Good doctor-patient communication is the most effective way to build a harmonious doctor-patient relationship and reduce medical disputes, where the communication skill is the key. In communication with the hospitalized patients, it should pay attention to the communication object choice;the choice of the communicator;communication time, location and the form; pay attention to the communication protocol; using a comprehensible language communication;stand in the perspective of patients in order to enhance the doctor-patient trust and im-prove the doctor-patient relationship.

Objective To study the pathological characteristics of allied Hirschsprung's disease (allied HD) by using NSE and S-100 protein immunohistochemical markers techniques,improve the early diagnosis rate. Methods 97 cases with HD were included in this study.The morphological and numeral change of the neuron and ganglion cell of the lesions was observed and compared with the normal controls.NSE and S-100 protein immunohistochemical markers were performed in 21 cases.Result The number of the neuron and ganglion cell of allied HD was statistically significantly higher than those in the normal control or HD group (P

Objective To explore the therapeutic strategy for intracranial ischemia due to extraand intracranial artery stenosis using endovascular stent angioplasty.Methods Totally 109 patients with extra-and/or intracranial artery stenosis were treated by endovascular stent in our hospital from March 2008 to September 2011.There were 93 cases with single stenostic lesion,16 cases with multiple stenosis and 5 cases with distal unruptured aneurysm.All patients received endovascular stentings and 94 cases were followed up for 3 20 months.Results All of the patients underwent endovascular stenting placement successfully.The average stenosises were(79.2 ± 13.4)％ before operation and(18.1 ± 9.20)％ after operation.During follow-up for(10.8 ± 4.2)months,mild restenosis occurred in 9 stenosises(7.0％)among 129 lesions and no serious stroke event was found.Conclusions Endovascular stent is safe and effective in treating extra and intracranial stenosis.It is important to investigate adequately cerebral blood flow in the multiple stenosis or in complicating other kind of vascular diseases before proper treatments.

Objective To investigate the apathy and neuropsychological characteristics of newly diagnosed Parkinson's disease (PD) patients.Methods Eighty-two newly diagnosed PD patients and 30 matched healthy controls by age,sex and education level were recruited in the present study.Apathy was assessed using Apathy Evaluation Scale (AES) and related factors,including age,sex,education level and disease duration were simultaneously evaluated.Unified Parkinson's Disease Rating Scale (UPDRS),Hamilton Depression Rating Scale (HAMD),as well as Montreal Cognitive Assessment (MoCA) were employed in order to respectively evaluate the motor function,depression and cognition.Results The AES scores in the PD patients were significantly higher when compared to the healthy controls.The prevalence of apathy and depression in the PD patients was 51.2％ (42/82) and 19.5％ (16/82),respectively.There were no statistically significant differences in age,sex,education level,UPDRS-Ⅱ/Ⅲ scores and MoCA scores between apathy (n =42) and no-apathy (n =40) PD patients (P ＞ 0.05),while the statistically significant difference in HAMD scores between apathy (n =42) and no-apathy (n =40) PD patients was shown (the HAMD scores of apathy PD patients were 10.61 ± 3.30,the HAMD scores of no-apathy PD patients were 5.96 ± 1.90,t =7.87,P ＜ 0.05).The correlation analysis indicated that there were no correlations between AES scores and the related factors,including age,education level,disease duration and UPDRS-Ⅱ / Ⅲ scores,but AES scores were positively correlated with HAMD scores.Conclusion In newly diagnosed PD patients,the apathy is independent of depression,motor dysfunction,as well as cognitive impairment,which may be an early signal for PD.

Objective To explore the mutation spectrum of breast and ovarian cancer susceptibility gene 1/2 (BRCA1/2) which was related to breast cancer in female residents of Wuhan,and assess the relation of gene mutation and risk of suffering breast cancer.Methods 128 cases of female individuals,including 58 cases of breast cancer after surgery,70 cases of benign breast disease,and 50 femal hcalthy volunteers were selected by simple randon sampling from Department of Breast Surgery of Renmin Hospital of Wuhan University.BRCA1/2 gene was sequenced and compared with the standard template sequence to explore the possible mutations.Results In the breast cancer group,mutation emerged in 11 cases and the mutation rate was 19.0％ (11/58),including 8 cases of the BRCA1 gene mutations (3 cases of 185 del AG,5 case of 5382 ins C) and 3 cases of the BRCA2 gene mutations (2 cases of 6174 del T,1 case of C5773T) ; in the benign breast disease group,mutation emerged in 5 cases,the mutation rate was 7.1％(5/70),including 4 cases of the BRCA1 gene mutations (1 case of 185 del AG,3 cases of 5382 ins C),and 1 case of the BRCA2 gene mutation (6174 del T).There was no mutation detected in healthy control group.The mutation rate of the breast cancer group was significantly higher than that of benign breast disease group and healthy control group (x2 =4.05,10.56,P ＜ 0.05); However,there was no significant difference between benign breast disease group and healthy control group (x2 =3.73,P ＞0.05).Conclusions The mutation of BRCA1 gene (185 del AG,5382 ins C) and BRCA2 gene (6174 del T,C5773T) is in the presence of female residents in Wuhan.Furthermore,the mutation in BRCA1/2 gene increases the risk of breast cancer.

