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.

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

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

OBJECTIVETo explore the effect of Chinese drugs for activating blood circulation and removing blood stasis (CDABCRBS) on carotid atherosclerotic plaque and long-term ischemic cerebrovascular events.

METHODSBy using open and control method, effect of 4 groups of platelet antagonists, platelet antagonists + CDABCRBS, platelet antagonists +atorvastatin, platelet antagonists +atorvastatin +CDABCRBS on carotid atherosclerotic plaque and long-term ischemic cerebrovascular events of 90 cerebral infarction patients were analyzed.

RESULTSThrough survival analysis, there was no statistical difference in the effect of the 4 interventions on the variation of carotid stenosis rates or ischemic cerebrovascular events (P > 0.05). The occurrence of ischemic cerebrovascular events could be postponed by about 4 months in those treated with platelet antagonists + CDABCRBS and platelet antagonists + atorvastatin +CDABCRBS. By multivariate Logistic analysis, age, hypertension, and clopidogrel were associated with stenosis of extracranial carotid arteries (P <0.05). Age, diabetes, aspirin, clopidogrel, CDABCRBS were correlated with cerebrovascular accidents (P < 0.05).

CONCLUSIONSWhether or not accompanied with hypertension is an influential factor for carotid stenosis, but it does not affect the occurrence of ischemic cerebrovascular events. CDABCRBS could effectively prolong the occurrence time of ischemic cerebrovascular events.

Adult ; Aged ; Brain Ischemia ; etiology ; Carotid Artery Diseases ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Stroke ; etiology

[ 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.

AIM: To study whether the excitatory amino acids (EAAs)-triggered excitotoxicity contribute to the evolution of hyperbilirubinemia-associated brain injury. METHODS: Newborn rabbits with hyperbilirubinemia were decapitated and then, Na~+-K~+-ATPase activities, neurotransmitters and non-neurotransmitters concentration in brains were determined. RESULTS: It was found that the activities of Na~+-K~+-ATPase both in brains and cytomembrane and the amounts of glutamate (P

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 observe clinical efficacy and safety of irinotecan combined with tegafur,raltitrexed or 5-fluoroura-cil for advanced gastric cancer. METHODS:One hundred advanced gastric cancer patients with first-line regimen failure were se-lected as research objects from our hospital during May 2013-May 2016. According to random number table,they were divided into observation group(n=32),control group A(n=33)and control group B(n=35). Observation group was given Irinotecan hydro-chroride injection 180 mg/m2,ivgtt(d1)+Tegafur capsule 60 mg/m2,po,bid(after meal),2 weeks as a cycle. Control group A was given Irinotecan hydrochroride injection 180 mg/m2,ivgtt(d1)+ Raltitrexed for injection 3 mg/m2,ivgtt(d1,15 min),3 weeks as a cycle. Control group B was given Irinotecan hydrochroride injection 180 mg/m2,ivgtt(d1)+Calcium folinate injection 200 mg/m2, ivgtt(d1)+5-fluorouracil injection 400 mg/m2,iv+2400~3000 mg/m2,ivgtt(46 h),d1,2 weeks as a cycle. On the 7th day after 2 courses of treatment,clinical efficacies of observation group and control group A were evaluated;on the 12th day after 3 courses of treatment,clinical efficacies of control group B were evaluated. Clinical efficacy and the occurrence of ADR were observed in 3 groups. RESULTS:One patient withdrew from control group A and 2 from control group B. 97 patients were included in the study finally,including 32 cases in observation group,32 cases in control group A,33 cases in control group B. The total remission rate of observation group(53.13%)was significantly higher than that of control group A(43.75%)and control group B(36.36%);to-tal control rate of observation group(81.25%)was significantly higher than that of control group A(68.75%)and control group B (57.58%),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05). CONCLUSIONS:Clinical efficacy of irinotecan combined with tegafur is better than irinotecan combined with ralti-trexed or 5-fluorouracil in the treatment of advanced gastric cancer with good safety.