By studying the physician-related factors in physicianpatient relationship,authors put forwards that excellent medical skill,good medical ethics,favorable communication ability,and adequate knowledge on relevant legal regulations are four key points to handle the physician-patient relationship harmoniously.This article will supply reference from the above aspects for the all-around quality-based education for medical students.

Objective To observe the effects of melatonin on synaptic plasticity impaired by spinal cord injury in rats. Methods A total of 54 female Sprague-Dawley rats were divided into sham group (n=18), control group (n=18) and melatonin group (n=18). Spinal cord inju-ry model was established with modified Allen's method at T10 (10 g from 25 mm height). The number of neurons and the expression of the Nissl body were detected with immunofluorescence and Nissl staining. The expression of neurofilament-200 (NF-200), brain-derived neuro-trophic factors (BDNF), Synapsin I and growth-associated protein-43 (GAP-43) was detected with Western blotting. Results Seven days af-ter injury, the number of motoneurons, the expression of Nissl body in motoneurons, and the expression of BDNF, Synapsin I and GAP-43 decreased in the control group compared with those in the sham group, and they increased in the melatonin group compared with those in the control group. Conclusion Melatonin can repair the impaired synaptic plasticity, which might promote the functional recovery after spi-nal cord injury.

AIM:To evaluate the clinical characteristics in retinal nerve fiber layer ( RNFL) thickness of the 8~17 years old near sightedness, provide the basis for juvenile glaucoma diagnosis, to avoid missed diagnosis and misdiagnosis.
METHODS:A total of 165 eyes from 99 healthy subjects ( age range 8 ~ 17 years ) were divided into low, moderate, high myopia and normal group. Cirrus HD OCT was used to measure the RNFL thickness. Each subject was performed circular scans around the optic nerve with a circle size of 3. 46mm. Total average, mean quadrant and clock - hour RNFL thicknesses were recorded and compared between the four groups. The characteristics of the RNFL thickness of myopia were observed.
RESULTS: Compared myopia groups with normal group, the mean RNFL thickness decreased, there was statistically significant difference in high myopia group (P<0. 05). The mean RNFL thickness of superior, inferior and nasal quadrant decreased, temporal quadrant was thickened. Compared moderate and high myopia groups with normal group, superior, inferior quadrant RNFL thickness were thinning, temporal quadrant was thickening, the differences had statistical significance ( P< 0. 05 ). The RNFL measurements were statistically significant thinner in the myopia groups compared with normal group at 1:00, 5:00, 6:00 and 12:00 o'clock ( P<0.05) and thicker at 8:00, 9:00, 10:00 o'clock (P<0. 05). The RNFL measurement was statistically significant thicker in the low myopia group compared with normal group at 3:00 o'clock (P<0. 05).
CONCLUSION: Compared adolescent myopia with normal, the Avg ( mean RNFL thickness ) , S ( superior quadrant RNFL thickness ) , I ( inferior quadrant RNFL thickness), 1:00, 5:00, 6:00 and 12:00 o'clock RNFL thickness is thinner, which is decreased with the increasing SE. While the temporal ( T) quadrant, 8:00, 9:00, 10:00 o'clock RNFL thickness is thicker, which increased with the increasing SE. Analysis of RNFL thickness in the evaluation of glaucoma should always be interpreted with reference to the refractive status, so as not to cause misdiagnosis of glaucoma. The highest diagnosis efficiency position of glaucoma is infratemporal (7:00~8:00 o'clock) and superior temporal (10:00 ~11:00 o'clock), which is not thinner in juvenile myopia, if these positions become thinner, it may be the possibility of glaucoma.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Neuromyelitis Optica ; therapy

OBJECTIVETo investigate the feasibility and effectiveness of modified Stoppa approach in treatment of bilateral pubic fractures of pelvic.

METHODSThe therapeutic effects of 16 patients with bilateral pubic fractures treated through the modified Stoppa approach from January 2010 to January 2014 were summarized and analyzed, involved 11 males and 5 females with an average age of 40.5 years old ranging from 17 to 59 years. According to Tile classification, there were 8 patients with type A, 6 with type B and 2 with type C. For 16 pelvic fractures, the modified Stoppa approach was used exclusively 11 cases, in combination with the iliac fossa approach in 4 cases, and in combination with the posterior approach in 1 case. The operation incision length, operation time , intra-operative blood loss and postoperative complications were observed. The fracture reduction and post-operative function were assessed by Matta criteria and Majeed system respectively.

