Objective To search the way of prolonging xenograft survival of discordant cardiac xenotransplantation.Methods All animals were divided into groups A,B,C and D receiving the following combined therapies respectively:cobra venom factor (CVF) in group A,CVF and pentoxifylline (FTX) in group B,CVF and CCS (CsA,CTX,MP)in group C,CVF,PTX and CCS in group D.The recipients were given CVF 150 μg/kg(i.P) twice daily 1,4 days before transplantation;PTX 50 mg/kg daily(i.P)1 h before transplamtation,then 25 mg/kg(i.P)in an interval of 6 h until rejection thereafter;CsA 10mg/kg(i.p) daily one day and 1 h before transplantation until rejection;CTX 40 mg/kg(i.p) one day before transplantation,then 10 mg/kg(i.P)daily 1 h before transplantation until rejection thereafter;MP 10 mg/kg(i.v)1 h before transplantation,then 1 mg/kg(i.m) daily until rejection thereafter.The expression of vascular cell adhesion molecular-1 (VCAM-1) of vascular endothelial cells (EC) in cardiac xenografts was detected by using immunohistochemical staining method.Results The mean survival time of cardiac xenografts was 57.5 h (group A),77.38 h(group B),79.13 h (group C) and 98.75 h(group D),respectively.Twenty-four h after transplantation.VCAM-1 expression in the groups B and D was not upregulated,but slightly up-regulated in group C and obvious in group A.At rejection,the up-regulation of VCAM-1 expression was mildest in group D and most obvious in group A.and VCAM-1 expression in group B was milder than that in group C (P＜0.05).Conclusions CVF combined with PTX and CCS could significantly prolong the survival time of cardiac xenograft.PTX mainly protected EC and CCS mainly inhibit inflammatory cell infiltration.Combined use of them could complement and reinforce mutually.

At present,due to the loss of humanities concern among hospitals,a series of negative issues including utilized and non-humanized physician-patient relationship have seriously hindered hospitals' survival and further development,and their role in social development.Therefore,it is necessary to discuss medical humanities concern in order to display its expected function and reconstruct a harmonious physician-patient relationship.

Constrained by traditional ethical concepts and medical reality,the hospice,as a new field of medical service,falls into a predicament in China.In order to get rid of the predicament at present and promote the construction of a harmonious socialist society,it is of great significance to comb,analyze and discuss the content,origins and development of the hospice,so as to seek a universal path for the future development of hospice.

The scientific spirit and humanistic spirit of medical staff are integrated originally.However,they are separated by many historical and realistic reasons,which result in the deterioration of doctor-patient relationship and doctor-patient conflict continuously.Facing the urgent call for the medical humanities spirit,it is an important topic to probe the scientific connotation of medical humanistic spirit,its lost cause and the return solution of it in the development of modern medicine.

Objective To investigate the effects of Dangshen (DS) extract saponins alleviating apoptosis in ischemia-reperfusion injury (I/R) of renal grafts and the mechanism. Methods The I/R injury model in SD rats was established after kidney transplantation. The SD rats were randomly divided into the following 3 groups (n = 20): sham operation group, I/R model group, DS saponin intervention group. Blood urea nitrogen (Bun) and creatinine (Scr) levels were determined at the 24th h after operation; apoptosis index (AI) was detected by using TUNEL method; the expression of Bcl2 and bax mRNA was detected by RT-PCR. Results As compared with the sham operation group,the blood Bun and Scr levels were significantly increased in the I/R model and DS saponin intervention groups (P＜0. 05). As compared with the DS saponin intervention group, the blood Bun and Scr levels were significantly increased in the I/R group (P＜0.05). The AI was significantly increased in the I/R model group and DS saponin intervention group. After DS saponin intervention, the AI was decreased from 40. 28 % in the I/R model group to 28. 45 % in the DS saponin intervention group (P＜0. 05). The expression of Bcl-2 mRNA in DS saponin intervention group and I/R model group was significantly decreased as compared with the sham operation group (P＜0. 05), but that of Bax mRNA was significantly increased in the I/R model group and DS saponin intervention group as compared with the sham operation group (P＜0. 05). After DS saponin intervention, the expression of Bcl-2mRNA was increased from 0. 25 in the I/R model group to 0. 391 (P＜0. 05), and that of Bax mRNA was decreased from 0. 565 in the I/R model group to 0. 473 (P＜0. 05). Conclusion DS extract saponin could significantly alleviate apoptosis in the I/R injury of renal grafts possibly by up-regulating the expression of Bcl-2 mRNA and down-regulating the expression of Bax gene.

