Following the important icleology of "Gorernance of the Country by morals"the author adrocates"undertalce mdical service by merals"in the health front.This artical expounds three theoretical signifieamces:medical practice is a charitable calse,and martvring virtue is the first;correlation and distinction between and key links of medical and headth culture,To explore rmplementation of "undertalce medical fervice by moral",On onehand we should wphold the 4 mian pillars--charity,profcieniy,trust,cooperation; On the other hand.to take the 4 measures --nuturing,stipulation of agrements,estblishment,model so as to estabmish a three--olim ensionoll line of medical ethics and morals.

Objective:To study CT findings of testicular torsion and improve the recognition of the disease.Methods:The clini-cal and CT findings in 13 cases with testicular torsion proved by operation were analyzed retrospectively.All patients underwent low dose precontrast and postcontrast helical CT.Results:All patients of the disease had feature of urgent onset and short course of disease(two hours～3 days).Two patients of these cases had patient history of injury.CT findings:precontrast CT found the volume of sick testes increased and their densities increased slightly and nonuniform.Postcontrast CT found their features of nonuniform enhancement and gyrate enhancement.Conclusion:CT manifestations of testicular torsion have some specific features,which can help to confirm the diagnosis by referring the patient’s history.

Objective To analyze the clinical characteristics of patients with cardiac amyloidosis.Methods The clinical data of 14 patients with cardiac amyloidosis were retrospectively analysed.Results The patients with cardiac amyloidosis had characteristics of large atriums and hypertrophic ventricular walls in echocardiography.And they also had low limb lead voltage in ECG.The ratio of(SV5+RV1)and left ventricle crossing area of all patients were obviously lower than 1.5.Biopsy behaved staining of congo red.And most patients had renal,dermatic and gastrointestinal involvements.Conclusion The patients of cardiac dysfunction with the characteristics of restrictive cardiomyopathy in echocardiogram and feature of low limb lead voltage in ECG,have the possibility of cardiac amyloidosis and need to prove it through biopsy.(SV5+RV1)/CSA may be a promising method for screening cardiac amyloid.

Objective Statistics and analyze the effect of comprehensive prevention measures for the ventilator associated pneumonia (VAP) morbidity and mortality,and investigate its actual applicate situation in the clinical.Methods Statistics and analyze the clinical date of 183 cases of our ICU mechanical ventilation patients in 2012 (group A),including morbidity,mortality,time of endotracheal intubation,length of stay and the primary pathogenic bacteria,and to compared with the relevant clinical data of 192 cases of our ICU mechanical ventilation patients in 2011 (group B),summarize and analysis the actual applicate situation of the comprehensive prevention measures in the clinical through the data contrast.Results The incidence of VAP in group A was lower than that in group B [31.7％(58/183) vs.58.3％(112/192)] (P ＜ 0.05),but the mortality was no statistical difference in both groups (P ＞ 0.05) ; the endotracheal intubation time and the average length of stay in group A were less than those in group B [6.3 d vs.10.6 d,7.6 d vs.11.9 d](P＜0.05); the main pathogenic bacterium of VAP with mainly gram-negative bacilh.Conclusions Comprehensive prevention measures can effectively reduce the incidence of VAP,but the mortality rate has no significant effect,need further clinical research;comprehensive prevention measures to reduce patients with tube time also confirm its effectiveness.Comprehensive prevention measures are economical and practical,is worth in clinical promotion.

Objective To approach the mechanisms and myocardial protective effect of Qishen Yiqi dropping pills on rats with myocardial infarction. Methods Sixty clean healthy male Sprague-Dawley (SD) rats were randomly divided into sham operation group, model group and observation group (each n = 20). The rat model of acute myocardial infarction (AMI) was established by ligation of left anterior descent (LAD) branch of coronary artery. After modeling, the rats in observation group were given 0.135 g/kg of Qishen Yiqi dropping pills, and sham operation group and model group were administered the same amount of normal saline, once a day for consecutive 28 days. At the end of treatment, the levels of serum inflammatory factors of leukotriene B4 (LTB4), prostaglandin E2 (PGE2), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay (ELISA); the changes of the indexes of hemodynamic [left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), the maximal rate of increase/decrease in left ventricular pressure (±dp/dt max)], the ratio of the heart weight/body weight, and the ratio of the left ventricular weight/heart weight (LVW/HW), the myocardial infarction area, myocardial histopathological changes were observed in the three groups; myocardial tissues inflammatory related factors [the mRNA and protein expressions of cytosolic phospholipase A2 (cPLA2), cyclooxygenase-2 (COX-2), 5-lipoxygenase (5-LOX)], and the expression levels of transforming growth factor-β (TGF-β)/Smads signal transduction pathway related protein (TGF-β1, Smad2/3, Collagen Ⅰ, Collagen Ⅲ ) and cell apoptosis related factors (Bcl-2, Bax) protein were measured. Results Compared with the sham operation group, levels of serum inflammatory factors, the index of LVEDP, the ratio of the heart weight/body weight, LVW/HW, myocardial infarction area, the mRNA and protein expression levels of inflammatory factors in myocardium, the expression levels of TGF-β/Smads signal transduction pathway related protein and the cell apoptosis related factors protein in model group were all significantly elevated, while LVSP and ±dp/dt max were obviously decreased in model group. Compared with the model group, the levels of inflammatory factor in serum [LTB4 (ng/L): 370.11±46.98 vs. 633.23±83.37, PGE2 (ng/L):48.75±26.35 vs. 131.25±29.75, TNF-α (μg/L): 177.28±22.65 vs. 248.47±16.21, IL-6 (μg/L): 493.22±165.99 vs. 638.41±191.66], LVEDP [mmHg (1 mmHg = 0.133 kPa): -2.03±2.98 vs. 7.03±1.39], the ratio of the heart weight/body weight [(6.53±0.11)% vs. (7.14±0.24)%], LVW/HW (0.26±0.01 vs. 0.32±0.02), myocardial infarction area [(27.21±2.87)% vs. (44.98±1.52)%], mRNA and protein expression of myocardial inflammatory factors, the expression of TGF-β/Smads signal transduction pathway related protein, and the protein expression of Bax were all significantly decreased in observation group (all P < 0.05), LVSP (mmHg: 129.01±11.93 vs. 108.11±12.69), the +dp/dt max (mmHg/s: 3101.3±378.6 vs. 2105.3±245.9), the -dp/dt max (mmHg/s: 2612.4±249.7 vs. 1654.4±188.1), while the protein expression of Bcl-2 in observation group were obviously increased (all P < 0.05). It was demonstrated by hematoxylin-eosin (HE) staining that there were no obvious pathological changes in the sham operation group; obvious infiltration of inflammatory factors in myocardium was shown in model group; pathological changes in the observation group were significantly improved as compared with those in the model group. It was shown by Masson staining that there were slight hyperplasia of myocardial fibers and no obvious pathological changes in the sham operation group. Severe collagen hyperplasia was found in model group, and the degree of fibrosis in the observation group was significantly improved. Conclusions Qishen Yiqi dropping pills can reduce the degree of myocardial fibrosis and inhibit the ventricular remodeling via TGF-β/Smads signal transduction pathway. The dropping pills can also suppress the release of inflammatory factors by reducing cPLA2 to decrease the inflammatory response and inhibit apoptosis and alleviate myocardial injury by up-regulating the expression of Bcl-2 and down-regulating the expression of Bax.

