Objective To investigate knowledge and attitudes of healthcare workers with respect to HIV/AIDS in Fugong County,Nujiang District and to highlight the difficulties facing local healthcare workers in HIV/AIDS health education in order to help them improve their skills and capability of health education through participatory learning.(note:the major inhabitants in NuJiang are the Lisu ethnic).Methods A survey with questionnaires was carried out before starting a HIV/AIDS health education training course for healthcare workers in Fugong County.Then an interactive and participative HIV/AIDS training was provided for these healthcare workers.A post-training survey was followed.Results Before the training course,the score of HIV/AIDS related knowledge was 56.71 on average.The average score increased to 83.93 after the participatory HIV/AIDS health education,(by SPSS analysis).Such an increase was obviously associated with their participation in the training course.The knowledge the participants learned during the training course was effectively used for conducting health education among local inhabitants.Conclusion We found that a participatory/interactive HIV health education training course is useful in raising the awareness and understanding of HIV/AIDS among healthcare workers in areas such as Fugong.We encourage more efforts to hold such courses in order to prevent the spread of HIV/AIDS.

Objective To study the effect of night large dose of sodium valproate on epileptiform discharges,and cognitive function of benign childhood epilepsy with centrotemporal spikes. Methods Ninety cases of benign childhood epilepsy with centrotemporal spikes were randomly divided into treatment group and control group (n= 45), both groups received regular total doses of sodium valproate therapy 25-30 mg?kg-1 ?d-1 . Patients in the treatment group received treatment that night doses of sodium valproate was double of morning doses. Every night dose was (17.96±1.21) mg?kg-1 , and every morning dose was (8.92±0.62) mg?kg-1 . The control group received the same dose [(13.37±0.80) mg?kg-1 ] of sodium alproate therapy twice a day, morning and evening. The epileptiform discharges, cognitive function, therapy effect were compared between two groups. Results Total effective rate of treatment group was 82.22% which were was significantly higher than that of the control group 62.22%(P<0.05);Epileptiform discharges reduction of treatment group was significantly higher than that of the control group (P<0.05), the effective rate of EEG improvement (84.44%)in treatment group was significantly higher than that in the control group 66.67% (P<0.05); FIQ, VIQ, PIQ in treatment group were significantly higher than those in the control group (P<0.05); There were no statistical differences of adverse reactions between two groups. Conclusion Night large dose of sodium valproate treatment can help control epileptic discharge, increase the plasma concentration, improve cognitive function, and therapy effect.

Objective To evaluate the clinical value of serum high density lipoprotein cholesterol (HDL-C)in the evaluation of synthetic function of the patients with liver diseases.Methods Abbott Aeroset automatic biochemical analyzer was used to detect serum HDL-C level in control group (30 cases) and liver disease group(87 cases).T test was used to analyze the differences of serum HDL-C level in liver disease group and control group,different liver disease groups and control group,and different liver disease groups.Results HDL-C level was (1.28 ±0.20)mmol/L in the control group,(0.77 ± 0.15)mmol/L in the liver disease group,and (0.81 ± 0.13)mmol/L in the hepatitis group,(0.68 ± 0.14)mmol/L in the liver cirrhosis group,(0.54 ± 0.05)mmol/L in the liver cancer group.The HDL-C level in liver disease group and hepatitis group,liver cirrhosis group,liver cancer group was significantly lower than that in the control group(t =15.5569,14.2463,45.4393,25.6344,all P ＜ 0.01).The HDL-C level in liver cirrhosis group and liver cancer group was significantly lower than that in hepatitis group (t =3.6583,16.9057,all P ＜ 0.01).The HDL-C level in liver cancer group was significantly lower than that in liver cirrhosis group(t =4.4103,P ＜ 0.01).Conclusion Serum HDL-C level can be used to evaluate synthetic function of the liver,the lower of serum HDL-C level,the more serious liver synthesis function is impaired.