RESULTSThe incision length of the modified Stoppa approach ranged from 8 to 10 cm (averaged in 9 cm). The operation time ranged from 75 to 135 minutes (averaged in 95 minutes). The intra-operative blood loss ranged from 400 to 900 ml (averaged in 600 ml). Sixteen patients were followed up from 7 to 18 months (averaged in 12.5 months). The fractures were all healed, the fracture healing time was 2.7 to 5 months (means 3.1 months). There were no infections, ectopic ossification, screw loosening, plate breakage and lateral ventral syndrome. According to Matta criteria for pubic fracture reduction, the result was excellent in 9 cases, good in 6, fair in 1. The Majeed function scores at 6 months after operation was 85.32±8.50; the result was excellent in 8 cases, good in 6 cases, fair in 2 cases.

CONCLUSIONThe modified Stoppa approach has characteristics of convenience and directness of incisions, clear operation field, easy reduction, few complications and fast recovery , it is an ideal choice in surgical treatment of bilateral pubic fractures.

Adolescent ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Orthopedics ; methods ; Pubic Bone ; injuries ; surgery ; Young Adult

BACKGROUND:Searching for a porous three-dimensional (3D) scaffold holding good porosity, mechanical property and biocompatibility has become a hot spot, in which, 3D printing technology also plays apart. OBJECTIVE:To prepare silk fibroin/col agen scaffolds using 3D printing technology and detect its performance. METHODS:Silk fibroin/col agen scaffolds were constructed using 3D printing technology, and the silk fibroin/col agen mass ratio was 4:2 (group A) and 4:4 (group B), respectively. The porosity, water absorption expansion rate, mechanical properties and pore size of the composite scaffolds were detected. The passage 3 rat bone marrow mesenchymal stem cel s were seeded onto the two scaffolds. The cel proliferation was detected using MTT assay at 13 days of culture, and the cel morphology was observed by hematoxylin-eosin staining and scanning electron microscope at 14 days of culture. RESULTS AND CONCLUSION:The porosity, pore size, and water absorption expansion rate of group A were significantly larger than those of group B (P<0.05), while the elasticity modulus showed no significant difference between groups. Bone marrow mesenchymal stem cel s on the two scaffolds increased gradual y with time, especial y in the group A (P<0.05). Abundant cel s distributed evenly in the group A, while few cel s distributed unevenly in the group B. These results suggest that the 3D printed scaffolds composed by silk fibroin/col agen mass ratio of 4:2 holds good physicochemical performance and cytocompatibility.

Objective Triple negative breast cancer(TNBC), a special breast cancer subtype, is lack of effective target therapy.The article aimed to investigate the role of lysophosphatidic acid (LPA) and Hippo Yes-associated protein (Hippo-YAP) signaling pathway in TNBC invasion and metastasis and the mechanisms.Methods The specific small interfering RNA (siRNA) of YAP was synthetized in vitro, and was transfected into MDA-MB-231 cells using liposome transfection.The experiment was divided into YAP-siRNA group, positive control group and blank control group.Each group is provided with 2 parallel holes.Evaluation was made on the effects of each group on Hippo-YAP, the mechanisms and regulation on upstream and downstream molecules of Hippo-YAP pathway.Results In experiment group, YAP content, the capacity of invasion and metastasis after transfection ([0.035±0.005], [2.200±1.000], [3.500±0.800]) significantly decreased compared with positive control group([0.343±0.012], [27.600±5.100], [22.300±5.000]) and blank control group([0.384±0.017], [26.500±4.800], [22.350±6.000]) (P<0.05).YAP expression levels at 60 min, 120 min, and 240 min in experiment group significantly decreased compared with positive control group and blank control group (P<0.05).YAP relative expression levels of 10, 20, 50 μmol/Lwere significantly lower than those of positive control group and blank control group (P<0.05).After respective interference of C3 transferase and Y27623, significant difference was found in the pYAP mRNA contents of experiment group([0.255±0.052], [0.326±0.017]), blank control group([0.048±0.032], [0.534±0.017]) and positive control group([0.052±0.021], [0.528±0.024])(P<0.05).The expression levels of YAP mNA and AREG mNA significantly increased in experiment group([0.176±0.032], [0.263±0.008]) compared with blank control group([0.043±0.013], [0.263±0.008]) and positive control group([0.049±0.025], [0.057±0.043])(P<0.05).Conclusion LPA induces breast cancer invasion and metastasis, which is YAP-dependent, time-dependent and concentration-dependent.LPA-Hippo-YAP singaling pathway may be one of the mechanisms promoting delayed metastasis of TNBC.

OBJECTIVETo investigate the effect of salidroside on hypoxia-induced apoptosis of corpus cavernosum smooth muscle cells (CCSMCs) in rats.

