By summarizing the features of medical diagnosis and treatment of schizophrenia,this article mainly analyzes the ethical disfigurement and relevant harm,discusses the ethical principles and requirement which doctors and nurses should abide by during the whole medical course,so that doctors' ethical diathesis can be improved,and a harmonious physician-patient relationship can be achieved.

0.05).Conclusions Epidural anesthesia and lower pneumoperitoneum pressure(8 mm Hg) can completely meet with demands of most LC operations,and have the advantages of safety,economy and minimal invasion.

Objective To summarize our experience in percutaneous transluminal angioplasty(PTA) in the management of thoracoabdominal aortic stenosis of Takayasu's arteritis. Methods From 1987～2001, 12 patients of Takayasu's arteritis with thoracoabdominal aortic stenosis underwent PTA. Aortography and pressure of stenotic segment of arota before and after angioplasty were used to evaluate efficacy. Color Doppler ultrasound examination and Doppler segmental pressure measurement were used in follow-up. Results Success was achieved in all cases without mortality and serious complications except for 1 case of acute thrombosis of iliofemoral artery. The residual stenosis were less than 50% in all cases and the pressure gradient was 5 0mmHg～10 5 mmHg with average pressure being 7 2 mmHg after angioplasty ,although they were 25mmHg～46 mmHg averaging of 37 7 mmHg before angioplasty. All cases were followed up for 9(12～72) months and the result was good without lumen restenosis and obstruction. Conclusions PTA is the first choice for Takayasu's arteritis of thoracoabdominal aortic stenosis of local size and proved to be safe, effectiveand economical. It is also effective for long size cases. It is not necessary to dilate aorta stenosis to normal size, and reducing pressure gradient effectively is enough.

Objective To investigate the causes of and preventive measures for complications following the placement of permanent inferior vena cava filter (VCF). Methods A total of 71 patients, with proven diagnosis of lower limb deep vein thrombosis (DVT) by Doppler ultrasonography, underwent the placement of permanent VCF from December 1999 to June 2003. Forty of the patients were acute lower limb DVT. Cavography was performed routinely during operation to confirm no thrombosis in inferior vena cava and access veins. The insertion site of filters was below the renal veins. Four types of permanent VCF were used: Titan-Greenfield filters, Simon-Nitinol filters, LGM filters and TrapEase filters. Anticoagulation treatments were used in all the cases post-VCF insertion. Results The placement of VCFs was successfully accomplished in all the cases in the study. Follow- up observations for 1～41 months revealed vena cava thrombosis at the site of insertion in 2 cases and filter tilting less than 15? in 5 cases. There were no events of filter migration, filter fracture, vessel wall perforation, filter embolism or access vein thrombosis, as well as pulmonary embolism (PE). Conclusions Different types of VCFs have different kinds of complications and their incidence rates. Preoperative ultrasonography and intraoperative cavography should be performed to evaluate the vena cava and access vein. Careful surgical management and strict anticoagulation therapy are the key to the successful VCF placement and the prevention of PE or other complications.

[Objective]To evaluate the surgical results of spinal scoliosis in the elderly and to investigate the indications,surgical techniques and factors which may contribute to the outcome. [Methods]A retrospective study was held.Sixty-four patients≥65 years undergoing different kinds of operation for lumbar spinal scoliosis from Sep.2004 to Apr.2008 were recruited.The mean patient age at surgery was 69.2 years(61~75 years).[Results]There were a variety of treatment methods of degenerative scoliosis based on symptomatology and radiologic measurements of scoliosis and stenosis.Sixty-four patients were followed up for an average of 37 months.The average correction rate of scoliosis was 51.2% after operation.No case was found spinal cord injury.Clinical symptoms and functional tolerance for daily activities improved after surgery.Radiographic evaluation showed a reduction in the deformity on the frontal and sagittal planes.There were no infections,pseudoarthrosis,instrument related failures or reoperations in this series.[Conclusion]The surgical results of lumbar scoliosis in the elderly are better than to those reported for the general population.Carefully perioperative preparation is very important in the treatment of elderly patients with lumbar spinal scoliosis.

