Object To emphasize the necessity and significance of informed consent in the plastic surgery.Further investigating the ethical implication involved in informed consent principles.To standardize the medical treatment action according to the informed consent principles.Methods Through the literature search method,counseling for experts,sampling surveys and other approaches to elucidate the importancy of informed consent in plastic surgery,to survey and analyze the difficulties and ethical dilemma encountered in the process of standardization.Results Plastic surgeons firmly are aware of the principles of informed consent,as a routine preoperative procedure,however there are still some difficulties in practice.Conclusions To respect the patient's right to know,plastic surgery doctors should be standardized to perform the principle of informed consent; meanwhile hospital should develop a series of systems to regulate the principle of informed consent.

A Neurospora sp was used to ferment organic waste materials such as sugarcane residue powder (bagasse), bran and cassava residue The feed complex enzymes including cellulase, saccharifying enzyme,neutral proteinase and other growth factors were produced The experimental results showed that suitable medium contained sugarcane residue powder 100 g ?bran 600 g, cassava residue 300 g, mixed nitrogen sucrose 20 g per kilogram solid materials and some content of phosphate, the water in medium was twice as weight as the solid materials;the suitable fermentation conditions were that the strain was cultured first for 2 days under 34℃ and then fermented for 2～3 days at 37℃, no light,keeping the watering medium and suppling enough oxygen during fermentation The cellulase (CMC+C1) was 1759mg/g/h, saccharifying enzyme to 3110 mg/g/h, neutral proteinase 297mg/g /h in ferment product On the other hand, light,enough air,lower temperature and less water content in medium were benefit to producing spores

OBJECTIVE: To study the mechanism and clinical significance of specific immunotherapy (SIT) on the expression changes of GM-CSF and IL-5 in the tissue samples of recurrent nasal polyps. METHOD: Perennial allergic rhinitis patients with recurrent nasal polyps were randomly divided into 2 groups. The experimental group of 19 patients was treated by SIT and standardized treatment (glucocorticoid nasal spray) , and the control group of 17 patients was only treated by standardized treatment (glucocorticoid nasal spray). We measured the expression levels of GM-CSF and IL-5 in the tissue samples of the nasal polyps by ELISA, and compared the results obtained before treatment with expression levels detected at 6 months and 1 year after the treatment. RESULT: The expression of GM-CSF and IL-5 in the recurrent nasal polyps reduced significantly (P < 0.05) in both groups after 6 months and 1 year post-treatment compared with pre-treatment, and the expression of GM-CSF and IL-5 in the experimental group was much lower than that of the control group. CONCLUSION SIT decreases the expression of GM-CSF and IL-5 and reduces the inflammatory reaction in the tissue samples of recurrent nasal polyps.
Enzyme-Linked Immunosorbent Assay ; Granulocyte-Macrophage Colony-Stimulating Factor ; metabolism ; Humans ; Immunotherapy ; Inflammation ; drug therapy ; Interleukin-5 ; metabolism ; Nasal Mucosa ; pathology ; Nasal Polyps ; drug therapy ; metabolism ; Rhinitis, Allergic, Perennial ; drug therapy ; metabolism

Objective To investigate the influencing factors on re-examination compliance of patients with breast cancer Who were in the stage of recovery.Methods By clinic services and telephones,we investigated the reexamination compliance of 189 cases of breast cancer.Results 66.1% of the cases took periodic re-examinations and on the opposite,33.9% of the patients didn't do so.Statistical meaning could be found from the difference of ages,living sites and survival time limits(P＜0.05).Conclusions The main factors to influence the re-examination compliance of patients with breast cancer are age,living site and survival time limit.And it is possible to improve the re-examination compliance of patients by enhancing health education,raising medicsl levels and service qualities,and creating comfortable environment for patients.

To determine the bufalin concentration in rats' plasma by establishing a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method, and to evaluate and compare the pharmacokinetic characteristics of bufalin-loaded bovine serum albumin nanoparticles (bufalin-BSA-NP) and bufalin.

A case of ulerythema ophryogenes (UO) is reported.A 12-year-old boy presented with erythema and follicular papules on the eyebrows and cheeks for 7 years.The lesions started as follicular papules surrounded by erythema,then spread symmetrically to the cheeks and forehead followed by the loss of eyebrows.There was no complaint of pruritus.Physical examination showed pinhead- to grain-sized,smooth,slightly indurated follicular hyperkeratotic papules surrounded by erythematous halo on the eyebrows,forehead and cheeks.Both eyebrows were nearly completely lost.Histological analysis of lesions from eyebrows revealed dilated follicular infundibulum with orthokeratotic plugs,sparse perivascular and perifollicular lymphohistiocytic infiltrate,widened and sclerotic collagen fibers in the dermis.According to the clinical manifestations and histopathological findings,the patient was diagnosed with ulerythema ophryogenes,and given oral vitamin A 2.5 million unit once a day,vitamin E 100 mg once a day,topical vitamine E cream twice a day,0.025％tretinoin ointment once at night.Two weeks later,the lesions improved.

