To enhance the capacity for extending and applying appropriate health technologies in rural areas in China,this paper proposes a supportive policy system that incoperates macro,average and microlevels. Thepolicysystemfocusesonorientation, incentives, regulationsand standardization,and its objectives and measures of each level are described.The policy system will contribute to the sustainable development rural health work.

Objective To observe the expression of novel URB gene in the differentiation display of 3T3-L1 preadipocytes and the effects of interleukin-6 (IL-6) and pioglitazone (PIO) on URB mRNA expression in 3T3-L1 adipocytes at different times. Method The 3T3-L1 adipocytes were treated with IL-6 and PIO under different concentration and different time phase, and real-time fluorescence monitoring RT-PCR was conducted to measure the URB mRNA level. Fat droplets were verified by oil red O staining. Results 1. URB mRNA level was increased gradually in the whole differentiation process. 2. The expression levels of URB mRNA was decreased along with the treatment of IL-6 in a dose-dependent manner in 3T3-L1 preadipocytes and adipocytes. 3. PIO increased the level of URB mRNA in 3T3-L1 adipocytes, and the reducing effect of IL-6 on URB mRNA could be corrected by PIO. Conclusion URB may be an important adipocytokin which affects energy metabolism and may work as a pharmacological gene target in the future.

Objective To verify the presence of anti-ovary antibodies in systemic lupus erythematosus (SLE) and its possible correlations with serum levels of hormone profile and menstrual disturbances in patients with SLE.Methods Clinical data of 78 consecutive paticnts who fulfilled 4 or more of the ACR 1997 revised criteria for SLE were studied and compared with 40 age-matched healthy controls,including anti-ovary antibodies.Results 27 (34.6％ ) patients with SLE,and 1 (2.5％) of the healthy controls tested positive of anti-ovary antibodies.The levels of E2 and T and P decreased[ E2:( 80.96 ± 36.2 ) ng/L vs ( 118.53 ± 42.4 ) ng/L; T:( 3.85 ± 1.18 ) nmol/L vs ( 6.43 ± 2.28 ) nmol/L; P:( 1.37 ± 0.59 ) μg/L vs ( 3.92 ± 1.23 ) μg/L],and the levels of FSH and LH and PRL increased in SLE patients when compared with healthy controls [ FSH:( 19.17 ± 9.26)IU/L vs (10.18 ±7.27 )IU/L; LH:( 21.19 ± 12.44)IU/L vs (13.79 ±8.27)IU/L;PRL:(6.18 ± 2.27 ) μg/L vs (2.37 ±0.63)μg/L,P ＜0.05 orP ＜0.01].The higher SLEDAI score,higher rate of menstrual disturbances (6.3 ±2.8 vs 3.5 ± 1.7,81％ vs 47％,P ＜0.05 or P ＜ 0.01 ) and decreased serum level of E2 [ (64.13 ± 26.36 ) ng/L vs ( 82.83 ± 28.71 ) ng/L,P ＜ 0.05 ]were found in SLE patients with anti-ovary antibodies positive than in SLE patients with anti-ovary antibodies negative.Conclusions The presence of anti-ovary antibodies was 34.6％ in SLE,and may correlate to decreased serum level of E2 and menstrual disturbance.

Objective To investigate awareness of definition, diagnostic criteria, severity classification and standard diagnosis and treatment for chronic obstructive pulmonary disease (COPD) among primary-care physicians at the grassroots in urban and suburban Shanghai.Methods In total, 298 physicians were surveyed by unified questionnaire for COPD-related knowledge in two secondary-care general hospitals (one in urban and suburban areas each ) and 12 community primary-care centers (four in urban and eight in suburban areas) in Shanghai.One hundred and fifteen physicians in two urban hospitals and one suburban hospital were trained professionally and then evaluated for its effectiveness.Results Awareness of diagnostic criteria of COPD was only 22.4% (35/156), 25.6% ( 10/39), 4.3 % (3/69)and 26.5% (9/34) among physicians in urban primary-care hospitals, urban secondary-care hospitals,suburban primary-care hospitals and suburban secondary-care hospitals, respectively.Their awareness of knowledge about use of anti-cholinergic agents was 13.5 % (21/156), 35.9 % ( 14/39), naught (0/69),and 14.7 % ( 5/34 ), respectively.Only 0.67 % of them ( 2/298 ) knew about severity classification of COPD.Awareness of definition and diagnostic criteria for COPD in the physicians increased to 72.2 % ( 83/115) after training from 18.2% (21/115) before it, and their awareness of severity classification for COPD increased to 45.2% (52/115) after training from 0.8 % (1/115) before it.Conclusions Awareness of COPD-related knowledge, especially of standard diagnosis and treatment for COPD, was poor in primary-care physicians at the grassroots in Shanghai, so it is necessary to strengthen training for them in COPD-related knowledge, including pulmonary function tests.