[Objective]To review the clinical data on patients suffering from multi-level lumbar spine fracture treated with TSRH-3D pedicle screw system,and to investigate the post-operative efficacy.[Method]Eighteen patients with multi-level lumbar spine fracture were treated with TSRH-3D pedicle screw system.The operations were performed 4 hours to 2 days after injury,and the follow-up period was 15-32 months(average,23 months).The X-ray and CT scan were taken preoperatively and postoperatively.[Result](1)Twelve patients injured from height falling(67%),5 from traffic accident(28%) and 1 from crush injury(5%).(2)The improvement rates of the spine motion,back pain and the lower extremity pain were 67%,94% and 78%,respectively.(3) Compared with preoperation,the height of anterior border of vertebra improved by 59.2%,lost by 5.2% on average(P

Many Novel approaches of epigenetic reprogramming of somatic cells have been reported. However,ethical issues caused by somatic nuclear transfer have triggered the development of alternative strategies for reprogramming somatic cells. Recently,many new advances have been acquired for reprogramming somatic cells,which could reverse differentiated somatic cells to a totipotent embryonic state,such as fusion of potential stem cells with somatic cells,incubation of cells in potential cell-free extraction and introduction of defined pluripotency factors into somatic cells. The epigenetic modification in these reprogramming processes,including germ cells and early embryoes,somatic nuclear transfer and other approaches for reprogramming of somatic cells were reviewed. Studies of epigenetics will be benefit for understanding the precise mechanism and improving the efficiency of somatic nuclear reprogramming,which will be eventually applied in the basic study and practice.

Objective To assess the efficiency,safety and indications of permanent inferior vena cava filters (VCF) placement for prevention of pulmonary embolism in cases of deep vein thrombosis (DVT). Method In this study 71 cases were treated with permanent inferior vena cava filters by way of the internal jugular vein and the common femoral vein. Cavography was performed routinely before inserting the VCF to confirm no thrombosis in IVC and access veins. The insertion site for filters is the subrenal vena cava. Results The procedure was successful in all cases. There was no case of symptomatic PE occurred during 1～41 months of follow-up. There were 2 cases of IVC thrombosis at the site of insertion and 5 cases of filter tilting less than 15?. There were no other complications. Conclusion Permanent IVC filter placement is an effective method for preventing fatal PE due to DVT. Imaging of the vena cava and access vein by venous ultrasound and cavography, strict anticoagulation therapy after VCF insertion are key to perform VCF placement, provide protection from recurrent life-threatening PE and reduce complications. The filter placement indications should be strict.

ObjectiveTo evaluate axillofemoral bypass(AxFB) for the treatment of chronic severe lower limb ischemia. Method Consecutive AxFB performed in Anzhen Hospital from January 1995 to November 2002 was retrospectively analysed, with 31 patients of aortoiliac occlusive disease undergoing axillobifemoral bypass (AxBFB) and 32 axillounifemoral bypass(AxUFB) respectively. Result On discharge, rest pain disappeared in 44 cases and intermittent claudication in 19 cases, with average ankle/brachial index changing from preoperative 0.18(0～0.49) to postoperative 0.68(0.29～1.04). Rate of limbs salvage was 87.4%, amputation rate was 7.9%. Three cases died with a perioperative mortality of 4.8%. The patency rate of 1,3,5 years were 93.2%,79.8% and 64.1%, respectively. Conclusion AxFB for aortoiliac occlusive disease is considered to be acceptable procedure in high-risk patients with poor femoral run-off and chronic critical lower limb ischemia.

BACKGROUND:Short-segment pedicle screw technology has been extensively used in the treatment and repair of thoracolumbar burst fractures. The technique of operative treatment through the paraspinal muscle approach has advantages such as less trauma and bleeding, and rapid recovery. However, it requires further investigations to verify the superiority of the paraspinal muscle approach of two lateral incisions near the posterior median line. OBJECTIVE:To evaluate the clinical efficacy and Cobb’s angle of short-segment pedicle screw fixation through paraspinal muscle approach of two lateral incisions near the posterior median line in the treatment of thoracic and lumbar fractures. METHODS:From September 2010 to June 2012, 56 patients with thoracic and lumbar fractures were included in the retrospective study, including 42 males and14 females, with an average of 45 years (range 18-59 years). According to the surgical approach, patients were divided into two groups, traditional approach (n=25) and paraspinal muscle approach (n=31). The operative time, intraoperative blood loss, postoperative drainage and postoperative ambulant time in the two groups were observed and compared. The visual analog scale scores at 7 days, 1 month and 6 months postoperatively were recorded. The Cobb’s angles of suffered vertebra were measured preoperatively and at 7 days and 6 months postoperatively. RESULTS AND CONCLUSION:Al patients were fol owed up after internal fixation. The paraspinal muscle approach was superior to traditional approach in the operation time, intraoperative blood loss, postoperative drainage and postoperative ambulant time, and visual analog scale scores at 7 days and 1 month postoperatively (P<0.05). There was no significant difference between the preoperative and postoperative Cobb’s angle in the two groups (P>0.05). The short-segment pedicle screw fixation through paraspinal muscle approach of two lateral incisions near the posterior median line in the treatment of thoracic and lumbar fractures, is an effective and minimal y invasive treatment, with less trauma, less bleeding, rapid recovery, and simple operations. Similar to open surgery, this treatment can recover the anatomical morphology and reconstruct spinal stability, and had good biocompatibility to the host.