Interventional treatment via portal vein system plays an important role in treating some liver diseases,such as interventional treatment for portal vein tumor thrombus,portal hypertension with liver cirrhosis,portal vein thrombosis and selective portal vein embolization inducing compensatory hypertrophy of the remnant liver.The author introduces the routes,methods and efficacies of the interventional treatment via portal vein.

Objective: To study the regularity of dry matter accumulation and its absorption and distribution of nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), and magnesium (Mg) in Artemisia annua, and to provide a scientific fertilizer application for the standardized cultivation. Methods: The sampling was carried out in the different growing periods of A. annua under field condition, and the amount of dry matter and the contents of N, P, K, Ca, and Mg in all parts of the plant were determined, respectively. Results: The dry matter mainly distributed in leaves within 40 d after transplanting, and this period could be defined as seedling period. The period within 40-100 d could be defined as vegetative growth period and the dry matter mainly distributed in leaves and branches. The period within 100-180 d could be defined as reproductive growth period. And the period of 100-140 d could be defined as earlier reproductive growth period, and the dry matter mainly distributed in branches and flower buds during this time. The period of 140-180 d could be defined as later reproductive growth period, the dry matter mainly distributed in branches and seeds during this time. The accumulation of nutrition was the lowest in seedling period; but the uptake of nutrition increased in vegetative growth period, and mainly distributed in leaves and branches. Nutrition mainly distributed in leaves earlier reproductive growth period, but transferred to flower buds gradually. Nutrition mainly distributed in seeds in the later reproductive growth period. The dry matter accumulation lineally increased with the assimilation and accumulation of N, K, Mg, Ca, and P. The uptake proportion of them was 4.21:4.17:0.74:0.63:0.24 in the whole growth period. Conclusion: Low nutrition should be applied during seedling stage to controlling the loss of nutrition. During the period of 40-140 d after transplanting, A. annua grows quickly, and mineral nutrition must be supplied especially N and K. The maximum uptake period of P, Ca, and Mg is in 100-120 d, so Ca, Mg, and P fertilizers should be applied earlier or by foliage spray to promote the formation of flower buds and seeds.

Objective: To investigate the strategy for the emergency management of acute intestinal obstruction resulted from colorectal cancer. Methods: We collected the clinical data from 88 patients with acute intestinal obstruction resulting from colorectal cancer. They were admitted in our hospital between 1997 and 2007 and received one-stage resection and primary anastomosis. The clinical data were analyzed retrospectively. Results: One-stage resection and primary anastomosis were performed in all the 88 cases. Wound infection occurred in 7 cases as a surgical complication and no anastomotic leakage appeared. There was no surgical death in all the patients. Conclusion: In the emergency management of acute intestinal obstruction resulting from right colorectal cancer, one-stage resection and primary anastomosis are feasible and safe. While subtotal colectomy is feasible and safe in the treatment of left colorectal cancer-induced acute intestinal obstruction.

Objective To explore the indication,technique and complications of Snodgrass operation in hypospadias repairment.Methods From Sep.2005 to Nov.2006,22 boys from 2 to 18 years old with hypospadias were treated with Snodgrass modification.The procedure was performed in 16 patients as a primary repairment and in 6 patients as the 2-stage repairment.The entire length of the urethral plate was incised along the midline in primary repairment,and the skin flaps and residual urethral plate were incised in the 2-stage repairment.The length of neourethra was from 1 to 10 cm.The neourethra was tubularized over a F 6 or F 8 catheter.The urethral stent was removed in 10 to 14 days pos-toperatively.Results Of the 22 patients,18(81.8%) required no other surgery as the repairment provided a normal appearing penis(straight,terminal meatus, cosmetics) without complications.Fistul aoccurred in 4 patients(18.2%) and meatal stenosis in 1 patient.Conclusion Snodgrass operation creates a vertical slit-like neomeatus.The procedures restores good function and normal appearance to the penis.