The construction of harmonious doctor-patient relationship is an important project in social medicine .The influen-cing factors about doctor-patient relationship are analyzed from three aspects which are responsibility ethics , bottom-line ethics and clin-ic ethics.Based on the discussion , certain countermeasures are proposed to reconstruct harmonious doctor -patient relationship .

This study is designed to obtain recombinant human acetylcholinesterase (rhAChE) and apply it in screening acetylcholinesterase inhibitors. The rhAChE was overexpressed in HEK293 cells transfected by plasmid of pCMV-AChE with the cationic liposome and rhAChE was found to be secreted into cell culture medium. AChE activity was assayed according to modified Ellman method to obtain kinetic parameters. IC so50 values for donepezil compounds of rhAChE were calculated to determine their activities of inhibition. The results showed that Km value was 151.9 micromol.L-1 donepezil inhibited rhAChE in a mixed competitive-noncompetitive way (Ki= 16.03 nmol.L-1, Ki = 18.36 nmol.L-1) and that most new compounds tested exhibited high activities of inhibition on rhAChE. The study suggests that rhAChE is available to be applied in screening AChE inhibitors in vitro.

Objective To analyze the change trend of hospitalized patients with pulmonary embolism in Wuzhou city during 2004-2014,and analysis of its risk factors.Methods From January 2004 to January 2014,from four comprehensive tertiary hospitals of Wuzhou city,we selected hospitalized cases of pulmonary embolism as investigation subjects,which from 2004 to 2008 were selected as control group,and from January 2009 to January 2014 were selected as observation group.The hospitalization rate,mortality rate and risk factors were compared between the two groups.Results From 2004 to 2008,there were 257 370 cases of hospitalized,pulmonary embolism hospitalized in 52 cases at the same period,accounting for 0.02％ of the total hospitalized cases.From January 2009 to January 2014,there were 367 728 cases of hospitalized,pulmonary embolism hospitalized in 115 cases at the same period,accounting for 0.03％ of the total hospitalized cases.The proportion of pulmonary embolism in total hospitalization between the two groups had statistically significant difference (P ＜ 0.05).From 2004 to 2008,in 52 cases of pulmonary embolism,24 cases (46.15％) died,includef 16 cases(30.7％) died of pulmonary embolism,and the rest 8 cases(15.38％) died of the complication.From 2009 to 2014,in 115 cases of pulmonary embolism,30 cases (26.08％) died,included 23 cases(20.00％) died of pulmonary embolism,and the rest 7 cases(6.08％) died of complications.The difference of the mortality rate in the two periods was statistically significant (x2 =3.879,P ＜ 0.05).52 cases of pulmonary embolism of the control group were selected to study risk factors and basic diseases,the risk factors and basic diseases of pulmonary embolism had 11 kinds,the highest frequency was in lower limb venous thrombosis,followed by surgery and lie in bed for a long time,again for malignant tumor,smoking,fracture,hyperlipidemia,arrhythmia(atrial fibrillation,etc.) and diabetes,etc.Conclusion The hospitalization proportion and mortality trend of hospitalized patients with pulmonary embolism in Wuzhou city remains unchanged,to study the risk factors in order to get a better prevention and treatment measures.

ObjectiveTo sum up the experience in the treatment of acute arterial ischemia in the extremities. Methods From 1980 to 2001,148 patients with acute arterial ischemia in the extremities were treated by multiple-means such as: embolectomy, interventional treatment, thrombolytic and antiagglutinatives. Results The cure rate in patients treated within 12 hours was 95.5%,mortality was 4.5%,while the cure rate, alleviative rate, amputation rate and mortality in patients treated 12～24 hours after onset were 64.8%,17.6%,9.9%,7.7%,respectively and that were 20%,34.3%,25.7%,20% respectively when treatment started 24 hours after the onset. The cure rate in 19 patients treated by nonoperative means was 10.5%, alleviative rate was 73.3%, amputation rate was 15.8%. Conclusion Patients with acute arterial ischemia suffer a high mortality. Mortality and disability rate can be reduced by early diagnosis, appropriate treatment and effective management for the systemic diseases.

The purpose of this study is to evaluate the interaction effects of In-Chen-How (Artemisia capillaries Thunb.) on the pharmacokinetics of acetaminophen and on liver microsomal cytochrome P450 enzyme activity in rats. The rats were divided into control group (n=8) without In-Chen-How and the pretreated group (n=8) administered with In-Chen-How (approximately 1.0 mL·kg-1, according to weight) for 5 consecutive days. Rats in the control group received water simultaneously. Each rat was then given acetaminophen. The pharmacokinetic parameters of acetaminophen of the two groups were significantly different. In the In-Chen-How pretreated group, the maximum concentration of acetaminophen and the area under the plasma concentration-time curve were reduced about 58.4%, 56.7% and 55.4%. To further explain the results, liver microsomal suspensions were obtained from rats that were randomly divided into control and In-Chen-How pretreated group. The levels of CYP1A2 and CYP2E1 in hepatic microsomal protein from pretreated group were increased as compared to that from the control group. It indicated that In-Chen-How can stimulate the activity of CYP isozymes. The changes in the pharmacokinetics of acetaminophen resulting from the administration of In-Chen-How are related to an increase in metabolic activity of CYP1A2 and CYP2E1.

