Universal health has been highly valued by the public and the government,and medical science and technology have been much improved.However,these are accompanied by a complex situation of doctor-patient relationship.We discuss here that humanism be fostered in medical education and clinical practice.A harmonious doctor-patients relationship can be maintained only when patientcentered medical service is applied and humanistic care is integrated but not overly dependent on technology and seeing patient as mere cases.

Objective To investigate the expression of serum interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)in the pa-tients with pulmonary tuberculosis and diabetes,and prelininary explore its clinical significance.Methods Experiment were divided into control group(health check-up outpatient,n=10),pulmonary tuberculosis group(n=20),diabetes group(n=20),tuberculosis combine diabetes group(n=20),tuberculosis combine diabetes group was divided into improved group,diabetes group and deterio-rated group after 2 months with therapy according to disease outcome,ELISA assay was used to measured the level of serum IL-2 and TNF-α.Results Before treatment:serum IL-2 levels of pulmonary tuberculosis group,diabetes group and pulmonary tuberculo-sis combine diabetes group were reduced (P<0.05),and the pulmonary tuberculosis group was lower than the pulmonary tubercu-losis group and diabetes group (P<0.05);serum TNF-αlevels of pulmonary tuberculosis combine diabetes group,pulmonary tu-berculosis group and diabetes group increased (P<0.05),and that of pulmonary tuberculosis combine diabetes group was higher than that of diabetes group (P<0.05).After treatment:the level of serum IL-2 increased and TNF-αsignificantly decreased in pul-monary tuberculosis combine diabetes improved group (P<0.05),the deterioration group had no change(P>0.05).Conclusion IL-2 and TNF-αplay a role in the immune pathogenesis of tuberculosis combine diabetes,which dynamic changes can reflect the progression and outcome of pulmonary tuberculosis combine diabetes.

Objective To explore the role of multi-media teaching in the ENT physician training. Methods 32 further-study professionals were randomly divided into 2 groups. The control group received traditional teaching methods(n = 16), and the experimental group received the multi-media teaching method (n = 16). After the training, all trainees would take the theory test and skill assessment Results The basic theory and clinical skill scores of the experimental group are better than the control group at the end of the training. Conclusion Multi-media teaching method is very suitable for ENT refresher training.

Objective To explore the effect of elbow release and debridment with arthroscopy for elbow malfunction. Methods The study was carried out on 15 patients (male 11, female 4; age 21-63 years old, average 40.1 years old) with the use of arthroscopy to brisement accretion and articular capsule from August 2001 to December 2003. The mean course was 55.2 months (range, 8-24 months). The flexion angle of joint preopration was 15?-60?, average 30.4?, the extension angle was -80?--20?, average -51.2?. The diagnosis was osteophyma and liberum in 4. The old fracture of radius capitulum was in 2; the old fracture of ulnar olecranon in 2; the old fracture of condyle of humerus in 3; degeneration in 4. The brachial plexus anesthesia,the elbow hung to traction, interna and extra-pathway, to cut synovium and accretion fibers with shver, removal liberum and milling osteophyma, meanwhile brisement articular capsule. Pathology manifestation in arthroscopy: there were a lot hyperemia synovium and fiber accretion. There was cartilage exfoliation in 8, hyperplasy and liberum in 5, ossification of cicatricle in 2. The motion range of elbow was reexamined, if the extension function was restricted, release was performed on anterior soft tissue and capsule. If the flexion function was restricted, release was carried out on posterior capsule via posterior straight approach(3 cm supra point of olecranon). Results All patients recovered daily life and occupation postoperative 7 to 14 days. Transient ulnar nerve paralysis occurred postoperatively in one case, which recovered three months later. There were no blood vessel and nerve injury. The mean follow-up period was 14.1 months (range, 7-20 months). At the final follow-up, the flexion of joint post operation was 70?-120?, to improve average 60.5?; the extension of joint post operation was -20?--5?, to improve average 37.6?. In accordance with HSS scoring system, excellent 7, good 5, fail 3. Conclusion Using of arthroscopy to release elbow joint have many advantages such as less trauma, quick recovery and less sequela. The application in release with arthroscopy is a good way for elbow malfunction.

Objective To introduce a method of dorsal augmentation rhinoplasty using autogenous septal cartilage. Methods Autogenous septal cartilage was obtained through a standard septoplasty approach. Graft was cut into single oval, or divided into two or three parts, then the cartilage was sutured by means of a mattress suture; or graft was made into an inverted V frame, depending on size and shape of dorsal depression, and finally graft was inserted for augmentation of dorsum. Results Since May 1989 to Dec. 2001, this technique was performed in 43 patients, 6 men and 37 women, with a range of 17-35 years and a mean age of 24 years. Follow-up ranged from 6 months to 5 years. The authors asserted the sustained satisfactory outcomes. Conclusion Autogenous septal graft is technically simple and relatively free of complication. Long-term evaluations show no absorption of grafts and preservation of desired shape.

