Universal health has been highly valued by the public and the government,and medical science and technology have been much improved.However,these are accompanied by a complex situation of doctor-patient relationship.We discuss here that humanism be fostered in medical education and clinical practice.A harmonious doctor-patients relationship can be maintained only when patientcentered medical service is applied and humanistic care is integrated but not overly dependent on technology and seeing patient as mere cases.

Objective To investigate the expression of serum interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)in the pa-tients with pulmonary tuberculosis and diabetes,and prelininary explore its clinical significance.Methods Experiment were divided into control group(health check-up outpatient,n=10),pulmonary tuberculosis group(n=20),diabetes group(n=20),tuberculosis combine diabetes group(n=20),tuberculosis combine diabetes group was divided into improved group,diabetes group and deterio-rated group after 2 months with therapy according to disease outcome,ELISA assay was used to measured the level of serum IL-2 and TNF-α.Results Before treatment:serum IL-2 levels of pulmonary tuberculosis group,diabetes group and pulmonary tuberculo-sis combine diabetes group were reduced (P<0.05),and the pulmonary tuberculosis group was lower than the pulmonary tubercu-losis group and diabetes group (P<0.05);serum TNF-αlevels of pulmonary tuberculosis combine diabetes group,pulmonary tu-berculosis group and diabetes group increased (P<0.05),and that of pulmonary tuberculosis combine diabetes group was higher than that of diabetes group (P<0.05).After treatment:the level of serum IL-2 increased and TNF-αsignificantly decreased in pul-monary tuberculosis combine diabetes improved group (P<0.05),the deterioration group had no change(P>0.05).Conclusion IL-2 and TNF-αplay a role in the immune pathogenesis of tuberculosis combine diabetes,which dynamic changes can reflect the progression and outcome of pulmonary tuberculosis combine diabetes.

Humans ; Otolaryngology ; Printing, Three-Dimensional

Objective To investigate the change in heat shock protein 70(HSP7O) in the brain tissue of fetal and newborn rats after prenatal hypoxic adaptation and the possible mechanism of the protective effect. Methods Twenty-two 22d pregnant Wistar rats were randomly divided into two groups: GroupⅠ(hypoxic adaptation group) and group Ⅱ(control group). The animals in group Ⅰ were placed in a tightly closed hypoxic adaptation chamber, of which the oxygen and carbon dioxide concentrations were monitored. The pregnant rats were taken out and exposed to fresh air for 5 mm when the 02 % in the chamber was reduced to 15 %, then the pregnant rats were placed back in the chamber and the above process was repeated once. The animals were then left for their natural labor. In control group the pregnant rats underwent the same process but the chamber was not tightly closed(O2 %= 21 %). Prenatal rats were delivered by cesarean section at lb. 3h, 8h, 24h, 48h, 72h, 120h and 168h after hypoxic adaptation and decapitated and brain was removed. Seven newborn rats from each group were decapitated and brain was removed for determination of HSP70 expression with immunohistochimical technique. Results No HSP7O expression was observed in the brain tissue of normal prenatal and newborn rats. HSP70 was observed in the different regions of hippocampus and cortex from 8h to 168h after hypoxic adaptation. Strongest HSP70 expression was observed in hippocampus CAl . Conclusions HSP70 plays a role in the formation of prenatal hypoxic adaptation.

0 05) The maternal plasma CGRP level was significantly higher(P

Objective To examine whether the prenatal hypoxia adaptation has any protective effect on the brain of the newborn rat Methods 12 22 day pregnant Wistar rats were randomly divided into 2 groups: the control group and the treated group In the treated group the pregnant rats were placed in a tightly closed hypoxia adaptation chamber When the O 2% in the chamber dropped to 15%, the rat was taken out to breathe fresh air for 5 min then put back in the chamber This process was repeated until its natural delivery In control the chamber was not tightly closed (O 2%=21%) 40 newborn rats weighing 6 8g were selected and subjected to brain ischemia and hypoxia, Left common carotid artrey was ligated under ether anesthesia 2h after recovery from surgery the newborn rats were placed in hypoxia chamber (T=36℃?1℃,O 2%=9%)for 1 5h 24h later they were sacrificed and brain was removed for microscopic examination (optical and electron) and flow cytometry measurement Results In the treated group most newborns were normal There were a few apoptosis cells in early stage The rate of apoptosis was 2 9%, necrosis cells could hardly be seen In the control group, although most neurons were also normal but there were apoptosis cells in early, middle and late stage and even necrosis cells The rate of apoptosis was 9 51%, which was significantly different from that in the treated group Conclusions Prenatal hypoxia adaptation has protective effect on the brain of newborn rat

