The relationship between medical practitioners and padtients always changes with time and this shift becomes quite striking nowadays.The characteristics and underlying reasons of this trend are expounded from such aspects as the changes in medical service system,the alteration in definitions of medical practitioners and patients, the advent of market economy.It is precondition and guarantee of handling the relationship properly to consummate relevant laws and codes,establish medical insurance institution,classify hospitals and set moral restraint for both medical practitioners and patients.

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Face ; microbiology ; Female ; Humans ; Middle Aged ; Mycobacterium avium Complex ; isolation & purification ; Mycobacterium avium-intracellulare Infection ; metabolism ; microbiology ; pathology ; Nasal Cavity ; microbiology ; Nose Diseases ; metabolism ; microbiology ; pathology ; Vimentin ; metabolism

Objective To evaluate the effect of hypoxemia factor on hippocampal long-term potentiation(LTP)in newborn rats undergoing propofol anesthesia. Methods Forty-two pathogen-free healthy Sprague-Dawley rats(21 males,21 females),aged 7 days,weighing 14-18 g,were divided into 3 groups(n=14 each)using a random number table:propofol plus air group(group PA),propofol plus pure oxygen group(group PO)and intralipid plus pure oxygen group(group IO).Propofol 50 mg/kg was injected intraperitoneally once a day for 7 consecutive days in PA and PO groups. Intralipid 5.0 ml/kg was injected intraperitoneally once a day for 7 consecutive days in IO group. The rats were exposed to air or pure oxygen for 6 h after the end of each injection. The arterial oxygen saturation and respiratory rate were determined after administration. The rats were returned to the cage after recovery of righting reflex. Six rats in each group were selected for preparation of hippocampal slices at 24 h after the last injection on 7th day,and the electric stimulation-induced field excitatory post synaptic potential(fEPSP)and success rate of LTP induction were recorded. Morris water maze test was performed in the other rats at 2 weeks after administration to assess the cognitive function. Results Compared with group IO,the respiratory rate,amplitude of fEPSP and success rate of LTP induction were significantly decreased,and the escape latency was prolonged in group PO(P<0.05).Compared with group PO,the arterial oxygen saturation,amplitude of fEPSP and success rate of LTP induction were significantly decreased,the escape latency was prolonged,and the number of crossing the original platform was decreased in group PA(P<0.05).Conclusion Hypoxemia factor increases propofol-induced neurotoxicity in the central nervous system of newborn rats.

Objective To explore the distribution of serum Mg,A1,Ca,Fe,Zn and Cu ions in Tibetan population in drinking tea type fluorosis areas,and to provide a clue for pathogenesis of drinking tea type fluorosis.Methods Tibetans from six villages in Qinghai Province (Maqin County and Dari County),who were over 16 years old,born and grew up in those villages,were included.All of the participants were received epidemic questionnaire survey,tea water samples were collected and the fluoride concentration was tested based on the standard of Brick Tea Fluoride Content (GB 19965-2005).Meanwhile,the daily amount of brick tea consumption was surveyed to calculate the daily intake of tea fluoride.Blood samples were collected and the concentration of serum Mg,Al,Ca,Fe,Zn and Cu ions was tested by the method of inductively coupled plasma mass spectrometry (ICP-MS).All of the participants were diagnosed by X-ray,the parts we scheduled were forearm,shank and pelvic,then the skeletal fluorosis was diagnosed based on the Diagnostic Criteria for Endemic Fluorosis (WS/T 192-2008).Results A total of 170 people were surveyed,74 people were skeletal fluorosis,and 96 people were non-skeletal fluorosis.The median (quartiles) of daily intake of tea fluoride was 7.35 (3.00,12.30) mg.The concentration of serum Mg ion was 22.02 (17.30,23.67) mg/L,Al ion was 0.22 (0.14,0.38) mg/L,Ca ion was 100.03 (88.56,112.73) mg/L,Fe ion was 1.66 (1.26,2.36) mg/L,Zn ion was 0.80 (0.63,0.95) mg/L and Cu ion was 1.28 (0.99,1.48) mg/L.The concentration of serum Fe ion was higher in male [2.13 (1.37,3.09) mg/L] than that of female [1.56 (1.18,2.02) mg/L,Z =3.28,P ＜ 0.01].The concentration of serum Mg,Ca,Cu and Zn ions in ≥70 years old group was 15.09 (13.64,24.13),68.67 (58.67,97.24),0.97 (0.72,1.34),and 0.54 (0.48,0.74) mg/L,respectively,which was lower than those in ＜ 40 years old group [21.67 (20.08,22.76),98.71 (90.77,113.97),1.35 (1.21,1.71),and 0.78 (0.73,1.01) mg/L],the differences were statistically significant (Z =2.26,2.99,3.01,3.34,P ＜ 0.05).Fe ion in 40-49 years old group was 1.77 (1.45,3.02) mg/L,in 50-59 years old group was 1.92 (1.44,2.66) mg/L,both of them were higher than those of ＜ 40 years old group [1.34 (0.94,1.57) mg/L,Z =-3.25,-2.89,P ＜ 0.05].People whose daily intake of tea fluoride over 4 mg had a lower concentration of Ca ion [98.22 (75.48,111.22) mg/L] than people whose daily intake of tea fluoride ＜ 2 mg [110.24 (97.50,113.97) mg/L,Z =2.41,P ＜ 0.05].No significant difference was found between different degrees of skeletal fluorosis and non-skeletal fluorosis (P ＞ 0.05).Conclusions In the Tibetans who lived in the drinking tea type fluorosis areas,the concentration of serum Mg,A1,Ca,Fe,Zn and Cu ions is similar between skeletal fluorosis and non-skeletal fluorosis,which is also similar between higher daily intake of tea fluoride and lower daily intake of tea fluoride.However,it is different between older people and younger people.

