The role of serotonergic system in vasovagal syncope (VVS) has been more concerned.Serotonin is a kind of neurotransmitter which is widely distributed in central nervous system.There are kinds of serotonergic receptors on postsynaptic membrane,among which 5-HT1A receptors participate in the mechanism of central blood pressure depression and promote the release of hormones such as prolactin and adrenocorticotrophic hormone.Acute administration of selective serotonin reuptake inhibitors (SSRIs) during head-up tilt test (HUT) blocks the reuptake of serotonin in the synapse space and thus increases stimulation of the serotonin receptors,which induces syncope episode.Long-term administration of SSRIs downregulates the postsynaptic serotonergic receptors,thus it weakens the reaction to the rapid change of serotonin concentration, which results in rapid depression of sympathic nerves and prevention of syncope episode.These demonstrate that central serotonergic system may participate in the pathogenesis of VVS and SSRIs are important for the diagnosis and treatment of VVS.

At present, oncology medical student in our country has many communication problems, such as communication awareness is not strong,the lack of communication,communication is not enough self-confidence and other issues.To improve the communication ability between doctors and patients for the oncology professional medical students:it is the necessary premise for correct implementation of diagnosis and treatment, an effective way to reduce medical disputes, adapt to the demand of the development of higher medical education.And pointed out the effective ways to improve the ability of doctor-patient communication:to set up the doctor-patient communi-cation and tumor department before the internship training course;establishlisten with your heart and professional guidancemode;with teacher actively guiding; learn to empathymode; adhere to the concept of taking pa-tients as the center.

Carcinoma, Hepatocellular ; pathology ; Drug Resistance, Multiple ; Humans ; Liver Neoplasms ; pathology

Animals ; Body Water ; Brain ; anatomy & histology ; Male ; Organ Size ; Rats ; Rats, Wistar ; Specific Gravity

Objective To clone the genes related to pregnancy induced hypertension (PIH) for the study of PIH pathogenesis. Methods The differential expressed cDNA of PIH and normal pregnant placenta were cloned using modified polymerase chain reaction based subtractive hybridization. The differential cDNA were sequenced. Results Ammong 86 clones from subtractive hybridization, 14 clones containing differential expressed gene fragments in PIH and normal placenta were identified, and these might be the genes associated with PIH. Compared with the expressed sequence tags (EST) in dbEST of National Center for Biotechnology Information, it showed that 11 of them were known gene fragments, and three were unknown. The three unknown gene fragments were registered in GenBank, the accession number is AF 232216, AF 232217, AF 233648 respectively. Conclusions Fourteen PIH related genes were cloned with subtractive hybridization. A new approach to study on the pathogenesis of PIH is presented.

Objective To investigate the relationship between Helicobacter pylori(H. pylori)infection and gastric metaplasia in the duodenal bulb and to pursue whether they play critical roles in pathogenesis of duodenitis and ulcer.Methods Eighty-two archive paraffin blocks of duodenal biopsy were obtained. All sections were stained with H-E, AB/PAS and Giemsa stains for histology, gastric metaplasia and H. pyloriassessment. There were 10 patients with normal duodenum, 47 with duodenitis and 25 with ulcer confirmed by endoscopy. Results There was a discrepancy in diagosis of the normal duodenal bulb mucosa between endoscopy and histopathology. Mild to moderate infiltration of inflammatory cell without gastric metaplasia were detected in 60% of cases with the normal duodenal bulb mucosa judged by endoscopy. Gastric metaplasia in duodenal bulb was the major phenomena in the patients with duodenitis and ulcer (37/82, 45%). H. pyloriinfection in the duodenal bulb always appeared in areas of gastric metaplasia. H. pyloriwas identified in 28 out of 37 (76%) cases in the gastric metaplasia mucosa. The prevalence of gastric metaplasia in the duodenal bulb between the patients with ulcer (72%) and duodenitis (40%) was significantly different (P=0.0078). The frequency of H. pyloricolonization was higher in the patients with duodenal ulcer (89%) than the patients with duodenitis (63%), but did not reach statistical significance(P=0.062). H. pyloriinfection was also higher in the ulcer patients with active, healed or scar stage, being 9/10, 5/6 and 2/2, respectively. Conclusions There is a difference in the frequency of H. pyloricolonization in the gastric metaplasia mucosa in the patients with ulcer and duodenitis, which suggests that infection with H. pylorimay play an important role in ulcer recurrence.

