Objective To investigate the expression and significance of Ezrin in skeletal muscle of myopathy patients. Methods The skeletal muscle specimens with obviously regenerating muscle fibers were obtained from 9 patients with pseudohypertrophic muscular dystrophy (DMD) and 5 patients with polymyositis (PM). Then frozen serial sections were made and the sections were treated with HE stain, immunohistochemistry stains including anti-Ezrin and anti-Neural cell adhesion molecule (NCAM) monoclonal antibodies. The pathological changes and the expression of Ezrin were observed. Results The small regenerating fibers, central location of nucelus and basophilia endochylema were observed under HE stain both in the patients with DMD and PM. Anachromasis of anti-NCAM monoclonal immunohistochemistry stain was found in the regenerating muscle fibers. Positive Ezrin expression was also detected in the regenerating fibers. However, this expression tapered gradually as the mature process of skeletal muscle. The expression of Ezrin was negative in the mature fibers. Ezrin expressed in the myoblasts. Conclusions Ezrin may be closely related to the regenerating skeletal muscle fibers of DMD and PM patients.

This study examined the impact of luteinized unruptured follicle (LUF) on endometrial receptivity. The menstrual cycle of 17 LUF patients (LUF group) and 13 ovulatory women (control group) was monitored by measuring LH level in urine and by ultrasonic examination. An endometrial biopsy at the sixth to tenth day after LH surge was taken in all the patients. The expressions of endometrial ER, PR and integrin ανβ3 were immunohistochemically determined. At the same time, the serum levels of E(2) and P were detected by chemiluminescence. The results exhibited that (1) The mean serum P level in LUF group (7.32±2.56 ng/mL) was significantly lower than that in control group (11.17±3.17 ng/mL) (P<0.01). But there was no significant difference in the mean serum E2 levels between LUF group (179.35±81.60 pg/mL) and the control group (198.58±75.23 pg/mL) (P>0.05); (2) The mean expression intensities of ER, PR in endometrium of LUF group (183.86±2.43, 167.94±3.04) were significantly higher than those in control group (109.35±6.31, 105.98±4.07) (P<0.01); (3) The mean expression intensities of integrin ανβ3 in endomtrium of LUF patients (114.90±11.38) were significantly lower than those in control group (191.34±1.82) (P<0.01); (4) The change profile of integrin ανβ3 expression in the endometrium of LUF patients was in positive relation with serum P level (r=0.77, P<0.01), but bore no significant relationship with serum E(2) level (r=0.01, P>0.05). It was concluded that the depression of serum P levels in LUF patients was closely related to the failure of the down-regulation of ER and PR, and the low expressions of integrin ανβ3 also suggested that the delayed implantation and the impaired endometrial receptivity had impact on embryonic implantation.

Peking University Health Science Center has various characteristics of educational manage-ment practice such as clear three level management, diversified management training and strict quality control, and at the same time there exist many deficiencies, such as lack of the implementation of management regulations and the requirements caused by multi-level management and management quality having ups and downs be-cause of human factors and etc.. By introducing life cycle management into national continuing medical educa-tion project management, we make management run through the whole life cycle of national continuing medical education project, namely five aspects of management from reporting and publishing, planning and publicity, holding and supervision, graduation and certificates, as well as summary and feedback, which plays an impor-tant role in standardizing the national continuing medical education project and improving the quality of the project.

Objective:To explore the methods to improve the professional core competencies of medical students in the standardized residency training.Methods:A total of 82 medical students who participated in the standardized residency training ("resident students" for short) in the same period were selected in this study, and the self-edited professional core competencies textbooks were used for regular theoretical study, and at the same time, clinical practice cases were collected for regular scenario reduction teaching. When the resident students entered the department and after 12 months of the standardized training, the professional core competencies training evaluation scale was used to evaluate and compare the scores of the resident students, and the value of the above-mentioned training model to improve the professional core competencies of the resident students was evaluated. SPSS 18.5 was performed for t test between groups. Results:After being trained by the above model, the selected students had significantly improved such competencies as communication, cooperation and problems solving ( P<0.05). Compared with the scores of resident students before and after the training, there was no significant difference in communication and cooperation with other students ( P>0.05), with low satisfactory communication with the leader ( P>0.05), but the problem-solving ability had been significantly improved ( P<0.05), while the score of which was low and it should be pay more attention to in the future training. Conclusion:In the process of standardized residency training, the application of the above-mentioned training model can significantly improve the professional core competencies of resident students, and at the same time, it's necessary to strengthen the cultivation of satisfactory communication with leaders and problem solving ability.

