Objective Identifying the factors of psychological pressure from medical disputes on clinical doctors and possible solutions. Methods Self-rating Anxiety Scale (SAS) and the Occupational Stress Indicator (OSI) were called into play, to study 52 clinical doctors in a tertiary hospital in a city, who had encountered medical disputes in recent two years. In parallel, 63 clinical doctors without such disputes and 50 non-clinical workers were randomly selected as the control group for questionnaires. Results Clinical doctors with such an experience were commonly found to be anxious, and their SAS score (58. 27±11.38)averaged higher than those in the control group. Doctor-patient relationship, legal liabilities and clinical positions were found to be positively correlated to psychological pressure of clinical doctors. Conclusions Medical disputes tend to add to psychological pressure of the doctors. Clinical doctors deserve psychological counseling and training and improvement of their working conditions.

Objective To observe clinical efficacy of recombinant human erythropoietin(rhu-EPO)in sepsis with anemia.Method From June 2005 to December 2006,sixty sepsis with anemia patients in the Second Affiliated Hospital of Tianjin Medical University were divided into control group(n=30)and theatment with rhu-EPO group(n=30).The exclusion criteria was:renal imufficiency patients needing blood purification,patients with hemorrhage of digestive tract,and patients who used rhu-EPO before.Patients in the rhu-EPO group were hypodermically injected with rhu-EPO at 48 hours after admission,6000 units par time,and continued every other day for two weeks.When the hemoglobin Was lower than 80 g/L,patients received red blood cell(RBC)transfusion or received other treatment decided by doctor.The data were expressed as(x±s),and were analyzed using Student's t test and Fisher's exact test with SPSS 11.5.A P valLie less than 0.05 indicated statistical significance.Results There Was no significant difference on hemoglobin between the two groups before treatment (P＞0.05).After treatment,the hemoglobin of patients in rhu-EPO group was higher than that in control group [(105.87±11.48)g/L vs.(91.23 ±19.89)g/L,P＜0.01].The units of RBC transfusions was less in patients of rhu-EPO group compared with control group[(2.0 ±0.47)U vs.(2.63±0.43)U,P＜0.01].There was no significant difference on mortality between two groups(P＞0.05).Conclusions In sepsis with anemia patients,administration of rhu-EPO every other day can increase red blood cell level and reduce RBC transfusion.

Population pharmacokinetics(PPK),which is based on the principle of statistics,can be used to estimate various inter- and intra-individual factors which affect pharmacokinetics.By using Bayesian estimator,PPK can predict individual pharmacokinetic parameters accurately.PPK is widely used in the immunosuppressive therapy with cyclosporine,tacrolimus,mycophenolic acid and sirolimus.

Recent research has revealed that scorpion venom contains short-chain peptides with the specificity on K+or C1-channels, in addition to the knowledge of many kinds of long-chain peptides with the specificity on Na+ channels. According to the similarity of molecular structure and/or function, they have been classified into several groups. These short-chain scorpion peptides are playing more and more important role in studying the structure and function of K+ or C1- channels. The advance of structure and function of short-chain scorpion peptides in recent years was briefly introduced.

DNT cells(CD4-CD8-double-negative T cells)ale newly discovered immune cells,whose surface ex press neither CD4 nor CD8 molecules.In recent years,the prognosis and survival quality of tumour patient have been greatly improved through cell immunotherapy.Immunocyte can kill the tumour directly Or through immunoregu lation.The study of DNT cells(double-nnegative T cell)on cancer cells will be of vital significance.

Objective　To analyse the sensitivity of fineneedle aspiration cytology (FNAC) of breast masses.Methods　A series of 1035 FNAC of breast masses was reviewed.502 cases acccepted operation for histopathologic diagnosis.Results　The sensitivity of FNAC for breast malignant tumor was 98.9% and the specificity was 85.7%.Conclusions　The FNAC of breast masses has high accuracy.

