In view of the transformation from traditional biomedicine to biology-psychology-social medicine,the comprehensive medical iournals,in order to advance the development of the medicine,should pay attention to the articles on psychology,society and environment with diseases;strictly investigate the ethics in the articles;and publish the articles on the medical humanity promptly.

Objective To explore the effect of health education on medication compliance of middle-aged and elderly hypertensive patients in rural areas. Methods Outpatients aged 45 hypertensive patients were divided into two groups, the intervention group was given health education knowledge, intervention of bad habits and knowledge of drug by oral presentations, banner ads, TV screen publicity, publicity, newspaper, telephone follow-up and other forms of propaganda. Results Hypertension knowledge, dietary knowledge, living habits, medication knowledge, medication compliance of patients in the intervention group were increased significantly, and there were significant difference in the four survey in the observation group with statistical significance(P<0.05). Conclusion Health education has a great influence on drug compliance among middle-aged and elderly hypertensive patients in rural areas, and has great significance for controlling blood pressure.

The overall 5-year survival rate for patients with metastatic colorectal cancer(CRC) is less than 10%.Median survival with 5-fluorouracil(5-FU)/leucovorin(LV) therapy is approximately 12 months.Recent additions to the chemotherapy armamentarium for this disease have begun to prolong median survival times.In trials in which patients are exposed to all three approved chemotherapy agents,oxaliplatin,irinotecan,and 5-FU/LV,or capecitabine during the course of their disease,median survival has reached 20 months. The addition of oxaliplatin and irinotecan to 5-FU/LV regimens has also led to the maintenance of quality of life for longer intervals than were traditionally observed with 5-FU/LV alone.Current standard first-line regimens for metastatic CRC are FOLFOX(infusional 5-FU/LV with oxaliplatin) and FOLFIRI(infusional 5-FU/LV with irinotecan).Ongoing investigations will identify a place for molecular targeted combination chemotherapy on metastatic colorectal cancer(CRC) and some trials achieved better efficiency.In this review,we discuss the current advances in combined management of metastatic colorectal cancer of 5-Fu,chemotherapy,Molecular targeted therapy.

Objective To study the photodynamic therapeutical efficacy of a novel photosensitizer DTP on sensitive gastric cancer cells (SGC7901) and vincristine-resistant gastric cancer cells (SGC7901/VCR).Methods The P-gp expression on the SGC7901 and SGC7901/VCR cell membrane was indirectly confirmed by fluorescence microscopy.The survival rates of SGC7901 and SGC7901/VCR cells were evaluated by cell counting kit (CCK-8) after photodynamic therapy with DTP.The intracellular DTP uptake levels of two types of cell were determined using a fluorescence spectrophotometer,and the intracellular DTP distributions were observed by laser scanning confocal microscopy.Results The novel photosensitizer DTP has considerable photodynamic cytotoxic effect on SGC7901 and SGC7901/VCR cells.However,this effect on the SGC7901NCR cells was relatively weak (P＜0.05),and could not be enhanced by P-gp inhibitor verapamil or cyclosporine A(P＞0.05).The DTP uptake level in SGC7901 cells was higher than that in SGC7901/VCR cells (P＜0.05),and could not be enhanced by P-gp inhibitor verapamil and cyclosporin A (P＞0.05).It was found that DTP distributed in the lysosomes of SGC7901 cells and in the lysosomes and mitochondria of SGC7901/VCR cells.Conclusions The novel photosensitizer DTP is not the substrate of multidrug transporter P-gp,and its weaker photodynamic cytotoxic effect on SGC7901/VCR cells is independent of the P-gp overexpression on its cell membrane,which may be related to the distribution of intracellular DTP in the two types of cell.

Objective To investigate the effects of penehyclidine on respiratory mechanics after tracheal intubation in patients with chronic obstructive pulmonary disease. Methods Sixty-six patients with chronic obstructive pulmonary disease were divided randomely into two groups. Group Ⅰ (penehyclidine group, 33 cases) was intravenously injected 1 mg of penehyclidine before intubation, group Ⅱ (control group, 33 cases)was not given bronchodilator. Lung-chest walt compliance, airway pressure, and resistance were measured at 1 h,4 h,and 6 h after tracheal intubation. Results Patients in group Ⅰ had significantly both lower airway pressure and resistance and higher lung-chest wall compliance than group Ⅱ (P < 0. 05). Conclusion Penehyclidine produces higher lung-chest wall compliance and lower airway pressure and resistance in patients with chronic obstructive pulmonary disease.