Objective To evaluate the value of detection of interleukin 28B (IL28B) rs12979860 by allele-specific PCR (AS-PCR) for the prediction of antiviral treatment hepatitis C patients.Methods One hundred seventy-four blood samples were random collected from hospitalized patients with hepatitis C,who came from department of infectious diseases,Renmin Hospital of Wuhan University from May 2011 to May 2012.Two pairs of specific primers were designed for rs12979860 gene polymorphisms,and one mutated base was introduced to the second or third site of the end of 3' with the reverse primer.rs12979860 gene polymorphism of 30 cases with hepatitis C was detected by AS-PCR,and gene sequencing was further used to verify the consistency of the two methods in parallel.Then,the frequency distribution of different rs12979860 genotypes with 174 cases were analyzed by the AS-PCR method in the population.Results The genotype CC,CT or TT of rs12979860 with 30 cases could be well identified by both AS-PCR and gene sequencing,and the coincidence rate was 100％ (x2 =60.0,P ＜ 0.01).Compared to gene sequencing,both of the sensitivity and specificity of AS-PCR were 100％.Compared to the control (CC genotype),TT genotype detection sensitivity by AS-PCR was 10-5,while sequencing sensitivity was 2 × 10-1.rs12979860 polymorphism in the TT,CC and CT genotype distribution in the Chinese population frequencies were 3.45％ (6/174),13.2％ (23/174) and 83.3％ (145/174),respectively.Conclusion AS-PCR can quickly,accurate,reliable,economic and efficiently detect IL28B rs12979860 gene polymorphism of hepatitis C in patients,which could predict the effect of antiviral therapy on patients with hepatitis C.

Objective To compare the clinical value of Heidelberg retinal tomography (HRT-Ⅱ) and Heidelberg optical coherence tomography (HRA OCT) in discriminating healthy eyes and pre-perimetric glaucoma eyes.Methods A total of 33 patients with pre-perimetric glaucoma and 37 healthy subjects were included in this study.All individuals underwent imaging tests with HRT-Ⅱ and HRA OCT within 1-month period.ANOVA and Kruskal-Wallis test were used to compare all of the parameters from HRT-Ⅱ and HRA-OCT between pre-perimetric glaucoma eyes and normal eyes.Receiver operating characteristic curves (ROC) were calculated for all of the parameters to seek the best discriminant point of each instrument between pre-perinmetric glaucoma and healthy eyes.Results Statistically significant differences were found in most of the HRT-Ⅱ parameters except for disc area and height variation contour between pre-perimetric glaucomatous eyes and normal eyes (all P＜0.05),which showed that most of the HRT-Ⅱ parameters were capable of diagnosing preperimetic glaucoma except for the disc area and height variation contour (all P＜0.05).66.7％ of the areas under the receiver operating characteristic curves (AUC) from HRT-Ⅱ parameters were larger than 0.800 and 58.3％ of the AUC were larger than 0.900.Statistically significant differences were found in most of the HRA-OCT parameters except for the nasal retinal nerve fiber layer (RNFL)thickness between pre-perimetric glaucoma eyes and normal eyes (all P＜0.05),which showed that most of the HRA-OCT parameters were capable of diagnosing pre-perimetic glaucoma except for the nasal RNFL thickness (all P＜0.05).66.7％ of the AUC from HRA-OCT parameters were larger than 0.800 and 33.3 ％ of the AUC were larger than 0.900.No statistically significant difference was found between the AUC for the best parameter diagnosing pre-perimetic glaucoma from HRT Ⅱ (cup/disk area ratio,AUC =0.984) and HRA OCT (average RNFL thickness,AUC =0.940).No Statistically significant differences were found in specificity and sensitivity of diagnosing pre-perimetic glaucoma between the two best parameters cup/disk area ratio and average RNFL thickness (both P＞0.05).Conclusions Both HRT-Ⅱ and HRA-OCT can well reflect the damage of optic disc and retinal nerve fiber layer in eyes with pre-perimetric glaucoma.HRT-Ⅱ and HRA-OCT have higher accuracy and similar sensitivity and specificity for the diagnosis of pre-perimetric glaucoma.

