The doctors'medical treatment in the medical service is not a private right, but a public power. It orignates from the patients'rights. The purpose is to sustain and enhance the patients' health, However, in our actual lives, the side effect of market - oriented economy brings out the power partly to deviate from the primary aim. This kind of phenomenon is called as alienation of doctor's power. The doctor's power of alienation infringes upon the rights of patients, causeing the conflicts between both sides and forms disputes of medical treatment. Only could the patients's rights and the doctors's duties be wholly defined by law, that the patients rights can be taken to restrict the doctors power, and the relationship between the two sides can be harmonious.

With specific physical characters,proton for postoperative breast cancer can improve dose homogeneity,lower dose to crucial organs such as the heart,lung and the opposite breast,and reduce the complications of normal tissues and incidence of the second primary tumor proton accelerated radiation for partial breast cancer can reduce therapy time,but its long time effect needs great patients and long time follow-up to beproved.

AIM: Anterior cervical discectomy and Cage bone graft fusion followed by steel plate internal fixation can decompress the vertebral canal and then spinal cord in patients with multilevel cervical spondylotic myelopathy. Complete decompression is very important for such patients. This study is to investigate the effect of this technique on reconstruction of spinal function.METHODS:①Thirty-eight inpatients with multilevel cervical spondylotic myelopathy admitted to Department of Spine Surgery, Tianjin Hospital between April 2003 and February 2006 were involved in this study. The involved patients, 35 male and 3 female, were aged 43-72 years, with disease course of 0.5 to 5 years. Informed consents of therapeutic regimen were obtained from all the patients.②All the patients underwent anterior cervical discectomy and cage placement operation. The patients with destabilized combination underwent titanium-plate fixation, and those with stabilized combination underwent cage implantation alone. The cage used in the experiment was made of tetragonal polyether ether ketone (Intromed Company), and titatium-plate was Zephir plate (sofarmor Danek Company). The elastic modulus of tetragonal polyether ether ketone Cage was similar to bone tissue and could allow X-ray pass through, which was easy for postoperative fusion of implanted bone. The outer design of Cage bone graft with certain angle could allow cervical physiological antecurvature well recover; Surface radian was the same as end plate, and good fitness contributed to the good fusion rate of bone graft; The sawtooth antiskid design on the surface provided good stability immediately after implantation; Elastic modulus was between os integumentale and cancellous bone that made stress-shielding and subsidence of fusion cage reduced, and had good anticausticity and biocompatibility. ③ The clinical results were evaluated with Japanese Orthopaedic. Association (JOA) scoring system before, 2,8 and 24 weeks after operation: upper limb motor function (4 points), lower limb motor function (4 points), sensation (6 points) and bladder function (3 points). Higher scores indicated better function. Postoperatively, body examination and X-ray and MRI scanning of anteroposterior cervical vertebra were performed.RESULTS: Thirty-eight patients with multilevel cervical spondylotic myelopathy participated in the final analysis. Within postoperative several days, nervous symptoms improved obviously, muscle strength of lower limb was increased, limbs were more flexible after operation than before operation, and paresthesia of two upper limbs recovered in 38 patients. JOA was a score of (9.25±1.85) before operation, and it was (12.4±2.08) at postoperative 2 weeks, (13.2±2.07) at postoperative 8 weeks and (13.8±1.67) at postoperative 24 weeks.CONCLUSION: Multilevel discectomy and Cage implantation obviously improve sensorimotor function and lessen symptoms of patients with multilevel cervical spondylotic myelopathy.