OBJECTIVETo observe the effects of qianggu electuary (QGE), a Chinese herbal preparation, on ovariectomy-induced osteoporotic rats.

METHODFemale Wistar rats were ovariectomized and administered QGE, calcium gluconate (CG) and longmu zhuanggu granules (LMZG) for 12 weeks. Bone mineral density (BMD), indexes of biomechanics and serum E2, Ca were detected in grouped rats including QGE, CG, LMZG and control groups.

RESULTQGE could significantly increase the BMD and maximum load, maximum stress YP-load of femora in the osteoporotic rats. The values of E2 in ovariectomized osteoporotic rats decreased, compared with those of control normal rats (P > 0.05), while in the QGE treated rats, the values of E2 increased.

CONCLUSIONQGE can increase the BMD and improve indexes of bone biomechanics in ovariectomized osteopotic rats, possibly due to its estrogen-like effect.

Animals ; Bone Density ; drug effects ; Calcium ; blood ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Estradiol ; blood ; Femur ; physiopathology ; Osteoporosis ; blood ; pathology ; physiopathology ; Ovariectomy ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar ; Stress, Mechanical

Objective To study the molecular mechanism of oridonin-induced apoptosis of ghoma SHG44 cells.Methods A growth curve was plotted using CCK-8 colorimetric method with different concentrations of oridonin (0,1.25,2.5,5,10,20,and 40 μmol/L)to observe its effect on the growth of SHG44 cells.Hoechst33258 and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining were used to examine the changes in cell morphology and flow cytometry was used to detect cell apoptosis.Western blotting was used to analyze the expression of apoptosis-related proteins (Caspase-3,cleaved Caspase-3,Bax,and Bcl-2)in SHG44 cells.Results SHG44 cell proliferation was significantly suppressed after 24 and 48 h Oridonin treatment,with a half-maximal inhibitory concentration of 7.865 and 4.74 μmol/L,respectively.Hoechst33258 and TUNEL staining showed changes in cell morphology such as shrinkage and nucleus fragmentation and morphogenesis,which are indicative of apoptosis.Western blotting analysis showed that oridonin inhibited the expression of Bcl-2 and activated the expression of Caspase-3 and Bax.Conclusion Oridonin can inhibit the proliferation and induce the apoptosis of SHG44 cells by regulating the expression of apoptosis-related proteins.