Objective To evaluate the therapeutic effect of minimally invasive retractor reduction and fixation through sinus tarsi approach together with external application of Chinese medicine for displaced intra-articular calcaneal fractures. Methods From October of 2009 to June of 2013, 52 patients with displaced intra-articular calcaneal fractures (Sanders type Ⅱ, Ⅲ) were enrolled into the study. The patients received minimally invasive retractor reduction through sinus tarsi approach and fixation with small plate and cannulated screws, and after the operation were given external washing with Chinese herbal formula Shenxing Fang ( mainly composed of Herba Lycopodii, Herba Speranskiae Tuberculatae, Rhizoma Sparganii, Rhizoma Curcumae, Herba Asari, Radix Aconiti Preparata, Radix Aconiti Kusnezoffii Preparat). Follow-up was carried out for the evaluation of the therapeutic effect of displaced intra-articular calcaneal fractures ( Sanders type Ⅱ, Ⅲ). Results Forty cases (involving 44 feet) received the postoperative follow-up for 12-18 months (average being 14.2 months). The Maryland foot scores were 95 points for type Ⅱ displaced intra-articular calcaneal fractures, and 86 points for type Ⅲ fractures. Satisfactory results were achieved in the height, width and length of the calcaneus as well as the B?hler's and Gissane angle ( P<0.01). Conclusion Minimally invasive retracter reduction and fixation through sinus tarsi approach together with external application of Chinese medicine exert satisfying effect for the treatment of displaced intra-articular calcaneal fractures.

Objective To summarize the experiences of diagnosis and treatment of dermatofibrosarcoma protuberans (DFSP). Methods The clinical data of 16 patients with DFSP were analyzed retrospectively. All the patients with DFSP underwent extensive tumor resection (3～5cm margin from the tumors).Free full-thickness skin flap transplantations was performed on 6 cases , three cases received skin flap shifting operations, and 1 patient with abdominal wall deficiency was repaired by artificial mesh . Results All the 16 patients presented as painless cutaneous nodules which enlarged slowly, but the majority of the tumors grew quickly in recent shorter time. Ten cases were primary tumors, and six were recurrence. The time of recurrence after surgery ranged from 3 months to 10.5 years with 1～3 times recurrence. There was no operative complications. Eleven patients were followed-up for 1～11 years and all survived,only one patient developed tumor local recurrence seven years after surgery. Conclusions A slowly enlarged painless cutaneous or subcutaneous nodules quickly growing in recent time is the clinical characteristic feature of DFSP. Extensive tumor resection is the treatment of primary DFSP.

Objective: To study the effects of glutamine on heat shock protein 70(Hsp70) expression and immune in patients with acute cerebral infarction.Methods: 60 patients with acute cerebral infarction were randomly divided into 2 groups,the control group(n=30) and the glutamine group.Patients in glutamine group were supplemented intravenously with alanyl-glutamine during 24 hours after hospitalization.Other treatments were the same as in the control group.Serum Hsp70 concentrations,immune parameters,and infection rates were compared.Results: The serum Hsp70 level,the immune globulin level,the CD4+ cell and CD4+/CD8+ in the glutamine group were significantly higher than those in the control group(P

Objective To analyze the characterization of cognitive function in Parkinson's disease with dementia and Alzheimer's disease. Methods Cognitive function was examined in Parkinson's disease with dementia (PDD) patients ( n = 30) , Alzheimer's disease (AD) patients ( n = 30) and healthy elderly control subjects ( n = 60) . Neuropsychological evaluation contained semantic fluency test, phonemic fluency test, action fluency test, objective and action naming tests. Results In PDD group , the score of semantic fluency test is 9. 33 ±2. 78, 6. 17 ± 1.67 of phonemic fluency test and 7.03 ±2. 34 of action fluency test,it is 6.90 ±2.47, 7.87±2.01,8.30±3. 17 of AD group. The score of objective and action naming tests is 36.33 ±3.39, 17.63 ±2. 17 in PDD group,while AD patients is 33.23 ±3.56 and 22.33 ±2.37. The verbal fluency tests and naming tests were impaired in PDD and AD patients compared with the healthy elderly control group (P ＜ 0. 01 ), phonemic fluency, action fluency and action naming were more impaired in PDD patients compared with the AD group , while semantic fluency and objective naming were more impaired in AD patients (P ＜ 0. 01 ). Conclusions Executive function deficit and naming impairment are found in PDD and AD patients, it shows that PDD is characterized by the addition of cortical dysfunction upon a predominant and progressive fronto-subcortical impairment. There is subcortical dysfunction in AD patients.

Objective To determine the prevalence of microembolic signals (MES) by using transcranial Doppler (TCD) and to assess their association with neuropsychiatric systemic lupus erythematosus (NPSLE) and clinical presentations in patients with systemic lupus erythematosus (SLE).Methods Forty-four patients with SLE underwent TCD for 30 min were included for MES detection and their clinical information were recorded.In addition to the frequency of patients with MES,patients with MES were followed-up for sixmonth.Mann-Whitney U test and Fisher exact test were applied to investigate the clinical characteristics.Results There were 4 patients with history of NPSLE and the occurrence times were from 8 to 120 month before our study.There were 4 patients had the abnormal neuropsychiatric symptom during our study period.MES were detected in 5/44 patients (11％) with mean 17.6 per 30 min.MES were more prone to be detected in patients with higher systemic lupus erythematosus disease activity index (SLEDAI) score [16(12.5,19) vs 8(5,10),U=14.5,P=0.001],shorter course of disease [1(0.1,48.5) vs 26(13,55),U=38,P=0.028] and neuropsychiatric symptoms [3 vs 1,P=0.003].Conclusion MES may be detected in SLE patients.MES is associated with higher disease activity,shorter course of disease and NPSLE.TCD microemboli detection may be a noninvasive method to evaluate NPSLE patients.