Excessive medical treatment goes against the human rights of patients and therefore must be stopped.Main reasons include the impulse of existing medical benefit mechanism,the morality decline of medical staff,and patients' eagerness to shake off physical pain and psychological advocating for high-cost medical expenditure.This paper also comes up with relevant countermeasures including reversing the current healthcare mechanism,establishing an evaluation system for medical ethics of medical staff,and building up a monitoring mechanism for the development of clinical guidelines of evidence-based medicine.

Objective To evaluate the safety of thrombolytic treatment using rt-PA at early stage of acute cerebral infarction in Chinese patients, and to analyze the significance of intra - cerebral hemorrhage after therapy. Methods 206 patients within 6 hours after the onset of stroke were divided into 3 groups: group A (thrombolytic treament using rt - PA with dosage of 0.9 mg/kg over 60 minutes) , group B (thrombolytic treatment using rt-PA with dosage of 0.7 mg/kg over 60 minutes) and group C (control group without rt-PA). Group A, group B, group C were divided into two subgroups according to using Clexane or not. Patients in subgroups A1, B1, C1 were treated with Clexane and in subgroups A2, B2, C2 were not. The Chinese Stroke Scale (CSS) and Barthel Index (BI) were used to evaluate the neurological function before and 24 hours, 3 days, 7 days, and 90 days rt-tPA. Results There was significant difference on hemorrhagic rate and cerebral hemorrhagic rate at the 48 hours and 14 days between group A, group B and group C. There was no significant difference on symptomatic cerebral hemorrhage in groups A, B and group C. There were significant differences between thrombolytic groups and group C on the effective and curative rate at 90 days after therapy. The mortality was lower in thrombolytic groups than in group C at 90 days. There was no significant difference between group A and group B , and also between the subgroups. Conclusion Thrombolytic treatment using rt-PA intravenously in patients with acute cerebral infarction within 6 hours was effective and safe. The dosage of 0.7mg/kg was suitable for Chinese patients.

Objective To investigate the feasibility and application scope of the looping technique by using a gooseneck snare and a loach guide wire in retrieving tubular foreign bodies within the vascular or ureteral duct. Methods During the period from July 2009 to Dec. 2013, six patients with ruptured catheter were admitted to authors’ hospital. All six patients were females. Three patients had internal ruptured peripherally inserted central venous catheter (PICC), one patient had ruptured implantable venous access port catheter and two patients had replacement of double “J” ureteral catheter stent. By using looping technique, i.e. a loach guide wire and a gooseneck snare were separately placed at the two ends of the tubular foreign body, then the gooseneck snare entangled the soft leading end of the loach guide wire to form a annular structure to seize the ruptured tubular catheter and then to pull it out of the body. Results With the help of the looping technique, the internal ruptured catheter or the double “J” ureteral catheter was successfully removed in all the six patients. Conclusion For the retrieval of the tubular foreign bodies within the vascular or ureteral duct, the looping technique by using a gooseneck snare and a loach guide wire is an effective and fast treatment. Therefore, this technique should be recommended in the clinical practice.

Objective To understand the endemic characteristics and regularity of cystic echinococcosis by evaluating and classifying its endemic situation in Non Tibetan Plateau regions,so as to provide the evidence for formulating effective preventive and control measures. Methods The prevalence data of cystic echinococcosis in 174 counties(cities,districts,banners)in Non Tibetan Plateau regions from a national survey were collected and analyzed by the sample cluster method in 2012. Results The 174 counties(cities,districts,banners)could be classified into 4 clusters by spatial distribution. The first cluster with human high prevalence rate,low infection rate of livestock,and positive rate of dog stool antigen included 3 counties. The second cluster with high infection rate of livestock,low prevalence rate of human,and positive rate of dog stool antigen included 20 counties(cit-ies). The third cluster with high positive rate of dog stool antigen,low prevalence rate of human,and low infection rate of livestock included 39 counties(cities,districts,banners). The fourth cluster with low rates of the above 3 indices included the rest 112 counties. Conclusions The results of the cluster analysis conform to the current epidemiological status of cystic echinococcosis in the Non Tibetan Plateau regions. The epidemiological characteristics and geographical distributions of the four area types will pro-vide a basis for the classified management and guidance of cystic echinococcosis control in these areas.

