Shortages in the fostering of medical humanistic spirits for students majoring medical science of law in medical colleges and universities were discussed from the perspectives of concept establishment,curriculum,clinical teaching and teaching staff.The fostering of medical humanistic spirits for students should be enhanced to achieve the balance between medical humanity and legal professionalism.

Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) plus Shen Ling Bai Zhu San for pediatric diarrhea due to spleen deficiency.Methods: A total of 105 children with diarrhea due to spleen deficiency were selected and randomized into two groups by the random number table method. Fifty-two cases in the control group were treated with oral Shen Ling Bai Zhu San, and 53 cases in the observation group were treated with additional Tuina treatment. The clinical efficacy was evaluated after treatment, and the changes of traditional Chinese medicine (TCM) symptom scores were observed. Results: During the trial, there were three dropouts in the observation group, and two in the control group. After the treatment, the total effective rate was 100.0％ in the observation group, and 90.0％ in the control group. The difference between the two groups was statistically significant (P<0.05). The scores of primary and secondary symptoms, and the total scores of TCM symptoms in both groups were significantly lower than those before treatment (P<0.05). And the scores of primary and secondary symptoms, and the total score of TCM symptoms in the observation group after treatment were lower than those in the control group (P<0.05). There were no obvious adverse reactions in either group during the treatment. Conclusion: Tuina plus Shen Ling Bai Zhu San has a better therapeutic effect in treating pediatric diarrhea due to spleen deficiency than Shen Ling Bai Zhu San alone.

Objective To evaluate the efficacy and safety of α1-adrenergic blockers for treating young men with primary bladder neck obstruction (PBNO). Methods A retrospective review was done of the presenting symptoms and videourodynamic findings of 22 young men younger than 35 years with PBNO. Mean age was 28 years (range 18 to 35). The presenting symptoms were hesitancy in 21 (95%), weak stream in 17(77%), frequency in 16(73%), urgency in 8(36%) and pelvic pain in 6 (27%). Mean symptom duration was 28(3-62)months. A dose of 4 mg Doxazosion was adminis-tered for at least 6 months. International prostate symptom score(IPSS), Quality of life(QOL), uro-flowmetry, post-void residual urine and blood pressure were assessed before and 6 months after medi-cation. Improved urine flow was defined as at least 3 ml. per second increase in the maximum flow rate. Improved symptom was defined as more than a 40% decrease in IPSS. Successful treatment was defined as improved in urine flow and symptoms. Results Follow-up data were available for 21 of 22 patients. The medication period was 8.7±2.5 months and follow-up duration was 12.3±4.9 months. Mean Ⅰ-PSS decreased from 16.9±3.7 to 10.7±4.5. Mean QOL decreased from 4.3±1.2 to 2.5±1.0. Mean maximum flow rate increased from (9.8±3.5)ml to (14.9±3.6)ml. per second. Mean post-void residual urine decreased from (78.2±35.6)ml to (46.5±19.4)ml. There were significant differences(P<0.01). Treatment was successful in 14 patients (67%). Drug tolerability was good. Mean blood pressure was (110.0±7.9)/ (75.0±5.9)mm Hg and (107.0±8.7)/(72.0±7.1)mm Hg before medicine therapy and after 6 months medication(P>0.05). Conclusions Videourody-namics is the diagnostic gold standard of PBNO. In our experience α1-adrenergic blockers are clinically effective therapy and safety for PBNO and have been well tolerated in young male patients.

