Evidence-based medicine mirrors the natural and social properties of human being,harmoniously integrating scientific spirit and humanistic spirit. Discussions were made on such aspects as the relationship between human spirit and harmonious doctor-patient relationship. The humanistic spirit of evidence-based medicine, and the humanistic spirit of evidence-based medicine as used in building harmonious doctor-patient relationship. The authors point out the following: 1) Medical science itself is a wealth of humanistic sprits, and medicinal science can better serve human being with humanistic spirit;2) Evidence-based medicine is completely in line with medical humanities, which scientifically reveals the "People-oriented medicine" as the essential attribute of human sciences;3) Modem clinical medicine has unveiled the evidence-based era. Based on these findings, the authors hold that in such an era,exploration and understanding of the human spirit as the core of evidence-based medicine and focusing on the cultivation of medical humanistic spirit, will be conducive to building a harmonious doctor-patient relationship.

OBJECTIVE:To improve the method of Chinese Pharmacopoeia on the extraction of volatile oil from Atractylodes macrocephala Koidz..METHODS:Volatile oil was extracted from Atractylodes macrocephala Koidz.and determined by the extraction method and determination method stated in Chinese Pharmacopoeia and by the new improved method respectively.And the components of volatile oil obtained in these two methods were respectively separated and identified by GC-MS.RESULTS:The extraction rates of volatile oil by the method of Chinese Pharmacopoeia vs.the new method were(1.28? 0.03) %(n=6) vs.(1.39? 0.03) %(n=6).As compared with the new method,seven components were missed by the method of Chinese Pharmacopoeia.CONCLUSION:The new extraction method of volatile oil can increase both the extraction rate of volatile oil and the kinds of the components in volatile oil,and it is obviously better than the method stated in Chinese Pharmacopoeia.

Objective To study the influence of excessive magnesium and/or deficient calcium intake on the bone mass of ovariectomized rats. Methods Three-month-old ovariectomized rats were fed with different types of drinking water: Interaction group was fed with deficient-Ca and excessive-Mg water: Ca 5 mg/L, Mg 60 mg/L; Excessive-Mg group was Ca 60 mg/L, Mg 60 mg/L; Deficient-Ca group was Ca 5 mg/L, Mg 30 mg/L; Normal group was Ca 60 mg/L, Mg 30 mg/L. After 3 months of treatment, the left femur was measured with the length and weight, then the content of Ca and Mg were determined, right femur was X-rayed, and right tibia was taken for the pathological examination. Results Calcium deficiency in water caused significant changes in all of the bone mass indexes, magnesium excess in water showed a tendency of Ca decreasing and Mg increasing in the bone. It was easily distinguish the difference in bone mineral and bone microstructure by X-ray and pathological examination: control group was the best, then was Mg excess group, Ca deficiency group was inferior, and the interaction group was the worst. Conclusion Calcium deficiency is one of the major reasons of osteoporosis, while the excessive intake of magnesium may not only disturb the bone metabolism but also aggravate the adverse effect of Ca deficiency on bone mineral and bone health.

Objective To introduce a kind of UPS for portable type-B ultrasonic in vehicular-charging at the situation of flowing in battle field. Methods Long time power supply for type-B ultrasonic and other related medical devices was realized through AC/DC alteration switch. Conclusion It functioned well in field test. Conclusion Being light and convenient with AC/DC, it is worth popularizing.

Objective To compare the effects of laparoscopy and open surgery of ligation of spermatic vessel cluster or internal spermatic vein for the treatment of varicocele.Methods By using randomized controlled trial,120 cases with varicocele who stayed and were treated in our hospital were divided into 4 groups(30 cases every group) from Jun.2007 to Oct.2011.The efficacy of 4 groups was observed and compared.Results Four operations were performed successfully.Laparoscopy approached less than open surgery in terms of the days of stay in hospital (P ＜ 0.05).The quality of semen in four groups was all increased by comparing spermatozoa density,motility rate before and after operation(P ＜ 0.05),but no difference was found among four groups (P ＞ 0.05).In 0.5-1 year follow-up,follow-up rate was 92.5％,without atrophy of testes.Conclusion The operation of laparoscopic spermatie vessel cluster ligation in patients with varicoceh has the advantage of confirmed effect,which is an alternative operative method of treatment for patients with varicocele.

OBJECTIVE:To investigate the postoperative analgesic effect of Dexmedetomidine combined with Remifentanil on patients in lung cancer resection and its effect on immune function. METHODS:60 lung cancer patients in lung cancer resection were randomly divided into control group(30 cases)and observation group(30 cases). All patients with endotracheal intubation re-ceived lung cancer resection under general anesthesia. After surgery,control group received Remifentanil hydrochloride 10μg/(kg·d)+Ondansetron hydrochloride injection 16 mg,adding into 0.9% Sodium chloride injection co-formulated into 100 ml;observation group received Dexmedetomidine hydrochloride injection 0.75 μg/(kg·d)+Remifentanil hydrochloride 10 μg/(kg·d)+Ondansetron hydrochloride injection 16 mg,adding into 0.9% Sodium chloride injection co-formulated into 100 ml. Background doses in 2 groups were 2 ml/h,self-controlled amount was 2 ml,lockout time was 15 min. Visual analog pain score (VAS),IFN-γ,IL-10 level,T cell subsets(CD3+,CD4+,CD8+,CD4+/CD8+)after 6,12,24,48 h and the incidence of adverse reactions in 2 groups were observed. RESULTS:VAS scores after 6,12,24,48 h in observation group were significantly lower than control group,and VAS scores after 24,48 h in 2 groups were significantly lower than that after 6 h,with statistical significance(P<0.05). IFN-γ levels after 6,12,24,48 h in observation group were significantly lower than control group,and IFN-γ levels after 12,24,48 h in 2 groups were significantly lower than that after 6 h,IL-10 level after 12,24,48 h in observation group were significantly higher than that 6 h and control group,with statistical significance(P<0.05). CD3+after 6,24,48 h,CD4+after 6,12,48 h,CD4+/CD8+af-ter 12,24,48 h in observation group were significantly higher than control group,CD8+ after 12,24 h were significantly lower than control group,CD3+,CD4+ after 12,24,48 h in 2 groups,CD4+/CD8+ in control group,and CD8+ after 12,24 h in observa-tion group and after 24 h in control group were significantly lower than that after 6 h,with statistical significance(P<0.05). There was no significant difference in the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:The postoperative anal-gesic effect of Dexmedetomidine combined with Remifentanil on patients in lung cancer resection is superior to Remifentanil alone, it can improve the immune function,with good safety.