OBJECTIVE:To investigate the effects and safety of Sophoraflavescens preparation combined with Fuzheng huayu capsule on hepatic hemodynamics and fibrosis indexes in patients with hepatitis B liver cirrhosis.METHODS:One hundred and two patients diagnosed as hepatitis B liver cirrhosis in our hospital during Feb.2013-Jun.2014 were divided into combination group and control group according to random number table,with 51 cases in each group.Control group was treated with Adefovir dipivoxil capsules 10 mg,po,qd;combination group was additionally given Fuzheng huayu capsules 1.5 g,po,tid+Sophora flavescens preparation (Matrine glucose injection 250 mL,ivgtt,qd,in the first 3 months,oxymatrine capsules 200 mg,po,tid,after 3 months) on the basis of control group.Both groups were treated for 12 months.The levels of HBV-DNA,liver function indexes (AST,ALT,TBIL),portal hemodynamic indexes [main portal vein inner diameter (D),mean blood flow velocity (Ⅴ)] and liver fibrosis indexes [laminin protein (LN),hyaluronic acid (HA),type Ⅳ collagen (Ⅳ-C)] were observed in 2 groups before and after treatment.The negative conversion rate of HBV-DNA and incidence of ADR were recorded.RESULTS:Three cases lost to follow up,and a total of 48 effective cases were included in control group;5 cases lost to follow up,and a total of 46 effective cases were included in combination group.Before treatment,there was no statistical significance in HBV-DNA levels,liver function indexes (AST,ALT,TBIL),liver fibrosis indexes (LN,HA,Ⅳ-C) and portal vein hemodynamic indexes (D,V) between 2 groups (P＞0.05).After treatment,above indexes of 2 groups were decreased significantly,and the combination group was significantly lower than the control group,with statistical significance (P＜0.05).The negative conversion rate of HBV-DNA in combination group was 93.5％,which was significantly higher than 79.2％ of control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Sophora flavescens preparation combined with Fuzheng huayu capsules can promote the recovery of liver function,regulate liver hemodynamics and alleviate hepatic fibrosis in patients with hepatitis B liver cirrhosis with good safety.

Objective To investigate the curative efficacy of adjuvant therapy of atorvastatin in chronic subdural haematoma ( CSDH ) patients treated with trepanation and drainage and its effects on level of serum neuron specific enolase ( NSE ) .Methods 98 patients of CSDH who received therapy in our hospital from January 2014 to April 2016 were selected as research objects.Retrospectively analyzing their clinic materials,those patients were divided into the control group(n=46)and the observation group(n=52)according to therapeutic schemes.The control group were given therapy of trepanation and drainage.Besides that,the observation group were given atorvastatin additionally.2 months later,curative efficacy,China stroke scale (CSS)score and ability of daily life(ADL)score were compared between the two groups.And level of serum NSE between the two groups before treatment and after 7 days were compared.Results The total therapeutic efficacy ratio of CSDH in the observation group was 88.5%,which was statistically higher than that of 71.7% in the control group(P<0.05).2 months after the treatment,in comparison with the control group,the observation group has lower CSS score(15.89 ±3.24 points vs.19.21 ±4.17 points)and higher ADL score(95.24 ±11.36 points vs.89.05 ±10.12 points)with both statistical differences( P<0.05 ) .7 days after the treatment, level of serum NSE in the observation group was statistically lower than that in the control group (10.38 ±2.35 U/mL vs.14.06 ±2.68 U/mL,P <0.05).Conclusion Adjuvant therapy of atorvastatin is effective for CSDH patients treated with trepanation and drainage,and it could improve neurologic function,ability of daily life and reduce level of serum NSE.

Objective To investigate the effect of 23.4% hypertonic saline(HTS)on intracranial pressure(ICP), cerebral peffusion pressure(CPP), cerebral blood flow(CBF)in poor-grade patients with subarachnoid hemorrhage(SAH).Methods Sixteen patients(Glasgow coma score ≤ 8)with poor-grade SAH received 23.4% hypertonic saline intravenously for elevated ICP.ICP, mean arterial pressure(MAP), CPP and the middle cerebral artery flow velocity(FV)were observed and recorded before and at 30, 60, 90,120, 150, 180 min after the injection respectively.Results Thirty minutes postinfusion, a significant increase in MAP, CPP, FV was seen together with a decrease in ICP(P<0.05).ICP remained reduced for 180 minutes, CPP and FV remained elevated for 90 minutes(P < 0.05).Conclusions HTS can significantly decrease ICP and improve CBF in patients with poor-grade subarachnoid hemorrhage and may be used for reversal of pathophysiologic changes caused by cerebral ischemia.