The study was to explore the change of coagulation factor VIII and IX activities in the platelet suspension collected by platelet apheresis during storage at 22 degrees C. 18 samples of platelet concentrates were collected by the cs-3000 plus and stored at 22 degrees C and then FVIII: C, FIX: C activities were detected at 0, 12, 24, 48, 72, 96, 120 hours respectively by SYSMEX CA-1500. The results showed that FVIII: C activity was (100.51 + 44.02)% at 0 hour, and then decreased dramatically to 10% - 40% of primary level from 12 to 120 hours, while FIX: C activity was (120.93 +/- 20.50)% at 0 hour and decreased to 10% - 35% of primary level from 24 to 120 hours. In conclusion, FVIII and FIX in the platelet concentrates stored at 22 degrees C could keep their biological activities at physiologically high levels.
Blood Platelets ; Blood Preservation ; methods ; Factor IX ; metabolism ; Factor VIII ; metabolism ; Humans ; Platelet Transfusion ; Plateletpheresis ; methods

OBJECTIVE: To investigate the related factors of aseptic necrosis of femoral head after closed reduction and internal fixation of femoral neck fracture. METHODS: From January 2009 to January 2016, 236 patients with femoral neck fracture were treated with closed reduction and internal fixation with 3 hollow lag screws, including 111 males and 125 females, aged from 19 to 89 (50.17±12.88) years. According to the follow-up results, the correlation of aseptic necrosis of femoral head was analyzed. Univariate analysis of age, gender, injured side, body weight, injury mechanism, preoperative waiting time, Garden classification and whether there was comminution of femoral neck cortex was conducted to obtain the independent variables with significant difference. Then binary logistic regression analysis was conducted to explore the independent risk factors of avascular necrosis of femoral head. RESULTS: The average follow-up period of 236 cases was 4.58 years. There were significant differences in the range of injury (24.69% vs. 5.16%, CONCLUSION High energy injury, preoperative waiting time (>48 h) and comminution of femoral neck cortex were independent risk factors for aseptic necrosis of femoral head. In addition, cortical comminution on the pressure side and tension side of the femoral neck is a strong prognostic risk factor for aseptic necrosis of the femoral head, because it indicates a more serious and complex injury mechanism.
Aged ; Female ; Femoral Neck Fractures/surgery* ; Femur Head Necrosis/surgery* ; Femur Neck ; Fracture Fixation, Internal/adverse effects* ; Fractures, Comminuted ; Humans ; Male ; Risk Factors

Isolated noncompaction of the left ventricular myocardium is a rare cardiac disorder due to an arrest in myocardial morphogenesis. It is characterized by prominent and excessive trabeculation in a ventricular wall segment, with deep intertrabecular spaces perfused from the ventricular cavity. Echocardiographic findings are important clues for the diagnosis. Clinical symptoms include signs of left ventricular systolic dysfunction even to the point of heart failure, ventricular arrhythmias, and embolic events. We describe two cases of isolated noncompaction of the myocardium, with ventricular tachycardia in one, and chest pain due to microvascular dysfunction in the other.
Adult* ; Arrhythmias, Cardiac ; Chest Pain ; Diagnosis ; Echocardiography ; Heart Failure ; Humans ; Morphogenesis ; Myocardium* ; Tachycardia, Ventricular

OBJECTIVETo investigate the mechanism by which propofol exposure causes PC12 cell apoptosis under hypoxic conditions.

METHODSPC12 cells were exposed to room air, 35% oxygen, or 5% oxygen (hypoxia) for 24 h in the presence of either 10 µmol/L lipid emulsion or 10 µmol/L propofol. After the treatments, the cell apoptosis was measured by flow ceytometry, and the level of reactive oxygen species (ROS) and the activity of superoxide dismutase (SOD) were evaluated.

RESULTSIn room air, PC12 cells treated with propofol showed increased apoptosis rate and ROS production as compared with the cells treated with the lipid emulsion; propofol treatment of the cells exposed to 35% oxygen showed obvious enhancement of the apoptosis rate, ROS production and SOD activity. Under the hypoxic condition, propofol treatment even further increased the apoptosis rate, ROS production and SOD activity. Lipid emulsion caused no such changes in cells exposed to room air, 35% oxygen or 5% oxygen.

CONCLUSIONUnder hypoxic conditions, propofol can cause apoptosis in PC12 cells by inducing oxidative stress injury.

Animals ; Apoptosis ; drug effects ; Cell Hypoxia ; Oxidative Stress ; PC12 Cells ; Propofol ; pharmacology ; Rats ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism