Doctor-patient relationship has attracted increasing attention.In the light of modern model to study the related theory,a preliminary study of the ancient Chinese doctor-patient relationship model has been done.The doctor-patient relationship in ancient society is the same complex and multi-level.Therefore,doctor-patient model could not be lumped together.According to the social status of patients and the extent of their demand for medical services,and the social status of doctors and their medical technique,the doctor-patient relationship could be divided into three typies-equality type,authority type,and principal and subordinate type.With a view of doctor-patient relationship of traditional Chinese medicine,there draws an acquisition value of the current complex patient relationship.

Objective To investigate the localization,zone and activation intensity of olfactory center in young versus elderly healthy volunteers by functional magnetic resonance imaging (BOLD-fMRI),so as to elucidate the effect of age on olfactory center in healthy population.Methods Thirteen right-handed healthy adult volunteers were recruited and divided into two groups:young group (5 males and 3 females,mean aged 23 years) and elderly group (2 males and 3 females,mean aged 69.2 years).The olfactory stimulus was r-undecalactone,and it was given according to a block design.The fMRI detection was performed on Philips Achieva 3.0 T MR scanner,and data of BOLE-fMRI was processed and analyzed to get cerebration image by using SPM2.Results In groupaveraged maps,both young and elderly group showed significant olfactory activation in right parahippocampal gyrus,left hippocampal sulcus,right and left superior temporal gyrus,etc,subcortical activation in right thalamus,dorsal pons,and cerebellum activation in cerebellar vermis.Activations in right inferior frontal gyrus,right middle frontal gyrus,right medial occipito-temporal gyrus and right fimbria of hippocampus were observed only in young group,while activation in bilateral middle temporal gyrus was observed only in elderly group.Activation area was apparently smaller and activation degree was lower in elderly group than in young group.Activation intensity in right superior parietal lobule and bilateral superior temporal gyri was higher in male group than in female group (t=13.7,6.08,5.36,respectively,all P＜0.001).Conclusions The intensity of activation in olfactory center is lower in the elderly than in the young,and absence of part of the active regions is found in the elderly,which demonstrates the regression of olfactory center in the elderly.The olfactory center shows right-predominant activation,and olfactory activation intensity in some cortical regions is higher in males than in females.

Objective To explore the effect of inferior hypothermy treatment on serum TNF and IL-6 in patients with severe cerebral trauma.Methods 46 patients were randomly divided into two groups:inferior hypothermy group(24 C88e8)and normal group(22 cases).There are the same basic treatments within the two groups,in the inferior hypothermy group we also sive them hypothermy treatment rectal temperature:32～34℃ which need to last for nearly 4～5 days,at the same time we give patients the lyric cocktail.the TNF,IL-6 and GCS grades on the lst and 14th day were tested.Results TNF and IL-6 as compared with normal group are higher than the inferior hypothermy group,the differences between the two groups are of statistical significance(P＜0.01).The difference of GCS grades between the two groups are of stafictical significance(P＜0.05).Conclusion The inferior hypothermy tbempy which inhibits TNF and IL-6 releasing after severe cerebral trauma and the following damages plays a very important role in the cerebral trauma therapy.

OBJECTIVE To provide references for clinical diagnosis of catheter-related bloodstream infections(CRBSIs) and focus on studying the spectras of pathogenic bacteria and the drug sensitiveness. METHODS A total of 137 patients enrolled from Jan 2005 to Dec 2007 in our hospital with positive catheter cultures were admitted to our retrospective analysis.Pathogenic bacteria,contaminant bacteria and the drug sensitiveness of main pathogenic bacteria were analyzed. RESULTS From them 80 patients were diagnosed CRBSIs.Among 92 strains of pathogenic bacteria,43(46.7%) strains were Gram-positives,31(33.7%) coagulase negative staphylococci(CNS) strains,31(33.7%) Gram-negative bacilli strains and 18(19.6%) were Candida strains. CONCLUSIONS CNS are the most common bacteria of CRBSIs,and the second are Candida.The common pathogen show multi-drug resistance.