Objective To assess the diagnostic value of chronotropic index in identifying coronary artery disease (CAD). Methods One hundred and sixty two patients with suspected CAD were referred for a routine treadmill exercise electrocardiogram and subsequently underwent selective coronary angiography within 3 weeks. The magnitude of ST segment depression and chronotropic index were measured by a computerized ECG system. CAD was defined by coronary angiography. Results In detecting CAD, the sensitivity was 70. 1% versus 60.9% (P< 0.05) ,the specificity was 84.0% versus 73.3% (P<0.05), and the accuracy was 76.5% versus 66.7% (P< 0.05) by chronotropic index and standard electrocardiographic test criteria. The value of Kappa statistic for chrono-tropic index consistency in our experiment was 0.534(>0.4). The number of diseased vessels was correlated with the mean value of chronotropic index. The chronotropic index decreased from 0.88±0.09 in patients without coro-nary disease to 0.68±0.06 in those with 3 vessels involved (P<0.01). A more closed relationship was found be-tween chronotropic index and lesion in the fight coronary artery. Conclusions Chronotropic index is possibly a valu-able positive index for the diagnosis of CAD. The sensitivity,specificity and accuracy of chronotropic index are signif-icandy higher than those of standard electrocardiographic test criteria in identifying CAD.

Objective To analyze the related factors of surgical site infections after spine surgery so as to provide basis for clinical prevention. Methods We retrospectively reviewed the clinical data on 2,083 patients who had undergone spine surgery during the period of June 2010 to May 2013, and then conducted a statistica analysis. Results A total of 38 patients developed surgical site infections. The incidence of surgical site infections after spine surgery was 1.8%. 11 risk factors including gender, history of smoking, and history of prolonged uses of medications were related to surgical site infections The logistic regression analysis indicated that surgical site infections were more closely related to gender, length of hospital stay, and spine surgical invasiveness index. Conclusions Multiple factors can be attributed to surgical site infections after spine surgery. Gender , length of hospital stay, and spine surgical invasiveness index are the independent risk factors.

The object of medical research is human life,thus the understanding level of human being determines medical mode and the development of medical science.The origin of Marx's theory on human being is the realistic human,which provides methodological basis for reflecting on the biomedical faults from a logical perspective.Marx held that technology is the objectization of the essential power of human being,while technology under the context of capitalist production relations has been turned into certain means to control workers.Tend of dissimilation also arises in some modern medical fields,thus serious reflection and criticism are in great need.The overall development of human being is the core content in Marx's theory on human being.Since modern medicine is during the transition from bio-medical model to bio-psycho-social medial model,the new medical model calls for an overall development of main body in all aspects including qualification,ability,and social relations,etc.

BACKGROUND:It is confirmed that astrocytes can differentiate into neurons by Neurogenin2 gene regulation, suggesting that Schwann cells may also differentiate into neurons by gene regulation.
OBJECTIVE:To evaluate the feasibility of Schwann cells differentiating into neurons by Neurogenin2 gene regulation.
METHODS:Rats Schwann cells were isolated, purified and identified. Then the Schwann cells were transfected with Neurogenin2 via green fluorescent protein gene-plentivirus. To induce neuronal differentiation, the Schwann cells were cultured in serum-free Dulbecco’s modified Eagle’s medium containing epidermal growth factor, basic fibroblast growth factor and brain-derived neurotrophic factor for 2 weeks. The morphology of induced cells was observed by microscope, and myelin basic protein and neuron-specific enolase were detected by immunocytochemistry.
RESULTS AND CONCLUSION:After transfection with Neurogenin2 via green fluorescent protein gene-plentivirus and induced differentiation, immunofluorescence assay demonstrated that 12.56%of the induced cellexpressed neuron-specific enolase, but the control group did not express neuron-specific enolase. Neurogenin2 gene-transfected Schwann cells can express neuron-specific enolase, suggesting Neurogenin2 gene may regulate transdifferentiation of Schwann cells into neurons.