Objective To introduce a new method of recombinative repair for the old malunion of the fracture of nasal bone. Methods Since 1996.5 to 2001.12, this technique was performed in 28 patients, 23 men and 5 women, with a range of 18～45 years, a mean age of 29 years. The nasal skin was protected with a rubber pad, and malformed nasal bones were beat out with a small hammer, so as to create a new refracture, then manual reduction was performed with finger and the septal periosted elevator. Results Follow-up ranged from 3 months to 5 years. Of all the patients, 23 cases were cured, 5 cases improved, and the overall effective rate was 100 %. Most of them were satisfied with the successful operation. Conclusion The operative procedure of recombinative repair is technically simple and easy, and the patients suffer little. It is an update and efficacious therapeutic method.

Objective To investigate the mechanism involved in the brain protection afforded by prenatal hypoxic adaptation by determining the quantitative variation in bcl-2 and bax mRNA expression.Methods Twenty-four Wistar pregnant (22d pregnant) rat were randomly divided into two groups: group I (hypoxia group) and group *** ( control group) . In group Ⅰ the pregnant rats were placed in an airtight cabin specially designed for hypoxic adaptation. When O2 % in the cabin decreased to 15%, the animals were taken out breathing fresh air for 5min and then placed back in the cabin and underwent another episode of hypoxia. In group Ⅱ the animals were placed in the cabin which was not tightly closed and underwent no hypoxia. 7 fetal or newborn rats were taken at 1st, 3rd, 24th, 48th, 72nd, 120th, and 168th h after prenatal hypoxic adaptation from each group and their brains removed for determination of bcl-2 mRNA and bax mRNA. Results In control group the expression of bcl-2 and bax were observed in the brain tissue of normal fetal or newborn rats from the 22nd day in the uterus to the 7th day postpartum during which there were no significant changes in bcl-2 gene expression while bax gene expression gradually decreased with time ( the decrease was of no statistical significance) . In hypoxia group bax gene expression decreased at 8th h after hypoxic adaptation and reached the bottom at 24th h which persisted until 120th h; while bcl-2 gene expression started increasing at 24th h after hypoxic adaptation and persisted until 72nd h. The bcl-2/bax ratio also started increasing at 8th h after hypoxic adaptation and peaked at 24th h and persisted until 72nd h. Conclusions In the brain tissue of fetal and newborn rats which have undergone prenatal hypoxic adaptation, bcl-2 gene expression is elevated, bax gene expression decreases and bcl-2/bax ratio increases. These changes are time -dependent.

Humans ; Otolaryngology ; Printing, Three-Dimensional

The myocardial protection technique of off-pump coronary artery bypass grafting ( OPCABG ) has been applied to the coronary artery bypass grafting (CABG) with heart valve surgery.This study is aimed at determining its clinical effect .A retrospective analysis design was adopted .39 patients were recruited .All patients ’ surgeries went smoothly but one ,whose blood pressure was in poor control after surgery and then returned to normal after as -sisted with intra-aortic balloon counterpulsation (IABP).Others had stable vital signs and circulation .Finally,all pa-tients discharged safely .Significant improvement can be seen during 3 months’ follow-up.Applying OPCABG to CABG with heart valve surgery has been proved effective in clinic .

Objective To investigate the effect of the locking plate fixation with anti-osteoporosis drug in the treatment of older patients with proximal humeral fractures. Methods Sixty-two patients with proximal humeral fractures who were treated in Yuzhou Mining Company Hospital of Kailuan Group of Hebei Province from Feb. 2011 to Oct. 2013 were divided into observation group(n=30)and control group(n=32). Patients in both groups were given locking plate fixation,and patients in the observer group were also received anti-osteoporosis treatment. The information including hospitalization periods,efficacy and bone mineral density of the two groups was recorded. Results The hospitalization periods of the observation group and control group were (6. 9 ± 1. 0)d,(9. 5 ± 1. 1)d,and the difference was statistically significant(t=8. 426,P﹤0. 05). The efficacy in observer group was excellent in 17 cases,good in 10 cases,fair in 2 cases and poor in 1 case,and the efficacy of the control group was excellent in 14 cases,good in 10 cases,fair in 5 cases and poor in 3 cases. The difference was statistically significant(χ2 =4. 617,P ﹤0. 05 ). After the anti-osteoporosis treatment,the bone mineral density of the observer group and control group were( 0. 79 ± 0. 13)g/cm2 and(0. 66 ± 0. 05)g/cm, the difference was statistically significant( t =10. 251,P ﹤0. 05 ). Conclusion The effect of locking plate fixation with anti-osteoporosis drug is better with shorter hospital stay,safe and reliable,and it is worthy of clinical application.