With the introduction of Western Medicine, the hospital began to be center of medical practice in the Republic of China, the masses knew the Western Medicine gradually and accepted it. Due to many reasons, conflicts between doctors and patients occurred during medical practice, even disputes between doctors and patients were sued, which were called" cases of medical disputes" at that time. To dissect typical cases, analyze the reasons for formation of medical disputes, expect reference to problems of medical disputes at present.

OBJECTIVE To study anatomical features of the cavernous segment of the internal carotid artery(ICA)via the extended transsphenoid approach under endoscope.METHODS Extended transsphenoid approach was performed on 11 adult cadaver heads.The appearance features of the cavernous segment of the ICA and its vessel branches were observed under endoscope.RESULTS The cavernous segment of the ICA can be divided into 5 segments and has 3 vessel branches.The optico-carotid recess is the landmark to define the ICA and optic nerve during operation.The optico-carotid recess is located between internal carotid and optic prominences,all of them are located on the lateral wall of the sphenoid sinus.CONCLUSION The cavernous segment of the ICA is the most important anatomic structure via the extended transsphenoid approach.The cavernous segment of the ICA,branch vessels,and important nerve tissue structures can be clearly visualized under endoscope via the extended transsphenoid approach.An extended transsphenoid approach with the help of an endoscope is an optimal surgical approach for the lesions that invade the internal wall of cavernous sinus.

Objective To evaluate the role of nucleotide‐binding oligomerization domain 2(NOD2) stimulation in innate immuni‐ty against M ycobacterium tuberculosis .Methods Plate counting as used to evaluate the effect of resisting M ycobacterium tubercu‐losis in human alveolar macrophages .Intracellular NOD2 expression were detected by flow cytometry .Quantitative real‐time PCR was performed to determine the NOD2 ,inducible nitric oxide synthase(iNOS) ,and DEF4B mRNA expression levels using the com‐parative threshold cycle method of relative quantitation .Reactive oxygen species(ROS) were detected by the DFCH probe .Results NOD2 stimulation enhanced the control of intracellular mycobacterial growth in human alveolar macrophages .Although ROS con‐centration did not changed ,the secretion of Nitro Oxygen and the expression of cathelicidin DEFB4 were significantly increased fol‐lowing NOD2 stimulation in human alveolar macrophages .Conclusion NOD2 stimulation may be involved in the early innate con‐trol of Mycobacterium tuberculosis primary infections inducing the generation of Nitro Oxygen and the peptides cathelicidin DEFB4 .

Purpose To study X-ray and CT findings of pulmonary infection in AIDS. Methods We evaluate 10 cases who have chest abnormalities. The all patients have X-ray and CT examination. Results Imaging of pulmonary tuberculosis in AIDS, including infiltrative imaging and diffuse patchy imaging, enlarged mediastinum lymph nodes and extra chest enlarged lymph nodes. The imaging of legionella species is infiltrative imaging. Carinii pneumonia appearances diffuse infiltrative and interstitial abnormalities. Conclusion Pulmonary tuberculosis, legionella species and carinii pneumonia are common infections in AIDS. The patchy, consolidations, diffused diseases and enlarged lymph nodes are important imaging appearances.

AIM: To investigate the protective effects and its mechanism of Ginkoglide A on stress ulceration in fats. METHODS: Wistar rats were randomly assigned to control, and Ginkgolides pretreatment group. The stress ulceration was produced by water immersion restraint, and gastric myoelectric activity during during was recorded by implanting electrodes in the stomach antrum smooth muscle. The malondialdehyde (MDA) concentration and superox- ide dismutase (SOD) activity in plasma, and gastric mucusal lesions were examined after the rat was killed. RE- SULT: Compared with the control group, previous intraperitoneal administratin of Ginkgolide A (5 - 20 mg/kg) not only had a highly significant decrease on stress - induced myoelectric activity disorder (P

Objective To study HRCT appearances,clinic value and pathological fundament of the pulmonary honeycombing.Methods 60 patients including three groups with pulmonary honeycombing underwent HRCT scan.The comparative study of HRCT-pathology was done in 6 pulmonary postmortems with honeycombing.Results On HRCT images,honeycombing cysts were round-like with air inside,the cyst walls included remains of pulmonary inherent components and hyperplastic fibrotic tissue in pathology.The diameter of cysts was small,58 cases of them belonged to small group(90.6%).The distribution of lesions was mainly at lower(47cases,71.9%)and peripheral lung zone(52cases,81.3%),but there were differences in different type of the diseases.The cysts might become larger and it is impossible to recovery.Conclusion The honeycombing cysts appear as cystic cavities arranging as multiple layers,the cystic walls consist of different tissues in pathology,that are the manifestations of the end-stage of pulmonary fibrosis.HRCT appearances in different patients in three groups were different.

