Currently,China lacks enough public health physicians and the quality of them varies much.In order to solve this problem,proving the access to public health physician is necessary.On the basis of literature research,this essay summarizes the existing problems of the access to public health physicians:improper professional education in university,curriculum setting and provision about physician registration.The essay argues that it is a feasible way to improve the access of public health physicians in China by further piloting and perfecting the unified post-graduation standardized training system,implementing curriculum reform to enhance students' practical ability and building network physician registration.

Objective To establish a quality standard of Hovenia dulics Thunb. Method The presence of quercetin was identified and assayed by TLC and HPLC, respectively. Result Linearity of marker was obtained over the range of 1.32 ～ 5.28 ?g (r =0.9999). The average recovery rate was 98.78% (RSD=1.08%). Conclusion TLC is specific. The method of quality is accurate, reappearance, simple, rapid, and suitable for the quality control of Hovenia dulcis Thunb.

Objective To investigate present situation of mental health of university teachers and the application effect of EAP modes. Methods 500 university teachers were selected as the research object and were managed with EAP modes.Before and after the use of EAP modes,mental health was investigated and analyzed. Results The score of SCL-90 factors after application of EAP modes was significantly better than prior to implementation. Conclusions The situation of mental health of university teachers is relatively poor,the implementation of the EAP modes can help to improve their mental health.

Epoxyeicosatrienoic acids(EETs)are the metabolic products of arachidonic acid(AA). They have the function of stimulating cell division, inhibiting platelet aggregation and regulating the transfer of cell calcium. In recent years, more and more people paid their attention to the effects of EETs on heart. This article will give a review about EETs and the relationship between EETs and heart.

Objective To investigate the effects of CD40-P227A SNP at human B cell signaling and function. Methods Human Ramos B cells were transfected with plasmids of CFP fusion wild type CD40 and mutant type CD40-P227A, together with plasmids of luciferase fusion NF-κB and AP-1, as well as plasmids of GFP fusion NF-κB. Activation of NF-κB and AP-1 pathway were detected by luciferase assay and flow cytometry, degradation of IκBα and nuclear translocation of NF-κB subunits were tested by Western blot and transfactor ELISA assay. Results Compared with wild type CD40, CD40-P227A SNP induced more degradation of IκBα, increased nuclear translocation of p65, p50 and c-Rel. As well as higher activity of NF-κB, as shown by increased NF-κB luciferase and GFP-NF-κB expressing B cells. Moreover, CD40-P227A SNP induced more activation of AP-1 pathway than CD40. CD40-P227A enhanced B cells function by inducing more excretion of IL-6 and TNF-α. Conclusion Our data indicate that CD40-P227A is a gain-of-function phenotype which induces activation of NF-κB and AP-1 signaling pathways and may contribute to the pathogenesis of the SLE autoimmune disease.

Objective To investigate the role of TRAF6 in NF-?B and AP-1 signaling pathway in human B cell line.Methods Human Ramos B cells were transfected with plasmids expressing YFP fusion dominant-negative TRAF6(DN-TRAF6),or transfected with shRNA-TRAF6 plasmid.After incubation overnight,cells were either sorted with flowcytometry or screened by G418.Activation of NF-?B and AP-1 pathway,including phosphorylation of I?B?,ERK,JNK and P38,as well as nuclear translocation of NF-?B subunits(P65,P50 and c-Rel)and AP-1 subunits(C-FOS,C-JUN,CREB and ATF) were detected by Western blot and ELISA.Results In cells which overexpress DN-TRAF6 or endogenous TRAF6 expression were knocked-down by shRNA,the phosphorylation of I?B?,as well as phosphorylation of JNK were inhibited.Furthermore,nuclear translocation of NF-?B subunits P65,P50,c-Rel,and AP-1 subunits C-FOS and C-JUN were also inhibited in B cells through overexpression of DN-TRAF6.Conclusion TRAF6 selectively activates some kinases in CD40 mediated NF-?B and AP-1 signaling pathway,and plays an important role in their activation.

Objective To investigate the clinical characteristics of polymyalgia rheumatica(PMR)and the difference between male and female patients. Methods The clinical features of 86 patients with PMR were retrospectively analyzed. Results The ratio of hip and shoulder girdle muscle pain in female patients is higher than that in male patients ( P < 0. 05 ) , whereas the ratio of hyperpyrexia, arthralgia, weight loss, the average level of CRP, as well as the percentage of elevated immunoglobulin and leukocyte count are all higher in male patients as compared with female patients (P <0. 05). Relapsing rate after treatment was higher in female patients than that inmale patients. Conclusion Systemic symptoms and inflammatory signs were more predominant in male patients. However, relapsing rate after treatment was higher in female patients.

Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiac conduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed, such as difficulty of sinus electrode implantation, coronary sinus injury and bleeding, still one third CRT cases remain unchanged cardiac function.Recently the epicardial lead CRT therapy by the cardiac surgeons appears promising to provide better clinic resynchronization.The aim of this research is to explore the clinical value of surgical epicardial lead CRT for the cardiomyopathy heart failure with micro-invasive thoracoscopy techniques. Methods During April 2007 to Sep 2009 eleven patients were diagnosed as advanced heart failure with cardiac dysynchronization proven by the ECG and tissue Doppler echo examination. The dysynchronization parameters of tissue Doppler echo includes left ventricle maximize delay time , the left dysynchronization index (Ts-SD), the inter-ventricle mechanical delay time (IVMD), left ventricle end-dilation diameters (LVEDD) and the left ventricle ejection fraction (LVEF). All the patients got the consent agreement before the surgery. In the hybrid operation room the right atrial and ventricle endocardial electrodes were placed firs guided by X ray under the general anesthesia and double lumnen incubation. Then the thoracoscope techniques were used to explore the left ventricle lateral wall. The right atrial and ventricle electrodes were connected into the three chamber pacemaker. The Tissue Doppler Echo TEE technique was used to check which part of the left ventricle lateral wall is suitable for the idea CRT therapy. Usually the latest activated part of the left ventricle wall is the goal place. Then the epicardial electrode was fixed with 4-0 prolene suture at the idea place. All the cases were performed by the same surgeons group in the same medical center. The resynchronization features were examined after surgery and during the follow up. Results The endocardial and epicardial electrodes were implanted successfully without any serious complication. All patients were weaned and discharged without any adverse cardiac episodes. There is no mortality during the follow up period. All the patients received the β-blokers, diuretics, ACEI/ARB and other traditional medicine for the heart failure.The Tissue Doppler showed the E peak wave separated form the A peak which means the good resynchronization between the atrium and the ventricle. After surgery during the follow up the left ventricle maximize delay time decreased from (393.4 ±40.2 ) ms to ( 102.1 ± 34.6) ms, the left dysynchronization index (Ts-SD) decreased from (145.2±29.3)ms to(51.0±21.4) ms, the inter-ventricle mechanical delay time (IVMD) decreased from (59.1 ±23.4) ms to (31.2 ± 11.5 ) ms, left ventricle end-dilation diameters increased from (73.1 ± 13.4) mm to (63.2 ± 6.7) mn and the left ventricle ejection fraction increased from 0.32 ±0.04 to 0.41 ±0.07. Conclusion The micro-invasive surgical synchronization therapy could get good CRT result for the cardiomyopathy heart failure patients. Some patients traditionally in the waiting list for the heart transplant could be considered for the CRT therapy candidates.

Objective To evaluate the role of p38 mitogen-activated protein kinase (p38MAPK) in the spinal cord in the development of persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR) and the relationship with Toll-like receptor 4 (TLR4).Methods One hundred and twenty male SpragueDawley rats,weighing 200-250 g,aged 2 months,in which intrathecal catheters were successfully implanted,were randomly divided into 5 groups (n =24 each) using a random number table:sham operation group (group S),SMIR group,SMIR + dimethyl sulfoxide (DMSO) group (group DMSO),SMIR + p38MAPK inhibitor SB203580 group (group SB203580) and SMIR + TLR4 small interference RNA (siRNA) group (group TLR4siRNA).The rats were anesthetized with intraperitoneal chloral hydrate 400 mg/kg.The skin and superficial muscle of the medial thigh were incised and a small pair of retractors inserted.This tissue was retracted for 1 h causing potential stretch of the saphenous nerve.2％ DMSO 10 μl and SB203580 5 μg were injected intrathecally at 30 min before operation and 1-12 days after operation in DMSO and SB203580 groups,respectively.TLR4siRNA 2 μg was administered intrathecally at 1 day before operation and 1-12 days after operation once a day in group TLR4siRNA.Mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) was measured at 1 day before operation and 1,3,7,12 and 22 days after operation.Four rats in each group were sacrificed after measurement of MWT at each time point,and the L4-6 segments of the spinal cord were obtained for detection of the expression of phosphorylated p38MAPK (p-p38MAPK) by Western blot analysis.Results Compared with group S,MWT was significantly decreased after operation,and the expression of p-p38MAPK was up-regulated after operation in SMIR and DMSO groups.Compared with group SMIR,MWT was significantly increased after operation,and the expression of p-p38MAPK was down-regulated after operation in SB203580 and TLR4siRNA groups,and no significant changes in MWT and p-p38MAPK expression were found at each time point in group DMSO.Conclusion TLR4-triggered activation of p38MAPK in spinal cord is involved in the development of SMIR-evoked persistent postoperative pain in rats.

Objective To investigate the change of the content of suppressor of cytokine signaling (SOCS-1) in the liver of septic mice and its working mechanism.Methods Adopted Cecalligation and puncture (CLP) to create models of sepsis and divided randomly adult male BALB/c mice into 8 groups,including normal controlled group,sham-operated group,and the killed groups 2 hours,6 hours,12 hours,24 hours and 48 hours after operation.After extracting the RNA and protein from the liver tissue of the mouse groups,reverse transcription polymerase chain reaction (RT-PCR) was adopted to determine the relative content of SOCS-1 mRNA in the tissue,Western blot was adopted to determine the relative content of protein and the SPSS statistics software was adopted to calculate the correlation.Then observed the pathological change of liver tissues,and detected SOCS-1 protein expression by immunohistochemistry.Results After CLP suergery,the expression of SOCS-1 on gene degree in the liver and the expression of SOCS1 on protein degree in the liver increased rapidly at the 6th hour ( P ＜ 0.05 ),with the former reaching peak ( P ＜ 0.05 ) at the 24th hour and the latter remaining high all the time.There were pathological changes such as fatty degeneration and necrosis in the septic liver tissue,hepatic SOCS-1 protein expression could be detected by immunohistochemistry.Conclusions CLP induced sepsis could lead to the increase of the expression of SOCS1 in the liver.