Relations between doctor and patient are basic and important human relation in medical practice.Because of some reasons,the relations appear tense status in our country,moreover the market economy flourishingly develops,as the result of medical organizations suffering more and more existent pressure.It is an important subject faced for people,especially for medical worker,to righly think the existed defects,and set up the mutual action between doctor and patient.

Angiotensin-converting enzyme 2 (ACE2)-angiotensin (1-7) [Ang (1-7)]-Mas constitutes the vasoprotective axis and is demon-strated to antagonize the vascular pathophysiological effects of the classical renin -angiotensin system .We hypothesize that upregulation of ACE2-Ang (1-7) signaling protects endothelial function through reducing oxidative stress , thus resulting in beneficial outcome in di-abetes.Ex vivo treatment with Ang (1-7) augmented endothelium-dependent relaxation (EDR) in renal arteries from diabetic patients . Both Ang (1-7) infusion via osmotic pump (500 ng? kg -1? min-1 ) for 2 weeks and exogenous ACE 2 overexpression mediated by ad-enoviral ACE2 via tail vein injection rescued the impaired EDR and flow-mediated dilatation ( FMD) in db/db mice.Diminazene acetu-rate treatment (15 mg? kg-1? d-1 ) activated ACE2, increased the circulating Ang (1-7) level, and augmented EDR and FMD in db/db mouse arteries.In addition, activation of the ACE2-Ang (1-7) axis reduced reactive oxygen species (ROS) overproduction de-termined by dihydroethidium staining , CM-H2DCFDA fluorescence imaging , and chemiluminescence assay in db/db mouse aortas and also in high-glucose-treated endothelial cells .Pharmacological benefits of ACE 2-Ang ( 1-7 ) upregulation on endothelial function were confirmed in ACE2 knockout mice both ex vivo and in vitro.We elucidate that the ACE2-Ang (1-7)-Mas axis serves as an important signal pathway in endothelial cell protection in diabetic mice , especially in diabetic human arteries .In summary, endogenous ACE2-Ang (1-7) activation or ACE2 overexpression preserves endothelial function in diabetic mice through increasing nitric oxide bioavail -ability and inhibiting oxidative stress , suggesting the therapeutic potential of ACE 2-Ang(1-7) axis activation against diabetic vasculop-athy.

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTL) is an aggressive non-Hodgkin lymphoma and there are no standard treatment options for ENKTL. For localized patients, radiotherapy alone or radiotherapy combined with chemotherapy could be took into consideration. Systemic combination chemotherapy remains the primary treatment for patients with advanced ENKTL. The efficacy of anthracycline based conventional chemotherapy in ENKTL is unfavorable. This paper reviews the treatment progress of ENKTL in recent years.

Relations between doctor and patient are basic and important human relation in medical practice.Because of some reasons,the relations appear tense status in our country,moreover the market economy flourishingly develops,as the result of medical organizations suffering more and more existent pressure.It is an important subject faced for people,especially for medical worker,to righly think the existed defects,and set up the mutual action between doctor and patient.

Objective To observe the effect of self mading Tongfengxiao decoction in treatment of acute gouty arthritis. Methods 69 patients were randomly divided into two groups. In the control group,33 patients were given diclofenac sodium sustained-release capsules and allopurinol treatment;In treatment group ,36 patients were given to the self mading Tongfengxiao decoction in addition to the western medicine received by the control group. The two groups were all treated for 14 days. Results The total effective rate was 94.4% for treatment group and 87.8% for control group respectively. Therefore, the difference of treatment effect between twp groups was significant ( P ＜0. 05 ) ;Also, the treatment group performed better than control group in term of reducing serum uric acid( P ＜ 0. 05).Conclusion The treatment of Tongfengxiao decoction combined western medicine for acute gouty arthritis had a good synergistic effect, and could reduce serum uric acid and improve clinical symptoms.

Objective To investigate apoptosis of placental syncytiotrophoblast in patients with early-onset and late-onset severe preeclampsia. Methods From November 2008 to May 2009, 15 cases with early-onset severe preeclampsia and 15 cases with late-onset severe preeclampsia matched with 10 women with normal pregnancies as control at Sixth Affiliated Hospital of Shanghai Jiaotong University were enrolled in this study. Enzyme-linked immunosorbent assay was used to measure syncytiotrophoblast microparticles (STBM) levels in peripheral venous plasma. Caspase-3 were measured by western blotting.Results (1)STBM: the level of STBM of (71 ± 21 )μg/L in early-onset group were significantly higher than (42 ±30)μg/L in late-onset group and (26 ± 11)μg/L in control group(P ＜0.05). The level of STBM in late-onset group and control group did not reach statistical difference ( P ＞ 0. 05 ). ( 2 ) Caspase-3:the level of caspase-3 protein were 0. 85 ± 0. 61 in early-onset group and 0. 77 ± 0. 46 in late-onset group,which were all significantly higher than 0. 32 ± 0. 15 in control group( P ＜ 0. 05 ). However, the level of caspase-3 protein in early-onset group did not show remarkable difference compared with that in late-onset group (P＞0. 05). Conclusion STBM are shed into the maternal circulation in higher amounts in earlyonset preeclampsia, which indicated that early-onset and late-onset severe preeclampsia may have different etiology and pathogenesis.

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 clinical value of ABCD score combined widl diffuse weighing imaging(DWI)for the estimation of transient ischemic attack(TIA)advancing to cerebral infarction in 7 days.Method The clinical dataincludingABCD score and DWI of 105 cases with TIA were analyzed.Results None of TIA patients with ABCD scores＜3 advanced to cerebral infarction.There were 83 cases with ABCD scores≥3,among whom 24 cases(28.9%)advanced to cerebral infarction.The higher ABCD scores,the higher incidence of cerebral infarction(P＜0.01).Nine of 42 cases(21-4%)with DWI abnrmal advanced to cerebral infarction,while 2 of 50 cases(4.0%)with normal DWI advanced to cerebml infarction (P＜0.05).Conclusion ABCD score is alleffective method for the estimation of TIA advancing to cerebral infarction,and when combined with DWI it is more efficient

Objective To investigate the effieacy and safety of intravenous itraconazole for the treatment of invasive fungal infection(IFI)in patients with hematological disease or undergoing allogeneic hematopoietic stem cell transplantation(HSCT).MethodsSix hundred and sixty-six patients with above mentioned conditions and diagnosed as IFI from January.2007 to July,2007 were enrolled.Intravenous itraconazole was administered at a dose of200 nag every 12 hours for 2 days and followed by 200 mg every 24 hours.Patients were then switched to oral itraconazole according to the clinical situation Responses were determined on the basis of clinical and microbiological criteria.Results The probability of defervescence Was 69.8%and the total response rates among related to itraconazole were the proven.probable and possible IFI patients were 73.7%.68.1%and 68.2%(P=0.380).Adverse effects were found in 58 patients (8.7%).which were mainly mild to medium reversible dysfunction of liver and gastrointestinal tract, Conclusion Itraconazole is an effective and safe antifungal agent for patients with hematological disease or undergoing HSCT and is suitable for empirical antifungal therapy.

Inflammatory bowel disease(IBD)is a chronic nonspecific intestinal inflammatory disease and the etiology and pathogenesis are not fully clarified. Studies showed that immune factors play an important role in the pathogenesis of IBD. Cytapheresis(CAP)is a new blood purification method which can selectively filter or adsorb the inflammatory cells and cytokines in systemic circulation. Many studies confirmed that CAP had some therapeutic effect on IBD. This article reviewed the advances in study on CAP in treatment of IBD.