In recent years, there were several extreme conflicts between doctors and patients in Otorhinolaryn-gology department. Medical field always contributes the disputes to medical system and patients′quality, however, the public blames the doctors′morality. This article analyzes these incidents in the perspective of ethics and social medicine, trying to find the causes. And it puts forward the countermeasures in terms of medical education, hospi-tal, and the medical personnel.

Type 1 diabetes, a complex genetic disease, is determined by both genetic and environmental factors. After excluding the five susceptibility loci discovered by genetic linkage studies and candidate-gene association studies, more than 30 new susceptibility loci have been found to be related with type 1 diabetes as a result of genome-wide association study.

Objective To evaluate the effect of octreotide on the survival of patients with advanced hepatocellular carcinoma(HCC).Methods Electronic databases searches were conducted.Meta-analysis of all randomized controlled trials (RCTs) comparing octreotide versus placebo or no treatment was performed.Results Five RCTs including 579 patients with HCC wers assessed.Meta-analysis of the five studies showed that octreotide had no significant effect on the 6,12 and 24 months survival rates of the patients(6months:OR=1.69,95%CI 0.89-3.21,P=0.11;12 months:OR=2.41,95%CI 0.83-6.93,P=0.10;24months:OR=0.58,95%CI 0.28-1.17,P=0.13).To perform the sensitivity analysis,the blank study,the trial detecting somatostatin receptor expression,the study with short survival or the two trials with short follow-up intervals were excluded,and the results also showed that the octreotide treatment had no significant effect on the 6 and 12 months survival rates.A sensitivity analysis based on two trials indicated that the 24months survival rate of the octreotide group was even lower than that of the control group(OR=0.51,95% CI0.27-0.98,P=0.04).Conclusions This Meta-analysis demonstrates that octreotide could not improve the survival of patients with advanced HCC.The administration of octreotide should not be recommended for the treatment of advaneed HCC.

Objective:To investigate the direct effect of different concentrations of hydrogen sulfide(H_2S)on neonatal rat myocardial cells by hypoxia injury during different time point,and the indirect effect of reoxygenation injury in order to analyze the protective role of H_2S on myocardial cells subjected to hypoxia/reoxygenation injury. Methods:Primary cultured myocardial cells from neonatal rats were randomly divided into 9 groups:Normal control group,Hypoxia NaHS 0 μmol/L group,100 μmol/L group,200 μmol/L group,400 μmol/L group and those groups subjected to hypoxia for 24 h,48 h and 72 h. Hypoxia/reoxygenation NaHS 0 μmol/L group,100 μmol/L group,200 μmol/L group,400 μmol/L group and those groups subjected to hypoxia for 24 h,48 h,72 h and then reoxygenation for 2 h. The number of survival cells were counted and the activity of lactate dehydrogenase(LDH)were measured respectively at each time point. Results:At the same time point of 24 h,48 h,72 h hypoxia,the number of survival cells increased and the activity of LDH decreased in hypoxia NaHS treatment groups as compared with Hypoxia NaHS 0 μmol/L group(P<0.01). The protective role of Hypoxia NaHS 200 μand 400 μmol/L groups were better than NaHS 100 μmol/L group at 24 h of time poit(P<0.05～0.01). The number of survival cells by hypoxia/reoxygenation increased and the leakage of LDH from reoxygenation cells decreased in hypoxia/reoxygenation NaHS treatment groups as compared with hypoxia/reoxygenation NaHS 0 μmol/L group(P<0.01).Conclusion:NaHS 100 to 400 μmol/L had the protective effects on myocardial cells by hypoxia/reoxygenation injury. NaHS 200 to 400 μmol/L might offer the best protective effects on myocardial cells by hypoxia injury at 24 h.

Gene chips have been widely applied for the study of lymphoma,involvement discovering tumor-associated genes,assisting classification and investigating cell origin.So far,studies about gene chips detection mainly focus on B-cell lymphomas and T-cell lymphomas.According to those studies,traditional classifications of some kinds of lymphomas have been suspected and cell origin of some kinds of lymphomas have been suggested,which lay the foundation for further study.However,there are still somethings unknown about extranodal NK/T-cell lymphoma,more gene chip detection should be performed for further understanding of the tumor.

Objective To investigate the relationship between the pattern of infarct distribution on diffusion-weight imaging (DWI) and progressive movement deficits (PMD) in patients with infarct in the perforator territory of the middle cerebral artery (MCA). Methods The patients with new infarction in the perforator territory of MCA were analyzed retrospectively. PMD was defined as an increase of at least 2 points on the motor item of the National Institutes of Health Stroke Scale (NIHSS) score persisting for at least 24 hours within 5 days of stroke onset. The demographic characteristics, risk factors, clinical presentation, and distribution characteristics of the infarcts in the PMD and non-PMD groups were compared. Results A total of 64 patients were enrol ed in the study, including 38 females and 26 males, aged 67. 5 ± 10. 8 years. There were 28 patients in the PMD group and 36 in the non-PMD group. The proportion of the infarcts located in the posterior paraventricular region (67. 8% vs. 25. 0%; χ2 =11. 5, P<0. 05) of the PMD group and the mean baseline NIHSS score (6. 9 ± 1. 8 vs. 4. 3 ± 1. 2; t=2. 42, P<0. 05) were significantly higher than those of the non-PMD group. Multiple logistic regression analysis showed that the posterior paraventricular type infarcts had significantly independently correlation with PMD (odds ratio 6. 31, 95% confidence interval 2. 20-18. 0; P<0. 001). Conclusions The posterior paraventricular type infarcts on DWI can be used as a neuroimaging marker for predicting PMD in patients with infarction in the perforator artery territory of MCA.

