Objective To determine the relationship between serum vitamin B_(12)(VB_(12))level and multiple sclerosis(MS).Methods The pertinent articles of the VB12 and the case control studies of MS were retrieved comprehensively by manual retrieval and computer retrieval.The methodology quality of the retrieved artilces were evaluated,and the arcb'cles were screened.Heterogeneity test was performed.The valid data was extracted and analyzed by Stata 10.1.Results In this study,9 studies were included.A total of 807 subjects were enrolled,including 414 patients and 393 controls.The Meta-analysis showed that the serum level of VB_(12) in patients with MS was lower than that in controls(standardized mean difference-0.24,95% CI-0.39 to-0.10).The sensitivity analysis indicated that the result of meta-analysis was reliable.Conclusion The serum level of VB_(12) might be associated with MS,and the deficiency of VB_(12) may contribute to the development of MS.

As the global economic integration, the trend of internationalization of medical education, social demand for foreign talents is more and more big, the English teaching, especially the doctor-patient communication in English teaching has become a major focus on the teaching content.Learning is the study of doctor-patient communication be-tween medical workers and patients how to mutual understanding, trust and cooperation, common a discipline, to conquer the disease and emphasize ability oriented ESP teaching concept, closely integrated with professional, promotes the student as the center, apply English teaching as means and tools to study, the two organically unifies in together.Practice shows that guided by the ESP teaching concept, improve medical students English power of expression of doctor-patient commu-nication attempt made substantial results.

Objective To study the effects of dibutyl phthalate(DBP) on estradiol biosynthesis and the related mechanism in puberty female rats.Methods Thirty-two female SD rats aged 21 days were randomly divided into the control group(corn oil) and low-dose(250 mg/kg),moderate-dose(500 mg/kg),and high-dose(1 000 mg/kg) DBP exposed groups,the rats were treated with DBP through gavage with a dose of 5 ml/kg,once a day for 8 consecutive weeks.After 8 weeks of exposure,the animals were sacrificed at proestrus.Radioimmunoassay was used to detect estradiol in the serum,the expression of aromatase mRNA levels was detected by real-time fluorescent quantitative RT-PCR.Results Compared with the control group,the body weight of rats in the moderate-dose group was significantly higher(P

OBJECTIVE:To provide the reference for verifying and improving the usage criteria and guidelines of compound oral contraceptives(COCs)in China. METHODS:The usage criteria and guidelines of COCs were introduced and compared issued by WHO,US and European Union(EU). RESULTS&CONCLUSIONS:WHO has established 4 standards and guidelines for COCs, i.e. Medical Eligibilitu Criteria for Contraceptive Use(MEC),Selected Practice Recommendations for Contraceptive Use(SPR), Decision-making Tool for Family Planning Clients and Providers,Family Planning:A Global Handbook for Providers. According to the specific circumstances of the user,MEC has been divided into 4 levels according to the situation of users,i.e. suitable for use,use cautiously,relative contraindication,absolute contraindication. SPR mainly describes the specific issues of how to use vari-ous contraception methods safely and effectively. The reading card mode for Decision-making Tool for Family Planning Clients and Providers can query specific methods and steps of contraceptive informed choice fast. Family Planning:A Global Handbook for Providers can provide practical guide for the family planning service providers in the first line. On the basis of WHO MEC and SPR,some projects are modified and added in the US MEC and SPR,including the classification of breast feeding,the risk grade of DVT/PE recurrence,etc. EU have formulated COCs criteria and guidelines earlier than WHO and US;the key points and specif-ic varieties of COCs are prompted and updated based on the latest evidence- based medicine,including a new assessment of the risk of thrombosis after using the COCs,the special safety tips for the use of Diane 35? and its generics. Concerning the optimal ev-idences of current COCs usage of WHO,US and EU,combined with domestic situation,our country may provide the clear and up-to-date usage criteria and guidelines of COCs for its users and medical staff.

It is of great significance to provide the policy and legal support for the health of whole people by clarifying the various medical policies and laws through the knowledge management model. A knowledge base of medical poli-cies and laws was thus developed using the ontology technology based on the basic structure of medical policies and laws, which is consisted of a front-end management system and a back-end management system with excellent knowledge management functions, and can thus help the decision makers to work out their policies by making full use of its medial and legal knowledge.

A mutation of intron 7, the point mutation in exon 9 was synonymous. Conclusion Two novel mutations of KEL gene are identified.

By analyzing the problems existing in the practice of doctor -patient communication , respectively discusses the speech act theory before the implementation of the implementation of doctor -patient communication oral English training , implementation , and after implementation of the positive role: instant help medical students to master a large number of medical English vocabulary;In view of the students come from different areas , instant help correct the pronunciation and intonation;Benefit based on speech act theory to guide the student to carry on the different roles played in English oral practice helps students to adopt direct and indirect speech act theory and the method of the oral English practice for communication;To improve medical students′professional recognition;To strengthen the medical students′sense of mission .