Objective To study the influence of blood glucose, blood lipids and other cerebral infarction risk factors in the mean platelet volume (MPV). Methods A total of 562 patients with cerebral infarction and type 2 diabetes mellitus (DM) and 216 cerebral infarction patients without DM (non-DM) were included in this study. The platelet parameter of peripheral blood and other laboratory indexes were detected including platelet count (PLT), MPV, platelet distribution width (PDW), plateletcrit (PCT), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and very low density lipoprotein (VLDL-C), urea nitrogen (BUN), creatinine (Cr), uric acid (UA), high-sensitivity C-reactive protein (hs-CRP) and homocysteine (HCY). The patients were scored by the National Institute of Health stroke scale (NIHSS) after hospitalization. The MPV changes in patients with cerebral infarction were observed, and different influences of blood glucose, blood lipids to MPV were analysed. Results Values of FBG, HbA1c, TC, TG, LDL-C, BUN, UA, HCY, hs-CRP, and NIHSS were significantly higher in DM group than those of non-DM group. The score of NIHSS was significantly higher in DM group than that of non-DM group. The level of HDL-C was significantly lower in DM group than that of non-DM grou. The MPV was significantly higher in DM group than that of non-DM group [(9.60 ± 1.35) fL vs. (9.27 ± 1.01) fL, P<0.05). There was a positive correlation between MPV and FBG, HbA1c, hs-CRP, WBC, VLDL-C and NIHSS, r=0.438, 0.410, 0.336, 0.164, 0.321 and 0.249 (P<0.05). Multiple regression analysis showed that FBG, VLDL-C, HbA1c, hs-CRP and NIHSS were the independent influential factors of MPV (P<0.05). Conclusion The influencing factors of MPV should be controlled in patients with cerebral infarction combined with type 2 diabetes mellitus, reducing the activation of platelet, and delaying the progress of cerebral infarction.

Objective: To observe the clinical efficacy of warm needling moxibustion plus isokinetic muscle strength training for knee osteoarthritis (KOA).Methods: A total of 135 patients with KOA due to Yang deficiency and coagulated cold were randomized into a warm needling moxibustion group, an isokinetic muscle strength training group, and a combined group by the random number table method, with 45 cases in each group. The warm needling moxibustion group was treated with warm needling moxibustion. The isokinetic muscle strength training group was treated with isokinetic muscle strength training. The combined group was treated with warm needling moxibustion plus isokinetic muscle strength training. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS) were scored before and after treatment, and isokinetic indicators of peak torque (PT), total work (TW) and average power (AP) were evaluated. Results: The total effective rate of the combined group was 92.5％, which was significantly higher than 83.3％ in the warm needling moxibustion group (P<0.05) and 72.5％ in the isokinetic muscle strength training group (P<0.05). After treatment, the scores of WOMAC (total, pain, stiffness, and function) and VAS, and isokinetic indicators (PT, TW, and AP) were all improved compared with those before treatment (P<0.05) in all three groups. The differences among the three groups were statistically significant (P<0.05). The WOMAC total score and score of stiffness in the combined group were lower than those in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), and the scores in the warm needling moxibustion group were lower than those in the isokinetic muscle strength training group (P<0.05). The WOMAC score of pain and VAS score in the warm needling moxibustion group and the combined group were lower than those in the isokinetic muscle strength training group (P<0.05). The differences between the warm needling moxibustion group and the combined group were not statistically significant (P>0.05). The WOMAC function score in the combined group was lower than that in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), while there was no statistical difference between the warm needling moxibustion group and the isokinetic muscle strength training group (P>0.05). PT, TW, and AP in the combined group were higher than those in the warm needling moxibustion group and the isokinetic muscle strength training group (P<0.05), and they were higher in the isokinetic muscle strength training group than in the warm needling moxibustion group (P<0.05). Conclusion: Warm needling moxibustion plus isokinetic muscle strength training has a better effect in the treatment of KOA due to Yang deficiency and coagulated cold than either warm needling moxibustion or isokinetic muscle strength training alone.

