Objective To compare the effect of Zhigancao Decoction and Zhenwu Decoction on hemodynamics, matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and myocardial enzyme of elderly patients with chronic heart failure.Methods 40 elderly patients with chronic heart failure in the first affiliated hospital of the medical college, Shihezi university were selected and randomly divided into Zhigancao Decoction group (n=20) and Zhenwu Decoction group (n =20) .The both of two groups were given conventional treatment, then were treated with respective drug according to different groups with two courses, one course of two weeks.The hemodynamic, MMP-9, TIMP-1 and myocardial enzyme spectrum indexes of two groups were compared post-treatment.Results After treatment, the indexes of hemodynamics in two groups were improved, hemodynamic indexes of Zhigancao Decoction recovered better than those of Zhenwu Decoction (P<0.05) .The serum MMP-9, MMP-9/TIMP-1 of Zhigancao Decoction group were lower and TIMP-1 was higher than those of Zhenwu Decoction group (P<0.05).The myocardial enzyme indexes in both groups were lower post-treatment, and the above indexes in Zhigancao Decoction were lower than those in Zhenwu Decoction group (P<0.05) . Conclusion Zhigancao Decoction could obviously improve the symptoms of chronic heart failure in elderly patients, which has the guiding significant in the clinical treatment.

BACKGROUND:The development of stem cel transplantation and genetic modification technology provides new ideas and methods for the treatment of pulmonary hypertension. OBJECTIVE:To investigate the therapeutic effects of transplantation of human telomerase reverse transcriptase (hTERT)-transfected human amniotic mesenchymal stem cels in pulmonary hypertension rats. METHODS:Human amniotic mesenchymal stem cels were cultured and purified in vitro, and then transfected with adenovirus-medicated hTERT. Sixty-six adult Wistar rats were enroled to prepare pulmonary hypertension models through intraperitoneal injection of 60 mg/kg monocrotaline and then 63 model rats were randomly assigned into three groups: model group treated with transplantation of 1 mL of L-DMEMvia the jugular vein, cel transplantation group treated with transplantation of 1 mL of untransfected human amniotic mesenchymal stem cel suspension, and transfection group treated with transplantation of 1 mL of human amniotic mesenchymal stem cel suspension transfected with hTERT. Hemodynamic changes, plasma endothelin-1 level, hypertrophy index of the right ventricle and myocardial cel apoptosis were compared among different groups at 3 weeks after transplantation. RESULTS AND CONCLUSION:After 3 weeks of treatment, there were no differences in the arterial blood pressure of the three groups (P > 0.05); however, the systolic pressure of the pulmonary artery and mean pulmonary arterial pressure were significantly lower in the transfection group than the model group and cel transplantation group (P < 0.05). Hypertrophy index of the right ventricle had no difference among the three groups (P> 0.05). The level of plasma endothelin-1 was significantly lower in the transfection group than the model group and cel transplantation group (P < 0.05). Apoptosis in myocardial cels was significantly reduced in the transfection group compared with the model group and cel transplantation group (P< 0.05). Experimental findings suggest that the transplantation of hTERT-transfected human amniotic mesenchymal stem cels can improve the hemodynamic levels in pulmonary blood vessels of pulmonary hypertension rats to protect vascular endothelial cels and reduce myocardial cel apoptosis.

Objective To explore the changing regularity of humeral distal epiphysial anteverted angulation with ultrasonic measurement. Methods Using an ultrasonic diagnostic apparatus with a high frequency bougie to detect the dextral elbow joint of 203 normal individuals whose age range is from 5 d to 23 years old. The subjects were divided into 5 groups by age (5 d-4 years old, 5-8 years old, 9-12 years old, 13-16 years old, ≥17 years old),and by sex into two large parts.Anteverted angulation of capitellum and lateral semitrochlear ossification center were measured with statistic analysis and correlation calculation.Results Anteverted angulation of capitellum was 48.89?? 8.96?, lateral semitrochlea 33.70?? 7.18?. Anteverted angulation of capitellum enlarges with age growth, and it reaches the climax ( 55.00?? 5.88?) at the age 13-16 years old. There was a significant difference among groups. After 17 years old, anteverted angulation slightly reduces to 52.38?? 8.27?, compared with the climax ( 55.00?? 5.88?), there was no statistical difference. Changing regularity of anteverted angulation was similar to that of capitellum. Just between the 5 d-4 years old group and 5-8 years old group, the difference was significant in angulation enlargement. There was no statistical difference among the groups above the 5-8 years old group, and no significant difference between male and female in humeral distal epiphysial anteverted angulation. Conclusions Ultrasonic examination can clearly display the images of humeral distal epiphysis. Observation and measurement is available for the epiphysial anteverted angulation by acoustic images, and the changing regularity of anteverted angulation can be illustrated.

Objective To analyse both micro level and macro level factors influencing maternal mortality in order to set the priority to lowering maternal mortality. Method The results of an analysis of maternal mortality were reported, based on a conceptual model that combines micro level and macro level variables taken from demographic, sociological and epidemiological research. Multi level analysis techniques were used to analyse the 1997 linked county level maternal death data and related county level social demographic and health resources data in 114 counties of 5 remote and poverty stricken provinces. Results The maternal mortality rate in research areas was as high as 159.3/100 000. The main factors influencing maternal mortality were institutional delivery rate, population density, percentage of minority population, and percentage of village without village doctor. Conclusion To advocate institutional delivery rate, to pay greater attention to minority and low population density area, and to standardised village doctors' responsibility are recommended strategies to lowering maternal mortality in remote and poverty stricken areas of China.