Objective To study the chemical constituents of Dysosma pleiantha.Methods Acidic resins were precipitated by 1% HCl solution, then the constituents were isolated and purified on repeated silica gel column.They were identified and structurally elucidated by physicochemical constants and spectral analysis.Results Ten compounds were obtained and identified: podophyllotoxone (Ⅰ), dehydropodophyllotoxin (Ⅱ), podophyllotoxin (Ⅲ), 4′-demethylpodophyllotoxin (Ⅳ), 4′-demethyldehydropodophyllotoxin (Ⅴ), kaempferol (Ⅵ), quercetin (Ⅶ), n-hexadecanoic acid (Ⅷ), ?-sitosterol (Ⅸ), and daucosterol (Ⅹ).Conclusion Compound Ⅴ is a new compound, compounds Ⅷ-Ⅹ are first separated from the plants of Dysosma Woodson and other compounds are first separated from D.pleiantha.

Objective To study the chemical constituents of Zanthoxylum dimorphophyllum and identify the chemical structures.Methods The compounds were isolated by silica gel,Flash column chromatography and purified by crystallization.Their structures were elucidated by spectral methods.ResultsSeven compounds were isolated and identified.They are 6-(3′,methyl-2′,3′-dihydroxy) butyl-7-methoxyl-8-(3″-methyl-2″-butenyl)-coumarin(Ⅰ),8-(3′-methyl)-2′,3′-butenyl-2′-(1″-hydroxy-1″-methyl)-ethyl-6,7-dihydrofurancoumarin(Ⅱ),6,7,8-trimethoxycoumarin(Ⅲ),scoparone(Ⅳ),umbelliferone(Ⅴ),canthin-6-one(Ⅵ),and syringaresinol(Ⅶ).Conclusion Compound I is a novel compound and all compounds are obtained from Z.dimorphophyllum for the first time.

ObjectiveTo determine the possibility of r eal-time perfusion imaging in the quantitative evaluation of myocardial perfusion in various segments of left ventricle. MethodsImages of ten anesthetized dogs were obtained at the mid-papillary muscle short-axis view with a real-time imaging system. Mechanical index (MI) was adjusted to 0.1 , 0.2 and 0.4 respectively, and frame rate was set at 20 Hz. Optison was infused intravenously at a rate of 0.1 , 0.2 and 0.5 ml/min, respectively. Images were recorded for 150 real-time frames commencing immediately after a couple of Doppler bursts. Myocardial opacification was assessed both visually and quantitatively for six segments of left ventricle (antero- and infero-septum, inferior, posterior, lateral and anterior wall). Myocardial signal intensity versus real-time frame curves were made and fitted to an exponential function: Y=A(1-e -?t ). ResultsUsing low MI (MI= 0.1 or 0.2 ) and with continuously infusion of Optison at a rate of 0.2 or 0.5 ml/min, real-time imaging resulted in sufficient myocardial opacification and left ventricular endocardial border definition, and displayed myocardial thickening and wall motion simultaneously. ConclusionsReal-time imaging has a potential in the quantitative assessment of myocardial perfusion, and allows simultaneous assessment of perfusion and myocardial function.

The reform for medical insurance payment was the important method for standardizing medical service provider behavior,controlling costs and improving efficiency,which was also the important measurement for further improve and implement the reform of drug and health system.Since the new medical reform in 2009,the central and local government had paid more attention on the role of medical insurance payment reform.Local medical departments of different places implemented reform pilots.Through summarizing the foreign and domestic researches around capitation,bundle payment and global payment,the experiences and effectiveness of these pilots were evaluated so as to provide corresponding policy implications.