The development of social medicalization is mainly based on technical and capital logic.De-humanization of technology and the profits-pursing nature of capital cause unbalanced development of modern medicine in the aspects of materials and human as value subject.As a component of medical humanities education,life education should be based on human's emotion of life,strengthened in the cultivation of sympathy,respect as well as concern and control of subject's expansion by emotional strength,which is also an important element in the cultivation of medical humanities spirit.

This paper firstly introduces the perspectives of medical ethics moral imagination, then illustrates the specific connotation of the medical students moral imagination:moral sensitivity, perspective transformation, situat-ed cognition and beyond and moral reflection and evaluation ability, finally analyzes the narrative method based class to cultivate the medical students moral imagination, the narrative is to cultivate the medical students moral i-magination again the main teaching method.

Objective To explore the role of the transforming growth factor-?1 (TGF-?1) and the vascular endothelial growth factor (VEGF) in the occurrence and development of the pulmonary fibrosis as well as the synthesis and distribution of these two factors in relation to the angiogenesis process of the pulmonary tissues. Methods The rats were randomly assigned to control group (CG) and bleomycin group (BLM) with the same physical conditions. The bleomycin was introduced to the lung tissues of the rats in the BLM group to mimic the pulmonary fibrosis process. The synthesis and distribution of VEGF and TGF-?1 were observed and recorded on day 3, 7, 14, and 28 in both groups by the immunohistochemical and in situ hybridization approaches. The pathological changes of the subjects were also observed and recorded using both the light-microscope and the transmission electron microscope (TEM) on the same dates.Results The BLM group demonstrated the great significance in both of the VEGF and TGF-?1 presentation and the pathological changes in the pulmonary tissues comparing to the CG group. In the BLM group, VEGF and TGF-?1presented dramatically in the early stages of the fibrosis and this phenomenon lasted with the parallel increases of both the factors. This presentation of VEGF and TGF-?1 showed the greatest distribution on day 28 in the lung interstitial cells and the areas of the presentation corresponded to that of the new angiogenesis and the fibrohyperplacia of the pulmonary tissues. The endothelial cells of the lung capillaries were observed to demonstrate early necrosis, separation from the base, and increased penetrance followed by a great amount of angiogenesis with twisted new blood capillaries and blood embolism formation within, which continued to show on day 28 in the BLM group.Conclusion The presentation of VEGF and TGF-?1 is highly corresponded with the angiogenesis of the bleomycin treated pulmonary tissues in the rats. The continued significant presentation of these two factors may relate to the damage of the new formed capillaries or the impairment of the pulmonary tissues in rats.

Objective　To evaluate the disc herniation by the technique of MRI FFE.Methods　T1WI,T2WI and FFE sequences were performed in 40 cases with cervical and lumbar vertebra disc herniation using 1.0T MRI equipment on sagittal and transection sections.The showing rate of disc fibrous circle rupture,extrusion directon and nerve-root pressure in disc herniation on FFE,T1WI and T2WI sequences were comparated emphasisly.Resilts　In the observation of cervical nucleus pulpous prolapse and free disc fragment showing fibrous circle rupture,extrusion direction and nerve-root pressure in cervical region,and showing fibrous cicrcle rupture in lumbar region,the FFE was better than T1WI,T2WI.In judging extrusion direction and nerve-root pressure,the FFE sequence was better than T2WI and T1WI respectively.Conclusion　MRI FFE can improve the diagnostic ratio of the extrusion of nucleus pulpous,annular bulge as well as free disc fragment.

By using(S)-MonoPHOS and ［Rh(COD)2］BF4 as catalyst, the asymmetric hydrogenation reactions of methyl-2-acylamino-3-arylacrylate and the effect of different amino protective groups on hydrogenation efficacy were studied. The products resulting from asymmetric hydrogenation were hydrolyzed by hydrochloric acid, and the corresponding amino acids were obtained at yields of 63%- 92%.