Objective:To observe the clinical efficacy of back-Shu and front-Mu points combination needling on balance and walking function in patients after stroke and its mechanism. Methods:A total of 79 patients with post-stroke balance and walking dysfunction were randomly divided into a control group and an observation group.Both groups received conventional treatments such as dietary guidance and oral medications as well as rehabilitation training.On this basis,the control group was treated with additional conventional acupuncture,and the observation group was treated with additional back-Shu and front-Mu points combination needling.Both groups were treated for 4 consecutive weeks.The thickness of abdominal muscle group(transverse abdominal muscle,rectus abdominis,obliquus internus abdominis,and obliquus externus abdominis),the scores of Berg balance scale(BBS),Fugl-Meyer assessment(FMA),and functional ambulation categories(FAC),and walking velocity and stride were compared between the two groups. Results:During the trial,there was 1 dropout case in the control group and 4 dropout cases in the observation group.Before treatment,there were no statistical differences in the abdominal muscle group thickness,scores of BBS,FMA,and FAC,and walking velocity and stride between the two groups(P>0.05).After 4 weeks of treatment,the thickness of abdominal muscle groups,scores of BBS,FMA,and FAC,and walking velocity and stride in both groups were improved(P<0.01),and the observation group was superior to the control group(P<0.05). Conclusion:Both conventional acupuncture and back-Shu and front-Mu points combination needling are conducive to the improvement of balance and walking function in patients after stroke.The back-Shu and front-Mu points combination needling method has better curative efficacy.Strengthening the core muscle group strength may be one of the mechanisms of back-Shu and front-Mu points combination needling treatment.

Objective To investigate the difference of cerebral inter-hemispheric functional connectivity between the patients with amyotrophic lateral sclerosis ( ALS) and healthy controls ( HC) by a newly developed voxel-mirrored homotopic connectivity ( VMHC) method based on resting-state functional MRI ( rs-fMRI) , as well as its correlation to the structural imaging indices and clinical neurological scales .Methods Twenty patients with ALS ( ALS group ) and 20 age-, and sex-matched healthy controls ( HC group) were examined by rs-fMRI and diffusion tensor imaging ( DTI ) on 3.0 T MR imaging system ( Siemens Trio Tim ).The rs-fMRI data preprocessing were performed using data processing assistant for rs-fMRI ( DPARSF) based on Matlab 2009a, and the rs-fMRI data analysis toolkit ( REST) with an automated VMHC approach was utilized to calculate and compare the VMHC correlation coefficients between the ALS group and the HC group[P<0.05, corrected with false discovery rate (FDR)].Region of interest (ROIs) were prescribed on the regions which showed abnormal VMHC coefficients in ALS group , then the mean time series of the ROIs were extracted to examine the difference of the seed ( ROIs)-based functional connectivity between the ALS and HC groups.At last, linear correlations were performed to assess the relationships among the VMHC coefficients and clinical measures including the revised amyotrophic lateral sclerosis functional rating scale ( ALSFRS-r) score, disease duration , the rate of disease progression and fractional anisotropy ( FA) values of the corpus callosum ( CC).Results Compared with HC group , the patients with ALS showed lower VMHC coefficients in the precentral gyrus ( M1 ) , postcentral gyrus ( PCG ) , inferior parietal lobule (IPL), cuneus/precuneus (Cu/Pcu), and anterior cingulate gyrus (ACC).Higher VMHC coefficients were found in the supplementary motor area , superior frontal gyrus , and middle occipital gyrus (P<0.05,FDR corrected).Significant functional connectivity alterations were detected in motor cortex and frontal/temporal/occipital lobe between the ALS and HC groups using seed ( ROIs )-based functional connectivity based on the regions which showed abnormal VMHC coefficients in ALS group ( P <0.05, AlphaSim corrected, clusters≥228 voxels).Significant positive correlation was detected between the VMHC coefficients (0.311 ±0.108) of M1 and FA values (0.394 ±0.016) of CC III region (r=0.530, P=0.016), between the VMHC coefficients (0.767 ±0.043) of ACC and FA values (0.360 ±0.105) of CC I region (r=0.513, P=0.021), respectively.Significant positive correlation was observed between VMHC coefficients (0.311 ±0.108) of M1 and the ALSFRS-r score (35.4 ±2.5) in ALS patients(r=0.447, P=0.048).There was not significant correlation observed between the VMHC coefficients and disease duration , or the ratio of disease prognosis (P>0.05).Conclusions Abnormal VMHC coefficients were detected in ALS patients.The decreased VMHC in ACC and M1 are associated with the reduced micro-structure integrity of CC, meanwhile, and they may be related to disease severity.