Objective To investigate the clinical efficacy of new-type patent endotracheal tube in difficult endotrachea intubation patients.Methods Seventy-three patients with the abnormal airways were selected as our subjects.Patients were given the traditional endotracheal tube by mouth after anesthesia.The successes patients in terms of endotracheal intubation were as group Ⅰ (n =73).The failed patients were asgroup Ⅱ (n =63),who performed the secondary endotracheal intubation with new type patent endotracheal tube.Analyze the success rate of intubation of the two groups when on use the tube core.Results The first time intubation success rate and intubation success rate was (2.7％ (2/73),13.7％ (10/73) respectively) in Ⅰ group,and 73.02％ (46/63) and 98.41％ (62/63) respectively in the group Ⅱ,and there was the significant difference between two groups (x2 =36.01,31.08 respectively,P ＜ 0.01).Conclusion The new type endotracheal tube was proved with three advamage of good plasticity,without need of auxiliary core intubation with trachealtube and give full play to lead the soft cannula guide tubes leading role.Therefore,the new type patent endotracheal tube has more efficacy over traditional tube.

Objective To establish the high-throughput screening fluorescence polarization assay for HSP90 inhibitor.Methods E.coli strain BL21 ( DE3) competent cells were transformed with pET24α( +)-HSP90αplasmid.The cell lysate supernatant was induced to product the soluble protein and purified with Ni-NTA agarose.Western blot analysis was used to identify whether the purified protein is HSP90α.The fluorescence polarization assay for screening HSP90 inhibitors was established and optimized using varying concentrations of recombinant HSP90 protein and molecular probe VER00051001.Meanwhile, the binding activity of GA and NVP-AUY922 for HSP90αwas measured by fluorescence polarization assay.Results HSP90αwas induced expression and purified successfully.The fluorescence polarization assay was performed using 80 nM probe VER00051001 and 2.01μg/mL HSP90α, with the Z factor of 0.83.GA and NVP-AUY922 competed with the probes VER00051001 for binding sites of HSP90, with IC50 of 55 nM and 13 nM, respectively.Conclusion A reliable model was established using fluorescence polarization assay for screening HSP90 inhibitors.

Objective To investigate the effect of different stimulants on the LAG3 expression and function of spleen lymphocytes in mice. Methods The spleen lymphocytes from mice were isolated by density centrifugation.The LAG3 expressions in T cell subsets after exposure to conA, PMA, PHA or anti-CD3/28 antibodies for 24 h or 72 h were analyzed by Flow cytometry.The IFN-γsecretions of conditional medium were detected by ELISA kit.The proliferation of lymphocytes was examined by MTT analysis.Results Treatment with conA for 24 h or 72 h dose-dependently increased LAG3 +CD3 +and LAG3 +CD4 +CD3 +T cell percentages.Similarly, an exposure of anti-CD3/28 antibodies for 72 h significantly increased LAG3 +CD3 +and LAG3 +CD4 +CD3 + T cell percentages.Meanwhile, conA and anti-CD3/28 antibodies increased the IFN-γsecretion of lymphocytes in a time-dependent manner.Furthermore, Treatment with conA, PMA, PHA or anti-CD3/28 antibodies for 72 h could enhance the proliferation of lymphocyte. Conclusion conA and anti-CD3/28 antibodies are effective activators of T cells, and both of them could promote the expression of LAG3 and IFN-γsecretion of lymphocytes.

Objective To investigate the correlation between developmental function and pathological behavior in children with autism. Methods A total of 154 children with autism were tested with Revised Chinese Version Psycho-Educational Profile (C-PEP) during 2011 to 2014. Results The scores of fine movement, hand-eye coordination, and oral language of developmental function were lower in the girls than in the boys (t>2.120, P<0.05). Among the children with autism aged 2-7 years, the developmental function was better in the older group than in the younger group (P<0.05);however, it was not better in the children aged 8-10 years and>10 years than in those aged 6-7 years. There was no difference in the scores of pathological behavior between the girls and the boys (P>0.05). Some pathological behaviors were milder in the older group than in the younger group (P<0.05). The scores ofP(pass) in developmental function were positively correlated with the scores ofA(absence) in pathological behavior (P<0.01), and negatively correlated with the scores ofS(severe) in pathological behavior (P<0.01). The scores ofF(fail) in developmental function were negatively correlated with the scores ofA(absence) in patho-logical behavior (P<0.01), and positively correlated with the scores ofS(severe) in pathological behavior (P<0.01). Conclusion Develop-mental function of children with autism is highly correlated with pathological behavior, and the rehabilitation and education of children with autism aged above 7 years should be concerned.

