The author in this text discusses the right of replicating medical records from the angle of law,and puts forward his own viewpoint,that is for the objective medical records,patients can copy them in any time,but for the subjective ones,it just depends on the cases. Generally speaking patients don't have the copy right about them,but when medical treatment trouble occurs,the patients should have the copy right to copy the sealed and stored medical records.

BACKGROUND: Spleen is correlated with mitochondrion. The "spleen governs movement and transformation of food and liquids" in traditional Chinese medicine refers to not only the digestion and absorption of food in gastrointestinal tract, but also the process of biological oxidation and energy production of mitochondrion.OBJECTIVE: To analyze the effects of Si-Jun-Zi decoction (SJZD), a typical prescription for invigorating spleen and replenishing qi, on repairing the mitochondrial damage of cells of liver, myocardium, gastric mucosa and skeletal muscle in rats with spleen asthenia.DESIGN: A randomized controlled observation.SETTINGS: Second Department of Internal Medicine, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine;Guangzhou University of Traditional Chinese Medicine.MATERIALS: The experiments were carried out in the internal medicine laboratory, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and the testing center of Guangzhou University of Traditional Chinese Medicine from June to December in 2004. Forty SD rats were provided by the animal center of Guangzhou University of Traditional Chinese Medicine. Xiao Cheng-Qi decoction consisted of officinal magnolia bark, immature bitter orange and rhubarb according to the ratio of 3:3:2; SJZD consisted of radix codonopsitis pilosulae, largehead atractylodes rhizome, India bread and liquorice root according to the ratio of 2:2:2:1, and it was provided by the Department of Pharmacy, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,and made into 100% decoction.METHODS: After raised for 1 week, the SD rats were divided randomlyinto 4 groups: normal control group, spleen asthenia group, natural convalescence group and SJZD-treated group, and the rats in the latter three groups were made into models of long-term spleen asthenia. Rats in the normal control group were fed with normal chow, intragastric administered with saline (3 mL), once every other day for 34 weeks. Rats in the spleen asthenia group were intragastricly administered with Xiao Cheng-Qi decoction (3 mL) and fed every other day for 34 weeks, the rats in the natural convalescence group were fed with normal chow for 8 weeks after being treated as those in the spleen asthenia group for 26 weeks, and those in the SJZD-treated group were treated as those in the spleen asthenia group for 26 weeks, and then intragastricly administered with SJZD (4 mL, once a day) and fed with normal chow for 8 weeks. At the end of the 34th week,the rats were decapitated under anesthesia, and the skeletal muscle, liver,gastric mucosa and myocardium were taken out rapidly. The protein amounts in mitochondrial suspension were detected with the biuret method,the content of mitochondria in I g tissue was calculated according to the tissue mass, and the mitochondrial ultrastructures were observed under transmission electron microscope.MAIN OUTCOME MEASURES: The contents and ultrastructures of mitochondria in skeletal muscle, liver, gastric mucosa and myocardium were observed.RESULTS: All the 40 rats were involved in the analysis of results without deletion. ① At the end of the 34th week, the mitochondrial contents of skeletal muscle, liver, myocardium and gastric mucosa were all significantly lower in the spleen asthenia group than in the normal control group (P＜ 0.01), and markedly higher in the natural convalescence group than in the spleen asthenia group (P ＜ 0.05-0.01). The mitochondrial contents of the tissues were the highest in the SJZD-treated group, which were significantly higher than those in the spleen asthenia group and natural convalescence group (P ＜ 0.05-0.01), as well as the normal control group (P＜ 0.01). ② Comparison of mitochondrial ultrastructures in skeletal muscle,liver, gastric mucosa and myocardium at the end of the 34th week: In the spleen asthenia group, the mitochondria of myocardial cells were seriously swollen, the compact substance of hepatocellular mitochondria were decreased or disappeared and the crest disrupted; the mitochondria of skeletal muscle were shrunk and decreased, mitochondrial membranes were disorganized and crest disappeared, mitochondrial membranes were disorganized and crest disappeared; For gastric parietal cell of spleen asthenia,the amount of mitochondria reduced, inner structure confused, mitochondrial crestae of gastric chief cell was broken. In the natural convalescence group, the changes of the mitochondrial morphology were slight. The mitochondrial morphology in the SJZD group was close to those in the normal control group.CONCLUSION: SJZD has the effects of increasing the contents of mitochondria in skeletal muscle, liver, myocardium and gastric mucosa and repairing the damaged structure of mitochondria because of spleen asthenia.

