Mitogen-activated protein kinase (MAPK) signaling pathways are involved in multiple important cellular responses. To activate their downstream protein kinases by phosphorylation is a crucial manner for MAPK family members to fulfill their physiological functions. Downstream of MAPKs, there exist three structurally related MAPK-activated protein kinases (MAPKAPKs or MKs), i.e., MK2, MK3 and MK5. Once upon activated by MAPKs, MKs signal to different cellular targets, to regulate gene expression at the levels of transcription and translation, control cytoskeleton remodelling and cell cycle, and mediate cell migration and embryonic development. Recently, based on the gene knockout studies, the function divisions among different MK subfamily members are gradually clear, leading to tremendous advancements of our knowledge on MKs.

Clinical practice guidelines are systematically developed clinical multi-discipline advisory statements which assist providers, recipients and other stakeholders to make informed decisions about appropriate health interventions. Chinese government and some clinical academic communities began to develop the domestic guidelines after 2000. Nevertheless, there were still some shortcomings presented in the domestic guidelines if assessed by the advanced appraisal instrument of the developed countries. There were four aspects as follow. The first, misunderstood the guidelines are the rule or text book. The second, ignored presentation of the procedure about development of guidelines. The third, there were a lack of high level evidences. The fourth, not declared editorial independence. However, it is necessary to develop the domestic guideline of China. With rising conflicts between the increasing needs for health care and shortage of our environment resource, development of the guidelines become one of the key steps in the process of clinical practice.

Clinical practice guidelines have been widely applied worldwide.Compared with the developed countries,however,the development of guidelines still has many limitations in China,which is mainly due to the lack of a guideline for guiding this process.Such a guideline,defined as “a structured and coordinated programme designed with the specific aim of producing several clinical practice guidelines should be able to specify the development,dissemination,implementation,evaluation,and update of each clinical practice guideline.Furthermore,the lack of high-quality randomized controlled trials and cohort studies also restricts the development of high-level guidelines.After the development of such a guideline for developing guidelines,we can expect the faster development of Chinese clinical practice guidelines that are more carefully designed,more reliable,and more practical.

There are some characteristics in the teaching of amateurish adult medical students.As a bridge connecting basic medicine and clinical medicine,pathophysiology is very important in medical education.Aiming at the specialties of amateurish adult medical students,it has very realistic significance for us to explore and reform the teaching methods of pathophysiology,in order to improve the teaching quality and effect.

Objective:To investigate the role of recombinant E.coli LLO/OVA on regulating the function of murine CD4+ CD25+ Treg cells.Methods:After E.coli LLO/OVA or E.coli OVA vaccination,the murine spleen CD4+ CD25+ Treg,CD4+ CD25- T and CD11c cells were collected respectively by magnetic beads sorting.The concentration of IL-10 in the supernatant of mix cocultured CD4+ CD25+ Treg and CD11c cells,and the suppression role of CD4+ CD25+ Treg cells on the proliferation of CD4+ CD25- T cells were determined.The percentage of OVA specific CD8+ T cells in mouse spleen was analyzed by flow cytometry.The number of metastatic tumor nodules in lungs of the mice transplanted with B16-OVA subcutaneouly was compared before and after dilition of CD4+ CD25+ Treg cells in mice.Results:Compared to E.coli OVA,E.coli LLO/OVA significantly downregulated IL-10 secretion of CD4+CD25+Treg cells and attenuated the suppressive effect of CD4+ CD25+ Treg on the proliferation of CD4+ CD25- T cells(P

0.05). The HDL-C level of B 2B 2 genotype (1.46?0.20)mmol/L was significantly higher than that of B 1B 1 genotype (0.90?0.21) mmol/L and B 1B 2 genotype (1.25?0.22)mmol/L, P

Objective:To provide policy recommendations for Beijing public health departments to grasp the dy-namic allocation of healthcare resources and the advantage of medical functional dispersal, and making appropriate health policies to rationally adjust the allocation of health resources. Methods:To study the dynamic function of Bei-jing medical, this study uses the method of accounting of cases summary of the annual report on health finance through the descriptive analysis of the gross fixed capital formation in various regional government-run health facili-ties. Results:The results of this study show that the quality of medical health administrative resources was higher, but effectively dispersed in 2015. By contrast, the basic public health resources allocation was unbalanced. Conclu-sion:This study puts forward the corresponding health policy suggestions. On one hand, it is important to make fur-ther policy to encourage high quality medical resources to be effectively relieved and the regional planning should be done according to market demand by avoiding the blind construction at the early stages. On the other hand, much at-tention should be paid on the balanced development of the basic public health service ability and the coordinated de-velopment of administrative capacity in health, and supporting policies should be formulated, which should rationally allocate the public health resources for a better overall medical functional dispersal.

