This paper reflected the development of modern medical technology from the view of ecology,indicating that the core idea of ecological medical model is that human and nature develop harmoniously. The theory basis,practical background and significance of ecological medical model are also described.

Objective To observe the variation of the levels of γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis before and after treatment.Methods A total of 159 patients with brucellosis were enrolled from the Second People's Hospital of Tianjin between September 2009 and August 2014,of which 122 were with acute phase and 37 with subacute stage.γδT cells,CD4+ and CD8+ T lymphocytes in peripheral blood of all patients before and after treatment were detected by flow cytometry.Thirty healthy controls were also enrolled.Measurement data were analyzed using t test and nonparametric Kruskal-Wallis test.Results The medians of γδT cells,CD4+ and CD8+ T lymphocyte counts of brucellosis patients with acute stage before treatment were 84.0/μL,780.5/μL and 774.0/μL,respectively,and those with subacute stage were 76.0/μL,887.0/μL and 890.0/μL,respectively.Those in control group were 49.0/μL,772.5/μL and 592.5/μL,respectively.γδT cells (U=114.5,P =0.001) and CD8+ T lymphocyte counts (U=1 185.5,P =0.003) in acute phase group were elevated than control group.γδT cells (U=359.0,P=0.013),CD4+ T lymphocyte counts (U=325.5,P=0.004) and CD8+ T lymphocyte counts (U=316.5,P=0.003) in subacute phase group were increased than control group.CD4+ T lymphocyte counts in subacute phase group were elevated than acute phase group (U=1 619.0,P=0.009).There were 31 patients with acute phase and 30 patients with subacute phase who completed 6-week treatment.γδT cells ([120.7 ± 104.9]/μL vs [82.2 ±85.3]/μL;t=3.568,P=0.001),CD4+ T lymphocyte ([802.1±300.6]/μL vs [663.0±280.6]/μL;t=2.904,P=0.007) and CD8+ T lymphocytes counts ([908.1±422.7]/μL vs [651.1±241.7]/μL;t=3.885,P=0.001) of brucellosis patients with acute stage before and after treatment were significantly different.γδT cells ([67.1± 38.4]/μL vs [48.4±32.1]/μL;t=2.695,P=0.012),CD4+ T lymphocytes ([817.1± 147.4]/μL vs [650.8± 196.5]/μL;t=5.301,P＜0.01) and CD8+ T lymphocytes counts ([703.7±191.5]/μL vs [537.4±186.0]/μL;t=5.152,P＜0.01) of brucellosis patients with subacute stage after treatment were significantly decreased compared with those of patients before treatment.Conclusions γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis are all in a state of immune activation.The levels of activation are highly correlated with disease progression.And detection of the variation of these cells contributes to understand the immune state of the acute and subacute brucellosis.

Objective To explore the efficacy of empathy training on the empathy and emotional intelligence in new employed nurses (engaged in clinical work within one year).Methods A total of 82 participants were randomly divided into the intervention group and the control group (n =41).The intervention group was conducted with empathy training in addition to routine clinical guidance,the control group was only conducted with routine clinical guidance.All subjects were assessed with the Interpersonal Reactivity Index (IRI-C) and Emotional Intelligence Scale (EIS) before and after intervention.Results Immediately after the intervention and 3 months after intervention,the scores of IRI-C in the intervention group were significantly higher than those of the control group((57.53 ±5.20) vs(50.50 ±7.64),(55.28 ±6.48) vs(46.90 ± 7.74),P ＜ 0.01).Samely,the scores of EIS in the intervention group were significantly higher than those of the control group((131.55 ± 10.49) vs(124.35 ±9.93) ;(126.27 ± 12.87)vs(119.38 ±9.45),P＜0.01).Conclusion Conducting empathy training can improve the empathic ability and emotional intelligence of new employed nurses.

