Excessive medical treatment goes against the human rights of patients and therefore must be stopped.Main reasons include the impulse of existing medical benefit mechanism,the morality decline of medical staff,and patients' eagerness to shake off physical pain and psychological advocating for high-cost medical expenditure.This paper also comes up with relevant countermeasures including reversing the current healthcare mechanism,establishing an evaluation system for medical ethics of medical staff,and building up a monitoring mechanism for the development of clinical guidelines of evidence-based medicine.

Objective To investigate the feasibility whether clearance of iohexol can be a reliable, sensitive and safe method for the determination of GFR. Methods The GFR of 19 patients with different renal functions were examined using clearance of 99m Tc-DTPA and clearance of iohexol. Then the correlation of them was analyzed. Serum and urinary iohexol was determined by X-ray fluorescence analysis. Results, These two methods were significantly correlated (r = 0. 98). Conclusion Clearance of iohexol is a safe, comfident, no-radioactivity method for the clinical practice of GFR determination.

Objective\ To evaluate the possibility of predicting renal function from creatinine clearance calculated by lean body weight(LBWCcr).Methods\ 81 patients of renal disease were selected.The ratio between 24-hour urinary creatinine excretion(24hUcr)and lean body weight(LBW)was evaluated in 51 patients.The other 30 patients was determined DTPA-GFR,LBWCcr and 4hCcr.DTPA-GFR was used as criteria.LBWCcr and 4hCcr were compared with it in order to validate the feasibility of LBWCcr and 4hCcr.Results\ There was no statistical significance among the three methods,P=0 56 The correlation coefficient between LBWCcr and 4hCcr with DTPA-GFR was 0 89 and 0 86,respectively.The analysis of linearity regression showed that the trend of LBWCcr was better than 4hCcrmin in predicting renal function.In fatty group and renal failure group the results were similar.Conclusion\ LBWCcr can estimate the renal function accurately,simply and rapidly.

45?,poor containment of femoral head,narrow joint space,and non-successive Shenton's line.Following Crowe classification,there were 5 cases(5 hips) of grade II,and 3 cases(3 hips) of grade III.Preoperative Harris hip score was 50 points(range,44-62 points).Total hip arthroplasty was employed in each patient.Prosthesis was fixed by Cementless or cemented modes.Cementless fixation was applied in 6 hips and cemented fixation in 2 hips.Cementless prosthesis was used on the affected side in each patient.Replacement time,bleeding volume during surgery,hospital days post-surgery,Harris scores,and peri-operative complications were recorded.Simultaneously,post-surgery healing was observed.All 8 cases were followed up for an average period of 6 months.All patients exhibited well recovered joint function.No infection,sciatic nerve injury,dislocation of hip joint,fracture of femoral shaft,thrombosis of deep veins,or prosthesis loosening were found in any follow-up case.Six months after surgery,Harris hip score was 88 points(range,86-94 points).Radiographs taken at 3 months post-surgery displayed the bone union of surgical region.All these findings suggest that acetabular medial wall displacement osteotomy in total hip arthroplasty produces obvious early-and middle-stage effects in treatment of hip dysplasia.

The present study retrospectively analyzed 8 patients with hip dysplasia (8 hips) comprising 2 males and 6 females, aged 46 years old (range, 35-65 years old) who received treatment at the Department of Orthopedics, Second Affiliated Hospital of Nanchang University between September 2004 and November 2006. Preoperative radiographs and CT examination showed that all patients presented with sharp angle of affected hip > 45°, poor containment of femoral head, narrow joint space, and non-successive Shenton's line. Following Crowe classification, there were 5 cases (5 hips) of grade Ⅱ,and 3 cases (3 hips) of grade Ⅲ. Preoperative Harris hip score was 50 points (range, 44-62 points). Total hip arthroplasty was employed in each patient. Prosthesis was fixed by Cementless or cemented modes. Cementless fixation was applied in 6 hips and cemented fixation in 2 hips. Cementless prosthesis was used on the affected side in each patient. Replacement time, bleeding volume during surgery, hospital days post-surgery, Harris scores, and peri-operative complications were recorded.Simultaneously, post-surgery healing was observed. All 8 cases were followed up for an average period of 6 months. All patients exhibited well recovered joint function. No infection, sciatic nerve injury, dislocation of hip joint, fracture of femoral shaft, thrombosis of deep veins, or prosthesis loosening were found in any follow-up case. Six months after surgery, Harris hip score was 88 points (range, 86-94 points). Radiographs taken at 3 months post-surgery displayed the bone union of surgical region. All these findings suggest that acetabular medial wall displacement osteotomy in total hip arthroplasty produces obvious early- and middle-stage effects in treatment of hip dysplasia.

