Improving the doctor-patient relationship is a long-term and complex process .that can't be available and unilateral in a short time .But we can't do nothing because of the difficult .The psychological cause of the doctor-patient nervous relationship is a pointcut that starts from me and now on .

Due to the deep-rooted structural problems of political and sanitary structures ,most methods and meas-ures of cure for public hospital are low efficient or none effective .Analysed the hospital background such as institu-tion,marketing and culture ,we should hold the tendency that hospital reforming didn't fit in with our country's situa-tion,it is important that the reforming become more systemcial and harmonized .Therefore ,we have to strengthen the governmental responsibility of public sanitation ,introduce a competitive mechanism ,promote the reform of property right, Drawing lessons and experiences from state-owned enterprise reform , we should explore a kind of standard modern management system which is suitable to non-profit hospitals in China .

Hydroxypropyl methylcellulose (HPMC) propels self-emulsifying drug delivery systems (SEDDS) to achieve the supersaturated state in gastrointestinal tract, which possesses important significance to enhance oral absorption for poorly water-soluble drugs. This study investigated capacities and mechanisms of HPMC with different viscosities (K4M, K15M and K100M) to inhibit drug precipitation of SEDDS in the simulated gastrointestinal tract environment in vitro. The results showed that HPMC inhibited drug precipitation during the dispersion of SEDDS under gastric conditions by inhibiting the formation of crystal nucleus and the growth of crystals. HPMC had evident effects on the rate of SEDDS lipolysis and benefited the distribution of drug molecules across into the aqueous phase and the decrease of drug sediment. The mechanisms were related to the formed network of HPMC and its viscosities and molecular weight. These results offered a reference for selecting appropriate type of HPMC as the precipitation inhibitor of supersaturatable SEDDS.

OBJECTIVE:To observe therapeutic efficacy of ursodeoxycholic acid(UDCA)combined with S-adenosyl methio-nine (SAMe) in the treatment of mild intrahepatic cholestasis (ICP) of pregnancy. METHODS:213 pregnant patients with mild ICP were selected and randomly divided into combination group (107 cases) and single drug group (106 cases). Combination group received UDCA combined with SAMe,and single drug group was given UDCA alone. Therapeutic efficacy and pregnancy outcome were compared between 2 groups. RESULTS:Compared to before treatment,TBA,CG,DBIL,ALT and AST of 2 groups were decreased after treatment,and the decrease of combination group was more significant than that of single drug group, with statistical significance(P<0.05). The time of itching control [(3.8±1.4)d] in combination group was lower than(5.3±1.5) d in single drug group,with statistical significance (P<0.05). After 3 and 5 days of treatment,itching degree score of combina-tion group was lower than that of single drug group,with statistical significance(P<0.05). There was no statistical significance in fetal distress rate,neonatal asphyxia rate,amniotic fluid contamination rate,cesarean section rate and neonatal 1 min Apgar score between combination group and single drug group(P>0.05);the preterm birth rate of combination group was 11.22%,which was significantly lower than 20.75% of single drug group,with statistical significance(P<0.05). CONCLUSIONS:Compared to UD-CA alone,UDCA combined with SAMe in the treatment of patients with ICP can control the clinical symptoms timely,recovery laboratory index as soon as possible and obtain better therapeutic efficacy.

Objective To study the antitumor effects of three different extracts from Pedicellus Melo on the proliferation of cancer cells in vitro, and discuss the possible mechanism. Methods Pedicellus Melo was extracted by water, 75%ethanol and 95%ethanol, respectively. The anti-cancer activities in vitro were detected by MTT assay on five tumor cell lines SGC-7901, NCI-H460, SMMC-7721, K562 and L929 cells. Flow cytometry was used to detect the cell cycle and apoptosis of different cell groups. Results After 72-hour treatment with water, 75%ethanol and 95%ethanol extracts, inhibitory effects were found in five tumor cell lines, which showed dose-dependent manner on the proliferation of the cells. The IC50 values were significantly lower in the two ethanol extracts than those of water extract (P<0.05) . And the IC50 values of 95%ethanol extract on SGC-7901, SMMC-7721, K562 and L929 cells were significantly lower than those of 75% ethanol extract (P <0.05). All the extracts were sensitive to SGC-7901 cells. Apoptotic rates of SGC-7901 cells treated with 95%ethanol extract of the concentrations of 0.4, 0.6 and 0.8 mg/L for 48 hours were (8.32 ± 0.55)%, (11.06 ± 1.15)%and (12.25±1.51)%. The cell cycle was arrested in S and G2/M phases. Conclusion Results demonstrate that 95%ethanol extract of Pedicellus Melo has significant inhibitory effect on SGC-7901 cells in vitro, which may be related to the induced apoptosis and the inhibition of cell division.

