1.Using the Rights to Control the Power——On the Relationship Between the Doctor's Power and the Patient's Rights
Chinese Medical Ethics 1994;0(06):-
The doctors'medical treatment in the medical service is not a private right, but a public power. It orignates from the patients'rights. The purpose is to sustain and enhance the patients' health, However, in our actual lives, the side effect of market - oriented economy brings out the power partly to deviate from the primary aim. This kind of phenomenon is called as alienation of doctor's power. The doctor's power of alienation infringes upon the rights of patients, causeing the conflicts between both sides and forms disputes of medical treatment. Only could the patients's rights and the doctors's duties be wholly defined by law, that the patients rights can be taken to restrict the doctors power, and the relationship between the two sides can be harmonious.
2.Anterior cervical interbody Cage placement for treatment of multilevel cervical spondylotic myelopathy: Reconstruction of spinal function
Jianguang LI ; Jun MIAO ; Qun XIA
Chinese Journal of Tissue Engineering Research 2007;11(25):5024-5026
AIM: Anterior cervical discectomy and Cage bone graft fusion followed by steel plate internal fixation can decompress the vertebral canal and then spinal cord in patients with multilevel cervical spondylotic myelopathy. Complete decompression is very important for such patients. This study is to investigate the effect of this technique on reconstruction of spinal function.METHODS:①Thirty-eight inpatients with multilevel cervical spondylotic myelopathy admitted to Department of Spine Surgery, Tianjin Hospital between April 2003 and February 2006 were involved in this study. The involved patients, 35 male and 3 female, were aged 43-72 years, with disease course of 0.5 to 5 years. Informed consents of therapeutic regimen were obtained from all the patients.②All the patients underwent anterior cervical discectomy and cage placement operation. The patients with destabilized combination underwent titanium-plate fixation, and those with stabilized combination underwent cage implantation alone. The cage used in the experiment was made of tetragonal polyether ether ketone (Intromed Company), and titatium-plate was Zephir plate (sofarmor Danek Company). The elastic modulus of tetragonal polyether ether ketone Cage was similar to bone tissue and could allow X-ray pass through, which was easy for postoperative fusion of implanted bone. The outer design of Cage bone graft with certain angle could allow cervical physiological antecurvature well recover; Surface radian was the same as end plate, and good fitness contributed to the good fusion rate of bone graft; The sawtooth antiskid design on the surface provided good stability immediately after implantation; Elastic modulus was between os integumentale and cancellous bone that made stress-shielding and subsidence of fusion cage reduced, and had good anticausticity and biocompatibility. ③ The clinical results were evaluated with Japanese Orthopaedic. Association (JOA) scoring system before, 2,8 and 24 weeks after operation: upper limb motor function (4 points), lower limb motor function (4 points), sensation (6 points) and bladder function (3 points). Higher scores indicated better function. Postoperatively, body examination and X-ray and MRI scanning of anteroposterior cervical vertebra were performed.RESULTS: Thirty-eight patients with multilevel cervical spondylotic myelopathy participated in the final analysis. Within postoperative several days, nervous symptoms improved obviously, muscle strength of lower limb was increased, limbs were more flexible after operation than before operation, and paresthesia of two upper limbs recovered in 38 patients. JOA was a score of (9.25±1.85) before operation, and it was (12.4±2.08) at postoperative 2 weeks, (13.2±2.07) at postoperative 8 weeks and (13.8±1.67) at postoperative 24 weeks.CONCLUSION: Multilevel discectomy and Cage implantation obviously improve sensorimotor function and lessen symptoms of patients with multilevel cervical spondylotic myelopathy.
3.Proton therapy in the postoperative treatment of breast cancer patients
Jianguang ZHANG ; Xiangkui MU ; Jiamin LI
Journal of International Oncology 2008;35(3):192-194
With specific physical characters,proton for postoperative breast cancer can improve dose homogeneity,lower dose to crucial organs such as the heart,lung and the opposite breast,and reduce the complications of normal tissues and incidence of the second primary tumor proton accelerated radiation for partial breast cancer can reduce therapy time,but its long time effect needs great patients and long time follow-up to beproved.