OBJECTIVE To analyze the susceptible factors and resistance of Acinetobacter baumannii in ICU,in order to create a novel thought of effective prevention and control of A. baumannii cross-infection. METHODS Specimens were collected from ICU patients with infections from Sep 2006 to Sep 2008. The infection characteristic was analyzed and the drug sensitivity was tested to know the risk factors of infection retrospectively. RESULTS The factors of low immunity,severe wound,invasive operation and using ventilator led to the serious cross-infection of A. baumannii in ICU .In vitro drug susceptibility test,the sensitive rates only to cefoperazone/sulbactam and amikacin were higher. They were 65.09% and 72.64%,respectively. CONCLUSIONS It has great significance in the prevention and control of A. baumannii cross-infection in ICU to strengthen the environment disinfection,were education of nosocomial infection knowledge among medical staff,executeing the hand-washing system strictly,useing the antibiotics rationally,keeping the susceptible crowd and adopting de-escalation strategy of prevention and control.

OBJECTIVE: To determine the prevalence of GJB2 mutations in newborns and provide clinical experience for newborn genetic screening. METHOD: Blood samples of 23 836 newborns in Beijing from March 2012 to December 2013 were screened for hot spot mutations of GJB2 associated with hearing loss. The genetic screening results were comprehensively analyzed with hearing results in genetic counseling. RESULT: One or two pathogenic mutations of GJB2 were spotted in 622(2. 61%) individuals. Among them, numbers of newborns with 1 mutation of c. 35deiG,c. 176191 del16,c. 235delC and c. 299300 delAT were 3,26,467 and 120. One compound heterozygote, and 5 homozygotes were also identified. Five hundred and fifty(88. 6%)newborns were followed up by telephones and SMS (short message service) and 325 newborns visit our genetic clinic regularly which were regarded as the research object. In the hearing screening, the referral rate for hearing loss in the first-step screening was 13.8% (45/325), and became 9.2% (30/325) upon retesting. Nine newborns (2. 8%) were diagnosed as hearing loss of different degrees as early as 3 months old,including 6 homozygous/compound heterozygote and 3 heterozygotes. CONCLUSION Patients with GJB2 mutations have various phenotype. Newborns with homozygous/compound heterozygous GJB2 mutations may pass the hearing screening at first. Carriers of GJB2 may also have hearing problems. The combination of genetic and audiological screening can play an important role in deafness detections of infants before key period of speech development.
Base Sequence ; Connexin 26 ; Connexins ; genetics ; Deafness ; genetics ; Follow-Up Studies ; Genetic Testing ; Hearing Loss ; genetics ; Hearing Tests ; Heterozygote ; Humans ; Infant ; Infant, Newborn ; Mutation ; Neonatal Screening ; Prevalence

BACKGROUND:Interlocking intramedul ary nail complications contain nail bent or broken, exit, re-fracture at spiketail or nail hole. Thus, our team designs a novel intramedul ary control ed dynamic nail.
OBJECTIVE:To evaluate the rationality and safety of intramedul ary control ed dynamic nail design and strength, and to give rational proposal for its clinical application.
METHODThe three-dimensional finite element models of composite femur, transverse fractures of the femoral shaft were constructed with intramedul ary control ed dynamic nailing. The stress and strain were detected under vertical loads and gait cycle.
RESULTS AND CONCLUSION:The maximum stress of the intact femur under the compression load was at femoral neck and the medial and lateral aspects of the femoral shaft;while the stresses of fractured femur were at the interface between screw and screw hole. In gait cycle, in case of intact bone, large stresses were found in the distal 1/2 of anteriomedialis of femoral shaft;while the stress distribution in fractured femur was similar with the 
former. Intramedul ary control ed dynamic nailing has the ability of generating compression between fragments. These suggest that intramedul ary control ed dynamic nailing is rational and good at design and biomechanical properties.