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In the context of the "Belt and Road" initiative, We systematically analyzed the general education and training systems of 16 Western Pacific countries and regions, including general practitioner college education, post-graduation education, and faculty status. Developed countries and regions have a long-term medical education system, strong faculty, and a comprehensive training model for general practitioners. Underdeveloped countries and regions are relatively weak in educational institutions, faculty, and general practitioner training models. The underdeveloped countries and regions should develop a general medical education and training system in terms of strengthening the construction of general medical disciplines, strengthening the supervision and certification of general practitioners, improving the general medical training model, and strengthening the construction of teachers.
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OBJECTIVE： To prepare Baicalin-loaded Polyethylene glycol-derivatized phosphatidylethanolamine （BAI@PEG-PE） nanomicelles， and to characterize it and study its cytotoxicity. METHODS： BAI@PEG-PE nanomicelles were prepared by film hydration method and their appearance characteristics were observed. The particle size， polydispersity index， Zeta potential， drug-loading amount and encapsulation efficiency of the nanomicelles were detected. Drug release of BAI raw material and BAI@PEG-PE nanomicelles in pH 7.4 phosphate buffer were compared within 1-84 h. Using coumarin 6 as fluorescent probe， the distribution of PEG-PE nanomicelles in H9c2 cardiomyocytes were observed. H9c2 cardiomyocytes were divided into model group， BAI raw material group and BAI@PEG-PE nanomicelles group. After treated with serum-free DMEM medium containing no or corresponding drugs for 0.5 h， isoproterenol was used to induce cardiomyocyte apoptosis. Nuclear morphology， cell apoptosis rate and protein expression of Bcl-2 and Bax were compared with among 3 groups. RESULTS： Prepared BAI@PEG-PE nanomicelles were uniform globular shape. The particle size was （16.7±0.8） nm， PDI was 0.11±0.01 and Zeta-potential was （－18.4±0.6） mV； drug-loading amount was （7.84±0.65）％， encapsulation efficiency was （85.7±4.9）％ （n＝3）. Accumulative release rate was 76.5％ within 84 h. BAI raw material was released completely within 24 h. PEG-PE nanomicelles could strengthen the intake of coumarin 6 in H9c2 cardiomyocytes， mainly gathering around mitochondria. Compared with model group， the apoptosis morphology of cardiomyocytes were improved significantly in BAI raw material group and BAI@PEG-PE nanomicelles group； apoptosis rate was decreased significantly； protein expression of Bcl-2 was increased significantly； protein expression of Bax was decreased significantly with statistical significance （P＜0.05 or P＜0.01）. Above effects of BAI@PEG-PE nanomicelles group were more significant （P＜0.05 or P＜0.01）. CONCLUSIONS： BAI@PEG-PE nanomicelles are prepared successfully， and show significant sustained-release effect and myocardial targeting， and can prevent cardiomyocyte apoptosis.
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Endothelial nitric oxide synthase (eNOS) is a major enzyme responsible for nitric oxide (NO) production. Both eNOS and NO play an important role in regulating vessel structure and function through participating in the physiological and pathological process. Generally, the phosphorylation of eNOS has been recognized as a common mechanism for regulation of eNOS function. However, recent studies have demonstrated several other new mechanisms, such as acetylation, S-glutathionylation, and protein-protein interaction. This review highlights the basic structure and functions of eNOS as well as the relationship between regulation of eNOS activity and cardiovascular diseases.
Subject(s)
Humans , Cardiovascular Diseases , Nitric Oxide , Nitric Oxide Synthase Type III , Oxidation-Reduction , Phosphorylation , Protein Processing, Post-TranslationalABSTRACT
Objective To investigate the related factors on effects of uterine artery embolization (UAE) in the treatment of dysmenorrhea in patients with adenomyosis, and to construct and validate the efficacy prediction model. Methods A total of 127 cases of adenomyosis patients with symptoms of dysmenorrhea in Guangzhou No.1 People′s Hospital and Nanfang Hospital of Southern Medical University from June 1999 to December 2009 were reviewed. The evaluation standard was to improve the degree of dysmenorrhea, the related factors of efficacy were analysed. Combined with artificial neural network theory, the effect prediction model was constructed, and the effectiveness of the model was evaluated using receiver operating characteristic (ROC) curve, and the effectiveness of the cut-off point was calculated. The model was validated by 68 cases of patients with adenomyosis in the Nanfang Hospital from January 2010 to November 2014. Results (1) In 127 cases of dysmenorrhea patients, UAE treatment was effective in 98 cases, effective rate was 77.2% (98/127). (2) Age was an independent predictor of effective UAE treatment (HR=1.129, P=0.026);in the range of this study, the greater the age, the higher the UAE treatment efficiency. (3) The developing situation of ovary branches of uterine artery was an independent predictor of effective UAE treatment (HR=0.460, P=0.020), the efficiency of patients whose intraoperative bilateral uterine artery ovarian branch did not develop was 89.7%(35/39), the efficiency of patients whose unilateral uterine artery ovarian branch was developing was 84.1% (37/44) and the efficiency of patients whose bilateral uterine artery ovarian branch were developing was 59.1% (26/44). (4) Blood supply of adenomyosisis was an independent predictor of effective UAE treatment (HR=0.313, P=0.001). Type Ⅰ (bilateral predominated) patients, efficiency was 93.5%(43/46);typeⅡ(bilateral balanced) patients, efficiency was 78.0%(39/50);type Ⅲ (unilateral predominated) patients, efficiency was 51.6% (16/31). (5) UAE for the treatment of adenomyosis efficacy of artificial neural network prediction model was constructed, the model′s area under the ROC curve was 0.808, the optimal cut-off point was 0.669 13. Actual verification of the model, sensitivity was 96.5%, specificity was 81.8%, positive predictive value was 96.5%and negative predictive value was 81.8%, the total accuracy was 94.1%. Conclusions (1) Age, the developing situation of ovary branches and blood supply of adenomyosis are the independent predictors of effective UAE treatment. (2) The artificial neural network prediction model is satisfied with the accuracy and the accuracy of prediction.
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Objective To detect the impact of Diltiazem on the major adverse cardiac events (MACE) in six months after percutaneous coronary intervention (PCI).Methods A total of 192 patients after PCI with coronary atherosclerotic heart disease were enrolled in this study.The patients were randomly divided into Diltiazem therapy group (101 patients) and non-Diltiazem therapy group (91 patients).The high-sensitivity C-reactive protein (hs-CRP) was assessed before and 24 h after PCI,and the incidence of Major adverse cardiovascular events(MACEs) were assessed at the sixth month after PCI.Results Compared with before PCI,hs-CRP level increased significantly in both group after PCI (P＜0.01),but hs-CRP level was lower in Diltiazem therapy group than in non-Diltiazem therapy group (P＜0.05).Compared with non-Diltiazem therapy group,there was lower incidence of MACEs during six months follow-up in Diltiazem therapy group.Conclusions Diltiazem can decrease the incidence of MACEs during six months after PCI.