The Roles of the clinicians in different medical models are quite different,which not only led to the change of the relationship between the clinicians and the patients, but also had a significant clinical effect. The authors compared the clinicians'role in different medical models and showed the humanism underlying this change.

Objective To study the clinical significance of partial splenic embolization (PSE) for the treatment of hypersplenism and the relationship between the therapeutic effect and the area of embolization. Methods Sixteen patients with hypersplenism were divided randomly into two groups: Group 1 (n=5) and Group 2 (n=11). The embolization area in Group 1 was 40%-59% and that in Group 2 was 60%-80%. A follow-up for 1 year was conducted in all patients. Results The short-term effective rates (CR+PR) of thrombocyte count were 81.3% in Group 1 and 93.8% in Group 2, respectively, whereas the long-term effective rates were 62.5% and 87.5%, respectively, and the corresponding one-year recurrence rates were 23.1% and 6.7%. The long-term effective rates of WBC count were 71.4% and 82.2% in groups 1 and 2, respectively, and the one-year recurrence rates were 28.6% and 17.8%, respectively. The long-term effective rates of RBC count were 70% in Group 1 and 83.3% in Group 2, respectively, and the one-year recurrence rates were 22.2% and 11.8 %, respectively. Conclusion PSE, resulting in a low recurrence rate, is effective in treating hypersplenism.

The article describes the molecular structure and biological characteristics of thrombin and thrombin receptor.It manly discusses thrombin caused the mechanisms of cerebral edema formation after intracerebral hemorrhage by prormoting cell inflammtory reaction,neuron apoptosis and injurying blood-brain barrier.

Objective To evaluate the effects of Lipo prostaglandin E1(Lipo-PGE1) on the lower limb blood vessel in diabetic patients.Methods The study was performed in 36 patients with diabetes related lower limb vascular disease.Before and after Lipo-PGE1 treatment for 28 days,vascular diameter and blood flow velocity of femoral artery,popliteal artery,posterior tibial artery and dorsal pedal artery were measured by Doppler ultrasonography examination.Results After the treatment with Lipo-PGE1,the vascular diameters of femoral artery,popliteal artery,posterior tibial artery and dorsal pedal artery were dilated;and there were significant differences in posterior tibial artery and dorsal pedal artery.After the treatment with Lipo-PGE1,blood flow velocity of femoral artery,popliteal artery,posterior tibial artery and dorsal pedal artery were increased,however,there were no significantly statistical differences.After the treatment with Lipo-PGE1,all the patients feel well.Painless walking distance and maximal walking distance of 18 patients with intermittent claudication were increased.Conclusion Lipo-PGE1 causes a significant improvement of diabetes related lower limb vascular disease.Furthermore,the results demonstrated the major effects on posterior tibial artery and dorsal pedal artery.Lipo-PGE1 can dilate the smaller artery,which is important and helpful for patients to improve symptoms and signs.

Objective:To review the research hotspots and evolution of electroencephalogram (EEG) biofeedback in attention-deficit/hyperactivity disorder (ADHD) by knowledge mapping software.Methods:Based on web of science core collection database,we searched the literature with keywords (EEG biofeedback OR neurofeedback) AND (ADHD OR attention-deficit/hyperactivity disorder) in topic and time limit set before December 31,2015.319 literature were accepted,using the CiteSpace to depict the hot keywords,cited references and countries.Results:United States of America,Germany,Netherlands were top 3 countries in publishing papers of EEG biofeedback in ADHD.Based on burst of cited references,the research evolution of EEG biofeedback in ADHD could be divided into three stages.The hotspots of EEG biofeedback in ADHD were Slow Cortical Potentials protocol and double-blind placebo-controlled study.Conclusion:Future research should focus on the mechanism of EEG biofeedback and such known protocols for individualized treatment,or be designed along the lines of learning theory.

0bjective To determine the effect of 2 therapies(early realignment versus delayed open urethroplasty)for posterior urethral injuries associated with pelvic fractures. Methods A sys-tematic review of all the relevant clinical trials was performed.Trials were identified from specialized trials register of Cochrane UGDP Group,the Coehrane library,additional electronic search(mainly MEDLINE、EMBSAE、CBM)and manual searching.Clinical trials comparing early realignment and delayed open urethroplasty of posterior urethral disruption associated with pelvic fractures were includ-ed.Statistics analysis was managed by using Review Manager 4.2. Results Ten clinical trials inclu-ding 470 patients were included.Meta-analysis indicated that odds ratio(OR)of the rate of urethral stricture was 0.27[95%confidence interval(95%CI)0.08,0.86,P=0.03].The OR of the percent-age of strictures needing urethroplasty was 0.25,95%CI 0.08,0.74,P=0.01. Conclusions Early realignment may provide better outcomes than delayed open urethroplasty after posterior urethral dis-ruption.It can decrease urethral stricture formation and the percentage of strictures needing urethro-plasty.But the results might be influenced by the bias of grouping,especially the severity of injuries.