Objective To investigate the effects of self-efficacy-oriented nursing intervention on postoperative quality of life of lung tumor patients. Methods Ninety patients with lung tumors undergoing chest surgery in our hospital from March 2010 to March 2012 , involved in the study. The nursing data were retrospectively analyzed for investigation of the nursing strategies. The patients were randomized into two group with random digits table in equal number: The control group received routine nursing and the intervention group with self-efficacy-oriented nursing intervention beside routine nursing care. 3 months after nursing intervention , the two groups were compared by Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) in terms of quality of life and psychological state. Results The scores of the intervention group by SDS and SAS were both significantly higher than those of the control group (P < 0.05). The scores of the intervention group on self efficacy and quality of life were significantly higher than those of the control (P < 0.05). Conclusion The self-efficacy-oriented nursing intervention applied in the postoperative nursing care to lung cancer patients can significantly improve the postoperative symptoms and psychological status. It can also improve their self efficacy and then enhance their quality of life.

Objective:To study the effect of microRNA (miR)-330-3p on hepatic ischemia-reperfusion injury (IRI) in mice, meanwhile, and to determine potential molecular mechanism.Methods:Eighty male C57BL/6 mice, aged 7-8 weeks, 23-25 g, specific pathogen free, were randomly divided into 8 groups (10 mice in each group) using random number table: reperfusion 2 h group, 6 h group, 12 h group, 24 h group, sham group, miR-330-3p agomir group (preoperative injection of agonist), miR-330-3p antagomir group (preoperative injection of inhibitor) and miRNA-NC group. Except for the sham group, the hepatic IRI model were established in mice. Polymerase chain reaction (PCR), Western blot and immunohistochemistry were used to detect the expression of miR-330-3p and phosphoglycerate mutase family member 5 (PGAM5), cleave caspase-1 and GSDMD. Luciferase reporter assay was performed to investigate whether miR-330-3p directly targets PGAM5. At the same time, AML12 cells were also treated with miR-330-3p mimics/inhibitor or PGAM5 siRNA, then the expression of PGAM5, NLRP3, cleave caspase-1 and GSDMD were detected by Western blot analysis.Results:Level of miR-330-3p gradually decreased after reperfusion, however, mRNA level of PGAM5 was increased thereafter ( P<0.05) as compared with the sham group. Serum level of AST and ALT were decreased in miR-330-3p agomir group while that of were increased in miR-330-3p antagomir group as a function of time following reperfusion, and the differences were statistically significant (all P<0.05). Cleave caspase-1 expression was decreased in miR-330-3p agomir group but was increased in miR-330-5p antagomir group ( P<0.05). Luciferase reporter assay was performed to determine PGAM5 was a target gene of miR-330-3p. SiRNA-mediated knockdown of PGAM5 decreased level of GAM5 (0.24±0.09), NLRP3(0.12±0.07), cleave caspase-1 (0.15±0.07) and GSDMD (1.08±0.08) as compared with the siRNA-NC group (1.17±0.14), (0.36±0.09), (0.68±0.09), (1.36±0.08), and the differences were statistically significant (all P<0.05). Conclusion:MiR-330-3p can alleviate hepatic IRI in mice, which may be related to inhibition of PGAM5-induced pyroptosis.

Benign Paroxysmal Positional Vertigo ; physiopathology ; Bronchoalveolar Lavage ; adverse effects ; Humans ; Pneumoconiosis ; physiopathology

