Evidence-based medicine mirrors the natural and social properties of human being,harmoniously integrating scientific spirit and humanistic spirit. Discussions were made on such aspects as the relationship between human spirit and harmonious doctor-patient relationship. The humanistic spirit of evidence-based medicine, and the humanistic spirit of evidence-based medicine as used in building harmonious doctor-patient relationship. The authors point out the following: 1) Medical science itself is a wealth of humanistic sprits, and medicinal science can better serve human being with humanistic spirit;2) Evidence-based medicine is completely in line with medical humanities, which scientifically reveals the "People-oriented medicine" as the essential attribute of human sciences;3) Modem clinical medicine has unveiled the evidence-based era. Based on these findings, the authors hold that in such an era,exploration and understanding of the human spirit as the core of evidence-based medicine and focusing on the cultivation of medical humanistic spirit, will be conducive to building a harmonious doctor-patient relationship.

OBJECTIVE:To improve the method of Chinese Pharmacopoeia on the extraction of volatile oil from Atractylodes macrocephala Koidz..METHODS:Volatile oil was extracted from Atractylodes macrocephala Koidz.and determined by the extraction method and determination method stated in Chinese Pharmacopoeia and by the new improved method respectively.And the components of volatile oil obtained in these two methods were respectively separated and identified by GC-MS.RESULTS:The extraction rates of volatile oil by the method of Chinese Pharmacopoeia vs.the new method were(1.28? 0.03) %(n=6) vs.(1.39? 0.03) %(n=6).As compared with the new method,seven components were missed by the method of Chinese Pharmacopoeia.CONCLUSION:The new extraction method of volatile oil can increase both the extraction rate of volatile oil and the kinds of the components in volatile oil,and it is obviously better than the method stated in Chinese Pharmacopoeia.

Objective To study the influence of excessive magnesium and/or deficient calcium intake on the bone mass of ovariectomized rats. Methods Three-month-old ovariectomized rats were fed with different types of drinking water: Interaction group was fed with deficient-Ca and excessive-Mg water: Ca 5 mg/L, Mg 60 mg/L; Excessive-Mg group was Ca 60 mg/L, Mg 60 mg/L; Deficient-Ca group was Ca 5 mg/L, Mg 30 mg/L; Normal group was Ca 60 mg/L, Mg 30 mg/L. After 3 months of treatment, the left femur was measured with the length and weight, then the content of Ca and Mg were determined, right femur was X-rayed, and right tibia was taken for the pathological examination. Results Calcium deficiency in water caused significant changes in all of the bone mass indexes, magnesium excess in water showed a tendency of Ca decreasing and Mg increasing in the bone. It was easily distinguish the difference in bone mineral and bone microstructure by X-ray and pathological examination: control group was the best, then was Mg excess group, Ca deficiency group was inferior, and the interaction group was the worst. Conclusion Calcium deficiency is one of the major reasons of osteoporosis, while the excessive intake of magnesium may not only disturb the bone metabolism but also aggravate the adverse effect of Ca deficiency on bone mineral and bone health.

Objective To introduce a kind of UPS for portable type-B ultrasonic in vehicular-charging at the situation of flowing in battle field. Methods Long time power supply for type-B ultrasonic and other related medical devices was realized through AC/DC alteration switch. Conclusion It functioned well in field test. Conclusion Being light and convenient with AC/DC, it is worth popularizing.

Objective To evaluate the clinical application of interventional therapy in all kinds of pelvic trauma emergency.Methods There were tolally 16 cases in this paper(13 male and 3 female, 17～45 years old with average 31 years old). All patients had blood loose shock ( different blood pressure drop, limb pulse weakness and so on ). The blood pressure was(50～100)mmHg/(20～60) mmHg before interventional therapy,emergency selective external iliac artery, internal iliac artery and/or bleeding artery embolization and artery occlusion broken operation were performed. After operation pay attention to observe the life physical sign.Results Bleeding of internal iliac artery trunk,internal pudendum artery and obturator artery was in 8,3 and 4 cases respectively;1 case had thrombosis in external iliac artery.After emergency interventional treatment, blood pressure rose again progressively and became stability(90～120) mmHg/(60～90) mmHg,no serious complication presented.Conclusion The interventional treatment is the rapid and reasonable selection to cure the pelvic closed vessal injury and to save life.