Spinal sensory evoked potential(SSEP)and spinal motor evoked potential(SMEP)of the injured spinal cord of the host rats were determined on the 7th,15th,30th.60th,120th and 240th day after they received implantation of the embryonic spinal cord from the fetus of E14 rats.The motor function of the hind limbs of the host rats were also observed.The rats with simple cord injury and those with cord injury and implantation of a piece of skeletal muscle served as the controls.It was found that the locomotor function of the host rats could be recovered on the 30th day after implantation,but the latent period of both SSEP and SMEP became normal on the 240th day.At that time,the latent period of evoked potentials of the 2 control groups also recovered gradually.It is believed that embryonic spinal cord may have effects on the recovery of the locomotor function of the host rats but more sophisticated methods are imperative to clarify the interela-tionship between the host tissue and the graft.

Objective To describe the structure and clinical application of the single arm suspended reduction fixation device(HOIST device) for spondylolisthesis. Methods HOIST device is composed of the hauling screw, open angle screw(upholding screw), blocker, angle connective bar and blocking ring. Through the different assembly of the angle screws and the connective bar, to increase or decrease the fixation angle of the angle screw which as an upholding arm and the connective bar to meet the needs of different lumbosacral angles and hauling screw reducing distance. Twenty three patients with an average slipping rate of 25％－ 50％ , were treated with the device, and among them, intervertebral implantation of BAK was done in 5 patients and intervertebral fusion was performed in 18 patients. Results The mean duration of follow up was 10.3 months. Olisthy was reduced completely, clinical symptoms disappeared and there was no serious complications. Conclusion This device only required fixation of the slipped and its inferior adjacent vertebral body, and then it causes little influence to the movement of the lumbar spine. The arm of force of the reduction is short, so it is especially indicated for mild and moderate spondylolisthesis.

Objective To Introduce the principle, structure and observe the effects of clinical application of Scofix instrumentation. Methods Scofix instrumentation consists of different size of open up pedicle screws, open up pedicle hooks, connecting rods, blockers and devices of transverse connection. The open up pedicle screws can be inserted continuously or intermittently, fixed by the connecting rods in the scoliotic segments, and then distraction, compression and derotation manipulation can be performed to correct the spinal deformity. Thirty three patients were treated with this methods. The average age at surgery was 14.4 years. The mean preoperative Cobb angle in idiopathic and congenital scoliosis was 70 and 68 degrees,respectively. According to the degree of deformity and spinal flexibility, the correction was done at one setting or in stages. Results Postoperative Cobb angle and the corrective rate in 19 cases of idiopathic scoliosis were 29.4?and 59.1%, respectively while in 14 cases of congenital scoliosis the figures were 33.3?and 52.3%, respectively. No severe complications occurred. Conclusion Scofix instrumentation which is designed by the principle of CD instrumentation and in conformity with the spinal structural features of Chinese adolescence has the function of distraction, compression and derotation and can be used for internal fixation of scoliosis in different ages. Because of the high risk and the great difficulty, the thoracic pedicel screws should be used carefully, and can be replaced by pedicle hooks if necessary.

Objective To determine the cause, prevention and management of failed spinal deformity surgery, and evaluate the indication of spinal revision. Methods Thirty-one cases of failed spinal deformity surgery were treated surgically. There were 18 males and 13 females with an average age of 14.7 years(ranged from 4 to 35 years) at the present procedures. The average number of previous surgeries for this group of patients was 1.5 times. The duration between the first surgery and revision was 13-114 months, with an average of 47.9 months. There were 16 patients with consistent back pain which became worse after movement, 5 patients with implant complication (broken, loosing, explosing), 21 patients with failure of instrumentation and deterioration of deformity, 5 patients with decreased sensory and motor function. The average preoperative angel of deformity was 75.3 degrees for scoliosis and 76 degrees for kyphosis and the flexibility was 9.8% and 25.2%, respectively. All patients underwent reconstructive surgery with segmental vertebral osteotomy and trans-pedicular fixation and fusion in one or two stages according to the location and degree of the deformity. Results The average follow-up period for this group of patients was 31.8 months in 20 cases. The postoperative correction rate for scoliosis and kyphosis was 55.2% and 67.5%, respectively. There were 4 cases (12.9%) developed temporary neural dysfunction postoperatively and were recovered within 1-3 weeks after appropriate treatment. Instrumentation failure was occurred in two cases and there was no other complication in this group. Conclusion It is might be benefit to follow the principle of spinal deformity correction, fuse with adequate bone grafting and combine with proper pedicle fixation, especially for the congenital scoliosis patients, which are the efficial methods to prevent the failure of spinal deformation surgery. The management for the patients suffered from long-time back pain, spinal pseudarthrosis or progressive aggravated deformity postoperatively should be individuated depending on the degree of deformity, flexibility of the spine and the age of patients.