OBJECTIVE To investigate the prevalence of strains producing extended-spectrum ?-lactamases (ESBLs) and AmpC ?-lactamases in Pseudomonas aeruginosa,and to supply the laboratory evidence for antibiotic rational application in clinic. METHODS Totally 105 clinical isolates of P. aeruginosa were identified with VITEK-32. Drug sensitivities were determined by Kirby-Bauer methods. ESBLs were detected by double-disc synergy test,and cefoxitin three dimensional test was applied to filter AmpC positive strains. RESULTS Among 105 strains of P. aeruginosa,28 strains (26.7%) were AmpC enzymes positive,20 strains (19.0%) were ESBLs positive,and 5 strains(4.8%)were AmpC+ESBLs positive. The detective rate of producing AmpC ?-lactamases strains was higher than that of producing ESBLs strains. There was significant difference between them. CONCLUSIONS ESBLs and AmpC ?-lactamases are two main enzyme types conferring resistance to ?-lactam antibiotics in clinical isolates of P. aeruginosa. Imipenem can be the first choice for treating infections caused by P. aeruginosa producing ESBLs or AmpC ?-lactamases.

OBJECTIVE To study resistance of Enterococcus in clinical isolates to high-level gentamicin(HLG) and investigate drug resistance of these Enterococcus.METHODS Totally 140 strains of Enterococcus were detected resistance to antibiotics by Kirby-Bauer test and agar-screening test.Data were analyzed using WHONET5.3 software.RESULTS Same result was obtained by two kinds of detecting methods,there were 73 strains of high level gentamicin resistance(HLGR,52.1%) and 67 strains of non-HLGR(47.9%),the resistance rate of HLGR was higher than that of non-HLGR,the isolation rate of vancomycin resistanct Enterococcus was 3.6%.CONCLUSIONS The most common enterococci causing hospital infection are E.faecalis and E.faecium.The drug resistance rate of E.faecium is higher than that of E.faecalis.It is imperative to select the proper method to detect HLGR of Enterococcus,and select proper antibiotic in terms of antibiotic susceptibility test during clinical therapy.

Objective To investigate the status of breastfeeding rate at discharging hospital and analyze influence of obstetrical service quality on breastfeeding rate, in order to improve the quality of obstetrical service and increase the breastfeeding rate. Methods A total number of 1 123 mothers who have 6~12 months babies were investigated through questionnaire including obstetrical service accepted, situation of breastfeeding rate at discharging hospital, mother's breastfeeding knowledge and behaviors with across-sectional method from August to October in 2000. Seven cities were chosen as the research site including Beijing, Changchun, Huhehaote, Xi'an, Luoyang, Kunming and Xiamen. The data were analyzed with SPSS/PC 10.0 statistical software. Results The exclusive breastfeeding rate was 52%, the full breastfeeding rate was 73% at discharging hospital. The influencing factors of breastfeeding rate at discharging hospital include mother's age, medical expenditure type, caesarean section, breastfeeding on demand, neonatal status, having milk bottle, feeding milk-powder and sweeten water in obstetrical wards, mother's breastfeeding knowledge and behavior, et al. Conclusions Breastfeeding rate at discharging hospital was low and it was related with quality of obstetrical service. So it is important to improve the quality of obstetrical service and health education on breastfeeding, in order to enhance the breastfeeding rate.

Humanities education is an important part in college and university education. Medical college and university libraries should strengthen their sense of responsibility and sense of mission, continuously expand and innovate the mode of humanity education, improve the environment of teaching, modify the system construction and promote the quality of straits to make library as an important field for medical students humanity education.

Objective To investigate the surgical patients' needs of community nursing services and actual utilization within one week of out hospital. Methods Sampled 257 adults surgical patients from certain general hospital, interviewed them by self-designed queostionnair to know their needs of community nursing services and actual utilization within one week after out of hospital. Results There were 96% pa-tients required community nursing services at the point of discharge. The content of services needs included dise ases cares, health teaching and prevention services. Different moded of community nursing cares were required. The actual utilization rate within one week was 16.5%, there were 54.5% and 63.6% of patients received wound care and medication administration separately, which were mainly provided by center visit. Conclusions There is a contradiction between the needs and actual utilization of com-munity nursing services. It is meaningful to enhance the utilization rate, extend the content and perfect the modes of community nursing services so as to satisfy discharged surgical patients' needs.

Objective　In order to explore the effect of 13-cis isotretinoin on androgen receptor in acneic patients and provide the theoretical basis for acne treatment. Methods　Radiological binding assay (RBA) was used to study the specific AR binding capacities between the experimental group and the control group before and after taking medicine. The serum testosterone level was measured with radioimmunoassay. Results　 16 weeks after taking medicine, the AR level in the acne patients decreased significantly compared with that before taking 13-cis RA (P＜0.05)，but the affinity change was not found, the testosterone levels did not evidently change either. Conclusion　The 13-cis RA can decrease the levels of AR and depress the hyperplasia of sebaceoous glands.