Humanistic quality of medical workers directly affects the quality of medical service and patient satisfaction.In view of patient′s value demand,this paper identified main setbacks in humanistic service in China in the course of medical service.The authors found out the reasons for the lack of humanities quality,and interpreted medical humanistic spirit,medical professional spirit,medical ethics and morality,and connotation of medical law culture.On such basis,the paper unveiled the importance of medical humanities accomplishment in medical practice and medical students′training,proposing to promote the concept of humanistic spirit of medicine and the doctor-patient communication skills.

Objective To study the effects of traumatic brain injury with or without hypotension on the development and severity of brain edema using the impact- acceleration model.Methods Brain tissue water content (BWC) was measured by the gravimetric technique in the cortex and striatum following traumatic brain injury (TBI) . The hypotension was induced by the combination of α - chloralose and pavulon after TBI.Results The mortality of this improved model of TBI was 48.6 %, but the rate of skull fracture was 6.4 %. Within the first 24 hours after TBI, the BWC of cortex and striatum in the survival rats showed a slight decrease at first, and then an increase. There appeared no difference in BWC between the two groups of TBI and the control. Nevertheless, the BWC in the area of parietal cortex at 24 hours after impact injury slightly increased by 0.5 % in comparison with that at 8 hours after impact [ (79.1 ± 0.5) % vs. (78.6 ± 0.5) %, P ＜ 0.05]. Meanwhile,the BWC of striatum didn't show the difference. However, while TBI was associated with hypotension, the BWC of both parietal cortex [ (81.5±0.9)% vs. (78.6±0.5)%, P＜0.001] and striatum [ (78.5±0.9)% vs. (75.5±0.9)%, P＜0.001) were significantly increased, by comparison with survival rats at 8 hours after impact. Moreover, the amplitude of increase in BWC achieved about 2.9 %.Conclusion The rats, suffering TBI without hypotension, presented the slight brain edema at the relatively late stage; by contrast, the rats,suffering from TBI with hypotension, had severe brain edema at the early stage.

Objective The aim of this study was to explore possible pharmacokinetic factors and develop a population pharmacokinetic model for remifentanil in adult patients.Methods Eleven healthy patients,undergoing elective major abdominal surgery,aged 25 to 86 years,received random-ly remifentanil 0.3μg·kg-1 ·min-1 (group R3),or 0.6μg·kg-1 ·min-1 (group R6).Frequent ar-terial blood samples were drawn according to predetermined time and assayed for remifentanil concen-tration.Nonlinear mixed-effects modeling (NONMEM)was used to evaluate the time courses of the measured concentrations.The covariates include age,bodyweight (WT),gender,lean body mass (LBM),body mass index (BMI)and body surface area (BSA).Results The pharmacokinetic data of remifentanil were well described using a three-compartment linear model with first-order elimination from the central compartment.Forward analysis showed that age,height and body mass index (BMI) does not affect the pharmacokinetic parameters,which are contrast with body weight,lean body mass (LBM),body surface area (BSA)and gender;further analysis demonstrated only a significant effect of body weight on remifentanil systemic clearance (CL)and volume of the central compartment (V). For typical 60 years patients,PK parameters were:V1 =7.64 L,V2 =4.81 L,V3 =4.34 L,CL1 =2.74 L/min,CL2 = 0.738 L/min,CL3 = 0.0905 L/min.Conclusion The pharmacokinetics of remifentanil is consistent with its rapid elimination by blood and tissue esterase in Chinese patients. The systemic clearance and volume of distribution of central compartment increases with body weight in the population and the range of covariates studied,which suggests that a patient with greater body weight needs a greater initial dose and maintenance infusion rate higher to obtain a stable plasma con-centrations and clinical effects.

Objective · To explore the effects of brisk walking on blood pressure, body mass index (BMI), and autonomic nerve activity of male elderly with hypertension in community-based health centers in Shanghai. Methods · A total of 630 elderly men received brisk walking treatment (>10000 steps/d) voluntarily, who were selected from six community-based health centers in Pudong New Area of Shanghai. Among them, 210 people stick to training for 12 weeks. According to whether suffering from hypertension, the people were assigned to hypertension intervened group (intervention group, n=110) and normal intervened group (control group 1, n=100). Blood pressure, BMI, heart rate and autonomic nerve activity before and after the training were compared. Results · After 12 weeks of training, systolic blood pressure (SBP), diastolic blood pressure (DBP) and sympathetic nerve activity of intervention group were significantly lower than those before the training (P<0.05). SBP was also significantly lower than control group 2 (P<0.05). However, heart rate, BMI, parasympathetic nerve activity and baroreceptor reflex sensitivity did not change significantly after the training (P>0.05). Conclusion · Brisk walking treatment lasting for 12 weeks can decrease blood pressure and sympathetic nerve activity in elderly men with hypertension. It is worthy to be popularized in the community.