4.Observation on Therapeutic Effect of 83 Cases of HIV/AIDS Treated with Traditional Chinese Medicine
Guangwen LI ; Jianguang ZHAO ; Guangping WEI
Chinese Journal of Information on Traditional Chinese Medicine 2006;0(01):-
Objective To observe the effect of pure Chinese traditional medicine preparation Fuzheng Anti-poisonous capsule and Kang Aibao Lives capsule to treat HIV/AIDS. Methods 140 examples confirmed by the Yunnan Province Centres for Disease Control and Prevention were treated by Fuzheng anti-poisonous capsule and Kang Aibao Lives Capsule,according to the Chinese medicine syndrome differentiation. 83 cases taking the medicine for more than 6 months were collected. The changes of Chinese medicine clinical symptoms and signs,the clinical symptoms and signs,the integrals,body weights,cold-catching numbers and CD4 were observed. Results The effective rate,steady rate and ineffective rate of Chinese medicine clinical symptom were 79.52%,10.84% and 9.63%,respectively. Increase,stable and reduces of integral were 48.19%,45.78% and 6.02%,respectively. Weight gain,stable and reduce were 56.62%,19.28% and 24.10%,respectively. Reduce,stable and increase of cold-catching number were 46.99%,43.37% and 9.64%,respectively. Effective,stable and ineffective of CD4 was 56.00%,10.67% and 33.33%,respectively. Conclusion The Chinese medicine has the remarkable curative effect in treating AIDS,and also has the obvious superiority.
5.An experimental study on adrenal glands homotransplantation to the subrenal capsule in adult rats
Guitang LI ; Jianguang GAO ; Yanzong MIAO
Chinese Journal of Urology 1994;0(02):-
adult female Wistar rats undergone bilateral adrenelectomy were diveded to four groups:(A)simple bilateral adrenalectomy;(B)bilateral adrenalectomy with pieces of adrenal glands alloimplanted to the subrenal capsule (SRC);(C)the same with group B followed by institution of cyclosporing A(CsA) from the operative day to the 14th postoperative day;(D) group C plus ACTH given from 3rd to 31st postoperative day. Five months follow-up showed that all the grafts survived, regenerated and the serum corticosteron levels were in correspondence with histological features. This result showed SRC is an ideal site for adreal homotransplantation. Varying degrees of lymphocytyc infiltration were present in the implants in group B on the 2nd to 21st postoperative day, the fragment in groun C and D in which CsA was given did not show any lymphocytic infiltration, even after CsA was discussed. ACTH instituted in group D remarkably enhances the regenerative speed of the grafts After CsA and ACTH were stopped, no rejection episode appeared and the adrenal grafts survived well. The result has been similar to clinical homotransplantation of adrenal glands with vasculas anastomosis.The technigue is simple and the adrenal gland used for homotransplantation is easy to obtain.
6.Studies on anti proliferation and inducing apoptosis effects of CIK cells against MGC 803 gastric cancer cell lines
Shu SUN ; Xuemei LI ; Jianguang WANG ; Wanshan YANG ; Xiangdan LI ;
Chinese Journal of Immunology 1999;0(12):-
Objective:To study the anti proliferation and inducing apoptosis effects of cytokine induced killer cells CIK cells on MGC 803 gastric cancer cell lines and to probe its underlying mechanism.Methods:To detect the anti proliferation and the cytotoxicity of CIK cells on MGC 803 gastric cancer line by MTT assay.The morphological changes of the apoptosis cell were observed by HE stain, scanning and transmission electron microscope. The positive expression of p53, p16,C myc were determined by immunocytochemistry (ICC).Results:MTT assay showed that the inhibitive rate inhanced obviously with the addition of Effect/Target rate and extension of time ( P
7.Topping-off technique for the protection of degenerative intervertebral disc
Cheng ZHAO ; Jianguang XU ; Xiaofeng LIAN ; Hao LI ; Manle QIU
Chinese Journal of Tissue Engineering Research 2013;(48):8349-8354
BACKGROUND:Topping-off technique can be used for fixation treatment through the combination of fusion and interspinous dynamic device, in order to prevent or slow down the adjacent lumbar segment degeneration.
OBJECTIVE:To obverse the protective effect of Topping-off technique (posterior lumbar interbody fusion
procedure combined with the fixation of dynamic interspinous device Coflex) for the degenerative intervertebral disc. METHODS:A total of 32 patients with degenerative lumbar diseases who had been treated with Topping-off technique were included in this study. The Oswestry disability index, the Japanese Orthopaedic Association scores, range of motion for Coflex implanted segment and during the relative signal intensity of the Coflex implanted segment in MRI image were recorded and calculated preoperatively and the entire fol ow-up period.