Aim To explore the role of PI3 K/Akt/Sirt1 pathway in cardioprotection of hydrogen sulfide ( H2 S ) postconditioning against ischemia/reperfusion ( I/R) injury. Methods Langendorff perfusion appa-ratus was used to build an isolated rat myocardial I/R model. Isolated rat hearts were subjected to 30 min global ischemia followed by 60 min reperfusion after 20 min of equilibrium. 60 male SD rats were randomly di-vided into 5 groups(n=12):control group(Control), ischemia/reperfusion group( I/R) , H2 S postcondition-ing group( H2 S) , inhibitor LY294002 group( LY) and H2 S with inhibitor group( H2 S+LY) . The left ventric-ular diastolic pressure ( LVEDP ) , the left ventricular developed pressure(LVDP), the maximum rate of in-crease or decrease of left ventricular pressure ( ± dp/dtmax ) were registered at the end of 20 min equilibri-um, 30 and 60 min of reperfusion separately. Triphe-nyl tetrazolium chloride( TTC) staining was used to de-termine the myocardial infarct size. The levels of Sirt1 and PGC-1 mRNA were tested using real-time PCR. The expressions of Sirt1 and PGC-1αwere detected with Western blot analysis. Immunohistochemical method was used to determine the location of Sirt1 . Results There were no differences in equilibrium hemodynamics observed between the experimental groups(P>0. 05). At the end of reperfusion, compared with I/R group, H2 S group had obviously ameliorated functional recov-ery and significantly decreased the myocardial infarct size(26. 9 ± 4. 9)% vs(48. 9 ± 5. 6)%(P <0. 05). Meanwhile, the expression of Sirt1 and PGC-1α in-creased significantly. However,LY294002 reversed the cardioprotective effects provided by hydrogen sulfide postconditioning and reduced the level of Sirt1 and PGC-1α, the percentage of Sirt1-positive nuclei. Con-clusion PI3 K/Akt/Sirt1 signaling pathway mediates the hydrogen sulfide postconditioning-induced protec-tion against I/R injury.

Objective To explore the operation of C-type osteotomy for reduction of prominent zygomatic complex. Methods Based on the severity and characteristics of prominent zygomaitc complex, Ctype osteotomy was designed for the malar complex reduction by using oral and minor pre-auricular approaches under general anaesthesia. Two paralleled osteotomic lines of C-type were marked from zygomatic alveola to the conjunction of lateral orbital margin and zygomatic arch through the inferio-lateral edge of orbit. The extension of zygomatic arch reduction was determined the width of two osteotomic lines. The bone which marked lines was removed by reciprocating saw and osteotome. The zygomatic arch root was osteotomiced by pre-auricular approaches. Then, the zygomatic complex could move freely towards superior-medial position. Finally, the zygoma was fixed with titanium mini-plates. Results 12 patients with prominent zygomatic complex had been successfully operated by C-type osteotomy from July 2006 to April 2009. Of them, six cases were symmetrical and six cases were unsymmetrical. Postoperative follow-up for 4-24 months, infection was not occurred, and the scar of pre-auricular incision was not obvious. All the patients obtained positive results. Conclusion C-type osteotomy for correction of prominent zygomtic complex through intra-oral and minor pre-auricular approach is an effective surgical method and gives superior results. It preserves the intactness of maxillary sinus, prevents facial slack, and is especially effective for patients with prominent zygomatic arch.

