Firstly, this paper stated the definition of doctor -patient conflict. Then, it analyzed the root of doctor-patient conflict from cultural, institutional, and legal aspects. At last, in order to build a harmonious doc-tor-patient, it pointed out that the balance of doctor-patient interests was the basis, establishment of a multi-level and multiform social safety mechanism was the foundation, multidimensional discussion of the social psycho-logical causes of doctor-patient conflicts deeply was the premise, and establishing guarantee mechanism from the perspective of balancing of interests was the guarantee.

OBJECTIVE:To evaluate the quality of solid lipid nanoparticle of the skin extract of Bufobufo gargarzans. METH-ODS:The morphology of solid lipid nanoparticle of the skin extract of B. gargarzans was observed by TEM. The particle size was determined by laser scattering particle size analyzer. The contents of cinobufagin and resibufogenin, encapsulation efficiency, drug-loading amount and accumulative release rate of cinobufagin were determined by HPLC. The stability of nanoparticle was in-vestigated within 24 h at 60,25 and 4 ℃. RESULTS:The solid lipid nanoparticle of the skin extract of B. gargarzans were uni-form in particle size and showed round and spheroidicity shape;average particle size was(138.5±4.2)nm,The encapsulation effi-ciency of cinobufagin and resibufogenin were 90.60% and 91.51%,and drug-loading amount were 35.82% and 44.15%. The accu-mulative release rate of cinobufagin was 50%at 4 h and reached 88%at 48 h,which was in line with Weibull equation(r=0.9438). Under 3 kinds of temperature conditions,encapsulation efficiency decreased gradually as the holding time of nanoparticle pro-longed;the decrease degree was the smallest at 4 ℃.CONCLUSIONS:The quality evaluation results of solid lipid nanoparticle of the skin extract of B. gargarzans are in line with the standard,and prepared nanoparticles show sustained-release effects and should be kept under low temperature.

AIM:To isolate and purify the active components from Centella asiatica, and to observe their effect on the proliferation and apoptosis of mouse spleen lymphocytes .METHODS:Semi-preparative high-performance liquid chro-matography was performed to further isolate and purify the extracts from Centella asiatica.The effects of the active components on apoptosis and mitochondrial membrane potential of the spleen lymphocytes were assessed by flow cytometry .The structures of the active components were identified by ultraviolet spectrometry , electrospray ionization negative-ion mass spectrometry , [1H] nuclear magnetic resonance (NMR) and [13C] NMR.RESULTS:The molecular weights of the active components from Centella asiatica, named compound I and compound II , were 302 and 286, respectively.The compound I and com-pound II from Centella asiatica significantly inhibited the proliferation , promoted the apoptosis and reduced the mitochondri-al membrane potential of mouse spleen lymphocytes .Compound I and compound II were identified as quercetin and kaempferol .CONCLUSION:The compound I and compound II from Centella asiatica show antiproliferative and immuno-suppressive effects on mouse spleen lymphocytes by promoting apoptosis and reducing mitochondrial membrane potential .

Objective To establish the reference interval of 3-14 years old children in Nanhai district of Foshan city .Methods 2 032 cases of 3-14 years old healthy children were detected and analyzed using MINDRAY BC-5800 automatic blood cell analy-zer .The levels of WBC ,RBC ,Hb ,PLT ,Hct ,MCV ,MCH ,MCHC ,RDW were analyzed .Results The levels of WBC ,RBC ,Hb , PLT ,Hct ,MCV ,MCH ,MCHC ,RDW in 2 031 cases were non normal distribution .The levels of Hb ,Hct had no statistical signifi-cance between male children and female children (P>0 .05);The levels of WBC ,RBC ,PLT ,MCV ,MCH ,MCHC ,RDW had statis-tical significance between male children and female children (P<0 .05) .Conclusion It is very important to establish the reference interval of 3-14 years old children in Nanhai district of Foshan city .

OBJECTIVETo observe the efficacy differences between acupoint catgut embedding at cervical Jiaji (EX-B 2) points combined with electroacupuncture (EA) at acupoints near ear and simple EA for the treatment of nervous tinnitus.