Objective To study the mechanism of acupuncture combined with herb decoction for brain occlusion. Methods one-side middle cerebral artery occlusion (McAo) rat by ehermoregulation was used as focal cerebral ischemia experimental animal. All animals were divided into four groups as model group, acupuncture group, herb decoction group, acupuncture combined with herb decoction group. And the dynamic changes of c-fos protein in ischemia region of brain tissue after treatment were observed. Results All of acupuncture group, herb decoction group and combining group could enhance the expression of c-fos protein in all stages of ischemia, and combining group was enhanced significantly. Conclusion Compared with herb decoction or acupuncture, the method of acupuncture combined with herb decoction could improved the stress ability of nerve cells of acute brain ischemia by enhance the content of c-fos protein significantly.

Objective To explore the clinical features of hyperthyroidism combined with Moyamoya disease. Methods The manifestations of clinic and neuroimaging in 4 patients with hyperthyroidism combined with Moyamoya disease were retrospectively analyzed.Results 4 patients were young or middle-aged females and onset of the disease were acute or subacute. 2 cases had the history of hyperthyroidism for 4 and 1 years and other 2 cases were diagnosed of hyperthyroidism in the duration of hospital stay. All of them presented with focal neurologic deficit(3 of motor weakness or fatigue in the limbs, 2 of facial paralysis and 2 of aphasia). All of them had thyromegaly Ⅰ?～Ⅱ? and 1 of them had vascular murmur in thyroid region.Thyroid function tests revealed thyrotoxicosis, the level of fT3 was 10.1～30.8 pmol/L,the level of fT4 was 17.9～154.8 pmol/L, the level of TSH was 0.01～0.1 mU/L.DSA or MRA showed stenosis or occlusion of the terminal portions of the bilateral or unilateral internal carotid arteries and abnormal vascular network in the vicinity of the arterial occlusion. The patients recovered after the anti-thyroid therapy and treatments for the cerebral stroke. Then ,15 ～ 60 months were followed up respectively, there was no relapsed of cerebral stroke in them. Conclusion Hyperthyroidism combined with Moyamoya disease is only seen in females. Cerebral stroke is occurred during the presence of thyrotoxicosis. Anti-thyroid treatment is beneficial for recovery of the centre nervous system and prevention of recurrence.

Objective To investigate the etiology, pathology, pathogenesy and treatment in patient with rhabdomyolysis (RM) complicated with acute renal failure(ARF). Methods Analysis of clinical and muscle pathological data combined with literatures were made for a patient with RM-ARF.Results The patient who had experienced exercise induced RM for 5 years. Alcohol drinking and infection were led to RM with ARF for this time. There was non-special inflammatory feature in light microscope by biopsy. The principle of RM management was prevention of hypovolemia and acidification of urine. Hemodialysis (HD)was chosen for treatment of ARF and basic recovery was obtained.Conclusions The etiology of this patient may be the alcohol drinking, particularly the infection which developed on the basis of recurrent RM. Muscle biopsy is useful not only for observing the pathological features of RM, but also for differentiation of etiological factors. The HD therapy used in time may be the key to get favorable effect for this case.

32 patients with old atlantoaxial dislocation with bulb-spinal cord compression were treated surgically from 1971 to 1989. Their diagnoses were confimed mainly by X-ray examination and measurement. The average time of follow-up after operation was 6 years. The rate fo excellence and good was 87.5% per cent. The causes of atlantoaxial dislocation, operative techniques involved and results are discussed. The authors think that the key to the increase of the therapeutic effects is early diagnosis and surgical treatment before the irreverisible changes of bulb-spinal cord compression occur.

Objective To study the characteristics of molecular genetics concerning Chinese mitochondr ial encephalomyopathy,lactic acidosis and stroke-like episodes (MELAS). Methods A3243G and T3271C point mutations in the mtDNA of muscle and (or) blood cells were investigated in 9 patients with MELAS and some o f their maternal relatives from 7 families by using PCR-RFLP. Furthermore,mut ant mtDNA in the sample harboring mutation was quantitatively analysed. Results The mtDN A A3243G point mutation was unanimously identified in tissues of all patients an d 1 of their relatives. However,the T3271C point mutation was identi f ied in none of series in our study. The proportion of mtDNA A3243G was 46.8%～ 61. 0% in muscle (4 cases) as well as 26.8%～50.3% in blood (9 cases). In the 3 p atie nts with muscles and blood cells available,their mutant mtDNA proportion in mus cle is consistently higher than in blood cells. The study of leukocytes of some maternal relatives from 6 families showed that,while only 1 proband had a siste r harboring A3243G mutation and none of the mothers of another 3 probands or sib lings of the other 2 probands had the point mutation. However,the sons of 2 pr o bands had not only phenotype of MELAS,but also mtDNA A3243G point mutation in t heir blood. Conclusion mtDNA A3243G mutation highly exists in the series with M E LAS syndrome in our study and can be detected in various tissues,which is consi stent with reports abroad. However,most of our cases are sporadic rather than m aternal inherited. It is presumedly caused by a de novo mutation. Whether i t is due to ethnic difference or sporadic event needs to be investigated further.