Objective To compare the prevalence of patent foramen ovale (PFO) in young and middle-aged patients with cryptogenic ischemic stroke (CS) and in normal population.Methods The casecontrol study included consecutive 318 young and middle-aged patients with CS and 336 normal control subjects with matched age and sex for group comparisons.Stroke risk factors including hypertension,diabetes mellitus,hyperlipidemia,ischemic heart disease,atrial fibrillation,carotid atherosclerosis plagues and smoking,etc.were studied.Transesophageal echocardiography (TEE) were performed to detect the presence of PFO.The prevalence of PFO and difference of risk factor levels between the groups was compared.Then the odds ratios (OR) of a PFO was estimated in CS patients versus control subjects.Results The prevalence of PFO was significant higher in patients with CS than in control subjects (145/318,45.6 ％ versus 46/336,13.7％,P ＜0.001).The odds ratio(OR) for PFO in CS for patients versus control subjects was 5.3 (confidence interval,3.6 to 7.8).The mean size of PFO was larger in stroke group than that in control group (P ＜ 0.001).There were no significant differences in levels of other stroke risk factors between two groups.Conclusions PFO may play an important role in etiology of CS in young and middleaged adults.Larger and longer PFOs may be more concomitant with ischemic attacks.More efforts should be employed in patients with CS to detect PFO for further treatment.

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.

CD4+CD25+ Regulatory T cells (Treg) have been found to down-regulate immune activation in HIV-1 infection. However, whether the depletion of Treg benefits to the disease status of HIV infection remains undefined. To address this issue, we enumerated the Treg absolute counts and frequency in 75 antiviral-na(i)ve HIV-1-infected individuals in this study. It was found that HIV-infected patients displayed a significant decline in Treg absolute counts but a significant increase in Treg frequency. In addition, with disease progression indicated by CD4 T-cell absolute counts, circulating Treg frequency gradually increased; while Treg absolute counts were gradually decreased, suggesting that the alteration of Treg number closely correlated with disease progression in HIV infection.Functional analysis further showed that Treg efficiently inhibit both CD4 and CD8 T cell proliferation in vitro. Thus, our findings indicates that Treg actively participate in pathogenesis of chronic HIV infection,influencing the disease progression.

Objective:To compare outcomes between standardized and misdiagnosis and mistreatment of osteosarcoma.Methods:A retrospective analysis of patients with high-grade osteosarcoma who received appropriate surgical treatment and chemotherapy (299 cases, control group) and those who were misdiagnosed (benign or infective) and received mistreatment (23 cases, study group) between January 2009 and December 2021. Gender, age, first operation mode, recurrence time, recurrence interval, metastasis time, metastasis interval, total survival time (months), survival status in the two group and tumor site reoperation mode in the study group were statistically analyzed. Further, chi-square test was performed for comparison of the clinical between two groups. The survival analysis was performed using Kaplan-Meier test and Log-rank test.Results:All the 322 patients were followed up. In the control group, the average follow-up time was 42 months (1-137 months), the average age was 24 years (3-80 years), male 184 cases, female 115 cases, and limb salvage rate was 85.3% (255/299). Seven patients underwent amputation, and the amputation rate was 17.7% (44/299). The recurrence rate was 8.4% (25/299), the average recurrence interval was 22.8 months (7-36 months), and the metastasis rate was 28.1% (85/299), the average metastasis time was 32.7 months (0-58 months). In the study group, the average of follow-up time was 30 months (9-117 months), the average age was 36 years (5-67 years), 17 males and 6 females. Among them, eleven patients were treated with limb salvage in the second stage, and the limb salvage rate was 47.8% (11/23). Seven patients underwent amputation, and the amputation rate was 30.4% (7/23). The recurrence rate was 26.1% (6/23), the average recurrence interval was 11 months (1-42 months), and the metastasis rate was 43.4% (10/23), the average metastasis time was 20.3 months (1-44 months). The 5-year survival rate was 50.7% in the study group and 56.1% in the control group. There was no significant difference between the two groups (χ 2=0.09, P=0.760). Conclusion:The overall prognosis of patients with high-grade osteosarcoma who receive active treatment after mistreatment is similar to that of patients with standardized treatment, but the recurrence and metastasis rate is higher, the recurrence time is earlier, and the amputation rate is higher.