Objective To provide evidences for rational use of antibiotics in treatment of hospital-acquired urinary tract infection.Methods The bacteria isolated from mid-stream urine samples were collected for susceptibility test(MIC)using international standard plate dilution method.According to breakpoints defined in CILS guidelines(2009),each strain of bacteria was determine for susceptibility to antimicrobial agents,and calculated for rates of resistance(R%),intermediate(I%)and susceptibility(R%)to compounds tested.Results 552 strains of bacteria were collected,including 432 strains(78.3%)of Gram-negative bacilli and 120(21.7%)of Gram-positive bacilli;Escherichia coli was one of the most common bacteria in the urinary tract infection(55.3 %),followed by Enterococcus(17.4%).The results of antibiotic susceptibility test in vitro showed that Enterobacteriaceae was 100% susceptible to imipenem;Gram-positive cocci were sensitive most to glycopeptide antibiotics.Conclusion Clinicians should pay attention to the species of pathogenic bacteria causing urinary tract infection and their susceptibility to clinically common used antibiotics for reasonable use of drugs.

Objective To explore the relationship between plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and the location and prognosis of acute ST-segment elevation myocardial infarction (STEMI) in elderly people.Methods From May 2012 to April 2014, the 137 elderly patients (aged≥60 years) with acute STEMI within 24 h after symptoms onset admitted in cardiovascular department of Ningbo First Hospital were selected as acute myocardial infarction group (AMI group), and 40 elderly healthy people (age≥60 years) as control group.The plasma NT-proBNP levels were detected by enzyme linked immunosorbent assay(ELISA), and compared between the two groups.The patients in AMI group were classified into four subgroups: anterior AMI group (A group, n=44), anterolateral AMI group (B group, n=21), anterior septal AMI group (C group,n=18) and inferior AMI group (D group, n=54), and the changes of plasma NT-proBNP levels in different infarction location were explored.Meanwhile, all patients were followed up for 30 days and 1 year to observe major adverse cardiac events (MACEs) and mortality rate, then to explore the relationship between plasma NT-proBNP level and prognosis in elderly people with STEMI.Results The plasma NT-proBNP levels were significantly higher in AMI group than in control group [(1 406.2±1 322.5)ng/L vs.(63.7±18.5) ng/L, P＜0.01].The changes of plasma NT-proBNP levels in high-to-low sequence were from A group to B group to C group to D group and to control group (P＜0.05).At 30 days, the plasma NT-proBNP levels were higher in death group than in survival group (P＜0.05), and were higher in MACE group than in non-MACE group (P＜0.05).At one year, there were no significant differences in plasma NT-proBNP levels between death group and survival group (P＞0.05), and the plasma NT-proBNP levels were higher in MACE group than in non-MACE group (P＜0.05).Conclusions In elderly STEMI patients, there is a correlation between plasma NT-proBNP levels and infarct location, with the highest NT-proBNP level in anterior AMI.The plasma NT-proBNP level could predict MACE.

Objective To investigate immune status changes in liver transplant patients suffering from early developed sepsis.Methods In this study 19 patients undergoing liver transplantation for severe hepatitis from Oct 2008 to Jul 2009 were enrolled.Immune status was compared between patients of severe hepatitis and 20 healthy volunteers.According to whether early sepsis developed or not,patients were divided into sepsis group (HSS) and non-sepsis group (HSNS).T lymphocyte subgroups of the peripheral blood were compared between post-transplant and pre-transplant in these two groups on different stages.Results Comparing to volunteers,T％ and IFN-γ/IL-4 of severe hepatitis patients significantly decreased,CD4 + CD25 + Foxp3 + Treg( ％ ),Foxp3 mRNA and IL-10 significantly increased.Early sepsis developed in 9 patients.Compared with pre-transplant levels,T％ in both groups significantly decreased on the first day post transplant.T％ in HSNS group increased to the level of pretransplant while T％ of HSS group remained at the low level.Treg％ ( t =3.265,P =0.004 ) and Foxp3 mRNA ( t =2.750,P =0.013 ) of HSNS group on day 14 decreased significantly lower than that before transplantation.Those two parameters of HSS group even increased slightly.IFN-γ/IL-4 in HSNS group increased significantly on day 3 (t =2.261,P =0.036),while there was no change in HSS group.The concentration of IL-10 in both groups significantly decreased,and the level in HSNS group remained at a low level,while that in HSS group increased on day 14.Conclusions Patients with severe hepatitis have weakened immune status.The imbalance of immune status recovers gradually since 7-14 days after transplantation in patients uncomplicated with sepsis.However,the immune status of receipients complicated with sepsis fails to improve.