Objective To investigate the association between psychological stress and oxidative damage in TNM stage Ⅲ patients with poorly differentiated gastric adenecarcinoma (GA). Methods One hundred and six patients with newly diagnosed poorly differentiated GA were assessed using the Hamilton Depression Rating Scale (HAMD), Zung Self-rating Depression Scale (SDS), Zung Self-rating Anxiety Scale (SAS), Symptom Checklist 90 (SCL-90), activities of daily living (ADL) and other multiple-item qnestionnaires. Oxidative-stress-related parameters in serum and the expression of DNA repair genes were monitored during a pretreatment period. Results The patients were divided into depression and nondepression groups (Groups A and B, respectively) based on a HAMD score cutoff of 20. The mean SDS, SAS, SCL-90, ADL and passive coping scores were higher in Group A, whereas social support and quality of life were lower. Serum total antioxidant capacity, eatalase, superoxide dismutuse concentrations and anti-superoxide anion capacity (A-ASC) were significantly decreased in Group A, whereas serum malondialdehyde (MDA) and 8-hydroxy-deoxyguanosine (8-OHdG) levels were significantly increased. Pearson correlation analysis revealed that depression was pesitively correlated with MDA, SAS, SCL-90 and ADL, but negatively correlated with A-ASC. Furthermore, real-time PCR revealed that the expression levels of hOGG1 and APEX1 were increased in Group A. Conclusion Psychological stress might be related to impaired antioxidant system in patients with GA, and it presents the first evidence of the involvement of oxidative DNA damage in the pathogenesis of depression.

Objective To analyze the clinical efficacy of endovenous laser treatment combined with transilluminated powered phlebectomy for great saphenous varicosity and summarize the experiencein order to achieve better results.Methods From January 2014 to June 2015,45 patients (52 limbs,including 17 males and 28 females,aged 36 to 68 years) diagnosed as great saphenous varicosity received endovenous laser treatment combined with transilluminated powered phlebectomy.Thirty-eight cases was unilateral great saphenous vafcose veins,7 cases was bilateral large saphenous varicose veins.The clinical efficacy was analyzed.Results All cases were performed successfully.The mean operation time was (68.4 ± 15.1) minutes,the average bleeding volume was (23.5 ± 10.7) ml,the number of mean operative incision quantity was (5.8 ± 1.9) and the average hospitalization time was (5.9 ± 1.6) days.All patients had no serious complications.During a mean follow-up time of 22 months (12 to 30 months),only one patient recurred.Conclusions Endovenous laser treatment combined with transilluminated powered phlebectomy for great saphenous varicosity is effective and safe.It also has the advantages of shorter operation time,less bleeding,shorter hospitalization time,small trauma and better cosmetic results.

0.05]. CONCLUSIONS: The currents of voltage-gated potassium channel was inhibited by chronic hypoxic. The inhibitory effect of cGMP on currents of voltage-gated potassium channel in PASMCs from both normal and chronic hypoxic rats may be probably through the phosphorylation of voltage-gated potassium channel.

Objective To compare the efficacy of endovenous laser treatment combined with transilluminated powered phlebectomy and traditional surgical treatment for great saphenous varicosity. Methods From January 2014 to January 2015,77 patients diagnosed as great saphenous varicosity were enrolled. They were randomly divided into two groups, 37 patients received endovenous laser treatment combined with transilluminated powered phlebectomy and the other 40 patients underwent traditional surgical treatment. The related indicators were compared.Results The mean operation time,average bleeding volume,operative incisionquantity and average hospitalization time of EVLT+ TIPP group were (66.1±14.7) min,(24.4±10.5) ml,5.7±1.7,(5.6±1.4) d respectively,of control group were (84.3±18.5) min,(59.0±15.6) ml,8.0±1.8,(10.1±3.1) d respectively,there were significant differences between the two groups(t =-4.749,-11.460,-5.714;P<0.001) .There were no significant complications in the two groups.In the EVLT+ TIPP group,6 patientsoccurred patsubcutaneous induration, 5 patients occurred subcutaneous hematoma and 7 patients had skinparesthesias.In the traditional operation group,2 cases occurred patsubcutaneous induration,3 cases occurredsubcutaneous hematoma and 2 cases had skin paresthesias.The EVLT+ TIPP group was slightly higher than thetraditional operation group in the complications, but there were no significant differences between them ( P>0.05).During a mean follow?up time of (18±7) months(12 months to 24 months),1 patient recurrence in theEVLT+ TIPP group,2 cases recurrence in the traditional operation group.The recurrence rates of the two groupswere similar,the difference was not significant between them(P=1.000) .Conclusion Endovenous lasertreatment combined with transilluminated powered phlebectomy for great saphenous varicosity is effective andsafe.It also has the advanta and better cosmetic results.

Objective To explore the effects of different extracts of modified Siwu Siteng Decoction (TFT-Ⅰ, TFT-Ⅱ) on rat models with hyperuricemia. Methods Rat model with hyperuricemia was induced by hypoxanthine and oxonic acid potassium salt. Seventy rats were randomly divided into 7 groups:normal group, model group, allopurinol group, TFT-Ⅰ high and low dose groups, TFT-Ⅱhigh and low dose groups. Each dose group was given lavage with related medicine, and blank group and model group were given lavage with distilled water for one week, respectively. Uric acid in serum (SUA) was measured through fully automatic biochemical analyzer, and xanthine oxidase (XOD) activity in serum and liver tissue was measured through colorimetric method. Results Compared with model group, TFT-Ⅰ and TFT-Ⅱ high dose groups significantly reduced the level of SUA, serum and liver XOD activity (P<0.05), with significant statistical difference between the two groups (P<0.05). TFT-Ⅰ and TFT-Ⅱ low dose groups had no significant effects on SUA, and XOD activity in serum and liver (P>0.05). Conclusion Alcohol soluble ingredients of astragalus membranaceus and Siwu decoction in modified Siwu Siteng Decoction can effectively reduce the level of blood uric acid.