Objective To investigate the causes and treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Methods A retrospective analysis was conducted in 6 cases (5 males and 1 female,aged 11 to 53 years) of familial neurohypophyseal diabetes insipidus with hydronephrosis treated in our institute from June 2009 to December 2010.All cases had polydipsia and polyuria since their childhood.The daily output of urine ranged from 5,290 to 15,040 ml.The urine specific gravity was less than 1.005.The water deprivation and vasopressin injection test showed positive results,and MRI showed that the shape and size of pituitary gland were in normal range.Ultrasound and IVU showed that all cases had hydronephrosis.Five adult cases were administered with Desmopressin 0.2 mg three times a day,and 1 juvenile patient given half dosage of Desmopressin as in adult.The case No.1 underwent percutaneous nephrostomy and bilateral ureteral reimplantation.Case No.2 received urethral catheterization for 5 days and Tamsulosin.Three cases with urinary tract infection were given antibiotics on the base of urine culture and antibiotic sensitivity test results.Follow-up was undertaken every 3 mon for the duration of 18-36 mon.Results In 6 cases,polydipsia and polyuria were significantly improved after the treatment.Daily urine output dropped to 6000 ml in 5 adult cases and decreased to 2000 ml in the juvenile case.The flank sore of case No.1 was relieved after percutaneous nephrostomy,and hydronephrosis improved 6 mon after bilateral ureteral reimplantation.The residual urine volume of case No.2 was reduced to 40 ml,and no recurrence was observed after anti-infection therapy.During the follow-up,6 cases showed relieved hydronephrosis and no recurrent infection.Conclusions It is of important to reduce the urine volume for the treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Early diagnosis and treatment of the diseases is crucial for the improvement of renal function.

This study presented our experience in the treatment of testicular torsion, which may help achieve early diagnosis and improve therapeutic effects. A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011. The age of the patients ranged from 16 days to 34 years. All the patients had unilateral testicular torsion, which took place on the left side in 43 cases and on the right side in 28 cases. The course of the disease varied between three hours to 30 days. Post-operative follow-up was conducted until October 2011. Items examined included signs and symptoms at their first clinical visit, ultrasound findings, treatment in emergency surgery, and post-operative follow-up. In this study, the 71 patients were diagnosed with testicular torsion by color Doppler sonography, 7 had testicular fixation, 63 patients received orchiectomy, while 1 patient did not undergo surgery due to pressure from family members. Post-operative follow-up showed that the one patient's testicle, which had been reserved, atrophied, while all the other survived. No recurrence was found during the follow-up visits. It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion, and the diagnosis and treatment by the first attending clinician is of critical importance.

Objective To investigate the effects of asymmetric dimethylarginine (ADMA) on apoptosis and phosphorylation of c-jun N-terminal kinase (JNK) in endothelial outgrowth cells (EOCs). Methods The mononuclear cells were harvested from umbilical cord blood by ficoll density gradient centrifugation, and induced into EOCs and then expanded in vitro. The identified EOCs were treated with different concentrations of ADMA (0, 1, 5, 10, 20 μmol/L) for 48 h. The adherent cells were treated with 10 μmol/L ADMA,then different concentrations of JNK specific inhibitor SP600125 (0, 5,10,20 and 40 μmol/L) were added and incubated for 48 hours. Caspase-3 activity was measured by microplate reader. Apoptotic incidences of EOCs were quantitatively determined by flow cytometry. The expression of Caspase- 3 and phosphorylase-JNK (p-JNK) were detected by Western blot assay. Results The treatment of ADMA (1-20 μmol/L) significantly induced apoptosis in EOCs by enhancing Caspase-3 express and also induced phosphorylation of JNK (P<0.05). Meantime, the JNK specific inhibitor SP600125 could attenuate the apoptosis induced by ADMA during this process (F=6.733,P<0.05) and inhibit the expression of Caspase-3 and p-JNK. Conclusion ADMA can induce apoptosis in EOC, which may be achieved by activating JNK signal transduction pathway.