Objective To observe the effect of bone marrow mesenchymal stem cells (BMSCs) transplantation on the expression of growth associated protein-43 (GAP-43) in rats after spinal cord injury (SCI). Methods The SCI models were made by impacting at the level of T11 segment. After modeling, the rats were randomly and equally divided into control group (n=18) and observation group (n=18). 1 week after injury, DMEM/F12 medium 0.1 ml was injected into tail vein of rats in the control group, and an equal volume of BMSCs suspension was injected in the observation group. 1, 2, 4, 8 weeks after SCI, the hindlimb function was evaluated by the Basso-Beattie-Bresnahan (BBB) score. 2, 4, 8 weeks after SCI, the expression of GAP-43 mRNA was detected by RT-PCR, and the expression of GAP-43 was detect-ed by the immunohistochemistry. Results 2, 4, 8 weeks after SCI, compared with the control group, The BBB score increased, the expres-sion of GAP-43 mRNA and GAP-43 increased in the observation group (P<0.05). Conclusion BMSCs transplantation can improve the ex-pression of GAP-43 in gene and protein level, and then promote the repair of SCI.

Objective To detect the expression of FoxO1 and FoxO3a in liver and muscle tissue from KKAy diabetic mice.Methods Study group consists of 7 KKAy diabetic mice until 12 weeks,thereafter fed high fat diet for 4 weeks.It was diagnosed as diabetes when blood glucose was more than(16.7 mmol/L) in two consequent weeks.Control group consists of 7 C57BL mice 16 week old.Dispatched the mice and took quadriceps of femoris muscle and liver tissue to detect the FoxO1 and FoxO3a protein expression by Western blot with antibody.Results Liver and muscle FoxO1 expression was higher in KKAy diabetic mice than that in C57BL mice.FoxO3a expression was much higher in liver than in muscle in both groups.Muscle FoxO3a expression was higher in KKAy diabetic mice than that in control mice.Conclusion FoxO1 and FoxO3a in liver and muscle expressed differently in diabetic mice and control mice.They may play a role in mechanisms of insulin resistance and type 2 diabetes mellitus.

Objective To detect protein PTEN in live and muscle tissue of KKAy diabetic mice and to investigate whether PTEN is associated with the insulin resistance in diabetic KKAy mice.Methods Animals were divided into normal diet C57BL group(n=7,sixteen-week-old C57BL mice),high fat diet C57BL group(n=7),diabetic KKAy group(n=7),the latter two groups were fed with normal diet until week 12,followed by high fat diet for 4 weeks.Blood glucose was measured every week,it would be diagnosed of diabetes if blood glucose more than 300 mg/dl(16.7 mmol/L) in two consecutive weeks.Dispatched the mice,took quadriceps of femoris muscle and liver tissue,added tissue lytic solution,measured the protein concentration by Bradford method and detect the PTEN protein expression in muscle and liver tissue by Western bolts methods.Results The PTEN protein level was significantly increased in quadriceps muscle and live tissue in KKAy mice as compared to the both age-matched C57BL control groups(P

Objective To detect the expression of FoxO3a in adipose tissue from KKay diabetic mice and the effects of treatment with rosiglitazone and metformin on FoxO3a expression in adipose tissue in order to understand the mechanism of insulin resistance.Methods Mice were randomly divided into 3 groups: the group without any treatment,group with rosiglitazone and group treated with metformin 3 g/kg/day.Control group consists of 7 C57BL mice 16.Dispatched the mice and sampled adipose tissue to measure the protein concentration by Bradford method and to detect Foxo3a protein expression on adipose tissue by Western Blot with multiple colony antibody 1∶1250.Results Foxo3a was highly expressed in adipose from KKAy diabetic mice as compared with that in control group(FoxO3a/?-actin ratio 1.76?0.19 vs 1.15?0.10,P