Interstitial lung disease (ILD) is a frequent complication of patients with connective tissue disease (CTD) and significantly affects morbidity and mortality. Disease course may vary from stable or mildly progressive to more severe, with rapid loss of lung function. At present, there are great challenges and poor prognosis in the diagnosis and treatment of CTD-ILD. Based on the evidence and guidelines from China and other countries, experts from the Chinese Rheumatology Association developed standardization of diagnosis and treatment of CTD-ILD. The aim is to strengthen the early identification of, standardize the diagnosis and treatment of CTD-ILD, and delay the progress of the disease.

Objective:To study the pharmacokinetics of the broad-spectrum antifungal drug butenafine nanomicelles (BTF-NM) after topical instillation.Methods:The self-assembly method was used to prepare BTF-NM.The particle size, Zeta potential, and polydispersity index (PDI) of BTF-NM were measured by a nano-particle size-Zeta potential analyzer, and the encapsulation efficiency was determined by high-performance liquid chromatography (HPLC). Forty-two healthy New Zealand white rabbits without eye disease were randomly divided into the BTF-NM group and the BTF suspension (BTF-S) group.The corresponding drugs were instilled in the conjunctival sac with a single instillation of 50 μl.The 7.5 mm filter paper was placed in the conjunctival sac of rabbit eye for 1 minute at 5, 15, 30, 60, 120, 180, 240 minutes after the administration.Then the rabbits were sacrificed by intravenous injection of 4% sodium pentobarbital solution through the ears of the rabbits.The aqueous humor was extracted and the corneal tissue was dissected.The drug concentration of BTF in different tissues was measured by HPLC.The study was approved by the Life Science Ethics Review Committee of Henan Eye Hospital (No.HNEECA-2019-01).Results:The particle size and PDI of BTF-NM were (15.65±0.04)nm and 0.11±0.01, respectively, the Zeta potential was (-0.29±0.36)mV, the encapsulation rate was (98.38±0.29)%.The peak time of the drug both in tears and corneal tissues after BTF-NM application was 5 minutes.The peak concentrations of the drug in tears and corneas of the BTF-NM group were (485.21±66.29) μg/g and (12.53±2.32) μg/g, which were 5.6 and 78 times than that of the BTF-S group, respectively.Within the observation time, the mass fractions of the drug in tears and corneas of the BTF-NM group at each time point were significantly higher than those of BTF-S group at corresponding time points (all at P<0.01), respectively.The area under the concentration-time curve (AUC) 0-240 minutes in tears and corneas of the BTF-NM group was 7 488.90 (μg/g)·minute and 829.01 (μg/g)·minute, which was 7.2 and 52 times than that of the BTF-S group, respectively.No drugs were detected in the aqueous humor of the BTF-NM group and the BTF-S group. Conclusions:BTF-NM is an ideal agent with a simple preparing process, high drug encapsulation efficiency and small particle size.Compared with BTF suspension, BTF-NM can significantly improve the bioavailability of BTF in rabbit corneas.

Objective:To investigate the pharmacokinetics of econazole solid lipid nanoparticles (E-SLNs) after administration of one single dose in rabbit eyes.Methods:E-SLNs with 0.2% econazole was prepared by microemulsion method.Its antifungal activity against Fusarium isolated from the eyes of patients with fungal keratitis was evaluated in vitro and was compared with natamycin eye drops.Four healthy New Zealand white rabbits were assigned to the blank control group without any drug interference during the experimental period, and other matched 21 rabbits were randomized into 7 groups according to the specimen-collected time, with 3 rabbits in each group.E-SLNs of 50 μl was singly applied to conjunctival sac in both eyes in the 21 rabbits, and tear was collected using a filter paper at 5, 15, 30, 60, 90, 120 and 180 minutes following administration of the drug.The cornea specimen was collected at above-mentioned time points respectively.The drug levels in each sample were assayed by high performance liquid chromatography.The accuracy, recovery rate, stability and antifungal activity of the drugs in tear fluid and cornea were detected.This study protocol was approved by the Life Science Ethics Review Committee of Henan Eye Hospital (No.HENNCA-2017-22). Results:For the tear samples and corneal tissue samples, the relative standard deviation ( RSD) of the accuracy of the drug was 2.34%-4.04%; the stability analysis result showed that the RSD of the drugs was less than 10%.The 50% minimum inhibitory concentration (MIC 50) and 90% minimum inhibit concentration (MIC 90) of E-SLNs were 0.37 μg/ml and 0.89 μg/ml, respectively.The MIC 50 and MIC 90 of natamycin were 1.15 μg/ml and 1.70 μg/ml, respectively.After one single dose application of E-SLNs eye drops, the peak time of the drug in tears fluids and cornea of rabbits were 5 minutes and maximum concentrations in tears and cornea were 597.64 μg/g and 33.15 μg/g, respectively. Conclusions:The drug levels in tears and cornea achieved are higher than MIC against Fusarium.