?AlM: To observe the changes of corneal topography and astigmatism et al with various duration of closing eyes and sleep;and study the impact of closing eye and sleep causing physiological hypoxia on corneal topography.
? METHODS: Sixteen volunteers were selected ( 32 eyes), 22-33 (26. 19 ± 3. 95) years old, without refractive errors and other eye diseases, as well as never wearing corneal contact lens, including 10 male eyes and 22 female eyes. The main parameters received corneal simulation K value, corneal astigmatism, corneal irregular measure ( ClM ) and the shape factor ( SF ) by Zeiss corneal topographer. They were measured before and after closed eyes 10, 20, 30, 60, 120min; before sleep and after over 6h sleep, they were detected immediately as soon as they opened eyes after 10, 20, 60, 120min.
? RESULTS: During closing eyes, there were no statistical significance on the changes of corneal topography, corneal astigmatism, and SF. After opening eyes and over 6h sleep, there were no statistical significance on the changes of corneal topography, corneal astigmatism, ClM, and SF.
?CONCLUSlON:Closing eyes and sleep don’t injure the cornea substantially, so corneal topography and corneal astigmatism don’t mainly change.

This paper is aimed to evaluate the CT manifestation of congenital pectus excavatum and its effect on the cardiac morphology. CT features of 34 children with pectus excavatum were retrospectively reviewed. The Haller index (HI), CT depression index (CTDI), cardiac rotation angle (CRA), pulmonary vein angle (PVA), cardiac compression index (CCI) and cardiac asymmetry index (CAI) were measured from the images on the PACS system. The relationships among these indexes were evaluated. The HI was 4.12 +/- 1.48, the CTDI was 2.39+/- 0.70, CRA was (53.52 +/- 7.68) degrees, PVA was (66.51 +/- 11.02) degrees, CCI was 2.43 +/- 0.95, and CAI was 1.55 +/- 0.56. There was statistical significance of CCI and CAI between children with severe or slight pectus excavatum. The HI and CTDI were positively related with CCI and CAI respectively, whereas there was no statistical significance of CRA and PVA between children with severe or slight pectus excavatum. There was no statistical significance of HI, CTDI, CRA, PVA, CCI and CAI among different age groups. The morphological change of the heart compressed in children with pectus excavatum can be accurately evaluated by multislice helical CT.
Child ; Funnel Chest ; pathology ; Humans ; Myocardium ; pathology ; Retrospective Studies ; Tomography, Spiral Computed

Animals ; Bilirubin ; toxicity ; Brain ; drug effects ; metabolism ; Nitric Oxide ; metabolism ; Rabbits

[ ABSTRACT] AIM:To observed the correlation between Th17 cell level and the symptom severity and prognostic factors of chronic obstructive pulmonary disease ( COPD) , and to explore the clinical application value of Th17 cell level in assessing the prognosis of patients with COPD.METHODS:The patients with diagnosed COPD ( n=110) in our hospital during May 2013 to December 2014, and 40 healthy subjects were enrolled in the study.According to the Global Initiative for Chronic Obstructive Lung Disease ( GOLD) , the COPD patients were divided into group A ( low risk, less symptoms) , group B (low risk, more symptoms), group C (high risk, less symptoms) and group D (high risk, more symptoms), which were given inhaled corticosteroid/long-acting β2 agonist or corticosteroid/long-acting β2 agonist +long-acting anti-muscarinic agent treatment for 3 months.The proportion of Th17 cells, cytokines (IL-17 and IL-6), the COPD assessment test ( CAT) score, age, body mass index, pulmonary function and the times of acute exacerbation of COPD in previous 1 year were observed before and after treatment.The correlation analysis between the level of Th17 cells and other clinical characteristics was performed.RESULTS:Th17 cell, IL-17 and IL-6 levels in COPD group were significantly higher than those in control group (P<0.05).With the increase in the severity of COPD symptoms, Th17 cells, cytokines (IL-17 and IL-6) and CAT score in groups B and D were significantly higher than those in groups A and C (P<0.05).The univariate analysis showed that the levels of Th17 cells in groups B and D before treatment were positively correlated with the CAT score (P<0.05), which were negatively correlated with FEV1, FEV1%Pred, FVC and FVC%Pred.The levels of Th17 cells were not correlated with the CAT score, FEV1 , FEV1%Pred, FVC and FVC%Pred in groups A and C.The levels of Th17 cells after treatment were positively correlated with the CAT score, which were negatively correlated with FEV1 , FEV1%Pred, FVC and FVC%Pred (P<0.05).CONCLUSION:The peripheral Th17 cell level has a good correlation with IL-17, IL-6, CAT score and pulmonary function in COPD patients, suggesting a potential value to predict the symptom severity and prognosis of COPD.

Objectieve:In order to get the photoacoustic (PA) image of micro-blood vessel deep inside biological tissue.Materials and Methods:A 532nm pulse laser with the repetition rate of 10Hz was used as the pumping source.A wide band unfocused needle ultrasound transducer was used to collect time-domain PA signal of the tissue-mimicking phantom by circular scan.The 2D optical absorption image was reconstructed by time-domain spherical back projection algorithm.The spatial resolution was measured by line-spread-function(LSF).Results:The experimental results demonstrated that the spatial resolution was 0.1 mm and the PA image of the micro-vascular network agreed well with the tissue-mimicking phantom.Conclusion:The proposed method is valuable for the diagnosis of early cancer inside tissue.