METHODSSixty-three patients were randomly divided into an observation group (31 cases) and a control group (32 cases). The observation group was treated with acupoint catgut embedding at C4-C7 Jiaji (EXB 2) points on the affected side combined with EA at acupoints near ears, including Ermen (TE 21). Tinggong (SI 19), Tinghui (GB 2), etc.; the control group was treated with EA at regular acupoints near ears alone. The EA treatment was given five times per week, and the acupoint catgut embedding was given once every two weeks. All the treatment was given for 6 weeks. The Tinnitus severity score (TSS)was applied to assess the severity of tinnitus before the treatment, 2 weeks, 4 weeks and 6 weeks into treatment and one month after treat ment. Also the efficacy of two groups was compared.

RESULTSAfter the treatment, the severity of tinnitus was both improved in two groups at each time point (all P<0.05). which was more significant in the observation group (P<0.05, P<0.01). The cured and markedly effective rate was 77.4% (24/31) in the observation group, which was superior to 50.0% (16/32) in the control group (P<0.05).

CONCLUSIONThe short-term and long-term efficacy of acupoint catgut embedding at cervical Jiaji (EX-B 2) points combined with electroacupuncture are both superior to those of simple electroacupuncture for treatment of nervous tinnitus.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Catgut ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Tinnitus ; therapy

Objective To analyze the semen quality in the outpatients from 3 male infertile clinics of Foshan city.Methods The semen from 1 865 outpatients with male infertility was detected and analyzed routinely by the CASA technology in strict accordance with the WHO operation technical specifications.The outpatients were divided into the normal group,mild,moderate and severe as-thenospermia groups according to the sperm vitality.Results There were 524 (28.1%)cases of abnormal sperm concentration,826 (44.3%)cases of abnormal sperm viability,985 (52.8%)cases of abnormal sperm motility,713 cases (38.2%)of teratosperm and 652 (35.0%)cases of leukocytospermia in all outpatients;the motion parameters were decreased along with the decrease of activity in each group,in which,the 6 indicators of VSL,VAP,VCL,LIN,STR and WOB were significantly lower than those in the normal activity group with statistical differences(P <0.05),furthermore,the sperm vitality had staitstcally significant differences among the mild,moderate and severe asthenospermia groups (P <0.05).Conclusion In the routine parameter indicators,the sort order of the percentage of abnormal results in turn were sperm motility、sperm viability、sperm deformity rate、semen WBC、sperm concentra-tion、semen liquefaction time、semen pH.With reduced sperm motility,the sperm motion parameters of VSL,VCL,VAP,LIN,STR and WOB were decreased,the results of each group were significantly lowered (P <0.05).

BACKGROUND:Common therapies for damage to the central tendon of finger extensor tendon include Matev, Carrol, Fowler methods as wel as residual central tendon flipping repair, but the therapeutic effects are no satisfied with bloated appearance, tendon adhesions, limited joint function. OBJECTIVE:To investigate the clinical effects of dorsal longitudinal driling and segmental tendon graft to repair old central tendon injury. METHODS:Eighty patients with old central tendon injury were randomized into treatment group and control group, with 40 cases in each group. In the treatment group, dorsal longitudinal driling and segmental tendon transplantation were given; while in the control group, Carrol, Matev, Fowler methods were chosen according to the individual conditions. Then, the therapeutic outcomes were compared between two groups. RESULTS AND CONCLUSION:The excelent and good rate was 85% in the treatment group and 65% in the control group, and there was a significant difference between the two groups (P < 0.05). Results from Valpar Component Work Samples showed that the number of cases adapting to the original work was 30 cases (75%) in the treatment group and 16 (40%) in the control group, and there was also a significant difference between the two groups (P < 0.05). The degree of proximal interphalangeal joint flexion was increased gradualy in the two groups at admission, at 15 days after hospitalization, at 1 day before discharge and at 4 months after discharge, and meanwhile, the degree of proximal interphalangeal joint dorsiflexion was reduced gradualy (P < 0.05). There were significant differences in the degree of proximal interphalangeal joint flexion and degree of proximal interphalangeal joint dorsiflexion between the two groups at 15 days after hospitalization, 1 day before discharge, and 4 months after discharge (P < 0.05). These findings indicate that the dorsal longitudinal driling and segmental tendon graft for repair of old central tendon injury can play an effective role in the recovery of articular flexion and extension function.