Objective To evaluate left atrial appendage regional function and movement changes of systolic and diastolic in patients with atrial fibrillation by speckle tracking imaging(STI) and real-time three-dimensional transesophageal echocardiography(RT-3D TEE).Methods Sixty-seven patients underwent RT-3D TEE was divided into 24 controls,22 paroxysmal atrial fibrillation,21 persistent atrial fibrillation.Left atrial appendage was divided into basal,middle and apical segment.Left atrial appendage emptying fraction of the overall (LAA-EF),basal emptying fraction (B-EF),middle emptying fraction (M-EF) and apical emptying fraction (A-EF) was measured by three-dimensional volume measurement.Each segment systolic strain rate (SRS) and diastolic strain rate (SRD) was measured by STI.Results LAA-EF,B-EF,M-EF,A-EF of paroxysmal atrial fibrillation and persistent atrial fibrillation group were lower than those of the control group,and persistent atrial fibrillation group was the lowest in the three groups.Compared with the control group,SRS and SRD of left atrial appendage basal,middle,apical segment was lower in paroxysmal atrial fibrillation group and persistent atrial fibrillation group,and persistent atrial fibrillation group decreased more significantly.Conclusions Paroxysmal atrial fibrillation and persistent atrial fibrillation can lead to left atrial appendage global or local systolic and diastolic function to reduce,and persistent atrial fibrillation decreased more significantly.

Objective To investigate the feasibility of bone marrow mesenchymal stem cells (BMSCs) combined with type Ⅱ collagen-hyaluronic acid-oxidized chondroitin sulfate (Col Ⅱ-HA-OCS) biomimetic hydrogel to repair articular cartilage defect in porcine and the role of the transplanted cells played in the process of cartilage repair.Methods A articular cartilage defect model which remaining cartilage calcified zone was created in the knee of Bama minipigs,the autologous BMSCs was used as seeds for transplantation and was labeled by the 5,6-carboxyfluorescein diacetate succinimidyl ester (CFDA SE).Animals were randomly divided into three groups:Group A (blank group) was left untreated,group B (cell-free biomimetic hydrogel group) was filled with biomimetic hydrogel and group C (BMSCs combined with biomimetic hydrogel group) was filled with the CFDA SE labeled autologous BMSCs combined with biomimetic hydrogel.One month after the operation,BrdU labeled liquid was injected intravenously into the animals 24 h and 48 h before specimens were taken from the executed animals.Partial cartilage repaired tissue in Group C was taken,cryosectioned and stained with DAPI and BrdU immunofluorescence.Confocal laser scanning microscope was used to observe and count the cells.Specimens of the three groups were analyzed through gross observation and histological staining,and scored according to the international cartilage repair society (ICRS) gross morphological score and ICRS histological score.Results Laser scanning confocal microscopy showed (97.3 ± 2.6) ％ of the cells were derived from the implanted BMSCs in repaired tissue and that the ratio of these cells with proliferative capacity was (76.6 ± 2.5) ％.Gross observation suggested most of the cartilage defect areas in Group C were filled with ivory tissue,but those in Group A and B were still obvious depression.Histological staining showed the cartilage defect areas in Group C were filled with cartilage like tissue,which was well integrated with the surrounding normal cartilage,presented a few cartilage lacunas could be seen,and had contents of Col Ⅱ and glycosaminoglycan similar with the adjacent normal cartilage.There was almost no filler in the defect area in Group A.There was little fibrous tissue in the defect area in Group B.ICRS gross score was (8.3 ± 1.0) points in Group C,higher than that in Group A [(0.5 ± 0.6) points] and Group B [(2.3 ± 0.5) points] (P ＜ 0.05).ICRS histological score was (10.3 ± 2.4) points in Group C,higher than that in Group A [(0.5 ± 0.6) points] and Group B [(4.5 ± 1.0) points] (P ＜ 0.05).Conclusions BMSCs combined with Col Ⅱ-HA-OCS biomimetic hydrogel for repairing porcine articular cartilage defects can achieve satisfactory results.Implanted BMSCs are the main component of the cell composition in the repaired tissue and gradually differentiated into chondrocytes.