Objective To study the effects of taking clopidogrel on relevant indicators of platelet aggregation function in 138 cases acute coronary syndrome (ACS) .Methods The platelet function analyzer and flow cytometry were adopted to detect the ADP‐induced platelet aggregation rate ,P selectin and activated GP Ⅱ b/ Ⅲ before medication and on 7 d after taking clopidogrel . Results The platelet aggregation rate after taking clopidogrel for 7 continuous d was decreased significantly (P<0 .01);the P se‐lectin level and activated GP Ⅱ b/ Ⅲ a expressed on platelet surface were significantly reduced (P<0 .01) as well .Conclusion Taking clopidogrel could reduce the platelet aggregation significantly in the patients with ACS and has the effect for inhibiting the platelet aggregation .

Objective To study the alternations of regulatory T cells in early HIV infected patients and its association with disease progression.Methods Fifty-one untreated HIV infected patients were enrolled and divided into 3 groups according to their infection time and CD+4 T cell levels(30 early HIV infected patients,15 typical progressors,6 AIDS patients).Twenty normal controls were enrolled.There were no significant differences between the age and sex among four groups.Blood was drawn by venipuncture from each subject in EDTA tubes and the levels of CD+4 CD+25 Foxp3 + regulatory T cells were detected by FACSAria flow-cytometry.Spearman correlation was used to detect association between CD+4 CD+25 Foxp3 + regulatory T cells and the absolute CD+4 T cells,viral load and activation of T cells.Results The levels of CD+4 CD+25Foxp3+ regulatory T cells showed the tendency of increasing tendency from normal control to early HIV infected patients,asymptomatic HIV infected patients and AIDS patients.Early HIV infected patients was significantly lower than that in AIDS group [3.79(2.11 - 5.43) % vs 8.09(4.90 - 8.90) %,Z = - 2.29,P = 0.022].The levels of CD+4 CD+25 Foxp3 + Treg cells were associated with viral set point(r = 0.479,P =0.038) and inversely associated with CD+4 T cells(r = -0.455,P =0.011) and closely associated with HLA-DR expression on CD+3 T cells(r = 0.533,P = 0.002).Conclusions The ratio of CD+4 CD+25 Foxp3 +regulatory T cells of early HIV infected patients was significantly increased and associated with viral set point and CD+4 T cell counts,which indicate that alternation of regulatory T cell may be an important factor contributing to the disease progression in early HIV infection.

Objective To investigate the effects of social support intervention on anxiety and depression of pulmonary hypertension(PH)patients,then provide a scientific basis for nursing of patients with pulmonary hypertension.Methods The general condition of PH questionnaire,self-rating anxiety scale (SAS),self-rating depression scale(SDS),social support rating scale(SSRS)were distributed to 131 patients with PH.Then make statistical analysis of patients'anxiety,depression and social support conditions.Results The score of anxiety and depression psychological conditions of patients with pulmonary hypertension was significantly higher than normal population,the difference wag statistically significant.Among 131 patients,16 patients with anxiety,accounting for 12.21% ;21 cases of patients with depression,accounting for 16.03% .28 patients at a high level of social support,92 patients at a medium level of social support,11 patients at a low level of social support,a total of 91.60% of the patients in the middle and higher levels of social support.Anxiety and depression scores had significant negative correlation with social support,objective support points and subjective support points.The anxiety,depression difference among different types of pulmonary hypertension was statistically significant.The difference of anxiety and depression scores between patients with idiopathic pulmonary arterial hypertension and patients with pulmonary hyper tension caused by congenital heart disease were significant.The depression scores between pulmonary hy pertension caused by pulmonary veno-occlusive disease and congenital heart disease were significantly different.Conclusions When nurses care pulmonary hypertension patients.those with different types of PH should be given targeted social support.Attention should be paid to transfer the source of social support to help them adopt a positive attitude to face the diseabe,then improve the treatment and care compliance of patients.

Objective To explore the distribution of RAS,AGT,ACE,eNOS,ET-2,ANP and NPRC of es-sential hypertension in Yunnan Han healthy population.Methods Gene chip technology was used to detect the pol-ymorphism of AGT M235T (MM, MT,TT), ACE I/D (II, ID, DD ), eNOS Glu298Asp (EE, ED, DD), ET-2 A985G (AA,AG,GG) ,ANP T2238C(TT,TC,CC) and NPRC A-55C(AA,AC,CC) in 97 health subjects.Results The MM,MT and TT genotype frequency of AGT M235T was 0.052,0.381 and 0.567 ,alle frequency of M and T was 0.242 and 0.758 in 97 healthy subjects of Yunnan population;The II, ID and DD frequency of ACE I/D was 0.340, 0.598 and 0.062, alle frequency of I and D was 0.680 and 0.320 in 97 healthy subjects of Yunnan population ;EE, ED and DD frequency of eNOS Glu 298 Asp was 0.845,0.144 and 0.011 ,alle frequency of E and D was 0.918 and 0.082 in 97 healthy subjects of Yannan population;AA,AG,GG frequency of ET-2 A985G was 0.020,0.258 and 0.722, alle frequency of A and G was 0.149 and 0.851 in 97 healthy subjects of Yunnan population;TT and TC fre-quency of ANP T2238C was 0.959 and 0.041 ,and CC was not detected;alle frequency of T and C was 0.979 and 0.021 in 97 healthy subjects of Yunnan population;AC and CC frequency of NPRC A-55C was 0.763 and 0.237, and no AA was detected,alle frequency of A and C was 0.381 and 0.619 in 97 healthy subjects of Yunnan popula-tion.Conclusion The polymorpbism of ACT M235T,ACE I/D,eNOS Glu298Asp,ET-2 A985G,ANP T2238C and NPRC A-55C is locally distributed in Yunnan Han healthy population.