Objective To observe the variation of plasma 8-hydroxy-2'-deoxyguanosine (8-OHdG),a biomarker of oxidative DNA damage,in patients with Alzheimer's disease (AD) versus vascular dementia (VaD),and to investigate the important role and the difference of oxidative DNA damage in the initiation and development of AD and VaD.Methods 35 AD patients,28 VaD patients and 23 age and sex matched normal controls were enrolled in this study.Plasma 8-OHdG was measured by an enzyme-linked immunosorbent assay (ELISA) method.Cognition function in AD and VaD patients was measured by Mini-Mental State Examination (MMSE).Results There were significant differences in plasma 8-OHdG concentrations among AD,VaD and control groups [(601.8±266.0) ng/L,(1748.0±665.6)ng/L,(352.0±94.5)ng/L,respectively,P＜0.001].Plasma 8-OHdG was significantly higher in VaD group than in control group (P＜0.05).While,there was no significant difference in plasma 8OHdG concentration between AD group and control group (P＞0.05).Plasma 8-OHdG was significantly higher in VaD group than in AD group (P＜0.05).Plasma 8-OHdG levels were positively related with age in AD,VaD and control groups (r=0.661,0.702,0.719,respectively,all P％0.01).No correlations were found between plasma 8-OHdG concentration and education level among the three groups (all P＞0.05).AD and VaD patients were subgrouped according to the risk factors including gender,smoking,hypertension,diabetes,hyperlipidemia.There were no significant differences in plasma 8-OHdG level between the subgroups (all P＞ 0.05).After adjusting for sex,age,education level,smoking,hypertension,hyperlipidemia and diabetes,logistic regression analysis showed that the probability of high plasma 8-OHdG level was higher in VaD group than in AD and control groups.Plasma 8-OHdG level had a negative correlation with MMSE score in VaD group (r=-0.592,P＜0.01),while no correlation was found between plasma 8-OHdG level and MMSE score in AD group (r =-0.122,P＞ 0.05).Conclusions There is significant oxidative DNA damage in VaD patients.Plasma oxidative DNA damage is more serious in VaD patients than in AD patients and healthy people.Plasma 8-OHdG level,a oxidative DNA damage biomarker,has a significant correlation with the degree of cognition impairment in VaD patients.

Objective To study the effect and safety of recombinant human brain natriuretic peptide (rhBNP)on hemodynamics in patients with refractory heart failure(RHF).Methods A total of 16 patients with RHF were enrolled in the study.We defined RHF as the symptoms and signs had not been improved with conventional intensive treatment.The patients started to receive the infusion of rhBNP with 1.5 μg/kg bolus intravenous injection followed by 0.007 5 μ4/(kg · min)for 24 hours.During 24 hours,the hemodynamic parameters,systolic blood pressure,heart rate and electrolyte were monitored.After rhBNP infused,echocardiography was used to measure the cardiac index(CI),left ventricular end diastolic diameter(LEVDD)and ejection fraction(EF)in the third day.Results After rhBNP infused,pulmonary capillary wedge pressure (PCWP),mean pulmonary artery pressure(MPAP)were significantly reduced at 15 minutes(PCWP[22.7 ±4.0]mm Hg vs[25.3 ±3.9]mm Hg;MPAP[31.9 ±3.6]mm Hg vs[34.6 ±7.8]mm Hg,P ＜0.05),the systolic blood pressure decreased remarkably at one hour([105.2 ± 11.5]mm Hg vs[119.0 ± 17.2]mm Hg,P ＜ 0.01),and the effect disappeared gradually,heart rate decreased remarkably([109.0 + 10.8]beat/min vs [82.2 ± 8.6]beat/min).blood K +,Na + and renal function remained unchanged(P ＞ 0.05).CI([3.7 ± 0.6]L/m2 vs[1.8 ±0.4]L/m2),LEVDD([63.6 ±5.7]mm vs[67.3 ±6.2]mm)and EF([43.1 ±8.3]％ vs [31.2 ± 6.4]％)were significantly improved(P ＜ 0.01).There was no symptomatic hypotension or other adverse events.Conclusion Injection of rhBNP is safe,feasible,and effective in patients with refractory heat failure for improving hemodynamics.

Objective To detect and genotype the single-nucleotide polymorphisms (SNPs) in coding and promoter regions of human glucagon gene in Han Chinese residing in Shanghai and to analyse its association with essential hypertension (EH). Methods The identification of SNPs was performed by both direct DNA sequencing and denaturing high-performance liquid chromatography (DHPLC). For genotyping of SNPs direct sequencing was performed in 96 patients with EH and 96 normotensive controls (NT). Results Two SNPs in glucagon gene, one in the coding region (C3689T) and the other in the joint region, (G5505A) were found. A higher frequency SNP, C3689T, was genotyped and no significant difference in C3689T genotype frequency was found between EH and NT. Conclusion There is an important ethnic difference in SNP distribution of human glucagon gene. The distribution of C3689T genotype in Han Chinese is not different between EH and NT.