ve To determine the most approprite hypoxic concentration and duration for prenatal hypoxic adaptation animal experiment by exposing pregnant rats to the hypoxic air of different oxygen concentration.Methods Full-term pregnant rats( gestation time 22 days) were placed in an airtight cabin specially designed for hypoxic adaptation experiment. The rats were divided into 7 groups. The Q2 concentration in the airtight cabin was decreased from 21% (group Ⅰ as control) to 18% (group Ⅱ), 17% (group Ⅲ), 16% (group Ⅳ), 15% (group Ⅴ), 14% (group Ⅵ) and 13% (group Ⅶ) respectively. The animals were exposed to short duration of hypoxic air twice with a break of 5min breathing fresh air. The duration of the first hypoxic episode lasted 10 min (group Ⅰ ) , 5 min (group Ⅱ), 7.5min (group Ⅲ), 9.83 min (group Ⅳ), 11.5 min (group Ⅴ), 13.17 min (group Ⅵ) and 14 min (group Ⅶ) respectively. The second hypoxic episode lasted 10min, 9.33 min, 11 min, 15.17 min, 13.33 min, 17 min and 18 min respectively. Ten newborn rats (1 day after birth) randomly selected from each group were placed in a 100ml airtight bottle and the duration from the start to the time when the newborn rat stopped breathing was recorded as hypoxia surviving time. Another 10 newborn rats randomly selected from each group were decapitated and brain was removed for light and electron microscopic examination to determine the degree of neuronal damages. Results In group Ⅰ-Ⅴ the newborn rats were normal (pink skin color and good extremity movement) . In group VI 10/55 (18%) newborn rats were cyanotic with diminished extremity movement, the others were normal. In group VIII 11/52(21% ) newborn rats died, 14/ 52(27%) were cyanotic with diminished extremity movement. Neuronal damages could be seen in cyanoticnewborn rats including decreased number, swelling, apoptosis of neurons and expanded mitochondria. The hypoxia surviving time was significantly longer in group Ⅳ, Ⅴ and Ⅵ than that in control group. Conclusions Hypoxic air containing 15% O2 is appropriate for animal experiment of prenatal hypoxic adaptation. It is better to divide prenatal hypoxia into two episodes lasting 11.5 min and 13.33 min with a break of 5 min between them when animals breathe fresh air.

Objective To investigate the mechanism involved in the brain protection afforded by prenatal hypoxic adaptation by determining the quantitative variation in bcl-2 and bax mRNA expression.Methods Twenty-four Wistar pregnant (22d pregnant) rat were randomly divided into two groups: group I (hypoxia group) and group *** ( control group) . In group Ⅰ the pregnant rats were placed in an airtight cabin specially designed for hypoxic adaptation. When O2 % in the cabin decreased to 15%, the animals were taken out breathing fresh air for 5min and then placed back in the cabin and underwent another episode of hypoxia. In group Ⅱ the animals were placed in the cabin which was not tightly closed and underwent no hypoxia. 7 fetal or newborn rats were taken at 1st, 3rd, 24th, 48th, 72nd, 120th, and 168th h after prenatal hypoxic adaptation from each group and their brains removed for determination of bcl-2 mRNA and bax mRNA. Results In control group the expression of bcl-2 and bax were observed in the brain tissue of normal fetal or newborn rats from the 22nd day in the uterus to the 7th day postpartum during which there were no significant changes in bcl-2 gene expression while bax gene expression gradually decreased with time ( the decrease was of no statistical significance) . In hypoxia group bax gene expression decreased at 8th h after hypoxic adaptation and reached the bottom at 24th h which persisted until 120th h; while bcl-2 gene expression started increasing at 24th h after hypoxic adaptation and persisted until 72nd h. The bcl-2/bax ratio also started increasing at 8th h after hypoxic adaptation and peaked at 24th h and persisted until 72nd h. Conclusions In the brain tissue of fetal and newborn rats which have undergone prenatal hypoxic adaptation, bcl-2 gene expression is elevated, bax gene expression decreases and bcl-2/bax ratio increases. These changes are time -dependent.

Objective To make cephalometric analysis on the morphology of mandibular angle and its relationship with adjoining craniomaxillofacial structures in adults, and to discuss the application of the results in preoperative analysis and operation design. Methods Cephalometric analysis was made on the following parameters in 30 adults (15 men and 15 women) for frontal and lateral cephalometric radiograms: the distance between the mandibular angles (Go Go) and between the malar points (Zy Zy), and the mandible mental angels (Zy Go Me) on an anteroposterior cephalometric radiograph; the gonial angle (Ar Go Me), mandibular plane sella nasion angle (MP SN) and ramus plane sella nasion angle (RP SN). Results Go Go in male was (130?6) mm, female (116?6) mm; Zy Zy in male was (156?5) mm, female (146?5) mm; Zy Go Me in male was (117?5)?, female (119?5)?; Ar Go Me in male was (117?5)?, female (119?5)?; MP SN in male was (27?5)?, female (29?5)?; RP SN in male was (94?5)?, female (93?5)?. Conclusion The morphology of mandibular angle should be envisioned in three directions. The results of evaluation can be served as the reference of preoperative analysis and surgery design.

The myocardial protection technique of off-pump coronary artery bypass grafting ( OPCABG ) has been applied to the coronary artery bypass grafting (CABG) with heart valve surgery.This study is aimed at determining its clinical effect .A retrospective analysis design was adopted .39 patients were recruited .All patients ’ surgeries went smoothly but one ,whose blood pressure was in poor control after surgery and then returned to normal after as -sisted with intra-aortic balloon counterpulsation (IABP).Others had stable vital signs and circulation .Finally,all pa-tients discharged safely .Significant improvement can be seen during 3 months’ follow-up.Applying OPCABG to CABG with heart valve surgery has been proved effective in clinic .