Objective To observe the effect of pure Chinese traditional medicine preparation Fuzheng Anti-poisonous capsule and Kang Aibao Lives capsule to treat HIV/AIDS. Methods 140 examples confirmed by the Yunnan Province Centres for Disease Control and Prevention were treated by Fuzheng anti-poisonous capsule and Kang Aibao Lives Capsule,according to the Chinese medicine syndrome differentiation. 83 cases taking the medicine for more than 6 months were collected. The changes of Chinese medicine clinical symptoms and signs,the clinical symptoms and signs,the integrals,body weights,cold-catching numbers and CD4 were observed. Results The effective rate,steady rate and ineffective rate of Chinese medicine clinical symptom were 79.52%,10.84% and 9.63%,respectively. Increase,stable and reduces of integral were 48.19%,45.78% and 6.02%,respectively. Weight gain,stable and reduce were 56.62%,19.28% and 24.10%,respectively. Reduce,stable and increase of cold-catching number were 46.99%,43.37% and 9.64%,respectively. Effective,stable and ineffective of CD4 was 56.00%,10.67% and 33.33%,respectively. Conclusion The Chinese medicine has the remarkable curative effect in treating AIDS,and also has the obvious superiority.

adult female Wistar rats undergone bilateral adrenelectomy were diveded to four groups:(A)simple bilateral adrenalectomy;(B)bilateral adrenalectomy with pieces of adrenal glands alloimplanted to the subrenal capsule (SRC);(C)the same with group B followed by institution of cyclosporing A(CsA) from the operative day to the 14th postoperative day;(D) group C plus ACTH given from 3rd to 31st postoperative day. Five months follow-up showed that all the grafts survived, regenerated and the serum corticosteron levels were in correspondence with histological features. This result showed SRC is an ideal site for adreal homotransplantation. Varying degrees of lymphocytyc infiltration were present in the implants in group B on the 2nd to 21st postoperative day, the fragment in groun C and D in which CsA was given did not show any lymphocytic infiltration, even after CsA was discussed. ACTH instituted in group D remarkably enhances the regenerative speed of the grafts After CsA and ACTH were stopped, no rejection episode appeared and the adrenal grafts survived well. The result has been similar to clinical homotransplantation of adrenal glands with vasculas anastomosis.The technigue is simple and the adrenal gland used for homotransplantation is easy to obtain.

Objective:To study the anti proliferation and inducing apoptosis effects of cytokine induced killer cells CIK cells on MGC 803 gastric cancer cell lines and to probe its underlying mechanism.Methods:To detect the anti proliferation and the cytotoxicity of CIK cells on MGC 803 gastric cancer line by MTT assay.The morphological changes of the apoptosis cell were observed by HE stain, scanning and transmission electron microscope. The positive expression of p53, p16,C myc were determined by immunocytochemistry (ICC).Results:MTT assay showed that the inhibitive rate inhanced obviously with the addition of Effect/Target rate and extension of time ( P

Objective To display of heterologous proteins on the surface of E. coli . Methods The 1653 bp luciferase report gene was knocked in Ipp and ompA genes of chromosome by Red recombine system and selection-counter selection kan/sacB. Results The quantitative analysis results of exogenous lu-ciferase expression displayed that it could be expressed as fusion with the outer membrane proteins on the cell surface. The fusion protein of foreign protein and outer membrane protein Lpp-OmpA-Luc could be high-effi-ciently displayed on cell surface. Conclusion The stable expression of exogenous gene on the surface of E. coli had no effect on the bacterial growth and propagation.

Objective To analyze the surgical treatment options and its results for thoracic and thoracolumbar disc herniation.Methods From June 2004 to December 2009,thirty-one patients of thoracic and thoracolumbar disc herniation with or without ossification of ligament flavum were surgically treated,including 22 males and 9 females,with a mean age of 54 years(range,24 to 71 years).According to Anand and Regan clinical classification,there was type 2 for 1 case,grade 3a for 2,grade 3b for 3,grade 4 for 6,and grade 5 for 19.The neurological status was Frankel B for 2 cases,C for 6,D for 11,and E for 12.Anterior surgeries were performed for 18 patients without ossification of ligament flavum.Anterior decompression was performed through the resection of posterior part of vertebral body,or subtotal resection of vertebral body,followed by strut graft and internal fixation.Posterior surgeries were performed for 13 patients with disc herniation and ossification of ligament flavum.The resection of hemi-articular process and total laminectomy was performed.Results The complications of 18 patients with anterior surgery included laceration of dura mater in 1 case,nerve root sleeve injury in 1 case,intercostal neuralgia in 3 cases,atelectasis in 1 case,and femoroiliac numbness in 2 cases.The complications of 13 patients with posterior surgery included intra-canal hematoma in 1 cases,leakage of cerebrospinal fluid in 2 cases,infection of incision in 1 cases,and pneumonia in 1 case.The patients were followed for 18 months(range,6 to 48 months).At final follow-up,the neurological status and local symptom improved in all patients,with Frankel C for 3 cases,D for 7,and E for 21;and Anand and Regan type 1 for 2 cases,2 for 1,3a for 1,4 for 2,5 for 10 and no symptom for 15.Conclusion For thoracic and thoracolumbar disc herniation,anterior surgery is suitable for patients mainly suffered anterior cord compression.Resection of posterior part of vertebral body or subtotal resection of vertebral body is often needed for sufficient decompression.Posterior surgery is suitable for patients with anterior and posterior cord compression due to ossification of ligament flavum,and the decompression can be obtained by resection of hemi-articular process and total laminectomy.