Objectives To evaluate the effect of the positive psychology intervention on SWB in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 108 patients with COPD were divided into control group and intervention group according to the principle of control matches,with 54 patients in each group.Patients in intervention group received a period of three months of positive psychology oriented psychological journal ,patients in control group were blank.Before and after the intervention,both groups of patients were assessed by Memorial University of Newfoundland Scale of Happiness (MNusH) and 12 General Health Questionnaire (GHQ-12),and used t tests andx2 test to compare two groups of patients,as well as the intervention group itself differences.Results After the intervention,the score of MNusH in the intervention group was (35.8 ± 8.3),which was significant higher than that of in the control group,t=7.110,P ＜0.05.The scores of positive emotion and positive experience of MNusH Scale of patients in intervention group were higher than control group,the scores of negative emotions and negative experience of patients in intervention group were lower than control group,the difference was statistically significant,t value was 3.269,6.878,8.156 and 7.801respectively,P ＜0.05.The intervention significantly reduced the incidence of psychological disorder of patients,x2=42.335,P＜0.05.Conclusion Positive psychology interventions can effectively improve negative emotions of the elderly hospitalized COPD patients,improve SWB of the elderly patients with COPD.

OBJECTIVE To observe the efficacy of specific immunotherapy (SIT) with Alutard and NHD in children with allergic rhinitis due to different level of skin prick test (SPT) with dermatophagoides farinae (DF) and dermatophagoides pteronyssinus (DP). METHODS A total of 178 children with persistent allergic rhinitis were included in this study. Their age ranged from 6 to 12 years. They were divided into 3 groups according to level of SPT. Group 1: The level of skin index (SI) of DF is greater than that of DP, Group 2: The level of SI of DF is equal to that of DP and Group 3: The level of SI of DF is less than that of DP. The children in each group were randomly divided into 2 subgroups: Alutard group and NHD group. The children were given SIT with Alutard or NHD for one year. Symptom and medication scores were recorded and analyzed. RESULTS After receiving therapy for 3 months and 6 months, symptom and medication scores of the Group 1 and 2 in the NHD group were lower than those in the Alutard group (P<0.05); Symptoms and medication scores of the Group 3 in the Alutard group were lower than those in the NHD group (P<0.05). After receiving therapy for 9 and 12 months, the symptom and medication scores of the NHD and Alutard group in all the three groups showed no statistical difference (P>0.05). CONCLUSION The efficacy of SIT with Alutard and NHD is different in children with allergic rhinitis with different levels of SPT due to DF and DP after 3 and 6 months, but is similar after 9 and 12 months. SIT with Alutard and NHD is effective in treating children with allergic rhinitis.

Objective To explore the effectiveness and safety of tiotropium bromide inhalation agent with tulobuterol patch in the treatment of C and D level of COPD in stable period .Methods According to the digital table,255 cases of C and D level in patients with stable COPD were randomly divided into the study group and control group,the patients in study group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day,and give tulobuterol patch(2mg/paste),one time every day.The control group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day.The changes of lung function were observed before and after treatment,the clinical symptom score and inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation condition.Results The patients in the two groups after treatment ,pulmonary function ,clinical symptoms score,inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation compared with statistical significance(all P<0.05).Subgroup analysis in study group ,emphysema phenotype visible persistent effect ,chronic bronchitis phenotype ,ACOS phenotype early effective treatment ,decreased efficacy after half a year .The adverse reac-tion of two groups of drugs were respectively 19.7%and 21.0%,there was no significant difference in the incidence of adverse reaction between the two groups (χ2 =0.071,P>0.05).Conclusion Tiotropium bromide inhalation agent with tulobuterol patch can improve clinical symptoms and pulmonary function in patients with C and D level part of the stable phase of COPD .

Objective To analyze the results of detection of infectious indicators of patients from the first affiliated hospital of Nanjing Medical University in recent 5 years ,and to provide a scientific basis for the control and prevention of infectious diseases . Methods The patients with clinical data from January 2010 to April 2014 were retrospectively analyzed ,then the infectious indica‐tors of all the subjects were detected and analyzed .Results HIV positive rate was between 0 .043% to 0 .061% ,positive rate of HCV was between 1 .07 to 1 .41% ,positive rate of TP was between 2 .01% to 2 .17% .HBsAg positive rate in 2010 was 8 .36% ,the positive rate was 7 .81% in 2014 .HBsAb positive rate in 2010 was 35 .36% ,positive rate was 50 .96% in 2014 .Conclusion Effec‐tively cut off the route of transmission could prevent the further spread of infectious disease .