TO LISTEN AND TO HEAR

This paper describes and gives directions for replicating a communication skills course that has proven effective with direct care providers and health professions students over a five year period. The basic philosophy is that this helpful and facilitative course allows the professional to make maximum useof his therapeutic training and skills. enhances the human contact of the person who provides direct care and helps theolder person make acreative adjustment to his aging process. Helpful and facilitative communication requires both skills and an enthusiastic belief in the therapeutic efficacy of these skills. Such skills and attitudes can be taught in a relatively brief course, in which participants also learn to teach, and make the commitment to teach. what they have learned. This is acapacity building course, which hasas itsgoal learning how to give the kind of help that encourages self reliance and an understanding that the basis of this kind of help begins with communication.     

HLA—DQA1—DQB1等位基因在IDDM易感性中的作用

运用序列特异性寡核苷酸探针23个,其中DQA_19个,DQB_114个,对48例IDDM及46例正常对照的白细胞DNA PCR扩增产物进行斑点杂交,检验DQA_1及DQB_1等位基因。发现HLA-DQ_α_(52~-)精氨酸及DQβ_(57~-)非天门冬氨酸的频率在IDDM中显著增高,与IDDM易感性高度相关。DQβ_(57~-)天门冬氨酸在IDDM中显著减少,似对IDDM的发病有“抵抗”作用。与白种人相比,NA/NA纯合子在IDDM中的频率显著低于白种人。A/A纯合子的频率又显著高于白种人。因此,DQ一个氨基酸的改变只是华人IDDM易感性的一个重要相关因素,不是唯一主要因素。     

HOW TO PREVENT PROGRESSION TO END STAGE RENAL DISEASE

Chronic kidney disease (CKD) and end stage renal disease (ESRD) are severe medical conditions, increasing threats to human health and socio‐economic burdens in industrialized countries. CKD is assessed by an estimation of the glomerular filtration rate (eGFR). ESRD is an indication for renal replacement therapy by either dialysis or kidney‐transplantation. Major risk factors for CKD are arterial hypertension, hyperglycemia and hyperlipidemia. The multifactorial pathogenesis of CKD and ESRD offers various therapeutic interventions: treatment of the underlying disease, anti‐hypertensive therapy, glycemic control and anti‐diabetic therapy, anti‐proteinuric therapy, renoprotection, and life style management. Angiotensin converting enzyme inhibitors (ACE‐I) and angiotensin II receptor blockers (ARB) lower the systemic blood‐pressure, reduce proteinuria and may slow or even halt the deterioration of renal function. Alert glycemic control is important to avoid or protract diabetic nephropathy. Restricted protein intake, cessation of cigarette smoking and chronic analgesic‐abuse may also prevent the progression of chronic nephropathy.     

MALE PSEUDOHERMAPHRODITISM DUE TO PARTIAL END-ORGAN INSENSITIVITY TO ANDROGENS

A 46XY individual with incomplete male pseudohermaphroditism was studied. The phenotype was distinctive, with a masculine habitus despite a small phallus, gynaecomastia and diminished virilization. Plasma levels of testosterone, oestrogens, gonadotrophins and sex-hormone binding globulin were elevated. It is proposed that this syndrome is a variant of Type I incomplete male pseudohermaphroditism.     

VARICEAL HEMORRHAGE—TO BLOCK OR NOT TO BLOCK?

Eighty-one cirrhotics, bleeding from esophageal varices, were randomized to receive either propranolol (38) or placebo (43) for 2 yr in an attempt to prevent rebleeding. The initial bleeding episode was controlled with conventional medical therapy, including up to one sclerotherapy treatment. A single dose of propranolol was selected, Inderal L.A. [R] 160 mg daily. Bleeding and death were the major end-points. Severe variceal hemorrhage occurred in 77% of those given placebo but only 47% of those receiving propranolol. Death rates were similar (44% and 37%, respectively). Side effects were uncommon and equal in both groups. The difference in rebleeding rates approached statistical significance (p = 0.07); the death rates did not. The tendency for propranolol to benefit was seen in all Child's classes.     

REDUCED''GONADOTROPHS RESPONSE TO RELEASING HORMONE''AFTER CHRONIC ADMINISTRATION TO IMPOTENT MEN

Ten endocrinologically normal men with secondary sexual impotence were given 500 microng LHRH subcutaneously every 8 h. After 4 weeks treatment the LH response to 500 microng LHRH was reduced from a peak of 35.7+/-5.2 to 16.8+/-3.5 mu/ml (P less than 0.01) and the FSH response from 4.2+/-0.93 to 2.39+/-0.4 mu/ml (P greater than 0.01). Circulating total testosterone, oestradiol, prolactin and sex hormone binding globulin showed no significant changes. Whether this inability of the pituitary to maintain it s response to LHRH is peculiar to impotent men requires further study.     

INSTRUCTIONS TO AUTHORS

<正>GENERAL INFORMATION World Journal of Hepatology(World J Hepatol,WJH,online ISSN1948-5182,DOI:10.4254)is a peer-reviewed open access(OA)academic journal that aims to guide clinical practice and improve diagnostic and therapeutic skills of clinicians.Aim and scope WJH covers topics concerning arrhythmia,heart failure,vascular disease,stroke,hypertension,prevention and epidemiology,dyslipi-     

INSTRUCTIONS TO AUTHORS

GENERAL INFORMATION World Journal of Hepatology(World J Hepatol,WJH,online ISSN 1948-5182,DOI:10.4254),is a monthly,open access(OA),peerreviewed journal supported by an editorial board of 573 experts in hepatology from 46 countries.     

INSTRUCTIONS TO AUTHORS

GENERAL INFORMATION World Journal of Gastrointestinal Endoscopy (World J Gastrointest Endosc, WJGE, online ISSN 1948-5190, DOI: 10.4253), is a monthly, open-access (OA), peer-reviewed online journal supp orted by an editorial board of 400 experts in gastrointestinal endoscopy from 45 countries.     

INSTRUCTIONS TO AUTHORS

GENERAL INFORMATION World Journal of Gastrointestinal Endoscopy(World J Gastrointest Endosc, WJGE,online ISSN 1948-5190,DOI:10.4253),is a monthly, open-access(OA),peer-reviewed online journal supported by an editorial board of 400 experts in gastrointestinal endoscopy from     

INSTRUCTIONS TO AUTHORS

GENERAL INFORMATION World Journal of Gastrointestinal Endoscopy (World J Gastrointest Endosc, WJGE, online ISSN 1948-5190, DOI: 10.4253), is a monthly, open-access (OA), peer-reviewed online journal     

INSTRUCTIONS TO AUTHORS

GENERAL INFORMATION World Journal of Gastrointestinal Endoscopy (World J Gastrointest Endosc,WJGE, online ISSN 1948-5190, DOI: 10.4253), is a monthly,open-access (OA),