ObjectiveTo investigate the diagnostic value and prognostic significance of plasma soluble triggering receptor-1 on myeloid cells ( sTREM-1 ) in patients with sepsis in the early stage.MethodsA total of 56 patients with systemic inflammatory response syndrome (SIRS) were enrolled for prospective and control study from May 2009 through July 2010. According to the criteria of sepsis set by SCCN/ESICM/ACCP/ATS/SIS in 2001, patients were divided into sepsis group ( n = 32), SIRS group (n = 24) . Meanwhile, 25 non-SIRS patients were enrolled in the control group. The sepsis group was further divided into two subgroups, namely survival subgroup and non-survival subgroup according to 28-day outcomes. The sTREM-1, procalcitonin (PCT), C-reactive protein (CRP), white blood cell count and neutrophil percentage count (NPC) were measured and APACHE Ⅱ scores were determined within 24 hours after admission. The correlation between sTREM-1 and APACHE Ⅱ score was analyzed. Quantitative data were analyzed by using F-test or Kruskal-Wallis test. ResultsThe plasma level of sTREM-1 in patients of sepsis group was significantly higher than that in SIRS group and control group [215. 1 (157.9 ～397.3) ng/L vs 103.6 (89.4 ～ 176.2) ng/L vs 33.6 (26.2 ～ 43.0) ng/L, P＜0. 05]. The plasma level of sTREM-1 in non-survival group was significantly higher than that in survival group[360.5 (262.2～434.5) ng/L vs 204. 1 (175.0～269.6) ng/L, P=0.002]. In sepsis group, the plasma level of sTREM-1 was positively correlated with APACHE Ⅱ score ( r, = 0. 426, P = 0. 032 ) The area under the ROC curve of sTREM-1 was 0. 935, larger than that of PCT and CRP. Conclusions Plasma sTREM-1 is a useful marker in diagnosis of sepsis at early stage. The increase in the level of sTREM-1 during the first 24 hours might be correlated with poor outcome of patients with sepsis.

OBJECTIVE:To establish a method for qualitative identification of Shenjin huoxue mixture.METHODS:Ly-copodii japonicum,Paeonia lactiflora,Dipsacus asperoides and Radix et Rhizoma Glycyrrhizae in the preparation were identified by TLC.RESULTS:At the corresponding positions,the color of TLC spots of Paeonia lactiflora,Dipsacus asperoides and Radix et Rhizoma Glycyrrhizae in the test samples and in reference substances were identical.There was no interference form negative control.But no characteristic spots of Lycopodii japonicum in the sample were noted.CONCLUSION:The established TLC identification method of Paeonia lactiflora,Dipsacus asperoides and Radix et Rhizoma Glycyrrhizae is reproducible,specific,reliable and suitable for the quality control of Shenjin huoxue mixture.The absence of characteristic TLC spots of Lycopodii japonicum in the sample is suggestive of the necessity of improving the production technology of Shenjin huoxue mixture.

Objective To evaluate the relationship between concentrations of nitric oxide (NO) and antigen-specific immunoglobulin G (IgG) in CSF and intracranial hypertension and epilepsy in patients with neurocysticercosis.Methods The NO concentration and the IgG level were measured in 40 cases of neurocysticercosisk, and the results were compared according to the patients whether had intracranial pressure or epilepsy. 23 patients with varicosis of great saphenous vein required subarachnoid anesthesia were served as control group.Results Compared with control group, the NO concentration in CSF significantly increased in patient group (P0.05) in the patients with epilepsy as compared with the cases without epilepsy.Conclusions The CSF NO concentrations are higher in the patients with neurocysticercosis who had intracranial hypertension or epilepsy. The IgG levels are also increased in the patients who had intracranial hypertension.

Objective To detect the expression of IL-6 in peripheral blood of patients with gastric cancer,as well as the expressions of IL-6,IL-6 receptor(IL-6R) and proliferating cell nuclear antigen(PCNA) in the neoplastic tissue in order to investigate the clinical significance of such expressions in looking for a convenient and effective way for the diagnosis and therapy of gastric cancer.Methods Enzyme-linked immunosorbent assay(ELISA) was employed for the parallel semi-determination of IL-6 levels in the peripheral blood of 30 patients with gastric cancer,as well as the levels of IL-6 and IL-6R in the neoplastic and adjacent tissues.The expression of PCNA in the neoplastic tissues was determined with immuno-histochemistry technique.Moreover,the correlation was comprehensively analyzed among IL-6,IL-6R,PCNA and the clinicopathologic findings of gastric cancers.Results The IL-6 levels in both peripheral blood and neoplastic tissues of 30 patients were significantly higher than those of the normal controls.The IL-6 levels in peripheral blood decreased significantly after operation;the IL-6 and IL-6R levels in cancer tissues were significantly higher than those in their adjacent tissues with a positive correlation between IL-6 and IL-6R levels.The expressions of IL-6,IL-6R and PCNA in both peripheral blood and neoplastic tissues of patients were positively related to the clinical manifestation of gastric cancer,including the differentiation degree of cancer cells,tumor size,infiltration extent and the metastasis of cancer cells.Conclusions IL-6,IL-6R and PCNA are the important factors which affect the degree of malignancy of the gastric cancer concerned,and they also,reflect the possibility of infiltration and metastasis of cancer cells.The IL-6 level in peripheral blood and the levels of IL-6,IL-6R and PCNA in tumor tissues of patients with gastric cancer are obviously high.The expression levels of all these factors are correlated with the clinicopathologic findings of gastric cancer.An adequate determination of IL-6 and PCNA is of benefit to the diagnosis and treatment of gastric cancer,and to the judgment of the course and prognosis of gastric cancer.