Objective To evaluate changes of regional cerebral metabolism by proton MR spectroscopy (~1H-MRS) in patients with minimal hepatic encephalopathy (MHE) and to correlate these changes with the neuropsychological test. Methods Fifty-four patients with cirrhosis including nine patients with hepatic encephalopathy (HE),23 patients with MHE,22 patients without HE and 13 controls underwent neuropsychological tests and ~1H-MRS scanning. The volumes of interest included occipital gray matter and left parietal white matter regions. Ratio of spectral peak areas of N-acetylaspartate (NAA),choline (Cho),myo-inositol (mI),and glutamine/glutamate (Glx) relative to creatine (Cr) were acquired. Statistical analysis was conducted using independent t test and one-way analysis of variance. The results of different groups were compared by using the nonparametric Mann-Whitney U test with Bonferroni correction. Correlations among the ~1H-MRS ratios, the grade of HE, neuropsychological test and ammonia data were calculated with Spearman correlation test. Results The ratios of NAA/Cr,Cho/Cr,mI/Cr,Glx/Cr of the occipital gray matter and left parietal white matter regions in patients with cirrhosis are 1.55±0.12,0.48±0.10,0.42±0.14,2.52±0.48 and 1.73±0.17,0.75±0.16,0.42±0.16,2.75±0.59respectively,and they are 1.53±0.10,0.48±0.09,0.51±0.11,2.20±0.39 and 1.69±0.15,0.82±0.14,0.53±0.12,2.40±0.40 in patients without HE,1.58±0.13,0.48±0.08,0.38±0.13,2.62±0.39 and 1.78±0.18,0.74±0.14,0.38±0.15,2.84±0.58 in patients with MHE,1.54±0.12,0.50±0.13,0.29±0.07,3.04±0.31 and 1.70±0.19,0.62±0.16,0.29±0.07,3.37±0.38 inpatients with HE.Compared with controls, decreased mI/Cr and Cho/Cr ratios and elevated Glx/Cr ratios were found in patients with cirrhosis (t=3.196,9.394,-6.527,P＜0.01,occipital gray matter. t=5.592,9.717,-6.681,P＜0.01,left parietal white matter＝ and in subgroup of patients without HE, with MHE and HE (F=5.097,25.896,20.204,P＜0.01,occipital gray matter.F=16.435,28.660,21.283,P＜0.01,left parietal white matter).Significant difference in these metabolic alterations was also found among the different groups of cirrhosis especially the ratios of Glx/Cr in occipital gray matter and left parietal white matter (P＜0.0084).The ratios of mI/Cr also significantly altered between patients without HE and with MHE (P＜0.0084).There was a significant negative correlation between the ratios of Cho/Cr,mI/Cr and the grade of HE (P＜0.01＝ and a significant positive correlation between the ratios of Glx/Cr and the grade of HE (r=0.709,P＜0.01,occipital gray matter; r=0.720,P＜0.01,left parietal white matter＝.NCT-A and DST of controls is (49±8) s and 39±6.They are (134±37),(83±26),(64±22) second and 15±2,25±9,35±8 in patients with HE,MHE and without HE respectively.The metabolic alterations of Cho/Cr,mI/Cr,Glx/Cr correlated significantly with neurepsychological tests in all subjects (P＜0.01＝.There was a significant positive and a negative correlation between the ratios of Glx/Cr and the data of NCT-A and DST respectively (r=0.570,-0.642,occipital gray matter; r=0.541,-0.632,left parietal white matter).The metabolic alterations of Glx/Cr had no correlation with ammonia data as well as other metabolic alterations.Conclusions ~1H-MRS study shows cerebral metabolic alterations of gray and white matter in patients with cirrhosis,especially the reduction in mI/Cr ratio and increase in Glx/Cr ratio. These changes correlate well with the neuropsychological tests and may be useful in predicting the presence of MHE.

BACKGROUND:Constant magnetic field of proper intensity can inhibit the proliferation of vascular smooth muscle cells,and it can be used to inhibit the restenosis following percutaneous coronary intervention.OBJECTIVE: To observe the effect of constant magnetic field of different intensities on the expression of osteopontin gene in rat aorta smooth muscle cells, so as to investigate whether magnetic field can be used to prevent and treat restenosis following percutaneous coronary intervention.DESIGN: A randomly grouping and controlled observation.SETTING: Department of Cardiology, Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERIALS: The experiments were carried out in the laboratory of Department of Cardiology (Military Institute of Cardiovascular Disease), Xijing Hospital of the Fourth Military Medical University of Chinese PLA from February to December in 2006. Male pure SD rats of 200-250 g were used.METHODS : Rat aorta smooth muscle cells were cultured in vitro in DMEM medium containing fetal bovine serum (0.1 in volume serum), and then the cells were randomly divided into control group, constant magnetic field of 1, 5, 10 and 50 Gs groups, those in the control group were not treated with magnetic field, and those in the other groups were treated with magnetic field and cultured for another 48 hours. Reverse transcription-polymerase chain reaction and Western blotting were combined with absorbance (A) scanning analysis to observe the effect of constant magnetic field on the expressions of osteopontin and its mRNA in smooth muscle cells.MAIN OUTCOME MEASURES: Expressions of osteopontin and its mRNA in smooth muscle cells.RESULTS: The expressions of osteopontin and osteopontin genes in the constant magnetic field groups were significantly decreased as compared with that in the control group (P ＜ 0.05), there were also significant differences among the constant magnetic field groups of different intensities (P ＜ 0.05). It was indicated that the stimulation of constant magnetic field was in an intensity-dependent manner, and the expressions of osteopontin and osteopontin mRNA were enhanced as the intensity of magnetic field was increased.CONCLUSION: Constant magnetic field of proper intensity can inhibit the osteopontin expression in vascular smooth muscle cells on the gene level, and magnetic field may play a role in preventing and treating the restenosis following percutaneous coronary intervention.

@@