Objective To explore an optimal method of producing STZ-induced type 1 diabetic KM mice model by investigating the molded rate of single high dose and multiple low dose of STZ injection.Methods Sixty KM mice were randomly divided into 4 groups(n=15), two control groups and two model groups.In the two control groups, one was blank control and the other was negative control.Mice in the blank control group treated with no injection, but mice in the negative control group were treated with injection of citric acid salt buffer.For the two model groups, one was single high-dose group, 150 mg/kg STZ was injected only once.The other was multiple low-dose group, 50 mg/kg STZ was injected for 5 consecutive days.After the last injection, daily food and water intake were tested, blood glucose level and body weight were examined once a week for 4 consecutive weeks. Results Mice in the two model groups showed typical features of diabetes.The blood glucose levels in the two model groups were significantly higher than in the two control groups ( P <0.05 ) .For the two model groups, the molded rate of 150 mg/kg and 50 mg/kg group were 60% and 53.33%respectively at 1st week, but at the 4th week, they were 60% and 80% respectively.The mortality of these two groups at the 4th week was 33.33% and 20% respectively.Moreover, the blood glucose level in multiple low-dose group increased stably from the 2nd week to the 4th week.Conclusion The multiple low-dose STZ injection (50 mg/kg for 5 consecutive days) is an optimal method for producing KM mice model of type 1 diabetes mellitus.

Objective To determine the effects of trimetazidine (TMZ) on pathology and energy metabolism of myocardium in chronic renal failure(CRF) rats.Methods CRF models were built in Sprague-Dawley (SD) rats with 5/6 subtotal nephrectomy, and animals were randomyly divided into sham group, control group and three groups treated with different doses of TMZ (3 mg/kg,6 mg/kg or 9 mg/kg).TMZ was intragastrically administrated to CRF rats for 17 weeks, while physiologicalsalinewasusedascontrol. Transthoracicechocardiographywasperformedand myocardial morphosis was observed.Left ventricular weight/body weight(LVW/BW) and heart weight/body weight (HW/BW) were measured, and heart rate, and mean arterial pressure (MAP)were detected at the end of the study, while several parameters were detected, including urea nitrogen (BUN), creatinine(Scr), triphosaden(ATP), adenosine diphosphate(ADP), superoxide dismutase (SOD), malondialdehyde (MDA), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α).Results (l)Left ventricle end-systolic dimensions, anterior wall end-diastolic and end-systolic thicknesses, and posterior wall end-diastolic thickness were significantly lower in rats treated with either medium dose or high dose of TMZ, as compared with control group(P＜0.05).(2)LVW/BW and HW/BW in rats treated with either medium dose or high dose of TMZ were significantly lower than those in control group(P＜0.05). (3)Various pathological changes were observed in control group, such as irregular arrangement and hypertrophy of the cardiomyocytes, myocardial fibrosis,mitochondrial swelling, focal muscle fiber dissolution, etc.However, all these pathological changes were apparently ameliorated in TMZ-treated groups, while the beneficial effects of TMZ therapy were dose-dependent. (4)No difference was observed in heart rate among all the groups.Although no difference existed in all the CRF rats, concerning on the systolic/diastolic blood pressure and mean arterial pressure (P＞0.05), these parameters were elevated in CRF rats, as compared with sham-operated group(P＜0.01). (5)ATP and ADP in TMZ-treated rats were significantly higher as compared with control(P＜0.05), moreover, medium dose and high dose of TMZ were superior to low dose (P＜0.05).(6)SOD was significantly increased in TMZ-treated rats (P＜0.05), while IL-6,TNF-α and MDA were significantly decreased in medium dose and high dose of TMZ, as compared with control(P＜0.05).Conclusion TMZ may prevent myocardial fibrosis and left ventricular hypertrophy in chronic renal failure via ameliorating myocardial energy metabolism and alleviating inflammatory reaction and oxidative stress.