The autonomy is one of the basic authorities of patients.It isn't only an ethical concept,but also can help enhance the efficacy and compliance to a certain extent.The autonomic behavior of the patients isn't as optimistic as we think.The patient's autonomy can be influenced by many factors.We should base on the principles,advantage,respect and communication,to encourage patients to make an appropriate and unbiased decision and change into a collaborative,patient-centered doctor-patient relationship model.

Radiation-induced stomatitis is a frequent side effect for head and neck cancer patients undergoing radiotherapy, which affects both the treatment and the life quality. The direct effects of radiation, oxidative stress, transcription factor, proinflammatory cytokine and pathogenic microorganism are involved in the onset of radiation-induced stomatitis. The pathologic process can be divided into five phases including initiation, up-regulation, amplification, ulceration and healing. Understanding of the pathogenesis and risk factors provides basis for prevention and control of radiation-induced stomatitis.

Objective To investigate effects of hydrogen sulfide on hepatic ischemia-reperfusion injury in rats.Methods Thirty healthy male SD rats weighing 220-250 g were randomly divided into sham operation group (S group),ischemia-reperfusion group(IR group) and different doses of hydrogen sulfide groups (H2S1～3 groups),every group contains six rats.In S group hepatic portal was only exposed but not ligated.In IR group the left and middle lobes of hepatic pedicle,portal vein and hepatic artery were clamped for 1 h and then reperfuse.H2 S1～3groups received intraperitoneal injection of NaHS 14,28,56 μmol/kg at 5 min before reperfusion.Blood samples were collected for measuring the activity of alanine transaminase (ALT) and aspartate transaminase (AST) in serum at 6 h after reperfusion.Liver tissue samples were collected for measurement the glutathione (GSH) content and pathologic examination.Results Compared with S group,the activity of ALT and AST in serum was increased,GSH content in liver tissue decreased in IR group ; Compared with IR group,the activity of ALT and AST in serum was decreased,GSH content in liver tissue increased in H2 S1～3 groups.Hepatic tissue pathologic injury was reduced in H2 S1～3 groups as compared with IR group.Conclusion Hydrogen sulfide can reduce hepatic ischemia-reperfusion injury in rats.

Objective To investigate the efficacy of Saururaceae lotion in treatment of gynecological inflammation ( chronic cervicitis,vaginitis).Methods 90 patients with gynecological inflammation(chronic cervicitis,vaginitis) were randomly divided into two groups,and each group 45 cases.The observation group was administered with Saururaceae lotion treatment, and the control group was treated with Jieeryin.Clinical efficacy and relapse situation were observed.Results The total effective rate of the observation group was 95.6% , higher than that of the control group(77.8% )(x2 = 5.362.P <0.05) ;The gynecological inflammation recurrence rate the observation group was 4.4% ,lower than that of the control group(33.3% )(x2 = 16.312,P <0.05).Conclusion Saururaceae lotion in treatment of gynecological inflammation was effective,and had low recurrence rate,and it was worthy of clinical application.

OBJECTIVE: To study the clinicopathologic features, immunophenotype, diagnosis and differential diagnosis of Sinonasal teratocarcinosarcoma (SNTCS). METHOD: The clinical findings, morphologic features and immunohistochemical markers in one case of SNTCS were studied, and the relevant literatures were reviewed. RESULT: The Tumor tissue is composed of three layers, with mature and immature squamous epithelium nests, neural epithelial cells and olfactory neuroblastoma-like cells derived of ectoderm; Sarcomatoid components and bone tissue derived of mesoderm; The glandular and tubular structures part of which is adenocarcinoma and respiratory epithelium derived of endoderm; The fetal clear cell squamous epithelium is typical. In addition, diffuse large cytoplasm-with high light and cytoplasm with dark light has no obviously boundery. Immunohistochemical staining showed immune markers of different germ layers corresponding, squamous epithelium, glandular epithelium and respiratory epithelium were positive for CK and EMA, neural epithelial cells and olfactory neuroblastoma-like cells were positive for S-100, NSE and Syn, sarcomatoid area was positive for Vim, light dye area was positive for Vim, CD99 and CK, dark area was positive for NSE and GFAP. CONCLUSION SNTCS is a rare malignant tumor with the features of teratoma and carcinosarcoma, its histopathological and immunohistochemical features were typical, should be more drawn and sliced to avoid misdiagnosis and missed diagnosis.
Adenocarcinoma ; Carcinosarcoma ; diagnosis ; immunology ; pathology ; Diagnosis, Differential ; Esthesioneuroblastoma, Olfactory ; diagnosis ; immunology ; pathology ; Humans ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; immunology ; pathology ; Teratoma ; diagnosis ; immunology ; pathology