Objective To evaluate the effect of biofeedback therapy for the treatment of myogenic fecal incontinence. MethodsA general assessment about anorectal function was made on 17 cases receiving biofeedback therapy including muscle power training,sensory training and coordination training. Results The clinical scores before and after biofeedback therapy were 1.66?0.23,3.80?0.42 respectively,with an effective rate of 82%. The anus maximum contracting pressure elevated,(73?20) mm Hg vs. (123?30) mm Hg; myoelectric amplitude increased,(122?32) ?V vs. (230?41) ?V;Contracting time prolonged,(4.1?2.0) s vs. (9.4?3.0) s; The sensory threshold was lowered,(50?12) ml vs. ( 20? 10) ml;The feel-contract time increased,(3.1?0.4) s vs. (1.2?0.3) s. Positive rectal contraction reflex was seen in 41% patients before therapy compared with 82% after therapy. Conclusions Biofeedback therapy increases contractility of sphincter,decreases threshold of rectal sensory,and is a therapy of choice for myogenic fecal incontinence.

Objective To study the X ray and CT findings of pneumocystis carinii pneumonia in AIDS. Methods Five AIDS patients who had chest abnormalities were analyzed. Results Pneumocystis carinii pneumonia appeared as diffuse infiltrative and interstitial fine nodules. Conclusion If the diffuse and infiltrative interstitial fine nodule are the appearances in patients with AIDS, the pneumocystis carinii pneumonia should be considered.

Objective The purpose of this study was to evaluate the constrast-enhanced CT features and pathologic findings of mediastinal tuberculous lymphadenitis in adults. Methods 39 patients with 180 lymph nodes diagnosed as mediastinal tuberculous lymphadenitis by operation, mediastinoscopy and biopsy were evaluated on enhanced CT scan, including 20 men and 19 women. The median age of the patients was 26 years(range from 16-67 years). Results Five post-contrast patterns of enhancement were found: (1) inhomogeneous enhancement(28.3%,51 nodes); (2) peripheral rim enhancement(26.1%, 47 nodes); (3) homogeneous enhancement(25.0%, 45 nodes); (4)nonenhancement( 14.4%, 26 nodes); (5) separate enhancement(6.11%, 11 nodes); CT-pathologic correlation demonstrated that patterns of enhancement of mediastinal tuberculous lymphadenitis were correlated with distribution of granulation tissue and caseous areas. 28 patients(71.8%) had a combination of enhancement patterns. 11 patients(28.2%) had a single enhancement pattern. Conclusion Constrast-enhanced CT appearance of mediastinal tuberculous lymphadenitis for diameter of 1.0-2.0 cm was homogeneous enhancement, nonenhancement, inhomogeneous enhancement and peripheral rim enhancement; for diameter of ≥2.0 cm was inhomogeneous enhancement, peripheral rim enhancement, homogeneous enhancement and nonenhancement. Peripheral rim enhancement or separate enhancement can suggest a diagnosis of tuberculosis.

Objective To investigate the fibrosis-associated genes, especially those transforming growth factor-β(TGF-β) associated, expression in the tissue of extensive fibrotic kidney resulting from severe by-dronephrosis. Methods Compared 12 extensive fibrotic kidneys resulting from severe hydronephrosis with 6 normal renal tissues using PCR array. All samples were collected from our hospital from Aug. 2005 to Dec. 2006. The data were treated with △△Ct method. When 2△△Ct≤<0.5 or≥2, the difference was considered sig-nificant. Results A total of 49 differential genes expressed in the fibrotic renal tissues were screened out, of which, 25 were up-regulated and 24 were down-regulated. The differential genes included members and receptors of TGF-β super family and bone morphogenetic protein(BMP) family, target molecule of TGF-β or BMP signal pathway and several regulators. Conclusions Through investigating with PCR array, we certifi-cated the positive effect of Nodal, GSC and IGFI to renal fibrosis. And we suppose that TGF-β play a sec-ondary role in renal fibrosis, while BMP family and Leftyl work in a functional genome in the regulating of renal fibrosis.