression was measured by RT-PCR and Western blotting.The effect of NF-?B on Xaf1 induced apoptosis was detected by DNA content flow cytometry after co-transfection.DNA binding activity of NF-?B was identified by gel mobility shift assay and transcription activity of NF-?B was analyzed by luciferase assay and RT-PCR.SAPK/JNK activity was checked by SAPK/JNK assay.RESULTS:Xaf1 did not modulate TNFR1 at protein and mRNA levels.Increased NF-?B activity in cells inhibited Xaf1 induced apoptosis.Expression of Xaf1 impaired modestly TNF-? induced NF-?B DNA binding activation and transcription activation,also modestly reduced SAPK/JNK activity.CONCLUSION:Xaf1 inhibits TNFR signal pathway,partly contributing to cooperation with TNF-? to induce apoptosis.

Objective To study the correlation of PAZ with anti-tuberculosis treatment regimen and drug-induced liver injury in tuberculosis patients with HBV-DNA positive in order to provide an optimized treatment regimen. Methods from Jan 2013 to Dec 2014, 199 pulmonary tuberculosis with HBV-DNA positive patients and 103 pulmonary tuberculosis patients without HBV in our hospital were collected. They were assigned as follows:122 cases were anti tuberculosis treatment with antiviral therapy,64 cases were A(HRZE),58 cases were B (HRE). 77 cases were anti tuberculosis treatment but not antiviral therapy , 41 cases were C (HRZE), 36 cases were D(HRE) and 103 patients without HBV were E (HRZE, the contrast group). We had observed the liver injury for 2 months after the treatment. Results 1.Incidence of liver injury was 34.38% in group A , higher than the cases in group B(20.69%,P > 0.05). 2.Incidence of liver injury in group C was apparently higher than in group D (73.17% vs. 30.56%,P < 0.05). 3.Incidence of liver injury in group B was lower than group D (20.69% vs. 30.56%,P > 0.05)4.Incidence of liver injury in group A was lower than group C (34.38% vs. 73.17%,P < 0.05).5. Incidence of liver injury in group A was higher than group E (34.38% vs. 17.48%,P< 0.05)and there was no difference between group B and group E (20.69% vs. 17.48%,P> 0.05). Conclusion Although anti tuberculosis treatment combined with antiviral therapy can be partially reduce the incidence of liver injury and relieve the severity of liver injury in tuberculosis patients infected with HBV , but PZA toxicity to hepatocytes is a major risk factor for liver injury , and we need to change the treatment plan to reduce the occurrence of liver injury.

Objective To compare the clinical characteristics,and outcomes of patients with heart failure with different left ventricular ejection fractions (LVEF).Methods A total of 1 182 hospitalized patients with heart failure (HF) were enrolled and retrospectively studied in the present study.The patients were stratified by LVEF as reduced (HFrEF,LVEF ＜ 40％,n =313),mid-range (HFmrEF,40％ ≤ LVEF ＜50％,n =287) and preserved (HFpEF,LVEF≥50％,n =582) ejection fraction groups.Among the 1 182 cases,941 of them (81.3％,84.9％,and 84.0％ inHFrEF,HFmrEF and HFpEF groups,respectively) were followed up for an median duration of 27.3 months.Results (1) Among the study patients,26.5％ were in HFrEF,24.3％ in HFmrEF,and 49.2％ in HFpEF groups.(2) Ischemic heart disease with HFmrEF was more frequent than that in patients with HFrEF.The average age,percentage of female subjects,systolic blood pressure,uric acid,N terminal B-type natriuretic peptide precursor (NT-proBNP),hemoglobin,and the incidence of hypertensive heart disease,anemia,atrial fibrillation in patients with HFmrEF were higher than those in patients with HFrEF,but lower than those in patients with HFpEF (all P ＜0.01).(3) The all-cause cumulative mortality was 10.8％ at 1 year,20.6％ at 2 years and 35.9％ at 5 years.No difference was observed in the all-cause cumulative mortality at 1 year,2 years,5 years among the three groups (all P ＞ 0.05).Conclusions The HFmrEF patients,as a new and distinct group,were with many intermediate characteristics compared with HFrEF and HFpEF subjects.However,the all-cause mortality was not significantly differeut among HF patients with different LVEF.

The presence of high-level talents plays a crucial role in ensuring the successful establishment of national regional medical centers.It presents the high-level talent management experience of Henan Children's Hospital,aiming to facilitate the coordinated development of pediatrics in Central China.To address the practical challenges and difficulties encountered in high-level talent management within hospitals,lean talent management is achieved by standardizing the management structure,clarifying management objectives,refining the management mechanism,establishing a performance appraisal incentive system,and implementing an integrated'induction and utilization'management approach.These measures effectively facilitate the development of national children's regional medical centers.

BACKGROUND: Little is known about the effects of environmental cobalt exposure on insulin resistance (IR) in the general adult population. We investigated the association between cobalt concentration and IR. METHODS: A total of 1281 subjects aged more than 20 years with complete blood cobalt data were identified from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 cycle. Blood cobalt levels were analyzed for their association with IR among all populations and subgroups by sex. Regression coefficients and 95% confidence intervals (CIs) of blood cobalt concentrations in association with fasting glucose, insulin and homeostatic model assessment of insulin resistance (HOMA-IR) were estimated using multivariate linear regression after adjusting for age, sex, ethnicity, alcohol consumption, body mass index, education level, and household income. A multivariate generalized linear regression analysis was further carried out to explore the association between cobalt exposure and IR. RESULTS: A negative association between blood cobalt concentration (coefficient = - 0.125, 95% CI - 0.234, - 0.015; P = 0.026) and HOMA-IR in female adults in the age- and sex-adjusted model was observed. However, no associations with HOMA-IR, fasting glucose, or insulin were found in the overall population. In the generalized linear models, participants with the lowest cobalt levels had a 2.74% (95% CI 0.04%, 5.50%) increase in HOMA-IR (P for trend = 0.031) compared with subjects with the highest cobalt levels. Restricted cubic spline regression suggested that a non-linear relationship may exist between blood cobalt and HOMA-IR. CONCLUSIONS These results provide epidemiological evidence that low levels of blood cobalt are negatively associated with HOMA-IR in female adults.
Adult ; Aged ; Aged, 80 and over ; Cobalt/blood* ; Cross-Sectional Studies ; Environmental Pollutants/blood* ; Female ; Homeostasis ; Humans ; Insulin/blood* ; Insulin Resistance ; Male ; Middle Aged ; Nutrition Surveys ; Sex Factors ; United States ; Young Adult