At the beginning, this paper introduced the concept of merit in folk medicine simply. Secondly, the situation that although the healer cure but with no contribution is introduced to analyze the reason. Finally, it discussed the characteristics of the doctor-patient relationship based on treatment effect of Ming dynasty and realis-tic enlightenment to current doctor-patient relationship:the industry has threshold, general knowledge should be unbounded;the responsibility has expanded, merit must be clarify;rights are in the ascent, exercising right should be in accordance with the laws;the rules are very important, later supervision is also needed.

BACKGROUND:Tissue-engineered skin is a new method to cure the massive defects of skin caused by burn or trauma.Therefore, the seed cells and scaffold on the tissue-engineered skin have become the focus today.DATA SOURCES: A computer-based online search of Pubmed database was undertaken to identify the articles about tissue-engineered skin published in English between January 1990 and January 2007 with the key words of "tissue engineered skin, stem cell". Meanwhile, we searched Chinese Journals Full-text Database for related Chinese articles published between January 1994 and January 2007 with the key words of index "tissue engineered skin, skin stem cell" in Chinese.STUDY SELECTION: The data were selected firstly to choose the full-text of articles met the criteria. Inclusive criteria:① Articles about seed cells of tissue engineered skin;②Articles about the scaffold of tissue-engineered skin. Exclusive criteria: Repetitive or analogical articles, Meta analysis or case reports.DATA EXTRACTION: Totally 97 articles on tissue-engineered skin were collected and 69 met the inclusive criteria after eliminated the repetitive or similar studies.DATA SYNTHESIS: The development of tissue engineering provides a new approach for the treatment of massive defects with skin transplantation, and gets rid of some problems such as donor site shortage, immune rejection, disease spread et al.① Skin seed cell: Embryonic stem cell and various adult stem cells can serve as seed cell of tissue-engineered skin, and embryonic stem cell is the first choice, which is transplanted on the biological scaffold to acquire the epidermis, dermis and compound skin.②Research progress of epidermis substitute.③Methods to make dermal substitute.④Research direction of compound artificial skin.⑤There are many problems in wide clinical application of tissue-engineered skin, but more and more attention has been paid on its research.CONCLUSION: Tissue-engineered skin is the best choice to cure the massive defects of skin and has a wide clinical prospect. With the rapid development of life science, operation technology, material science and many other related subjects, the ideal tissue-engineered skin can be obtained with similar function and feature to natural skin.

Objective To study the effect of nebulized inhalation of ipratropium bromide and ambroxol hydrochloride (mucosolvan) on pulmonary function in elderly patients who need thoracotomy.Methods From June 2011 to December 2011,a total of 60 elderly patients undergoing thoracotomy were randomly divided into 2 groups:the treatment group (n =30) and control group (n=30).The patients in treatment group were treated with ipratropium bromide 0.5 mg and mucosolvan 15 mg diluted in 5 ml saline for inhalation with an oxygen flow rate of 6 L/min,15 min,3 times/d,and the patients in control group were treated with ipratropium bromide 0.5 mg diluted in 5 ml saline for inhalation with an oxygen flow rate of 6 L/min,15 min,3 times/d.The resting lung function in patients was measured before nebulization treatment.After 3 days treatment,the resting lung function was measured again,and vital capacity (VC),forced expiratory volume in one second (FEV1),FEV1 ％,maximal voluntary ventilation (MVV) were recorded.Results After 3 days treatment,the indicators of lung function including VC,FEV1,FEV1 ％,MVV were significantly increased in both groups (P＜0.01).The increase in VC,FEV1,FEV1 ％,MVV were significantly higher in the treatment group [(0.39±0.08)L,(0.20±0.10)L,(10.61±4.66)％,(10.24±5.07)L,respectively] than in control group [(0.31±0.05)L,(0.13±0.06)L,(7.40±3.89)％,(6.76±3.70)L,respectively] (t=4.81,3.64,4.13,3.48,all P＜0.05).The incidence of postoperative pulmonary complications was lower in treatment group[16.7 ％ (5/30)] than in control group [30.0 ％ (9/30)] (x2=11.45,P＜0.05).Conclusions The nebulized inhalation of ipratropium bromide and ambroxol hydrochoride can improve the lung function in elderly patients undergoing thoracic surgery,better withstand the thoracotomy and decrease the incidence of postoperative pulmonary complications.