METHODSRat CCSMCs were cultured in vitro by the enzyme digestion method and identified by immunofluorescent staining of anti-alpha-SMA and anti-Desmin. The non-toxic dose of salidroside was determined by MTT assay. Low-oxygen mixed gas (1% O2, 5% CO2, and 94% N2) was piped into a modular incubator chamber to induce hypoxia. The CCSMCs were divided into a normal, a hypoxia, and a 32 microg/mL salidroside intervention group. The apoptosis of the CCSMCs was detected by flow cytometry and the expression of the caspase-3 protein determined by Western blot.

RESULTSThe majority of the CCSMCs were positive for alpha-SMA and Desmin at immunofluorescent staining. Salidroside at < 32 microg/ml produced no obvious toxicity to CCSMCs. Compared with the normal control group, the rates of early and late apoptosis of CCSMCs were both increased significantly in the hypoxia group ([12.77 +/-1.41]% vs [18.69 +/- 1.29]%, P < 0.01 and [14.63 +/- 2.00]% vs [21.03 +/- 1.530]% , P < 0.05). Western blot showed a markedly increased expression of cleaved caspase-3 (P < 0.01). Intervention with 32 microg/ml salidroside significantly reduced hypoxia-induced early apoptosis of CCSMCs ([13.46% +/- 1.87]%, P < 0.01) and decreased the expression of cleaved caspase-3 (P < 0.01).

CONCLUSIONSalidroside can reduce the expression of cleaved caspase-3 and inhibit hypoxia-induced apoptosis of CCSMCs in rats.

Animals ; Apoptosis ; drug effects ; physiology ; Caspase 3 ; metabolism ; Cell Hypoxia ; physiology ; Cells, Cultured ; Glucosides ; pharmacology ; Humans ; Male ; Myocytes, Smooth Muscle ; cytology ; drug effects ; enzymology ; Penis ; cytology ; drug effects ; Phenols ; pharmacology ; Rats

Objective To study the difference of attentional bias towards general negative words between non-mediated obsessive-compulsive disorder (OCD) patients and healthy controls.Methods Event-related potentials (ERPs) were collected from 26 non-mediated OCD patients and 24 normal controls while they performed an emotional Stroop task.Results Compared to healthy controls,OCD patients showed significantly longer reaction time (OCD:(467 ± 14.88) ms,Controls:(409.65 ± 15.49) ms,P＜ 0.01),and had significantly larger P2 and P3 amplitude to all three types of words (P2 amplitude:OCD:(10.41±0.49) μV,Controls:(8.89±0.48) μV,P＜0.05;P3 amplitude:(10.04±0.68) μV,Controls:(7.68±0.67) μV,P＜0.05).In addition,the P2 peak latency of the frontal area in OCD patients was significantly longer than that in healthy controls(OCD:(190.09±4.71) ms,Controls:(179.60±4.72) ms,P＜0.05).Conclusion Current findings suggest that OCD patients are characterized by a general attentional inhibition deficit but not an attentional bias to the negative words.

OBJECTIVE: To explore the methods to assess the function disorder of patients with mild psychiatric impairment due to road traffic accidents. METHODS: In contrast to that of the patient with physical impairment, the function disorder of the patient with mild psychiatric impairment was assessed by the standard assessment instruments, such as the Barthel index of ADL (BI), Functional Activities Questionnaire (FAQ), Social Disability Screening Schedule (SDSS), Activity of Daily Living Scale (ADL), Physical Self-maintenance Scale (PSMS), and Instrumental Activities of Daily Living Scale (IADL). RESULTS: Except BI, the each total score of FAQ, SDSS, ADL, PSMS, and IADL correlated well with the rank of psychiatric impairment. The difference of each total score of rating scales among different physical impairment rank was not statistically significant. At the impairment rank of level 10, the difference of each total score of FAQ and ADL was not significant between the two groups; each total score of BI, SDSS, and IADL in psychiatric impairment was higher than that of physical impairment, while the total score of PSMS in psychiatric impairment was lower than that of physical impairment. At the level 9, except PSMS, the each total score of BI, FAQ, SDSS, IADL and ADL in psychiatric impairment was higher than that of physical impairment. At the level 8, except BI and PSMS, the each total score of FAQ, SDSS, IADL and ADL in psychiatric impairment was higher than that of physical impairment. CONCLUSION The different criteria for assessment of mild psychiatric and physical impairment may exist, and appropriate indexes for assessment between physical and psychiatric impairment need to be further elucidated.
Accidents, Traffic ; Activities of Daily Living ; Cognition Disorders/etiology* ; Disabled Persons/psychology* ; Humans ; Mental Disorders/etiology* ; Surveys and Questionnaires