The Roles of the clinicians in different medical models are quite different,which not only led to the change of the relationship between the clinicians and the patients, but also had a significant clinical effect. The authors compared the clinicians'role in different medical models and showed the humanism underlying this change.

With the development of peaple's life and the change of diet,the incidence rate of colorectal cancer is increasing. There are Twenty-five percent of patients were found liver metastases in the first diago-sis. Surgical resection of liver metastases from colorectal cancer is known to be associated with long term sur-vival. So it is the key to increase the resection rate for colorectal cancer patients with liver metastases. The in-curruence of neoadjuvant therapy may be useful in therapy of colorectal cancer patients with liver mtastases.

Objective To apply the membrane technology for purifying rough cordyceps polysaccharides solution,the optimal operation condition and effective cleaning method were researched.MethodsTo mainly analyze the flux of membrane and its recovery.Results The optimal experiment operation condition obtained is 60℃,pH value 7-8,and pressure 0.3-0.4 MPa,by which the polysaccharides recovery was about 30%,more than by traditional ethanol extraction,and the most impurities as infusibility substance and protein colloid etc.were taken out.Moreover,the flux of membrane recovery can be above 90% after 80℃ water and 1% NaOH solution was alternately used to wash the fouling membrane under intermittent little back-pulsing. Conclusion The process of membrane technology purifying rough cordyceps polysaccharides is simpl and feasible.

We analysed the therapeutic effect and laboratory findings in the patients of a-cute cerebral infarction treated with PGMS and PSS. The results show that the efficient rate of PGMS group was obtained to 95. 6% and 70. l%,and was better than that of PSS group, but there was no statistic significance. The laboratory findings show the i both of them had the effect of anticogau ant and decreasing blood viscosity and serum co tents of lipids. But PGMS had a slight anticoagulant effect and could obviously decrease olood viscosity and serum contents of lipids. here was no side effects in the PGMS group. So PGMS is considered to be a prospective drug for treating acute cerebral infarction.

Attention Deficit Disorder with Hyperactivity ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; methods

Objective To evaluate the postoperative complications and visual quality after manual small incision cataract surgery (MSICS) versus phacoemulsification (PHACO).Methods A systematic review of MSICS and PHACO was conducted by a computer search on Medline,Pubmed,CBM and CNKI and a supplementary manual search was also done.The effect was measured as an odds ratio (OR) and weighted mean difference (WMD).RevMan 5.0 software was used to perform the Meta-analysis.Results A total of 9 articles were included in the Meta-analysis.Naked visual acuity at 1 week after surgery (OR =0.93,95％ CI 0.68-1.27),posterior capsular ruptured after surgery (OR =1.07,95％ CI 0.73-1.58),corneal edema after surgery (OR =0.90,95 ％ CI 0.70-1.16),surgically induced astigmatism at 1 month after surgery (WMD =0.08,95％ CI-0.02-0.17) in MSICS and PHACO was no statistically significant difference (P ＞0.05).Conclusion MSICS is safe and reliable surgery as same as PHACO for the patients with cataract,MSICS is more consistent with China' s national conditions.

Objective To evaluate the application of duct endoscopy in the diagnosis of breast diseases characterized by nipple discharge.Methods One hundred and sixty-nine consecutive cases from October 2003 to September 2004 who had duct endoscopy for nipple discharge were reviewed and followed up.Results Of 169 cases,79 ductitis,62 intraductal papilloma,9 intraductal carcinoma in situ,19 without breast diseases were diagnosed under duct endoscopy.During following up,the diagnostic accuracy of intraductal papilloma and intraductal carcinoma in situ with duct endoscopy was 89.8%(44/49) and 55.6%(5/9),respectively.There was only one patient who had breast pain and mild skin redness which was cured with oral antibiotics for 3 days.Conclusion Duct endoscopy is an only technique to explore the etiology for duct discharge under vision.It is direct,safe and effective,with a high accuracy.

Objective To evaluate the efficiency of ten years of iodized salt supply in prevention and control of iodine deficiency disease (IDD) in Tianjin. Methods 1 200 pupils aged 8-10 years with 1:1 of sex ratio were chosen in the regions where iodized salt supply had been conducted for 10 years (1995-2005), the prevalence rate of goiter, the level of urine iodine and the iodized salt consumption were investigated. Results The prevalence rate of goiter of children aged 8-10 years in Tianjin decreased from 32.6% to 1.8% after 10 years of iodized salt supply, the median of urinary iodine increased from 96 ?g/L to 228 ?g/L. In the high water iodine regions, the prevalence rate of goiter was 8.1%, the median of urinary iodine was 576 ?g/L. Conclusion 10 years of iodized salt supply can significantly prevent and control IDD in the regions where there is iodine deficiency in drinking water, but the problem should not be neglected that iodine excess in the regions where the concentration of iodine in drinking water is higher. Reasonable iodine supplement is the key to prevent and control IDD as a whole.

Objective To evaluate the interactive relationship between inflammation detected by single photon emission computed tomography combined with computed tomography (SPECT/CT) and magnetic resonance imaging (MRI) detection of synovitis,bone marrow edema (BME) in the early rheumatoid arthritis (RA) patients.Methods Twenty patients with early RA were included into this study.All patients were diagnosed based on the 2010 ACR/EULAR classification criterion.Patients' unilateral hands (MCP 2-5 and PIP 2-5 joints) were inspected by SPECT/CT (label:99Tcm-MDP) and MRI (3.0 T).SPECT/CT and MRI images were analyzed by two reviewers blinded to other clinical information.Increased bone metabolism of the regional area of interest (ROI) was analyzed and the uptake ratio was calculated.MRI quantitative evaluation was completed by RAMRIS score system.Statistical analysis was performed using SPSS 17.0 software.Student's t-test,analysis of variance (ANOVA),x2 test and post-hoc analysis (Scheffe) were used for comparison of datas,correlation analysis was carried out with Spearman rank correlation test.Results Twent ypatients with a total of 160 joints were examined.MRI examination revealed synovitis (39,24.4％),or BME (24,15.0％) in 63(39.4％) joints.99Tcm-MDP uptake increased in 79(49.4％) joints,and the uptake ratio was higher than normal joints (1.59±0.26 vs 1.15±0.09,t=6.408,P＜0.01).The uptake ratio between the graded synovitis level and RAMRIS synovitis score had a moderate correlation (r=0.535,P=0.001).The uptake ratio of BME level and BME score was well correlated (r=0.765,P=0.001).Conclusion In early RA patients,MRI is sensitive for synovitis and BME.SPECT/CT can detect early abnormal bone metabolism associated with inflammation,which is more sensitive than MRI.SPECT/CT can be used to detect changes of RA at the molecular level.Compared with synovitis,BME is more closely related to bone metabolism changes,which may suggest that BME may play a major role in the bone destruction in RA.However,further studies are needed to verify this hypothesis.

Adult ; Chylothorax ; etiology ; Female ; Humans ; Neck Dissection ; adverse effects