Objective: To investigate the activity of coagulation and fibrinolysis systems in bronchoalveolar lavage fluid (BALF) in lung fibrosis in rats, and to study their role in diagnosis of lung fibrosis. Methods: Thirty-six Sprague-Dawley rats were randomly divided into 2 groups (n=18 in each group ). Lung fibrosis and control models were made by tracheal instillation bleomycinA_5 (BLMA_5) (5 mg/kg) and saline. On days 7, 14 and 28, the recalcification time points of normal pooled plasma for studying procoagulation activity (PCA), the levels of von Willebrand Factor (vWF), the activities of Antithrombin-Ⅲ(AT-Ⅲ) , plasminogen activity inhibitor-1 (PAI-1) and urokanise-type plasminogen activator(uPA) in BALF were measured respectively. Results: (1) In BLM group,the recalcification time points in BALF were (56?10), (78?3) and (172?11) seconds respectively, they were (190?10), (186?8) and (184?6) seconds respectively in control group. The difference was significant(P

Objective To discuss mammographic findings and pathologic foundation of the fat necrosis of the breast and to improve the imaging diagnosis of the fat necrosis of the breast. Methods The mammographic findings of 91 cases with pathologically proved breast fat necrosis were retrospectively analyzed, of which 2 cases were bilateral breast fat necrosis, and a comparison with pathological results was made. Results The mammographic findings included (1)No abnomal mammographic findings (n=14, 15.4%);(2) Single and multiple lipid-cysts (n=6, 6.6%);(3) Masses (n=20, 22.0%), of which 1 case was bilateral breast mass;(4) Nodules (n=13, 14.3%);(5) Focal opacities like stars or pieces in the subcutaneous fat layer (n=28, 30.8%), of which 1 case was bilateral breast lesion;(6) Faint reticular opacity in the subcutaneous fat layer (n=5, 5.5%);(7) Structure distortion (n=5, 5.5%). The location of the liesions:(1) 55 lesions located in fat layer;(2) 13 lesions standed out to the fat layer or located the boundary of the fat layer and breast parenchyma. When routine mammography demonstrated the disease located the boundary of the fat layer and breast parenchyma, there will be helpful with tangent location mammography to show the disease in the subcutaneous fat layer;(3) 9 lesions located in the breast parenchyma;(4) 14 lesions did not find abnormity in the mammography. The pathologic appearance (1) A lipid cyst is the characteristic mammographic finding in the early stage of the lesion;(2) Asymmetry density masses or nodules in the subcutaneous fat layer is the characteristic mammographic finding in the metaphase stage of the lesion, which hinted necrotic fatty tissue gradually be replaced by fibrous tissue;(3) Focal opacities like stars and irregular reticulation findings in the subcutaneous fat layer or superficial layer adenoid tissues are the characteristic mammographic findings in the later stage of the lesion, which hinted that necrotic fatty tissue was licked up, circumference remained some fibrous tissue.The mammographic findings of the different pathological stages often appear in the same time. Conclusion The mammographic findings of fat necrosis of breast was different in its different stage. The mammography is very helpful for making the diagnosis of breast fat necrosis.