Objective To investigate the value of CT and endoscopic ultrasonography (EUS) in the diagnosis of gastrointestinal stromal tumors (GIST). Methods Eleven patients with surgically and pathologically proved GIST were collected and retrospectively analyzed.Plain CT scanning was performed in all 11 cases and enhancement in 10 cases, while additional EUS in 8 cases.Results Of the 11 lesions, 8 were located in stomach, 1 in esophagus, 1 in duodenum, and 1 in rectum, respectively.In benign GIST, the diameter of the tumor was less than 5 cm, with clear margin and homogeneous density.In malignant GIST, the characteristic appearances were as follows: (1) The diameter of the tumor was more than 7 cm; (2) The tumor was lobular in shape; (3) Lesions contained intratumoral small or large patchy necrosis; (4) The tumor had large and deep ulcers; (5) Around the tumor, small vessels arranged in clumps or in line; (6) The tumor contained scattered small calcifications; (7) Invasion of adjacent tissues and metastasis.The positive predictive value of CT for location of GIST was 54.5% (6/11), the positive predictive value of EUS was 87.5% (7/8).By pathology, benign GIST was identified in 3 cases, malignant in 7 cases, and active proliferation in 1 case.The positive predictive value of CT for differentiation of benign and malignant GIST was 72.7% (8/11), the positive predictive value of EUS was 62.5% (5/8).Conclusion CT combined with EUS are helpful in evaluating the gastrointestinal origin of GIST, and in differentiating between benign and malignant GIST, and in instructing clinical treatment and estimating prognosis.

[Objective] To analyze the image findings of MR enterography (MRE) and diffusion weighted imaging (DWI) in Crohn disease (CD) and to discuss the diagnostic value of MRI for evaluating the activity of CD.[Methods] 26 patients proved by clinical,imaging and pathological data were enrolled in this study.The intra-/extra-intestinal image features of CD were retrospectively analyzed,and the intestinal lesions were evaluated by MRE+DWI scoring system.The differences in image features of active and inactive CD were compared.[Results] 26 bowel segments were evaluated and included active (n =20) and inactive CD (n =6).The intestinal performance of CD included wall thickening,T2WI hyperintensity and hyperenhancement.The pathological changes of active CD were more serious when comparing with that of inactive CD.DWI showed hyperintensity in the affected bowel wall.ADC of active C D [(0.9 ± 0.2) × 10-3 mm2/s] was significantly lower than that of inactive CD [(1.5 ± 0.4)× 10-3 mm2/s] (P ＜ 0.001).Extra-enteric performance of active CD included comb sign,lymphadenectasis of mesentery,mesenteric exudation,fistula and abdominal abscess.[Conclusion] MRE combined with DWI can accurately assess CD activity and diagnose extra-enteric complications.

Objective To explore the diagnostic value of magnetization transfer imaging (MTI) and DWI for detecting intestinal wall property of crohn's disease (CD). Methods Forty four patients with CD were prospectively enrolled in the study, and MR enterography (MRE), MTI and DWI were performed. According to MRE findings, patients were divided into three subgroups:acute inflammatory group, chronic fibrotic group and combined inflammatory with fibrotic group. Intestinal wall T2WI signal, magnetization transmisson rate (MTR) and ADC value were measured on MRE, MRI and DWI imagings, respectively. The differences of MTR and ADC among the three groups were analyzed by one-way ANOVA;the differences of T2WI scores were analysed by Kruskal Wallis;the differences of MTR and ADC values between normal and pathological intestinal wall were analyzed by paired t test;ROC curve were used to evaluate the CD fibrosis and inflammation diagnostic efficiency of MTI ana DWI based on MRE signs. Results Among the 44 cases, 11 cases were in the acute inflammatory group, 18 cases were in the chronic fibrotic group and other 15 cases were in the combination group. The T2WI score, MTR and ADC among the three groups showed significant differences (all P<0.01).The mean MTR and ADC of pathological intestinal wall of the 44 cases were (40.77±6.05)%and (1.04±0.18)× 10-3mm2/s, and the adjacent normal bowel were (21.75±4.17)%and (1.97 ± 0.23) × 10- 3mm2/s, respectively. Moreover, the difference of the above values showed significant differences (t=19.12,-21.80 respectively, all P<0.01). There was a negative correlation between MTR and T2WI score (r=-0.71,P<0.01). While ADC value was positively correlated with T2WI score (r=0.80, P<0.01). Using ROC curve analysis to differentiate the CD fibrosis from acute inflammation, the area under the curve (AUC) of MTR and ADC were 0.97 and 0.96 ,respectively. Conclusions Both MTI and DWI can be used to assess the properties of intestinal wall, which has the same diagnostic efficacy to identify the acute inflammation and fibrosis.