Seen from the judicial fulfillment of the medical treatment indemnity,there exists a lot of dissatisfaction,which derives from the wrong application of law to a great degree.It is the reasonable and feasible choice to apply the law correctly and carry out the actual indemnification principle of the General Rule of the Civil Law in the medical treatment indemnity realm so as to promote the formation of the dispersion mechanism of the sounder medical treatment responsibility.

The paper expounds the ethics problems caused by doctor's selling activities in consulting room,which means the conflicts between doctors and patients, purchase pressure implied in seeking medical ad vice, disgrace to the aim of medical service etc. Furthermore puts forward some suggestions about strengthening management, stopping doctors' selling activities:1. to curb doctors' selling activities in consulting room; 2. to formulate health law and regulations, standardize medical behavior; 3. to deepen health reformation, improve investment mechanism.

Traditionally the cultivation mechanisms of pathological postgraduates can not fully adapt to the demand of research and society in China,to some extent,which impedes the development of pathology.Combining our practical conditions with overseas experiences,we try to make the beneficial thinking and adjustment on the existing cultivation mechanisms.

Objective To study the indications of endoscopic treatment for carpal tunnel syndrome(CTS).Methods From July 2004 to September 2007,21 patients(24 wrists) with CTS received endoscopic treatment in our hospital.Under local anesthesia,an 1-cm incision was made at the level of the proximal transverse wrist crease ulnar to the palmaris longus tendon.A special cannula was inserted into the carpal tunnel,and then the transverse carpal ligment was cut and the median nerve was decompressed.All the patients were re-examined in 1,2,3,and 5 months postoperation.Results According to the criteria of Kelly,11 cases achieved excellent outcomes in 5 months,meanwhile 6 were good,2(3 wrists) were fair,and 2 were poor.One of the 2 poor cases received a second operation by traditional procedures(nerve release) 7 months after the first surgery,another case were treated by conservative therapy because of sympathetic symptoms.Conclusions ① Endoscopy is the first choice for idiopathic cases,while open surgery should be performed on secondary cases(rheumatic synovitis,fracture deformity,tumar,inflammation,gout,neurodegenerative desease etc.).② The carpal tunnel release should be used for patients with abnormal opponens function of the thumb,as well as advanced cases.③ Routine operation are the first choice for eldly patients but not for the younger ones.

The hypercholesterolemia model was established by feeding mice on hypercholester-ol diet. FGS was administered to the hypercholesterolemia mice at the dose of 250,750 and 1500mg ? kg-1 ?d-1, respectively. On the 10,20,30 and 40th day, the serum cholesterol was determined. The results were as follows: 40th day the concentration of TC(Ⅰ,Ⅱ,Ⅲ) was 37. 6,54. 2 and 66. 2mg ?dL-1 lower than that of the control group; and the cocentration of LDL-C was 47. 6,86. 6 and 94. 4mg ?dL-1 lower than that of the control group; while the concentration of HDL-C was 16. 1,38. 2 and 36. 7mg?dL-1 higher than that of the control group. It was proved that FGS was an effective serum cholesterol regulator.

Objective To explore the effect of hypoxia on the in vitro invasion of lung carcinoma cells and its molecular basis. Methods Small cell lung carcinoma cells(H128) were exposed to hypoxia(5%O 2,5%CO 2,90%N 2) or anoxia(95%N 2,5%CO 2)condition for 48 hours. The invasive ability of the cancer cells was assayed with HABM-HEM model. The expression of E-cadherin and ? 1-integrin on the cells was also assayed by flow cytometry. Results Compared with normoxia group, the invasive ability of the cancer cells increased, the expression of E-cadherin decreased, and the expression of ? 1-integrin increased in hypoxia group. In anoxia group, the invasive ability and the expression of E-cadherin and ? 1-integrin all decreased compared with normoxia group. Conclusions Moderate hypoxia can down-regulate the expression of E-cadherin, up-regulate the expression of ? 1-integrin, and increase the invasion of carcinoma cells. But serious hypoxia can decrease the expression of adhesive molecules and the invasion of the cancer cells.

