This paper analyzed some policies of new health care reform from the perspective of doctor -patient trust.The implementation of the policy of income and expenses in two lines has changed the management mode of township hospitals , eliminated some factors harming the doctor -patient relationship .The policy of equalization of public healthand other policies have guided the hospitals to change the way of service , service and health man-agement into the village increased the degree of doctor -patient trust .But at the same time , to ensure the new health care reform run smoothly , township hospitals introduced various ways of prescribing restraints .In addition , the policy of zero profit for basic drugs also brought some restrictions and regulations , resulting in a decline of satis-faction of patients , who have a tendency to blame the hospitals and doctors for these inconveniences .This misun-derstanding has becomed the new difficulties for doctor -patient trust as policy running .

Objective To investigate the effects of ulinastatin(UTI)on the nerve regeneration of mice experimental allergic encephalomyelitis and the expression of related factors and protein.Methods Forty mice were randomly divided into four groups:ulinastatin group(U),atorvastatin group(A), empty control group(C)and normal control group(N).The experimental autoimmune encephalomyelitis(EAE)in mice was constructed by Freund's complete adjuvant and MOG35-55 polypeptide.Histopathological changes were observed by HE,LFB and Bielschowsky stained at the 3rd week and 4th week after immunized of each group.The expressions of CD4 +T cells were estimated by immunohistochemical method.The expression of myelin basic protein (MBP),brain-derived neurotrophic factor(BDNF),growth associated protein-43(GAP-43),2',3'-cyclic nucleotide-3'-phosphodiesterase(CNP)were detected by Western-blot.Results The largest neurological score of group U was lower than group C,and the difference was statistically significant(P<0.05 ).Pathological features showed that the inflammatory cells,demyelination of spinal cord and axonal injury of group U were lighter than group C.With the duration of treatment,nerve injury decreased.After UTI treatment,the expression of MBP,BDNF,GAP-43,CNP increased.They were statistically significant difference when compared with group C(P<0.05).There was no significant difference between ulinastatin and atorvastatin in the treatment of EAE.Conclusion Ulinastatin could reduce the extent of nerve damage effectively and promote its regeneration which provide a theoretical basis for the clinical treatment of MS.

Objective To analyze and summarize the MR findings of intraspinal primary melanocytie neoplasms.Methods Five cases of intraspinal primary melanocytic neoplasms were retrospectively analyzed with emphasis on the location,growth pattern and MR signal intensity features of the tumors.Results A total of six tumors were found in five cases (one case had two tumors).The tumors were located in the cercival spine (2),thoracic spine (2),thoracolumbar junction (2) respectively.One tumor was located in the intramedullary space and 5 tumors in the extrumedullary-intradural space.Growth of the tumors were limited in the intradural space without evidence of extradural extension.The intramedullary tumor exhibited hyperintensity on both T2WI and T1 WI.The intradural tumors showed hyperintensity on T1WI and hypointensity or isointensity on T2WI of various degree.Three of these tumors were predominantly hyperintense on T1 WI and homogeneously hypointense on T2WI.Conclusion The intraspinal primary melanocytic neoplasms could be diagnosed pre-operatively due to their unique signal intensity features on imaging.

Objective To determine the serum concentrations of free carnitine in lipid storage myopathy(LSM) and the roles in diagnosis,classification and therapy of LSM. Methods Fasting blood samples of 8 LSM cases identified by muscle biopsies, 9 cases of other neuromuscular diseases and 18 cases of normal controls were enzymatically analyzed for free carnitine levels. Results In 8 LSM cases serum values of free carnitine were 4.4?2.5 mg/L, in 9 cases with other neuromuscular disease, serum levels of free carnitine were 10.2?2.5 mg/L and in 18 normal controls,11.8?2.9 mg/L. LSM cases showed significant decrease of free carnitine concentrations as compared with normal controls and other patients with neuromuscular diseases (P

The research reviews the purpose, significance and indwelling method of indwelling nasal jejunum in critically ill patients with neurosurgery in recent years and It also studies the effects of indwelling on organ function. For example, improving pulmonary ventilation function can reduce the mechanical ventilation time of patients with mechanical ventilation; can effectively promote intestinal tissue and function, reducing electrolyte disturbance;and long-term catheter can affect the liver function, the occurrence of gastric retention, diarrhea, obstruction of the pipeline and the related complications. The authors hope to provide a reference for the clinical care. At present, the use of nasal jejunum is the trend of enteral nutrition in critically ill patients with neurosurgery, but the replacement time of nasal jejunum tube, oral care and other related complications are lack of corresponding research.

In order to provide insights into sampling in suspected cases of morphine poisoning,the present study was conducted to investigate the distribution patterns of morphine in organs in rats with acute morphine poisoning at different post mortem intervals.Localization and semi quantitation of morphine in the brain,kidney,heart and liver were determined in rats at 15min to 5h after intravenous administration of morphine and at different intervals from 0 to 48h after death using the immunohistochemical SP method and image analysis.The results showed that the morphine could be detected in cytoplasms of certain parenchymal cells in all organs examined short time after delivery of morphine.With the extension of post delivery intervals,the level of morphine inereased,peaked,followed by decrease thereafter.The amount and the distribution patterns of morphine varied greatly with different organs.In the brain,the morphine could be detected earlier than in the heart,kidney and liver.It could detected 15min after the drug administration,with a peak,and disppeared at 5h after drug delivery.It decayed slowly as compared with the heart and lung.The kidney was the second organ in which the morphine was detected early with a high level and decayed slowly.In conclusion,immunohistochemical SP method can be used as a specific technique to detect morphine in organs in suspected cases of morphine poisoning.Both brain and kidney were the candidates for sampling in such case.