Objective To investigate the curative efficacy of safflower yellow sodium chloride in the treat-ment of acute myocardial infarction (AMI)and its effects on cardiac function and oxidative stress.Methods 110 cases of AMI meeting the inclusion criteria were randomly divided into two groups equally.The control group was given conventional drug treatment and percutaneous coronary intervention (PCI),while the observation group was given con-ventional drug treatment and PCI in combination with safflower yellow sodium chloride.Then,the curative efficacy, indices of cardiac function and oxidative stress were observed and compared.Results The observation group had a total effective rate of 94.5%,which was significantly higher than 81.8% in the control group (χ2 =4.94,P =0.026).After the treatment,SV (t =3.23,P =0.002),CO(t =3.82,P =0.000)and LVEF (t =3.14,P =0.002) in the observation group were significantly higher than those in the control group (all P <0.05 ).As to oxidative stress,in comparison with the control group,SOD (t =8.42,P =0.000)was significantly higher and MDA (t =3.99, P =0.000)was significantly lower in the observation group (all P <0.05 ).Conclusion Adjuvant treatment of safflower yellow sodium chloride for AMI was effective,which could significantly increase curative efficacy,improve cardiac function and alleviate oxidative stress.

Airway remodeling is one of the main pathological changes of bronchial asthma. It has shown that a variety of cytokines, including chemokines, growth factors, matrix proteins, participate in and even strengthen airway remodeling through building complex signal transduction pathways. Many traditional Chinese medicines,such as shegan mahuang decoction,have a regulatory role in airway remodeling.

Induced pluripotent stem cell ( iPS cell ) , similar to embryonic stem cell, can be repro-grammed to the pluripotent state by ectopic expression of specific transcription factors. The iPS cells have pluri-potency and can be induced into neuron cells,which represent a promising cellular tool to study human neurode-velopmental disease,drug screening,diagnosis and personalized treatment. This article reviews the latest progress on iPS cell and its applications in neural developmental disease.

Objective To explore the effect of paravertebral nerve block for preemptive analgesia on patients with thoracic surgery,and provide reference for clinical anesthesia.Methods From March 2014 to February 2016,102 patients with thoracic surgery in our hospital were selected as the research object,and they were divided into the observation group and the control group with 51 cases in each group according to the anesthesia methods.All the patients were given total intravenous anesthesia.Patients of the control group were injected propofol 1~2 mg/kg,sufentanil 0.4~0.5 g/kg,midazolam 0.1 mg/kg and rocuronium 0.5~0.7 mg/kg,while patients of the observation group were injected ropivacaine(with concentration of 0.5%)5 mL,sufentanil 0.1~0.3 μg·kg-1·min-1 and propofol 6~8 mg·kg-1·min-1 as an addition with the use of ultrasound to guide the paravertebral nerve block.The effect of the two groups were compared.Results The dosage of propofol,remifentanil and rocuronium in the observation group were significantly lower than those in the control group during the operation.The VAS score,postoperative pulmonary complication rate,ICU rate,extubation time,postoperative recovery time at different time of observation group were significantly lower than those of the control group,and SpO2 was higher in control group 30 minutes after tracheal extubation, the differences were significant (P<0.05).Conclusion Paravertebral nerve block requires less dosage of anaesthetic, and it has more significant analgesia effect on patients with thoracic surgery, which can efficiently promote the recovery of patients.