Objective: To assess the trends in clinical characteristics and treatments for in-hospital patients with ST-segment elevation myocardial infarction (STEMI) in western rural China from 2001 to 2011. Methods: A two-stage random sampling procedure was used in our study. In 1st stage, stratiifed random sampling was applied to identify the participating hospitals and in 2nd stage, random sampling was applied to determine the patients to be studied. Taking 2001, 2006 and 2011 as 3 time points to study the in-hospital records for STEMI treatments. The results in each year were analyzed by weighted calculation in order to adjust the proportional impact by different sampling and therefore, to relfect the entire condition in western rural area. Results: A total of 32/35 hospitals with 1028 STEMI records were enrolled. From 2001 to 2011, the admitted STEMI patients from 64 (54-70) years of age increased to 67 (56-75) years,Ptrend<0.05, while gender composition was similar, the risk factors for cardiovascular disease such as hypertension, dyslipidemia and smoking substantially increased. Among patients without contraindications, the ues of following medications increased from 2001 to 2011: aspirin from 73.6% to 89.9%, clopidogrel from 0% to 66.5%, β-blockers from 25.4% to 64.3% and statins from 7.5% to 89.8%, allPtrend<0.01. From 2001 to 2011, the rates of primary PCI application were from 0% to 0.3%,Ptrend=0.51, the rates of thrombolytic therapy increased from 33.4% to 55.4%,Ptrend<0.01. At the year of 2001, 2006 and 2011, the reperfusion rates were 33.4%, 50.7% and 55.4%, Ptrend<0.01; the mortality within 7 days of admission were 3.0%, 10.1% and 6.7%, the rates of death or treatment withdrawal because of terminal status were 5.3%, 12.3% and 10.9%, there was no signiifcant trend in the above 2 rates after adjustments. Conclusion: The quality of medical care for STEMI was signiifcantly improved in western rural China from 2001 to 2011, while there are still gaps between western rural area and other regions.

Objective: To assess the trends of clinical characteristics, diagnostic and treatment conditions and outcomes for in-hospital patients with ST-segment elevation myocardial infarction (STEMI) in eastern rural China from 2001 to 2011.
Methods: Through a two-stage random sampling, a representative in-hospital STEMI patient group in eastern rural China of 2001, 2006 and 2011 were enrolled. In 1st step, a simple random-sampling procedure was conducted to identify the collaborating hospitals and in 2nd step, a systematic sampling procedure was performed to select representative patients from those admitted to each collaborating hospital for STEMI during the study period. Then we obtained patients’ clinical information from their medical records. Finally, we weighted the ifndings for each year to represent the overall situation.
Results: A total of 2820 STEMI medical records from 32 collaborating hospitals were enrolled. From 2001 to 2011, the median age of STEMI patients increased from 66 to 68 years, P<0.01, the percentage of female patients elevated from 31.4%to 35.8%, P<0.05. The ratios of cardiovascular risk factors were gradually increased. Among the patients without documented contraindications, application of percutaneous coronary intervention (PCI) increased from 0%to 27.5%, P<0.01, reperfusion increased from 49.7%to 58.8%, P<0.01. Administration of aspirin elevated form 80%to 87.8%, Clopidogrel from 0%to 72.6%, statins from 16.7%to 89.6%;administration ofβ-blockers within 24 h of admission elevated from 41.5%to 55.5%, P<0.05 and ACEI/ARB from 58.3%to 69%, P<0.01. In 2001, 2006 and 2011, the in-hospital mortality within 7 days were 6.8%, 8.3%and 5.7%respectively;mortality plus treatment withdrawal because of terminal status at discharge were 10.2%, 12.4%and 9.5%respectively. After adjustment, the above ratios did not change signiifcantly.
Conclusion: From 2001 to 2011, application of PCI grew from nothing and effective medication was improved for in-hospital STEMI patients in eastern rural China. However, there were still obvious gaps for diagnosis and treatment from the guideline requirement;the patient outcomes have not been improved.