OBJECTIVE:To investigate the postoperative analgesic effect of Dexmedetomidine combined with Remifentanil on patients in lung cancer resection and its effect on immune function. METHODS:60 lung cancer patients in lung cancer resection were randomly divided into control group(30 cases)and observation group(30 cases). All patients with endotracheal intubation re-ceived lung cancer resection under general anesthesia. After surgery,control group received Remifentanil hydrochloride 10μg/(kg·d)+Ondansetron hydrochloride injection 16 mg,adding into 0.9% Sodium chloride injection co-formulated into 100 ml;observation group received Dexmedetomidine hydrochloride injection 0.75 μg/(kg·d)+Remifentanil hydrochloride 10 μg/(kg·d)+Ondansetron hydrochloride injection 16 mg,adding into 0.9% Sodium chloride injection co-formulated into 100 ml. Background doses in 2 groups were 2 ml/h,self-controlled amount was 2 ml,lockout time was 15 min. Visual analog pain score (VAS),IFN-γ,IL-10 level,T cell subsets(CD3+,CD4+,CD8+,CD4+/CD8+)after 6,12,24,48 h and the incidence of adverse reactions in 2 groups were observed. RESULTS:VAS scores after 6,12,24,48 h in observation group were significantly lower than control group,and VAS scores after 24,48 h in 2 groups were significantly lower than that after 6 h,with statistical significance(P<0.05). IFN-γ levels after 6,12,24,48 h in observation group were significantly lower than control group,and IFN-γ levels after 12,24,48 h in 2 groups were significantly lower than that after 6 h,IL-10 level after 12,24,48 h in observation group were significantly higher than that 6 h and control group,with statistical significance(P<0.05). CD3+after 6,24,48 h,CD4+after 6,12,48 h,CD4+/CD8+af-ter 12,24,48 h in observation group were significantly higher than control group,CD8+ after 12,24 h were significantly lower than control group,CD3+,CD4+ after 12,24,48 h in 2 groups,CD4+/CD8+ in control group,and CD8+ after 12,24 h in observa-tion group and after 24 h in control group were significantly lower than that after 6 h,with statistical significance(P<0.05). There was no significant difference in the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:The postoperative anal-gesic effect of Dexmedetomidine combined with Remifentanil on patients in lung cancer resection is superior to Remifentanil alone, it can improve the immune function,with good safety.

Objective To compare the effects of laparoscopy and open surgery of ligation of spermatic vessel cluster or internal spermatic vein for the treatment of varicocele.Methods By using randomized controlled trial,120 cases with varicocele who stayed and were treated in our hospital were divided into 4 groups(30 cases every group) from Jun.2007 to Oct.2011.The efficacy of 4 groups was observed and compared.Results Four operations were performed successfully.Laparoscopy approached less than open surgery in terms of the days of stay in hospital (P ＜ 0.05).The quality of semen in four groups was all increased by comparing spermatozoa density,motility rate before and after operation(P ＜ 0.05),but no difference was found among four groups (P ＞ 0.05).In 0.5-1 year follow-up,follow-up rate was 92.5％,without atrophy of testes.Conclusion The operation of laparoscopic spermatie vessel cluster ligation in patients with varicoceh has the advantage of confirmed effect,which is an alternative operative method of treatment for patients with varicocele.

BACKGROUND: Decoy receptor 1 (DcR1), which acts as decoy receptors, is resistant to apoptosis induction by related apoptosis inducing ligand (TRAIL). OBJECTIVE: To investigate the expression of the DcR1 (TRAIL-R3) protein in human herniated and normal lumbar intervertebral discs (IVD). METHODS: The expression and distribution of DcR1 proteins were assessed by using immunohistochemistry in 20 herniated lumbar IVD and 8 normal lumbar IVD tissues samples following discoidectomy from January to September 2010. RESULTS AND CONCLUSION: Percentage of nucleus pulposus and anulus fibrous cells with DCR1 expression was obviously more in the herniated group than in normal IVD group. The current results indicate that the expression of DCR1 rises after herniation.