0.05). The production of TNF-? in LPS group was higher than that in control group (61 ng/L vs 156 ng/L, q=5.12, P

BACKGROUND:Clinical resection of thoracolumbar spinal tumor has a great impact on the spinal stability. Positive internal fixation is required clinicaly in order to maintain the spinal stability. The use of titanium mesh implantation can provide a firm internal fixation folowing resection of tumors. OBJECTIVE:To explore the spinal stability undergoing titanium mesh implantation with internal fixation folowing thoracolumbar tumor resection. METHODS:Twenty-four patients with thoracolumbar tumor admitted at the Central Hospital of Suining City from September 2013 to September 2014 were randomly selected and given tumor resection folowed by titanium mesh implantation with internal fixation. After treatment, patients were folowed up for 1-12 months to observe and analyze the neural functional recovery and spinal stability of the patients. RESULTS AND CONCLUSION:Al the 24 patients successfuly completed the operation treatment, and there was no case of death at the end of folow-up. During the folow-up, patient's clinical symptoms and neural function were significantly relieved, and Frankel classification was significantly improved after treatment. Regular X-ray examination showed that there was no change in the position of titanium mesh and anterior internal fixation system. There was also no titanium mesh colapse, internal fixation fracture and loosening, and the spinal stability was stil excelent. These findings indicate that patients were not changed, and did not appear because the amount of loose, good spinal stability. Resection of thoracolumbar tumors showed that the thoracolumbar spinal reconstruction with titanium mesh implantation combined with internal fixation folowing tumor resection can obtain good clinical effect and excelent biocompatiblity.

AIM:To observe the changes of nuclear factor-?B (NF-?B) activity and inducible nitric oxide synthase (iNOS) expression in hypoxic pulmonary hypertension(HPH). METHODS:The rat model of HPH was used. The NF-?B activity and iNOS expression in lung tissue were determined by immunohistochemistry(IHC), in situ hybridization (ISH), RT-PCR and Western blot.RESULTS:ISH showed that iNOS mRNA expression in intraacinar pulmonary arteriole (IAPA) in H28 d group(hypoxic treatment for 28 days) was stronger than that in normal group, H5d group and H14 d group. RT-PCR showed that the iNOS mRNA in H28 group was 2.1 times, 1.9 times and 1.8 times higher than that in normal group, H5d group and H14 d group, respectively. The nucleic anti-NF-?B stain was observed in H28 d group, which was significantly stronger, but the I-?B amount was 2.8 times, 2.7 times and 2.5 times lower than that in normal group, H5d group and H14 d group, respectively. CONCLUSION: The activity of NF-?B was correlated with the hypoxic pulmonary vessel structural remodeling and iNOS expression.

In order to study the effect of nitric oxide (NO) on the expression of hypoxia-inducible factor-1 alpha (HIF-1alpha) mRNA in hypoxic pulmonary hypertension (HPH) rats, 30 healthy male Wistar rats were randomly divided into normoxic control group, chronic hypoxic group and hypoxia plus L-arginine (L-Arg) group. The animal model of HPH was developed. The mean pulmonary arterial pressure (mPAP) was measured by inserting a microcatheter into the pulmonary artery. The HIF-1alpha mRNA expression levels were detected by in situ hybridization (ISH) and semiquantitative RT-PCR. It was found that after 14 days hypoxia, the mPAP in normoxic control group (17.6 +/- 2.7 mmHg, 1 mmHg=0.133 kPa) was significantly lower than that in chronic hypoxic group (35.8 +/- 6.1 mmHg, t=0.2918, P<0.05) and mPAP in chronic hypoxic group was higher than that in hypoxia plus L-arginine group (24.4 +/- 3.8 mmHg, t=0.2563, P<0.05). ISH showed that the expression of HIF-1alpha mRNA in the intraacinar pulmonary arteriolae (IAPA) in normoxic control group (0.1076 +/- 0.0205) was markedly weaker than that in chronic hypoxic group (0.3317 +/- 0.0683, t=3.125, P<0.05) and that in chronic hypoxic group was stronger than that in hypoxia plus L-arginine group (0.1928 +/- 0.0381, t=2.844, P<0.05). RT-PCR showed that the content of HIF-1alpha mRNA in chronic hypoxic group (2.5395 +/- 0.6449) was 2.16 times and 1.75 times higher than that in normoxic control group (1.1781 +/- 0.3628) and hypoxia plus L-arginine group (1.4511 +/- 0.3981), respectively. It is concluded that NO can reduce the mPAP by the inhibition of the expression of HIF-1alpha mRNA, which may be one of the mechanisms through which NO affects the pathogenesis of HPH.
Anoxia/metabolism ; Arginine/pharmacology ; Hypertension, Pulmonary/*metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; Nitric Oxide/*pharmacology ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Random Allocation ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription Factors/*biosynthesis ; Transcription Factors/genetics