This article was aimed to study the effect of pinellia combined with prunella vulgarisin of different ratios on the extraction yield of trigonellin and uracil, in order to investigate the changing disciplines and reasonable com-bination of Shuangxia Soup. A Welch Ultimate AQ-C18 column (4.6 mm×250 mm, 5 μm) was used in the study. The mobile phase, consisting of solvent A (water) and solvent B (acetonitrile) was programmed as a linear gradi-ent. The flow rate was 1.0 mL·min-1. And the detection wavelength was 265 nm. The column temperature was 25℃. HPLC was used in the determination of extraction yield of trigonellin and uracil for the comparison among different compatibilities. The results showed that the linearity was achieved in the range of 0.872-4.36 ng for trigonelline, and 10.8-50.4 ng for uracil. The average recoveries were 96.53%-101.48%, with RSD of 0.18%-4.26%. Com-pared with pinellia, the extraction yield of trigonelline was reduced and the extraction yield of uracil was increased after the compatibility. It was concluded that different compatibilities of Shuangxia Soup had effects on the extrac-tion yield of trigonelline and uracil. The best compatibility ratio still requires in-depth study.

Objective To discuss the value of the mammography in the diagnosis of ductal carcinoma in situ (DCIS) and guidelines ofthe operation.Methods 107 pathologically proved DCIS were retrospectively reviewed.Results There were 62 microcacifications(57.9%),the range of microcacifications was varied , of them,13 were masses or local compact with microcacifications ; 17 were localized infiltration and bad structure (15.9%);20 were masses (18.7%) ;1 papillae enhancement (0.9%),7 were normal(6.5%).Conclusion Multiplicity microcacifications are the most frequently appearance of X-ray in DCIS;mammography could find the early microcarcinoma and the early carcinoma , especially the DCIS ; mammography could exactly reflect the multifocus , it is of value in confirming the range of the operation.

OBJECTIVE: To strengthen the standardized management in dispensary for outpatients,ensure drug quality and medication safety. METHODS: Systemic regulatory system and the operation rules which included the detailed management regulations,work procedure,division of labor of post and management system of different category of drugs etc were established. RESULTS & CONCLUSION: The institutionalization and standardization of the management contributed to the standardization of personnel's behavior,reduction of conflicts between pharmacists and patients,enhancement of patients' trust degree and satisfaction,and the medication safety of patients.

Background and purpose:As a member of the catenin family, Delta-catenin protein could promote proliferation and invasion of tumor cells, but the accurate mechanism of Delta-catenin promoting cell proliferation is not clear. In the present study, we illustrated that Delta-catenin’s effect on cell apoptosis and their relationship with mitogen-activated protein kinase (MAPK) signaling pathway, and the possible mechanism was also explored for Delta-catenin promoting invasion and proliferation of tumor cells. Methods:The alterations of p38 and c-jun N-terminal rinasel JNK protein activity were detected in SPC and SK lung cancer cell lines with Delta-catenin overexpression or not, by Western blot method. At the same time, the apoptotic number of tumor cells was also examined by FCM method. Furthermore, the number of invasive tumor cells was examined by Matrigel invasive experiment. Results:Compared with untreated group and empty vector group, the activity of p38 protein was unchanged in lung cancer cell lines with Delta-catenin overexpressed (P>0.05), but the activity of JNK protein was decreased signiifcantly (P<0.05),meanwhile, apoptotic proportion of tumor cells were also reduced (P<0.05), and invasive ability of tumor cells was enhanced signiifcantly (P<0.05). Conclusion:Delta-catenin probably decreases apoptosis number of lung cancer cells via inhibiting the activity of JNK pathway, and then promotes invasive ability of tumor cells.

Objective To gain accurate imaging i nformation of biliary tract after surgery. Methods The biliary tract of 170 cases after s urgery had been observed dynamically from different directions for longer time. The results of data on biliary tract change were stored in disc, or picture. Results Of 170 cases, 120 cases were cured with out any abnormal change on cholangiography, and then the T-tube was removed. Of another 50 cases, 30 cases revealed remnant stone on cholangiography, 9 cases s howed inflammatory stricture of biliary tract, 4 cases displayed common bile duc t tumor, and 7 cases had false filling-defect. Then, the results were further c onfirmed by sonography, CT, choledochoscopy, and operation. Conclusion The dynamic observation of biliary tract by T-tube cholangiography after surgery is usual way that is handy, pract ical, painless, and economic.