Inquisition language,as the information carrier on observing and describing disease status,makes it possible for patients to communicate well with doctors to acknowledge disease information.In order to make inquisition language possess specific properties of medical conversation,doctors need to master language skills in procedural inquisition,proper listening and responding to inquisition,distinguishing inquisition,transitional inquisition and secret-involved inquisition.Upholding inquisition language with courtesy,comfort,being explanatory,encouraging,and protecting is the basic requirement of clinical ethics.

AIM To study the targeted transfer and expression of human endothelial nitric oxide synthase gene-immunoliposome delivery system mediated by caveolin-1 antibody in hypercholesterolemic endothelial cells. METHODS Cultured ECV304 cells were divided into normal and hypercholesterolemic groups and transfected with control vector pcDNA3.1, cationic liposome-eNOS complex (lip-eNOS) or polylysine modified caveolin-1 antibody-cationic liposome-eNOS complex (Ab-lip-eNOS) respectively. The negative control group was also used. The experiments were made in triplicates. 48 h after transfection, the cellular eNOS mRNA was detected by RT-PCR, the eNOS activity assayed by NADPH-diaphorase staining and the generation of NO in medium determined by Griess method. RESULTS Ab-lip-eNOS and lip-eNOS could efficiently induce the expression of exogenous eNOS gene in endothelial cells cultured in normal or hypercholesterolemic condition, increase eNOS mRNA level, eNOS activity and NO content, which were significantly different from the endogenous eNOS gene expression of negative control and control vector groups (P

Objective To investigate the popularity and distribution of Paragonimus westermani in Nankun Mountain,Northern suburban of Guangzhou.Methods 2012 snails and 63 crabs were picked from creeks.Three feces samples of wild cats in epidemic area and two feces samples of domestic cats inoculated with P.westermani metacercariae were collected.The cercariae,metacercariae and eggs of P.westermani were detected.P.westermani-positive cats were identified by detection,in which adults of Paragonimus were checked.P.westermani eggs artificially inoculated were also anatomized.Results Infection ratio in snails was 0.15‰(3/2000),while infection ratio of P.westermani metacercariae in crab was 100%(59/59),with an intensity of infection of 2~516 metacercariae per crab,and 2~10 matacercariae per gram crab.Snails and crabs were identified to be Semisulcospira libertina type and Sinopotamon pinheense type,respectively.P.westermani eggs were also found in two feces samples from wild cats,with an infection ratio of 66.66%(2/3).Eleven adults of P.westermani were found in two domestic cats inoculated with P.westermani.Conclusion Nankun Mountain in northern suburban of Guangzhou as an ultra-high infectious focus of P.westermani(Grade I) is reported for the first time.In view of the fact that P.westermani is one of the major disease paragonimus and the infectious focus Nankun Mountain nature reserve is an 4 A scenic spot and popular summer resort,tourists can become infected by P.westermani by drinking water from streams,springs and ponds.More attention should be paid to prevent human infection with P.westermani in Nankun Mountain.

Objective To analyze the clinical effect through 20 adult atrial septal defect repair cases with totally thoracoscopic and summarize the experience of totally thoracoscopic cardiac surgeries.Methods From March 2014 to August 2016, 20 adult atrial septal defect cases repaired by totally thoracoscopic were enrolled in the study. Extracorporeal circulation was established by inserting artery pump tubes into the right femoral artery and vein tubes in to the right femoral vein, cold blood cardioplegia was perfused ante gradely through the aortic root in order to protect the myocardium, then atrial septal defect repair cardiac surgeries were implemented by perforating 3 holes through the right chest wall. Analyze the operation time, aortic cross clamping time, CPB time, amount of drainage, hospital stay, postoperative complications and so on.Results The operation time was 3.5~5.0 h, and the average level was (3.8 ± 0.5) h. The blocking duration of the ascending aorta ranged from 28 to 46 min, and the average level was (29.8 ± 8.2) min. The duration of extracorporeal circulation ranged from 86 to 108 min, and the average level was (80.6 ± 11.5) min. Ventilation time ranged from 5 to 8h, and the average level was (6.0 ± 0.8) h. The amount of thoracic drainage ranged from 100 to 260 ml, and the average level was (150.0 ± 35.0) ml. Hospital stay ranged from 6 to 9 days, and the average level was (6.5 ± 1.2) days. All the operations were completed successfully. There were no in-hospital death or serious post-operative complications. UCG performed 3~5 days after the operation revealed surgical results were satisfactory. Follow up to 1~28 months were available in all cases. During the period, the heart function was conifrmed asⅠ level.Conclusion Adult atrial septal defect repair surgeries with totally thoracoscope is safe and reliable and have advantages of less injury, rapid discovery, light pain, and less postoperative drainage.

Objective To investigate the effectiveness and safety of applying midzolam combined with propofol in conscious sedative and analgesic colonoscopy.Methods 145 cases of ASA I-II were included in this study.The patients were randomly divided into two Groups:Group A(painless colonoscopy),Group B(conventional colonoscopy).Group A was given midazolam 0.05mg/kg、fentanyl 1?g/kg intravenously before operation.Group B was underwent conventional colonoscopy.Results The MAP,SpO2 at 1min after injection is lower significantly than that before injection in Group A(P0.05).The incidence of respiratory inhibition(SPO2

Objective To investigate the efficacy of medial plantar flaps with cutaneous nerves on fixing palm skin defects for patients injured while working.Methods All cases with palm skin defects who received medial plantar flaps grafting from June 2003 to January 2013,were analyzed retrospectively.The data included 13 males and 10 females,with the mean age of 36 years old (range,18-61 years old).There were 16 cases with right hand injury and 7 cases with left,whose skin defects ranged from 3.6 cm×2.8 cm to 7.0 cru×5.5 cm.All cases had skin and soft tissue injury while 5 cases with vascular and nerve injury,3 cases with tendon involvement and being exposed,6 cases with open metacarpal fractures.15 patients were treated with emergency surgery within 8 hours after injury,while 8 patients were treated 10 days after debridement surgery.Results Altogether,23 patients who received medial plantar flaps grafting operations,with palm skin defects,were included in this study.All cases were followed up for 3 to 36 months with a average period of 18 month.The grafted flaps range from 4.6 cm×3.8 cm to 8.0 cm×6.5 cm.Among the patients,19 of them recovered excellently with healing by first intention,with 7-14 d healing time,fully-retained hand functions and palm appearance,and 4-8 mm for between two points distinguish test.Flaps survived fairly well in 3 patients because partial necrosis happened at plantar skin graft donor site.After being debrided and dressed,the wound healed at second phase with a healing time of 12-21 d and 5-9 mm for between two points distinguish test.The operated hands could flex and extend functionally in the follow-up period.Only one patient did not recovered from medial plantar flap grafting and the flap did not survive operationally.The patient recovered after another operation with groin skin grafting later.According to Gu Yudong et al' evaluation criteria,such as improved hand function,19 cases were scored as excellent recovery,3 cases as good,and 1 as poor.The excellent rate was 95.7％ (22/23).Conclusion Medial plantar flaps with cutaneous nerves are ideal flaps for palm skin defects restoration,which characterized by the advantages of fixed anatomical position,high survival rate and being good to the functional recovery and palm appearance.

OBJECTIVETo detect and compare the transcriptional activities of tumor-specific survivin and AFP promoters in various hepatocellular carcinoma cell lines and to lay some groundwork for targeting gene therapy in human hepatocellular carcinoma.

METHODSThe fragment of survivin and AFP promoters were acquired by PCR amplification and were cloned into the reporter plasmid pGL3-Basic, which contained a luciferase gene. The constructed eukaryotic expression plasmid pGL3-SUR and pGL3-AFP, in which the expression of the luciferase was derived by survivin or the AFP promoter, were transfected into three HCC cell lines. At 24 hours post transfection (p.t.), the activity of the luciferase was determined with Dual-Luciferase Reporter Assay System. A pGL3-CMV, containing the CMV promoter controlled luciferase gene, was used as a positive control.

RESULTSBoth survivin and AFP promoters had transcriptional activities in all three HCC cell lines and the transcriptional activity of the survivin promoter was much higher than the AFP promoter (52-98 times) and reached a level of 16% approximately 21% of the transcriptional activity of the CMV promoter.

CONCLUSIONOur data reveals that the survivin promoter possesses a high transcriptional activity in all three established HCC cell lines and may serve as a useful tool for transcriptional targeting gene therapy of HCCs.