Objective To follow up the rehabilitation, education, and assistive devices utilization of school age children with cerebral palsy. Methods From 2012 to 2015, 80 children with cerebral palsy were called their parents with telephone and filled in the questionnaires. Results 69 children (85.25%) continued to receive rehabilitation, 11 children (13.75%) stopped rehabilitation. 42 children (56.25%) received education in ordinary schools, 15 children (18.75%) received education in special schools, 4 children (5.00%) were nursed in nursing institu-tion, 16 children (20.00%) stayed at home and did not receive any education. The main problem and needing at present were receiving reha-bilitation, receiving school education, relief the rehabilitation cost of more than one institution, etc. 61 children (76.25%) ever applied for as-sistive devices, 19 children (23.75%) did not. The feedback of application process in order were smoothly;applied, but didn't get;the assis-tive devices that received was inappropriate. 29 children (73.75%) needed assistive devices currently, 21 children (26.25%) did not. When asked the category of needed assistive devices at present, 19 parents (20%) answered that they did not know the category of assistive devices well or they did not know which kind of assistive devices they needed. Conclusion It is important to provide quality and quantity rehabilita-tion and education service, popularize the knowledge of assistive devices and their clinical application for cerebral palsy children. Assistive devices providing departments should do more communication with cerebral palsy children and their parents, in order to reduce the waste of resources, and increase the rational use of resources, and provide more benefits for children with disabilities.

Objective To investigate the influence of Ulinastatin (UTI) on the hyper-permeability of vascular endothelial cells induced by tumor necrosis factor alpha (TNF-α).Methods Inflammation model was induced by TNF-α in human umbilical vein endothelial cell line (EA.hy926).The experiment was designed into 4 groups:normal group,TNF-α group,UTI group and TNF-α with UTI (U + T) group.Methyl thiazolyl tetrazolium (MTT) method and epithelial voltameter (EVOM) method were used to measure cell viability [absorbance (A) value] and transepithelial electrical resistance (TER) of EA.hy926 cells respectively.The expression of VE-cadherin was measured by reverse transcription polymerase chain reaction (RT-PCR) and immunocytochemistry.Results Compared with normal group,the TER of EA.hy926 cells induced by TNF-α was significantly decreased (67.200 ± 8.937 vs.33.600 ± 8.771,P =0.010).The permeability in EA.hy926 cells increased obviously.The hyper-permeability of EA.hy926 cells induced by TNF-α could be alleviated by UTI at the concentrations of 1-100 U/mL in a dose-dependent manner (40.133 ±7.484 vs.33.600 ±8.771,P=0.382;49.232 ± 3.162 vs.33.600 ± 8.771,P =0.044;63.700 ± 8.515 vs.33.600 ± 8.771,P =0.013).The expression of VE-cadherin mRNA reduced significantly in the TNF-α group (1.089 ±0.018 vs.0.835±0.021,P =0.000) compared with normal group.This effect of TNF-α could be attenuated by UTI.When EA.hy926 cells exposed to UTI at 10 U/mL and 100 U/mL,a significant increase of the expression of VE-cadherin mRNA was observed (0.976 ±0.014 vs.0.835 ±0.021,P =0.001;1.115 ±0.015 vs.0.835 ± 0.021,P =0.000).And the inhibition of UTI manifested a dose-dependent manner (1-100 U/mL).The results of the immunocytochemistry showed that the expression of VE-cadherin in TNF-o group was decreased significantly (0.061 ± 0.013 vs.0.093 ± 0.014,P =0.049) compared with normal group.And the low-expression of VE-cadherin could be alleviated by UTI (0.032 ± 0.004 vs.0.061 ± 0.013,P =0.016).Conclusion The high permeability of EA.hy926 cells induced by TNF-α could be inhibited by UTI at the concentrations of 1-100 U/mL in a dose-dependent manner.