Objective To evaluate the efficiency of ten years of iodized salt supply in prevention and control of iodine deficiency disease (IDD) in Tianjin. Methods 1 200 pupils aged 8-10 years with 1:1 of sex ratio were chosen in the regions where iodized salt supply had been conducted for 10 years (1995-2005), the prevalence rate of goiter, the level of urine iodine and the iodized salt consumption were investigated. Results The prevalence rate of goiter of children aged 8-10 years in Tianjin decreased from 32.6% to 1.8% after 10 years of iodized salt supply, the median of urinary iodine increased from 96 ?g/L to 228 ?g/L. In the high water iodine regions, the prevalence rate of goiter was 8.1%, the median of urinary iodine was 576 ?g/L. Conclusion 10 years of iodized salt supply can significantly prevent and control IDD in the regions where there is iodine deficiency in drinking water, but the problem should not be neglected that iodine excess in the regions where the concentration of iodine in drinking water is higher. Reasonable iodine supplement is the key to prevent and control IDD as a whole.

0.4,P0.05)with HHS.[Conclusion]The result of this study suggest that HHS can not capture additional important quality of life domains except for physical function and pain relief that are influenced by THA.So it's necessary to combine HHS and a quality of life survey such as SF-36 to allow a more global assessment of THA.

Objective To investigate the prevention and treatment of the complications due to CT-guided percutaneous transthoracic biopsy. Methods CT-guided percutaneous transthoracic needle biopsy was performed in 168 patients aged from 14 to 79 years old. The complications and the contributing factors were analyzed. The methods for the prevention and treatment of the complicaitons were suggested. Results CT-guided percutaneous transthoracic needle biopsy was succeeded in 168 cases. The major complications associated with CT-guided needle biopsy included pneumothorax (8.33%) and pulmonary hemorrhage (20.24%). Pneumothorax was associated with the lesion size, lesion location, and times of puncture. Pulmonary hemorrhage was associated with the lesion size as well as the pre-operative evaluation of the vascular structures with contrast CT. Chest tube placement was performed in 1 out of 14 cases of pneumothorax. Other cases were not particularly treated. Conclusion The prevention of complications is important for CT-guided needle biopsy. The key factors to prevention the complications include accurate location of the lesions and correct evaluation of the vascular structures before the operation and skillful intraoperative puncture.

Background Experimental study showed that heparanase (HPA)is overexpressed in choroidal neovascularization,suggesting that it may play a role in the pathogenesis of angiogenesis.To certify HPA inhibitor suppress the formation and development of new blood vessel has an important significance for the treatment of choroidal neovascularization.Objective The aim of this study was to investigate the effect of HPA inhibitor on the proliferation of human umbilical vein vascular endothelial cell (UVEC) and the expression of HPA.Methods Hunan UVEC was primarily cultured and passaged and the third generation cells were used in the experiment.Phosphomannopentaose sulfate (PI-88) solution,a HPA inhibitor,was prepared with endothelial cell medium and the end concentrations were 400.00,200.00,100.00,50.00,25.00,12.50,6.25 mg/L respectively.The cells were treated with PI-88 solutions for 24,48 and 72 hours.The growth and proliferation of human UVEC were analyzed using MTT colorimetric assay at absorbance 570 nm.The expression of HPA in the cells was detected by immunochemistry in 48 hours after addition of PI-88.Results Cultured human UVEC showed the fusiform and polygon in shape.The A570 values of human CVEC were significantly different among various concentrations of PI-88 groups (F=2.721,P=0.053 ) and different action time (F=9.656,P =0.002).When PI-88 was administered for 24 hours,the A570 values of human UVEC were insignificantly altered in comparison with the one without PI-88 culture group (P＞0.05 ).However,in 72 hours after experiment,the A570 values were significantly declined as the PI-88 concentration was ＞50.00 mg/L ( P＜0.05 ).When PI-88 was administered for 48 and 72 hours,the A570 values of human UVEC were significantly higher than those of 24 hours in ＜50.00 mg/L groups (P＜0.01 ),but no statistical differences were seen in ＞100.00 mg/L groups among various time points (P＞0.05 ).HPA was intently expressed in the cytoplasm of human UVEC.However,at 48 hours after addition of ＞25.00 mg/L PI-88,the HPA expression was obviously weaker.Conclusions PI-88 can suppress the growth and proliferation of human UVEC at the dose-and time-dependent manner by downregulating the expression of HPA in the cells.