Objective To investigate the impact of high altitude on human gastric mucosa and its underlying mechanisms. Methods Twenty-five native Tibetans with chronic mountain sickness CMS residing at high altitude (4500 m) were examined for ultrastrueture and pathological changes of gastric mucosa. The other 25 native Tibetans residing at low altitude (＜2000 m) were served as control.The expression of hypoxia-inducible factor (HIF)-1α in human gastric mucosa was detected with immunohistochemistry. Results The color of gastric mucosa presented dark in patients with CMS.The histopathological examination showed significant differecnce in incidence of cnronc body gastritis and atrophic gastritis between CMS group and control group (P＜0. 05). The transmission electronic microscopy revealed that the epithlieal cells of gastric mucosa were impared in CMS group compared to control group. The expression of HIF-1α protein was increased in CMS group in comparison of control group (102.94± 34.04 vs 14.04 ± 6.53, P＜0.05). Conclusions The high altitude may involve in damage of gastric mucosa and the up-regulation of HIF-1α protein may involve in its mechanism.

The grass-root level health workers play a decisive role in health services, the researches on human re-sources in primary healthcare, therefore, in many countries of the world have been widely concerned. This article re-flected on 20 research papers related to recent aspects of primary healthcare human resources; described the amount, quality, structure and distribution of workforce for health; analyzed the factors of health workforce development in eco-nomic, social, policy and other aspects and elaborated the strategy to develop primary health professionals, namely through strengthen the training of talent personnel in rural areas, adjust the professional structure of medical education, and implementation of preferential policies to attract and stabilize the health personnel.