RESULTS AND CONCLUSION:Al patients were fol owed-up for 20.6 months averagely. Up to the last fol ow-up, the Oswestry disability index and Japanese Orthopaedic Association scores were significantly improved when compared with those before treatment (P<0.001). There was no significant difference in the range of motion for Coflex implanted segment before and after treatment (P=0.19). The relative signal intensity of the Coflex implanted segment was significantly improved when compared with that before treatment (P<0.01). The clinical application of the Topping-off technique showed a protective effect on the intervertebral disc.
8.Extreme lateral transforaminal lumbar interbody fusion (E-TLIF) designed via digital technology
Mingjie YANG ; Lijun LI ; Jianguang ZHU ; Jie PAN ; Jun TAN
Chinese Journal of Orthopaedics 2011;31(10):1093-1098
ObjectiveTo design a new operation approach:extreme lateral transforaminal lumbar interbody fusion (E-TLIF) via digital technology and to discuss its feasibility in treatment of degenerative lumbar diseases.MethodsCT scan image data of lumbar vertebra were obtained from volunteer (a healthy male of 26 years old,67 kg in weight and 172 cm in height).Mimics was used to read and reconstruct the data into 3D images.We observe the anatomical bone structures of intervertebral foramen and nerve roots through CT scan and 3D reconstruction in Mimics to analysis the feature of this area.Then E-TLIF operation,pedicle screw insertion and cage placement were simulated by computer via digital technology in Mimics.The feasibility of this new approach was proved through operating on lumbar of formalin doused body with E-TLIF approach.ResultsAn incision of 9 cm lateral form the central line and 45° from the sagittal plane is operated to fully expose the foraminal area.Remove superior facet while save inferior facet is feasible with this approach in E-TLIF.There is enough room for fully revealing and excision of intervertebral disc,and cage placement through enlarged foraminal area.Digital technology is a more economic,efficient way to design a new operation approach.The results are in accord with the formalin doused body test.ConclusionMimics is an effectively,reliable and economic method to design an operation approach.And the result suggested that E-TLIF is a safe,less minimal invasive and more efficient operation approach in treatment of degenerative lumbar diseases.
9.Display of heterologous proteins on the surface of E. coli by Red recombineering
Shanhu LI ; Qingguo SHI ; Cuifen HUANG ; Jianguang ZHOU
Chinese Journal of Microbiology and Immunology 2008;28(7):656-660
Objective To display of heterologous proteins on the surface of E. coli . Methods The 1653 bp luciferase report gene was knocked in Ipp and ompA genes of chromosome by Red recombine system and selection-counter selection kan/sacB. Results The quantitative analysis results of exogenous lu-ciferase expression displayed that it could be expressed as fusion with the outer membrane proteins on the cell surface. The fusion protein of foreign protein and outer membrane protein Lpp-OmpA-Luc could be high-effi-ciently displayed on cell surface. Conclusion The stable expression of exogenous gene on the surface of E. coli had no effect on the bacterial growth and propagation.
10.Exogenous EGF Effect on Change of Ultra-structure in Sensory Neuron Following Nerve Injury in Rat
Feng ZHANG ; Yudong GU ; Jianguang XU ; Jifeng LI
Fudan University Journal of Medical Sciences 2000;27(6):446-448,452
Purpose To observe exogenous epidermal growth factor (EGF) influence upon sensory neurons axotomy-induced and change ultra-structure of sensory. Methods Eighteen male Sprague-Dawely rats weighing 180-200 g(8-9 weeks of age)were randomly divided into two groups.One as control,the other was treated with EGF.Sciatic nerve injury model was set up by transecting left side sciatic nerve at 0.5 cm away from performed muscle.The proximal stump of sciatic nerve was ligated to inhibit nerve regeneration.Then 5 μl of normal saline in the control groups and an equal volume of EGF solution (containing 10 μg EGF) in the EGF treated groups were injected into the proximal of ligated nerve.The rats were sacrificed in 7,14,28 days of operative intervals respectively and transcardialy perfused with 4% para-fromaladehyde.The L5 dorsal root ganglion(DRG) were harvested.Eletromicroscope technique was used to observe the changes of L5 DRG sensory neurons axotomy-induced. Results A series of changes happened in the control group.The size of the nucles decreased.Nucleoplasm was scattered.The nucleolus was pale.Edema,loss of crest and matrix was found in the mitochondria. Satellite cells detached from the soma.The ultrastructure of L5 DRG sensory neurons in EGF groups get near to normal following nerve injury. Conclusions EGF could protect sensory neurons.