Objective To investigate the outcomes of surgery combined with albendazole liposomes in the treatment of advanced hepatic alveolar echinococcosis.Methods This is a retrospective study on 71 patients with advanced hepatic alveolar echinococcosis treated from January 2002 to November 2013.The patients were divided into 4 groups according to the surgical methods and whether surgery was combined with albendazole liposomes.Results On follow-up from 5 ～ 44 months,the mortality rates for the volume-reduction surgery group was 82.3％,the volume-reduction surgery + albendazole group 52.3％,the radical operation group 28.5％,and the radical operation + albendazole group 21.1％.The mortality rate of the radical operation + albendazole group,when compared with the radical operation group and the volume-reduction surgery + albendazole group was significantly different (P ＜ 0.05).The mortality rate of the radical operation group,when compared with the volume-reduction surgery + albendazole group showed no significant difference (P ＞ 0.05).The mortality rate of the volume-reduction surgery group,when compared with the volume-reduction surgery + albendazole group,the radical operation group,and the radical operation + albendazole group was significantly different (P ＜ 0.05).Conclusions The treatment of radical operation combined with albendazole liposomes for advanced hepatic alveolar echinococcosis reduced recurrence,improved quality of life and prolonged survival.It is a feasible method to treat these patients.

[Objective]To discuss the effects of angiogenesis about nerve growth factor(NGF) during the peripheral nerve regeneration.[Method]Thirty-six Sprague-Dawley rats with 10mm gap of sciatic nerve were randomly divided into two groups which had been bridged with the new double channel nerve conduit of fusiform shape.Each group contained eighteen animals,in the first group,200 ?l of chitin for medical use was injected into the conduit,in the second group,the two branches of the conduit contained 100 ?l of the chitin and 5 ?l NGF or ciliary neurotrophic factor(CNTF).At four,eight or sixteen week after operation,the angiogenesis of NGF was evaluated with Hematoxylin and Eosin(HE) staining and electron microscope.[Result]There were not significant differences of the regenerative nerve fibres between two channels in the first groups,but in the second group,the regenerative nerve of NGF branch channel was red,crisp and the nerve of CNTF branch channel was yellow and tenacious.HE staining showed that there were much more new vessel in the regernerative nerve tract of NGF the branch channel,and the regernerative nerve fibre was disorder,there were much more fibroblasts and vessels observed under eletron microscope.[Conclusion]NGF can significantly promote the angiogenesis during the peripheral nerve regeneration,the mechanism may be related to fibroblast.

Objective To study the mechanism of gastric bypass operation on treatment of type 2 diabetes mellitus,recognize the etiology and pathogenesy of the disease and frame therapy strategy for type 2 diabetes mellitus.Methods The literatures about gastric bypass operation on treatment of type 2 diabetes mellitus,including clinical cases reports and evidence-based studies were reviewed.Results Gastrointestinal bypass operation was regarded as an effective treatment for type 2 diabetes mellitus.There were three hypotheses of therapy mechanism: early delivery of nutrients to the distal intestine,exclusion of the proximal intestine and incretin/anti-incretin.Conclusion Gastrointestinal bypass operation is now considering as an effective treatment,there is still a lack of basic experimental studies to clarify the mechanism.