Objective: To study the protective effect of baicalin on myocardial ischemia reperfusion injury and its correlation to myocardial cell autophagy in experimental rats. Methods: The animal models were established by intragastric infusion at 7 days prior operation in different groups.Atotal of 48 rats were divided into 4 groups: Sham operation group, Sham+baicalin group, Ischemia reperfusion (IR) group and Baicalin treatment group. n=12 in each group. Hemodynamics at different time points and myocardial infarction (MI) size at 45 min after reperfusion were recorded; protein expressions of LC3-II and autophagy-related Becl-1 at 30 min after reperfusion were examined by Westernblot analysis; the opening condition of mitochondrial membrane channel transition pore (mPTP) was detected by NAD+ content. Results: The MI sizes in Sham operation group and Sham+baicalin group were too small to compare; MI sizes in IR group and Baicalin treatment group were (41.32±1.85) % vs (23.30±1.60) %, P<0.001. Protein expressions of LC3-II in IR group and Baicalin treatment group were (1.051±0.005) and (0.863±0.009) which were both higher than Sham operation group (0.763±0.007), P<0.01;Becl-1 were (1.169±0.002) and (0.943±0.005) which were both higher than Sham operation group (0.647±0.014),P<0.01; LC3-II and in Becl-1 expressions in Baicalin treatment group were decreased than IR group, P<0.01. NAD+ contents (by nmol/mg) in IR group and Baicalin treatment group were (6.02±0.33) and (9.56±0.53) which were both lower than Sham operation group (11.28±0.37), P<0.001; NAD+ content in Baicalin treatment group was increased than IR group,P<0.01. Conclusion: Baicalin had no autophagy effect in normal myocardial cells, but it may decrease the MI size and reduce excessive autophagy in myocardial cells after IR which might be related to inhibiting mPTP opening.

Objective:To do confirmatory factor analysis to prove structure validity of Mental Health Scale for Primary School Students.Method:Data was collected from 2030 primary school students and was analyzed by LISREL 8.0 program. Result:The subscales of Mental Health Scale for Primary School Students had good structure validity, the sample data fit for the hypothesized model. Except that for Interpersonal Relationship subscale, the indexes of other subscales (Learning subscale, self subscale and adjustment subscale) fit for the model with all coefficients over 0.9, these indexes were GFI?AGFI?NFI?NNFI?CFI?IFI. For the total scale, four latent variables had loaded to the observed items significantly, the whole scale had perfect fit between the observed data and hypothesized structure.Conclusion:Mental Health Scale for Primary School Students has good psychometric quality and can be used for Chinese primary school pupils.

Objective:To evaluate the occluding effect of 2 kinds of Er laser on dentinal tubules.Methods:27 dentine discs were prepared,etched with 0.5 mol/L EDTA and then divided into 3 groups(n =9).The samples in group A without treatment were used as the controls,in group B treated with Er:YAG laser irradiation and in group C treated with Er,Cr:YSGG laser irradiation.The occluding effect was examined by scanning electron microscopy (SEM).Results:Micrographs of SEMshowed obvious occluding effect in group B and C.The dentinal tubule exposure rates of group A,B and C were 33.61 0% ±7.545%,4.1 86% ±0.723% and 3.798% ± 0.843% respectively(among 3 groups,P <0.01 ;B vs C,P >0.05).Conclusion:The 2 kinds of Er laser can block dentinal tu-bules.

Objective To clone survivin gene, prepare its monoclonal antibody(McAb) and check its expression in liver carcinoma cells.Methods Survivin gene cDNA was amplified by RT-PCR from human breast carcinoma cell line MCF-7 and constructed into prokaryocytic expression vector.Fusion-protein of human Survivin was expressed and used for immunizing BALB/C mice.The spleen cells from immunized mice were fused with SP2/0 cells and selectively cultured with HAT medium.ELISA and Western blot were used to screen and identify the McAbs.Immunocytochemical staining was applied for survivin expression in liver carcinoma cells.Results The full survivin gene was cloned. The hybridoma cell that secret specific monoclonal antibody against human surviving was identified.The immunoglobulin subclasses of the McAbs were IgG1.Western blot showed that the McAbs against survivin can specifically react with MS-Survivin fusion protein. The positive reaction was found in hepatocarcinoma cell line HepG2 and hepatocarcinoma tissue by immunocytochemical staining.Conclusion The McAbs against the human Survivin were successfully prepared by a MS2-Survivin fusion protein expressed by E.coli. and the McAb had positive reaction with HepG2 and hepatocarcinoma tissue. It may be a useful tool to study the functions of survivin and check clinical cancer samples.