ObjectiveTo design a new operation approach:extreme lateral transforaminal lumbar interbody fusion (E-TLIF) via digital technology and to discuss its feasibility in treatment of degenerative lumbar diseases.MethodsCT scan image data of lumbar vertebra were obtained from volunteer (a healthy male of 26 years old,67 kg in weight and 172 cm in height).Mimics was used to read and reconstruct the data into 3D images.We observe the anatomical bone structures of intervertebral foramen and nerve roots through CT scan and 3D reconstruction in Mimics to analysis the feature of this area.Then E-TLIF operation,pedicle screw insertion and cage placement were simulated by computer via digital technology in Mimics.The feasibility of this new approach was proved through operating on lumbar of formalin doused body with E-TLIF approach.ResultsAn incision of 9 cm lateral form the central line and 45° from the sagittal plane is operated to fully expose the foraminal area.Remove superior facet while save inferior facet is feasible with this approach in E-TLIF.There is enough room for fully revealing and excision of intervertebral disc,and cage placement through enlarged foraminal area.Digital technology is a more economic,efficient way to design a new operation approach.The results are in accord with the formalin doused body test.ConclusionMimics is an effectively,reliable and economic method to design an operation approach.And the result suggested that E-TLIF is a safe,less minimal invasive and more efficient operation approach in treatment of degenerative lumbar diseases.

Background:Inflammation plays an important role in intestinal ischemia-reperfusion injury(IRI),and erythropoietin (EPO)has been reported to have anti-inflammatory activity. Aims:To explore the protective effect of EPO on intestinal IRI and its potential mechanism. Methods:Thirty-two healthy male Sprague-Dawley rats were randomly divided into four groups:sham operation group(sham group),IRI group,EPO group and 740Y-P group. Rats in IRI,EPO and 740Y-P groups were injected intraperitoneally with 0. 9% NaCl,EPO and EPO + 740Y-P,respectively,one hour before the establishment of intestinal IRI model by superior mesenteric artery clamping(45 min)-reperfusion. All rats were sacrificed one hour after reperfusion. Histopathological changes of small intestine were observed;expression of proteins in PI3K/ Akt and NF-κB signaling pathways was measured by Western blotting;expression and secretion of inflammatory cytokines, including interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and monocyte chemoattractant protein-1(MCP-1)were examined by real-time PCR and ELISA. Results:Compared with sham group,the damage score of small intestine,protein expressions of PI3K,p-Akt and p-NF-κB p65,as well as mRNA expressions and serum levels of IL-8,TNF-α and MCP-1 in IRI group were significantly increased(P < 0. 05). EPO pretreatment could ameliorate the histopathological changes of small intestine in IRI model rats,inhibit PI3K/ Akt and NF-κB signaling activation and down-regulate expression and secretion of inflammatory cytokines. When 740Y-P,a PI3K agonist,was used combinedly,the effect exerted by EPO was diminished. Conclusions:EPO pretreatment can protect against intestinal IRI by inhibiting the activation of PI3K/ Akt/NF-κB signaling and the subsequent inflammatory response.