Sixty male rats divided into the control and the gelatin group were fed with 20% protein synthetic diet. The diet for the former group contained 24% casein, whereas for the latter 11% gelatin and 12% casein. , Having been fed for some days, all rats were irradiated with 875 rad (LD85-90). The main results were summarized as follows;1. The gelatin group had higher survival rate than the control group. 2. The body weight of gelatin group was less declined than that of control group and then much restored than the latter. 3. The survival time of dying rats within 14 days following the exposure to 875 rad in gelatin group was more longer than that in control group. 4. The gelatin group had less biological lesions than the control group.It was suggested that the gelatin diet had distinctly prophylactic-therapeutic action on acute radiation damage and its mechanism was probably related to the prevention from disturbance of collagen metabolism.

Objective To evaluate the efficacy of pressure-controlled volume-guaranteed (PCVVG) mode for lung protective ventilation in patients requiring one-lung ventilation (OLV) during thoracoscopic surgery.Methods Sixty patients,aged 50-70 yr,with body mass index of 18-26 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical resection of esophageal cancer performed via video-assisted thoracoscope under general anesthesia,were divided into 2 groups (n=30 each) using a random number table:volume-controlled ventilation group (group V) and PCV-VG group (group P).The ventilator settings were adjusted,with a tidal volume 10 ml/kg and respiratory rate 10-12 breaths/min during two-lung ventilation,and with a tidal volume 6 ml/kg and respiratory rate 12-16 breaths/min during OLV.The inspiratory/expiratory ratio was 1 ∶ 2,pressure restriction was 35 cmH2O,and 33％ oxygen was inhaled at 2 L/min.The end-tidal pressure of carbon dioxide was maintained at 35-40 mmHg.Visual analog scale score was maintained ≤ 3 after operation.After admission to the operation room (T0) and at 1,3 and 7 days after operation (T1-3),forced vital capacity (FVC),forced expiratory volume in first second (FEV1),and maximal mid-expiratory flow (MMEF) were measured,arterial blood samples were collected for blood gas analysis,arterial carbon dioxide partial pressure and arterial oxygen partial pressure (PaO2) were recorded,and alveolar-arterial oxygen tension difference (PA-a O2) was calculated.Clinical Pulmonary Infection Score was assessed at T1,T2 and T3.The chest tube removal time and length of postoperative hospital stay were recorded.Results Compared with the baseline at T0,FVC,FEV1,MMEF and PaO2 were significantly decreased,and PA-aO2 was increased at T1-3 in the two groups (P＜0.05).Compared with group V,FVC,FEV1,MMEF and PaO2 were significantly increased,PA-aO2 and Clinical Pulmonary Infection Score were decreased,and the chest tube removal time and length of postoperative hospital stay were shortened at T1-3 in group P (P＜0.05).Conclusion PCV-VG mode can achieve lung protective ventilation,which is helpful in improving outcomes in the patients requiring OLV during thoracoscopic surgery.

Objective Study the epidemiological and clinical findings of patients with Brucellar epididymo-orchitis (BEO),to provide a theoretical basis for clinical diagnosis.Methods A study was carried out to analyze the patients' files of epidemiological,outcome,clinical and laboratory features of 23 cases of BEO and 185 in patients with brucellosis in Hulunbuir People's Hospital during 2011-2013.Results The age of patients with BEO and without epididymo-orchitis (EO) were (34.48 ± 10.32) years old and (42.07 ± 12.19) years old,the difference was statistically significant (t =-2.842,P ＜ 0.05).Patients with BEO and without EO of brucellosis patients with hypogastralgia ratio was 78.3％ (18/23) and 8.6％ (14/162),the difference was statistically significant (x2 =68.238,P ＜ 0.05).The proportion of BEO cases with abnormal White Blood of Cell (WBC) and C-reactive protein (CRP) levels were 34.8％ (8/23) and 91.3％ (21/23),which was significantly higher than those in without EO group [9.9％ (16/162),63.0％ (102/162),x2 =11.066,7.260,all P ＜ 0.05].After 2 to 7 days,BEO patients with scrotal swelling and pain and/or tenderness relieved.After two weeks treatment,11 patients of the urinary system showed normal by ultrasound,and no patients underwent testicular resection.Conclusions Young male patients with Brucellar are prone to BEO.Laboratory abnormalities are mainly leukocytosis and high CRP level.