Carcinoma, Hepatocellular ; genetics ; Gene Targeting ; Genetic Therapy ; Humans ; Inhibitor of Apoptosis Proteins ; Liver Neoplasms ; genetics ; Microtubule-Associated Proteins ; genetics ; Neoplasm Proteins ; genetics ; Promoter Regions, Genetic ; genetics ; Transcription, Genetic ; Transfection ; Tumor Cells, Cultured ; alpha-Fetoproteins ; genetics

Urinary brain-derived neurotrophic factor (BDNF),an ubiquitous neurotrophin,was found to rise in patients with benign prostatic hyperplasia (BPH).We hypothesized that the urinary level of BDNF could be a potential biomarker for lower urinary tract symptoms (LUTS) in patients with BPH.Totally,76 patients with BPH-caused LUTS and 32 male control subjects without BPH were enrolled.International Prostate Symptom Score (IPSS) was applied to assess the symptom severity of LUTS.Urodynamic tests were performed for the diagnosis of underlying detrusor overactivity (DO) in the patients with BPH.Urine samples were collected from all subjects.Urinary BDNF levels were measured using enzyme-linked immunosorbent assays and normalized by urinary creatinine (Cr) levels.Seventy-six BPH patients were divided into moderate LUTS group (n=51,7＜IPSS ≤ 20) and severe LUTS group (n=25,IPSS＞20) according to the IPSS.Of the 76 BPH patients,DO was present in 34 (44.7％)according to the urodynamic test.The urinary BDNF/Cr levels were significantly higher in BPH patients with moderate LUTS (8.29±3.635,P＜0.0001) and severe LUTS (11.8±6.44,P＜0.0001) than normal controls (1.71±0.555).Patients with severe LUTS tended to have higher urinary BDNF/Cr levels than patients with moderate LUTS (11.8±6.44 vs.8.29±3.635,P=0.000).The conditions of BPH with LUTS correlated with elevated urinary BDNF levels,and urinary BDNF levels were even higher in BPH-DO patients.The results of this study have provided evidence to suggest that urinary BDNF level test could evaluate the severity of LUTS in BPH patients,and BDNF level can be used as a biornarker for the diagnosis of DO in BPH patients.

Adolescent ; Adult ; Athletic Performance ; psychology ; Back ; physiology ; Electromyography ; Exercise ; physiology ; Humans ; Imagery (Psychotherapy) ; Male ; Young Adult

OBJECTIVETo investigate the effects of ulinastatin on gut mucosal apoptosis and bacterium translocation in a rat model of sepsis.

METHODSFifty rats were randomly assigned into 4 groups, namely the control (n=5, no operation or drugs), ulinastatin pretreatment (n=15, treated with 25,000 U/kg ulinastatin 2 h before operation), ulinastatin treatment (n=15, treated with 25,000 U/kg ulinastatin 2 h after operation) and sepsis model (n=15, without drug treatment) groups. The rats in the later 3 groups were subjected to cecal ligation and puncture (CLP). At 3, 6 and 12 h after CLP, the rats were sacrificed and the ileum was removed to examine the pathology and apoptosis of the mucosa. The DNA of Bacillus coli in the whole blood was detected using PCR.

RESULTSSepsis caused of epithelial cell loss in the ileal villi, ulceration and blebbing of the lamina propria. Ulinastatin treatment administered before and after the operation both significantly alleviated these morphological anomalies. The sepsis rats showed significantly increased intestinal mucosal apoptotic index as compared with the other 3 groups (P<0.05). Ulinastatin pretreatment, in comparison ulinastatin treatment 12 h after CLP, significantly increased the intestinal mucosal apoptotic index (P<0.05). Bacillus coli DNA was positive in sepsis and postoperative ulinastatin treatment groups but negative in the control and pretreated groups.

CONCLUSIONIncreased intestinal musocal apoptosis and gut bacterial translocation occur in rats following sepsis, and ulinastatin can effectively decrease intestinal mucosal apoptosis and inhibit bacterial translocation.

Animals ; Apoptosis ; drug effects ; Bacterial Translocation ; drug effects ; Female ; Glycoproteins ; pharmacology ; therapeutic use ; Ileum ; drug effects ; microbiology ; pathology ; Intestinal Mucosa ; drug effects ; microbiology ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sepsis ; drug therapy ; Trypsin Inhibitors ; pharmacology ; therapeutic use