Objective To introduce the new technique of transperitoneal laparoscopic ureterovesical reimplantation and to evaluate its feasibility and clinical significance. Methods Overall,17 cases (5 men and 12 women) of ureterovesical obstruction (left,7 and right,10) were included.Of them,10 cases were diagnosed with simple congenital ureter outlet stricture;1 had calculi and polyp formation at right ureter outlet;2 had recurrent ureter outlet stricture after open ureterovesical reimplantation (1 of them had 2 calculi at lower part of the ureter);1 had double nephroureteral upper unit ureter outlet stricture with 2 calculi;2 had recurrent ureter outlet stricture after holmium laser section;1 with urinary TB had right ureter outlet stricture after left nephrectomy.Among the 17 cases,severe hydronephrosis occurred in 12,and moderate,in 5.Transperitoneal laparoscopic ureterovesical reimplantation was performed in the 17 cases (ureterovesical anastomosis in 15 and bladder flap ureterovesical reimplantation in 2). Results The operations were all successful in 17 cases with operating time of 90～160 min (mean, 112 min) and blood loss of 60～100 ml.The drainage tubes were removed 1～3 days after surgery without urine leakage.The urinary catheters were removed 1 week after surgery and double J stents,1 month after surgery. Six months after surgery cystography showed Ⅲ?urine reflux in 6 cases, Ⅰ?-Ⅱ? urine reflux in 5 and no reflux in 6.One year after surgery cystography showed Ⅲ? urine reflux in 3 cases, Ⅰ?～Ⅱ? urine reflux in 4 and no reflux in 10.During 3～24 months' follow-up, ultrasound B and IVU showed moderate hydronephrosis in 4 cases,mild,in 5 and no obvious hydronephrosis in 8. Conclusions Laparoscopic ureterovesical reimplantation is a feasible,less painful and minimally invasive alternative method for treatment of ureterovesical diseases.By comparison,bladder flap ureterovesical reimplantation has better anti-urine reflux effect but more complicated than ureterovesical anastomosis does.Long term efficacies of the methods need further observation.

Purpose:To improve the methads of approach in s urgery of esophageal cancer ,increase resection rate of esophagectomy, decrease the remnant cancer in margin and mortality after operation, enhance the postoper ative effect. Methods:From Jan.1999 to Dec. 2002,we adopted different surgica l approach as in esophagectomy in 297cases with esophageal cancer, such as left posterior thoracotomy(group I), left posterior thoracotomy with cervical incisi on (group Ⅱ),right anterior thoracotomy (group Ⅲ), right posterior thoracotomy (group Ⅳ). Results:The rate of operative resection was 98.7%(293/297)an d for groups Ⅰ, Ⅱ, Ⅲ, Ⅳ they were 98.2%(86/87)、98.1%(52/53)、98.5%(133/135) 、100%(22/22) respectively;operation-related mortality was 1.7%(5/297) and fo r groups Ⅰ, Ⅱ, Ⅲ, Ⅳ it was 2.3%(2/87)、1.9%(1/53)、0.75%(1/135)、4.5%(1/22) respectively;the occurrence of remnant cancer was 3.8%(11/293) and for groups Ⅰ, Ⅱ, Ⅲ, Ⅳ it was 4.7%(4/86)、3.8%(2/52)、2.6%(3/133)、9.1%(2/22) respective ly;the rate of postoperative complication was 12.8%(38/297) and for groups Ⅰ, Ⅱ, Ⅲ, Ⅳ it was 17.2%(15/87)、9.4%(5/53)、11.1%(15/135)、13.6%(3/22) respectiv ely. In the number of lymph node resected , there was statistical difference bet ween groups Ⅲ, Ⅳ and Ⅰ, Ⅱ(P0.05).Conclusions:Right anterior thoracotomy, right posterior thoraco tomy were more satisfactory operative approaches in radical total thoracic esop hagectomy of esophageal carcinoma. Through these two approaches,we not only can resect mediastinal and abdominal lymph nodes radically, but can also decrease t he cancer of at the margin and mortality after operation.