Objective To observe the clinical efficacy of electroacupuncture plus electro-spoon needle-cupping in treating lumbar-dorsal myofascial pain syndrome.Method Sixty patients with lumbar-dorsal myofascial pain syndrome were randomized into group A, group B, and group C, 20 cases in each group. With same acupoints selected, group A was intervened by electroacupuncture plus electro-spoon needle-cupping, group B was by electroacupuncture, while group C was by conventional acupuncture. Visual Analogue Scale (VAS) was observed before and after treatment, and the clinical efficacies of the three groups were compared.Result After treatment, VAS scores were significantly different from those before treatment in the three groups. (P<0.05). After treatment, the VAS scores in group A and B were significantly different from that in group C (P<0.01,P<0.05); the VAS score in group A was significantly different from that in group B (P<0.05). The total effective rate was 95.0% in group A, versus 90.0% in group B and 80.0% in group C, and the total effective rate of group A was significantly different from that of both group B and C (P<0.05).Conclusion Electroacupuncture plus electro-spoon needle-cupping is an effective method in treating lumbar-dorsal myofascial pain syndrome.

Objective To observe the space-time patterns of damaged outer hair cells(OHCs) in rat cochlea at the early stage after exposure to impulse noise. Methods Wistar rats were exposed to 100 emissions of impulse noise (3 seconds interval between each emission) at 154 dB SPL. Four times (10 min, 30 min, 3h and 6h) after the noise exposure, the animals were sacrificed and the organs of Corti were processed for detection of OHC death modes. The apoptotic and necrotic OHCs were distinguished by propidium iodide (PI), a fluorescent probe specifically labeling the nuclear DNA. The specimens were examined under a fluorescence microscope for assessment of OHC damage. Results Nuclear chromatin began to shrink as the chromatin condensed around the nuclear periphery. The peripheral chromatin ring condensed into discrete mass. Chromatin masses appeared to bleb off from the nuclear surface, forming apoptotic bodies at 10 min after the noise exposure. There were a few swollen nuclei appeared 30 min after the noise exposure. Loss of OHC nuclei could be seen 3 h after the noise exposure. The cochlear lesion expanded to contain a large number of missing OHCs and seriously shrunken nuclei at 6 h after the noise exposure. Conclusions The results of the study indicate that death of OHCs takes place extremely rapid after the impulse noise exposure. The apoptosis of OHCs precedes necrosis. OHC apoptosis is a quick process. Most of dead outer hair cells were eliminated 6 h after the noise exposure.

Objective To investigate the impact of smoking on the level of urinary 8-iso prostaglandin (PG) F2? (8-iso-PGF2?) of patients with acute cerebral infarction. 8-iso-PGF2? is a product of arachidonic acid catalyzed by free-radical, and it has been identified as an indicator of oxidative stress in vivo during reperfusion. Methods Plasma and urine samples were obtained from 28 patients with acute cerebral infarction. Among them 14 patients with no smoking habit were chosen as control group according to the selection criterion, and the other 14 patients with smoking habit were chosen as investigation group according to the same criterion. There was no significant difference between the two groups in age, gender ratio, blood pressure, lipids level, blood glucose, focus location, and degree of the cerebral focus of infaration. The concentration of urinary 8-iso PGF2? and levels of low-density lipoproteins (LDL), total cholesterol, LDL-triglyceride (TG) and LDL-free cholesterol in plasma were measured by enzyme immunoassay. The quantification of urinary 8-iso PGF2? and LDL levels in plasma were performed for each sample respectively. Results The concentration of urinary 8-epi PGF2? of the patients with smoking habit was significantly higher than that in the patients of control group (75.79?10.76 vs 67.36?9.18 ng/mmol creatinine, P0.05, respectively) between the two groups. Conclusions Cigarette smoking may raise the urinary 8-iso-PGF2? level of patients with acute cerebral infarction, suggesting an increase in the level of oxidative stress in vivo in these subjects.

Objectives To explore the effects of hypertension on the oxidative susceptibility of plasma low-density lipoprotein (LDL) in patients with cerebral infarction. Methods A total of 79 patients, 39 males and 40 females with mean age of 67?7, with hypertension accompanied by similar size of cerebral infarction in the perfusion domain of middle cerebral artery, were involved in this study. The hypertension was graded as follows: grade Ⅰ (n=27), the systolic blood pressure (SBP)/diastolic blood pressure (DBP) was 140-159mmHg/90-99mmHg; grade Ⅱ (n=29) with SBP/DBP of 160-179mmHg/100-109mmHg; grade Ⅲ (n=23) with SBP/DBP exceeding 180mmHg/110mmHg. Serum concentrations of LDL were determined with enzymatic colorimetry employing an automated multianalyzer. The lag time (ox-LDL lag-time) in conjugated diene production at 234nm was determined by copper-stimulated oxidation. Results No statistical difference was found in LDL-total cholesterol, LDL-triglyceride, LDL-free cholesterol among grade Ⅰ, Ⅱ, Ⅲ groups (6.1?0.4, 0.87?0.08, 1.6?0.7mmol/L; 5.7?0.6, 0.86?0.05, 1.8?0.9mmol/L; and 5.6?0.7, 0.87?0.1, 1.7?0.8mmol/L, respectively). Correlation analysis showed the lag time in conjugated diene production in patients with cerebral infarction was negatively related to the grade of hypertension in all the subjects, and the lag time in grade Ⅰ, Ⅱ, Ⅲ groups was 84.26?8.491, 69.84?7.748 and 61.95?8.482 min, respectively (r=0.673 3, P