Acute and chronic wounds seriously threaten patients' life health and quality of life, therefore, wound repair has become a hot topic of research for scholars at home and abroad in recent years. With the development of material science and tissue engineering, more and more biomaterials prepared from natural ingredients were used in basic research and clinical treatment of wound repair. Such biomaterials can be used as templates for wound tissue regeneration to induce autologous cell adhesion and migration, and promote the deposition of extracellular matrix, which have broad clinical application prospects. This paper reviews the characteristics and application advance of natural biomaterials which are popular in the field of wound repair, aiming to provide ideas for the research and development of new wound dressing and tissue engineering skin.

Background and purpose:Hepatocellular carcinoma(HCC)is a major disease seriously threatening human health.Poly(ADP-ribose)polymerase-1(PARP1)is an enzyme that catalyzes poly ADP-ribosylation.Given the role of PARP1 in DNA damage repair,it is generally considered as an oncogene.However,the expression of PARP1 and its mechanism in HCC are not yet clear.This study aimed to investigate the role of PARP1 in the occurrence and development of HCC and its potential mechanisms.Methods:First,we analyzed the expression pattern of PARP1 in The Cancer Genome Atlas(TCGA)and Clinical Proteomic Tumor Analysis Consortium(CPTAC)HCC database,and identified the expression trend of PARP1 in our HCC cohort using real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR)and Western blot.Then,the enzyme activity of PARP1 was inhibited by PJ34,an inhibitor of PARP1 and the expression of PARP1 in HCC cell lines was downregulated with small RNA interference technology.Based on these models,the following experiments were conducted:First,the effect of PARP1 on cell viability was assessed by cell counting kit-8(CCK-8)assay and flow cytometry;Second,the expression levels of stemness-related genes in HCC cells were identified using RTFQ-PCR;Third,the effect of inhibition of PARP1 on migration and invasion of HCC cells was detected by migration and invasion assay(transwell assay).Finally,bioinformatic analysis was performed to identify new target genes and the pathways regulated by PARP1 in HCC progression.Rescue experiments were performed to determine whether PARP1 target genes were involved in the malignant phenotypes of HCC cells.Results:The expression of PARP1 was significantly up-regulated in HCC tissues in both TCGA and CPTAC database.RTFQ-PCR and Western blot assays showed that PARP1 was obviously up-regulated in HCC tissues compared to paracancerous tissues.Survival analysis showed that PARP1 expression was significantly negatively correlated with the prognosis of patients.The results of CCK-8,flow cytometry,RTFQ-PCR and transwell assay indicated that inhibition of PARP1 attenuated proliferation and activity of HCC cells,as well as weakened their stemness,migration and invasion.Bioinformatics analysis suggested that PARP1-regulated genes were enriched in the nuclear factor-κB(NF-κB)and necroptosis pathways,with POU class homeobox 2(POU2F2)potentially being a target gene of PARP1.Correlation analysis,along with RTFQ-PCR and Western blot detection,confirmed that the expression of POU2F2 was regulated by PARP1,while not affected by PJ34,indicating the effect of nonenzymatic function of PARP1 on POU2F2.CCK-8,flow cytometry and RTFQ-PCR results showed that the reintroduction of POU2F2 enhanced proliferative capacity,increased activity,and promoted stemness of HCC cell lines with PARP1 knockdown.Conclusion:By positively regulating the expression of POU2F2,PARP1 promotes malignant phenotypes of HCC cells,providing new insights for clinical treatment and drug development for HCC.