AIM:To detect the existence of signal joint T-cell receptor excision DNA circles(sjTRECs)of 23 TCR V? subfamilies in mononuclear cells of patients with multiple myeloma(MM),and to evaluate the recent thymic emigrants of corresponding V? subfamily nave T cells in MM patients.METHODS:23 TCR V? subfamily sjTRECs were amplified in genomic DNA from 5?104 PBMCs of 12 cases in MM patients by using semi-nest PCR.10 normal individuals served as controls.RESULTS:The number of detectable V? subfamily sjTRECs was 5.00?2.45 from MM patients,as compared with 9.60?5.48 from normal individuals,the difference was significant(P

Objective To investigate the 4-year follow up of cognitive function outcomes and characteristics in patients after stroke.Methods Sixty three cases according with the diagnostic standard of acute unifocal subcortical stroke were consecutively collected in neurological ward from December 2009 to November 2010.They were followed up for average four years.Forty one out of them completed the neuropsychology tests identical to the baseline,which covered the general cognition function,attention,execution,memory,language,spatial,etc.According to the standard of clinical diagnosis,cognition function is divided into five degrees,including normal,VCI-ND,mild VaD,moderate VaD,and severe VaD.The improved group had 13 cases whose cognition function was improved by one or more ranks.The progressive group had 12 cases whose cognition function progressed by one or more ranks.The stable group had 16 cases whose cognition function remained the same as the baseline.Results According to qualitative analysis on the baseline versus 4-year follow-up outcome,in 13 improved cases,8 were VCI-ND and 5 were mild VaD.In 16 stable cases,11 were normal,4 were VCI-ND and 1 was mild VaD.In 12 progressive cases,3 were normal (change to mild VaD after follow-up),5 were VCI-ND (change to mild and moderate VaD after follow-up) and 4 were mild VaD (change to moderate VaD after 4-year follow-up).In the comparison of baseline cognition function among the improved,progressive and stable group,there was only one significantly different score (the right number of SCWT-A) in the improved and progressive group.The cognition function of improved group had significant differences in CFT-copy,right number of SCWT-C and the time of TMT-B before versus after follow-up.The cognition function of progressive group had significant differences in AVLT-Delay Recall and CFT-Recall.Conclusion Long-term cognitive function outcome after stroke is heterogenetic.The location of cognitive impairment or progression is not the same model for different cognitive outcome group.

Objective To analyze the relationship of the serum concentration of TSH in pregestational women with pregnancy and pregnant outcome,and to investigate the high risk value of TSH in eugenic and healthy examination before pregnancy.Methods The distribution of TSH in fertile woman and the relationship of serum TSH level with sex hormone levels,rate of pregnancy,and adverse pregnant outcomes (no healthy infants were born,abortion,premature delivery,and malformation) were investigated in national-free pregestational eugenic and healthy examination during 2013.The high risk level of TSH in pregestational women was determined.Results The average level of TSH in 5 798 prepregnant women was 2.36 mIU/L with the median of 2.01 mIU/L,and the serum level of TSH showed abnormal distribution with long tail.The pregnant rate of fertile women within one year was 76.1％.The beneficial range of TSH levels for pregnancy was 0.35-3.5 mIU/L,while the pregnant rate in other ranges of TSH level was decreased with statistically significant difference (P＜0.01).When the concentration of TSH was below 0.35 mIU/L or above 5.5 mIU/L,abnormal pregnant outcomes were significantly increased (P＜0.01).Logistic regression analysis indicated that the relative risks of infertility and abnormal pregnant outcomes were significantly increased.Compared with TSH 0.35-2.5 mIU/L group,there were significantly differences in FSH,LH,and estradiol (E2) in TSH＞4.5 mIU/L or＜0.35 mIU/L group (P＜0.01).TSH was related with LH,E2,progesterone,and prolactin (r=0.29,-0.28,-0.37,0.36).Conclusion The high risk value of serum TSH in prepregnant women should be below 0.35 mIU/L or above 5.5 mIU/L.