OBJECTIVE: To investigate the effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus(PDA). METHODS: A total of 106 premature infants were enrolled in the study, including 35 PDA infants with hemodynamic changes (hsPDA group), 35 PDA infants without hemodynamic changes (non-hsPDA group) and 36 non-PDA infants (control group). Serum level of neuron-specific enolase (NES) was detected and craniocerebral ultrasound examination was performed on d3, d7 and d14 after birth. The correlation between blood flow rate of PDA and gray scale value of lateral ventricle was analyzed. RESULTS: Gray scale values of lateral ventricle and serum levels of NES in hsPDA group were higher than those in control group on d3, d7 and d14 (P<0.01), but no significant difference was observed between non-hsPDA group and control group (P>0.05). There was a positive correlation between the blood flow rate of PDA and gray scale value of lateral ventricle (r=0.876, P<0.01) in premature infants. CONCLUSION Patent ductus arteriosus with hemodynamic changes is closely related to white matter damage in premature infants, and early intervention is necessary.
Ductus Arteriosus, Patent ; complications ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Ultrasonography ; White Matter ; pathology

Objective: To explore the gene transduction method of chimeric antigen receptor (CAR) mediated by novel cationic polymer nanocarrier mPEG-P (Asp-AED-g-HFB) (PAEF) and PigyBac transposon system to modify natural killer (NK) cells, providing a new strategy for immunotherapy of cancer cells. Methods: PAEF/DNA (transposase+transposon) complex were prepared. The particle size distribution and surface potential of PAEF/DNA complexes were measured with Nano-ZSE Dynamic Light Scattering System (Malvern Instruments). The DNA encapsulation rate, release and stability of PAEF were evaluated by DNA gel electrophoresis, and then by combiningwithparticlesizeandsurfacepotentialtodeterminethepreferentialN/PratiotoenterNKcells.Thecell cytotoxicity of PAEF/DNA complexes under different N/P ratios was analyzed by CCK-8 cytotoxicity test. Transduction efficiency of NK cells was evaluated by Fluorescence microscopy and Flow cytometry, and the feasibility of PAEF gene transfection vectors was assessed. Results: PAEF could encapsulate DNA to form nano-complexes with the diameter of 100-150 nm, which was suitable to mediate DNA entering into cells. PAEF could completely encapsulate DNA with N/P ratio of 20. In the presence of reducing agent dithiothreitol (DTT), PAEF had a good ability to release DNA. NK-92 cells transfected with PAEF/DNA complex, which was formed at the N/P ratio of 80, attained a significantly higher cell viability than cells of lipofectamine transfection group [(72.50±3.9)% vs (64.03±1.8)%, P<0.05]; Fluorescence microscopic observation showed more fluorescence and higher fluorescence intensity in cells of PAEF/DNA group; Flow cytometry showed the highest transfection efficiency of 83.4%. Conclusions: Nanocarrier PAEF can encapsulate DNA well by electrostatic adsorption, and has good biocompatibility and high efficiency for gene transduction. It provides a good experimental basis for adoptive immunotherapy.