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.

Humans ; Otolaryngology ; Printing, Three-Dimensional

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 make cephalometric analysis on the morphology of mandibular angle and its relationship with adjoining craniomaxillofacial structures in adults, and to discuss the application of the results in preoperative analysis and operation design. Methods Cephalometric analysis was made on the following parameters in 30 adults (15 men and 15 women) for frontal and lateral cephalometric radiograms: the distance between the mandibular angles (Go Go) and between the malar points (Zy Zy), and the mandible mental angels (Zy Go Me) on an anteroposterior cephalometric radiograph; the gonial angle (Ar Go Me), mandibular plane sella nasion angle (MP SN) and ramus plane sella nasion angle (RP SN). Results Go Go in male was (130?6) mm, female (116?6) mm; Zy Zy in male was (156?5) mm, female (146?5) mm; Zy Go Me in male was (117?5)?, female (119?5)?; Ar Go Me in male was (117?5)?, female (119?5)?; MP SN in male was (27?5)?, female (29?5)?; RP SN in male was (94?5)?, female (93?5)?. Conclusion The morphology of mandibular angle should be envisioned in three directions. The results of evaluation can be served as the reference of preoperative analysis and surgery design.

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 analyze the surveillance data from 2003 to 2007 for Hubei province,investigate the epidemic characteristics of human rabies in these years,so as to provide scientific basis for its control and prevention.Methods Rabies data collected from the National Disease Surveillance Reporting System from 2003 to 2007 in Hubei province and 134 Rabies cases investigated in 2007 were analyzed in detail.Results The results showed that the trend of the number of rabies reported cases in Hubei province was obviously increased from 2003 to 2007.The involved counties and districts of the epidemic situation were widely expanded accordingly.Each month had Rabies case,but a lot of cases were dominated in August to November for every year.Most of the cases were farmers and students.The sex ratio of male to female was 2.38∶1.The age of the cases were mainly ranged from 5 to 15 and from 40 to 70 years old.Investigation of 134 cases indicated that the median of the incubative period was 66 days;94.78% of cases were injured by the dog;only 15.67% of injured cases were treated by the medical institution;the vaccinate ratio was 14.93%;the proportion of patients who received wound treatment,vaccinate and passive immunization were 5.80% of all the grade-Ⅲ-exposed patients.Conclusions The epidemic situation of Rabies was serious from 2003 to 2007 for Hubei province.The main reasons of the increase of rabies cases in Hubei province are absence of the effective management of the dog,the lack knowledge of rabies prevention,low rate of vaccine and passive immunization after exposure,and the lack of the standardized management for some of the low level medical institutions.

OBJECTIVE　To evaluate the availability and safety of a new carbapenem meropenem.METHODS　The randomized study was conducted in 60 patients with respiratory tract infections.They were divided into two groups:meropenem or imipenem/cilastatin.RESULTS　The cure rate,effective rate and bacterial clearance rate for meropenem were 80.0%,93.3%,92.3%,respectively and for those of imipenem/cilastatin were 76.7%,90.0% and 91.3%,respectively.The rate of adverse reactions for both meropenem/cilastatin was 3.3%.CONCLUSION　Meropenem appeared to be a highly effective and safe agent in treatment of respiratory tract infections.Its efficacy and safety are similar to that of imipenem/cilastatin.

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 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.