Objective To evaluate the clinical application of interventional therapy in all kinds of pelvic trauma emergency.Methods There were tolally 16 cases in this paper(13 male and 3 female, 17～45 years old with average 31 years old). All patients had blood loose shock ( different blood pressure drop, limb pulse weakness and so on ). The blood pressure was(50～100)mmHg/(20～60) mmHg before interventional therapy,emergency selective external iliac artery, internal iliac artery and/or bleeding artery embolization and artery occlusion broken operation were performed. After operation pay attention to observe the life physical sign.Results Bleeding of internal iliac artery trunk,internal pudendum artery and obturator artery was in 8,3 and 4 cases respectively;1 case had thrombosis in external iliac artery.After emergency interventional treatment, blood pressure rose again progressively and became stability(90～120) mmHg/(60～90) mmHg,no serious complication presented.Conclusion The interventional treatment is the rapid and reasonable selection to cure the pelvic closed vessal injury and to save life.

10.3969/j.issn.2095-4344.2013.23.015

Objective To investigate the feasibility and efficacy of using small intestinal submucosa (SIS) as scaffold in cystoplasty augmentation for treating the neurogenic bladder.Methods We retrospectively reviewed our database of 14 patients with neurogenic bladder,including ten male and four female,between January 2011 and March 2014.The mean age in those patients was 29 years old (range 14-56 years old).The etiology of neurogenic bladder included myelomeningoceles in 8 cases and spinal cord injuries in 6 cases.The urodynamic examination showed that the mean volume of maximal bladder pressure was (150.1± 64.2) ml,mean bladder compliance was (5.2± 3.9) ml/cmH2O,maximal detrusor pressure was (44.1 ± 29.2) cmH2O.The SIS cystoplasty was performed in all patients,which the Surgisis(R) ES was used during operation.In order to enlarge the bladder,the 4-layer tissue graft was fashioned into a strap shape,rehydrated and continuously sutured to the mucous edge of opening bladder walls.Seven patients accepted the ureter reimplantation with anti-reflux technique simultaneously.Serial video-urodynamics,magnetic resonance urography (MRU) and serum analyses were used to assess the outcomes of surgery.Results All patients were undergone the operation successfully.The mean operative time was 120 min.Bowel function returned promptly after surgery.No metabolic consequences were noted.Renal function was preserved.The duration of follow-up ranged from 6 to 48 months (mean 24 months).Compared to the preoperative findings,there were significant increasing in maximum bladder capacity (P＜0.05) at the 6,12 and 24-month follow-up (150.1± 64.2) ml preoperatively,(274.9±88.7) ml at 6 months,(322.5± 144.4) ml at 12 months and (279.9± 157.9) ml at 24 months,The significant differences also exhibited in the increasing of bladder compliance (P＜0.01) at the 24-month follow-up [(5.2±3.9) ml/cmH2O preoperatively,(26.1 ±29.4) ml/cmH2O at 24 months] and decreasing of maximum detrusor pressure (P＜0.05) at the 12 and 24-month follow-up [(44.1±29.2) cmH20 preoperatively,(20.1±9.8) cmH2O at 12 months,(20.2±19.1) cmH2O at 24 months].Two patients were observed scaffold rupture one week postoperatively and healed with patent drainage.One patient developed calculi in neo-bladder at 3-months follow-up and treated with transurethral lithotripsy.Four patients were noted vesico-ureteral reflux at 12-month follow-up.The botulin toxin detrusor injection was used in 2 cases.After indwelling the catheter for 3 months,the symptoms of reflux disappeared.The oral administration of solifenacin (5mg twice per day) and tolterodine (4mg once per day) was used in other 2 patients,who also accepted the catheter indwelling at the same time.The symptom of reflux relieved in only patient.Conclusions SIS can be used effectively as a scaffold for bladder augmentation.Tissue engineering technology provides a potentially viable option for genitourinary reconstruction in patients with neurogenic bladder.

Objective: To observe the therapeutic effect of treating postoperative gastrointestinal syndrome with combined needles and herbs. Method: Altogether 117 in-patients were randomly allocated into the treatment group of 86 cases and control group of 31 cases. Point injection was mainly adopted in the treatment group plus Chinese herbal decoction, while Western medicine was adopted in the control group. And then the therapeutic effect of the two groups was compared. Result: The total effective rate of the treatment group and control group were 96.5% and 80.6% respectively, and the treatment course of the treatment group was significantly shorter than the control group (P ＜ 0.01). Conclusion: Combined needles and herbs have excellent effect in treating postoperative gastrointestinal syndrome and were superior to Western medicine.