Objective To investigate survival for primary duodenal carcinoma patients after radical resection and identify risk factors associated with overall survival.Methods Data of 51 patients with primary duodenal carcinomas who underwent radical resection between December 2003 and December 2012 at Beijing Cancer Hospital were included.Survival analysis was drawn by Kaplan-Meier method,univariate and multivariate analyses were performed to identify variables associated with survival after resection by COX regression model.Results The median overall survival time was 67 months,and the median disease-free time was 40 months,1-,2-and 3-year overall survival rates were 88％,84％ and 67％,respectively.Multivariate analysis revealed that regional lymph-node positive (P =0.032) and CA199 ＞ 37 U/ml (P =0.037) were independent risk factors of patients' overall survival.Conclusions Radical resection improves survival for primary duodenal carcinoma patients.Regional lymph-node positive and CA199 ＞37 U/ml were the most important risk factors of patients'overall survival.

Objective To observe the application effect of the risk of ovarian malignancy algorithm(ROMA)in screening ovarian cancer among high risk population.Methods The human epididymis protein 4(HE4)and carbohydrate antigen 125 (CA125 )were detected in 1 753 cases of high risk for overian cancer,56 cases of ovarian cancer(positive control)and 60 healthy people,patients. Then the ROMA value was calculated in combination with the subject′s menstruation status.The detection results were analyzed and compared among groups.The high risk group for ovarian cancer devided according to the ROMA value was further performed the confirmatory test and the low risk group was monitored by follow up.The detection rates of ovarian cancer were compared be-tween the two subgroups.Results In the high risk population,the diagnostic performance of the ROMA value for ovarian cancer was superior to that of the single HE4 or CA125;the ROMA value had statistically significant difference between the high risk sub-group in the high-risk population with ovarian cancer or the healthy control group(P <0.05);in 1 753 cases of high risk popula-tion,37 cases were included in the high risk subgroup,in which 3 cases of ovarian cancer were screened out and in clinical early stage.The detection rate of ovarian cancer in the high risk subgroup was 8.1%.No case of ovarian cancer was detected out in the low risk subgroup.Conclusion The ROMA value is conducive to early screening for ovarian cancer in the high risk population, which can save the medical cost and increase the detection rate.

Objective To explore the clinical value of AFP-L3,GP73 and GGT as biomarkers in diagnosis of hepatocellular carcinoma (HCC).Methods According to the pathological diagnosis,141 patients were divided into two groups,HCC group were 74 cases,benign liver disease group were 67 cases.Use ELISA method tested the serum AFP-L3 and GP73 levels.The GGT level was detected by the automatic biochemical instrument of all the 141 patients.AFP-L3,GP73 and GGT concentration difference was compared between the two groups.ROC curve was used to determine the cut-off level to diagnose HCC.The value of single use AFP-L3,GP73,GGT and joint the three indexes to diagnose HCC were analyzed.Results The average level of AFP-L3 in the patients with HCC was (113.58±63.62) μg/L,it was significantly higher than that in the patients with benign liver diseases [(23.19±34.54) μg/L] (P ＜ 0.001).The area under the ROC curve of AFP-L3 level was 0.802.Taking AFP-L3 level ≥ 38.47 μg/L as diagnostic criteria,the sensitivity of AFP-L3 level in HCC diagnosis was 81.08 ％ and the specificity was 88.06 ％.The average level of GP73 in the patients with HCC was (126.55±49.56) μg/L,it was significantly higher than that in the patients with benign liver diseases [(56.97±26.48) μg/L] (P ＜ 0.001).The area under the ROC curve of GP73 level was 0.811.Taking GP73 level≥69.44 μg/L as diagnostic criteria,the sensitivity of GP73 level in HCC diagnosis was 75.68 ％ and the specificity was 91.04 ％.The average level of GGT in the patients with HCC was (173.20±179.18) U/L,it was significantly higher than that in the patients with benign liver diseases [(90.77±81.53) U/L] (P ＜ 0.001).The area under the ROC curve of GGT level was 0.713.Taking GGT level ≥ 110.77 U/L as diagnostic criteria,the sensitivity of GGT level in HCC diagnosis was 74.32 ％ and the specificity was 77.61％.Joint use AFP-L3,GP73 and GGT to diagnose HCC,the sensitivity was 83.78 ％,specificity was 92.53 ％.Conclusion Combined detection of tumor markers AFP-L3,GP73 and GGT can improve the positive rate of HCC,which has good clinical application value.