The rapid development of medical science and technology, which has greatly promoted the development of medicine and the improvement of diagnosis and treatment, has also brought about various negative impacts in clinical practice on the doctor-patient relationship. The paper attempts to analyze these impacts from such perspectives as medical treatment, society, ethics, and law and proposes some corresponding countermeasures in perspective of the present reality: (1)rationally controlling medical expenses; (2) effectively stepping up communication; (3)appropriately handling difficult ethical problems; (4) amplifying necessary health rules and regulations. The goal is to create a win-win situation for both progress in medical science and technology and improvement of the doctor-patient relationship.

OBLECTIVE:To promote a sustained and quick development of the high-tech medicine industry in our country.METHODS:The related literature was consulted and the current developmental status of the high-tech medicine in-dustry in our country was analyzed.RESULTS&CONCLUSIONS:The high-tech industry in our country can be pushed on only through rearrange industry mix at the right time,constructing a serial comprehensive development terrace,supporting es-pecially those medicine enterprises that with core technology and independent intellectual property rights,building a virtual strategic league together with the academy of higher learning and scientific research institutes.

Objective To study the allele and genotype distribution of CD14 gene promoter region-159C/T,-260C/T polymorphisms in Chinese patients with Henoch-Schonlein purpura(HSP),and to discuss the association between CD14 gene promoter region polymorphisms and HSP.Methods Under the case-control study,CD14-159C/T and CD14-260C/T site polymorphisms in 144 children with HSP and 180 healthy controls were analyzed with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP),and the relationship between CD14-159C/T and CD14-260C/T site polymorphisms and the risk of HSP were analyzed.SPSS 13.0 software was used to analyze the data.Results The distribution of CD14 gene-159C/T polymorphism was significantly different between gastro-intestinal(GI)involvement group,renal involvement group and healthy control group(P=0.041,0.010,respectively);but the CD14 gene-260C/T polymorphism was significantly different between simple lesion group,renal involvement group and healthy control group(P=0.003,0.037,respectively)and C and T allele were significantly different between simple lesion group,joint damage group,GI involvement group,renal involvement group,healthy control group(P=0.017,0.035,0.024,0.007)and the relative risk for different types of HSP in T allele carriers was higher than that in C allele carriers(simple lesion:OR=2.097,95%CI 1.131-3.823;joint:OR=1.603,95%CI 1.031-2.493;GI:OR=1.602,95%CI 1.062-2.415;renal:OR=1.843,95%CI 1.175-2.889;respectively).Conclusions CD14 gene promoter region polymorphism is associated with HSP and T alele of CD14-260C/T may be a risk factor for HSP.

To confirm the etiology of a dead case for a 6 year-old female Ailurus fulgens,one strain of the predominant bacteria from pathologic tissues(heart,liver,spleen,lung and other samples) of the dead Ailurus fulgens were examined and isolated.The isolate was named R1 and no other bacteria were isolated.The bacterial etiological examination(morphological characteristics,biochemical characteristics and 16S rDNA gene detection)of R1 showed that it was identifed as K.peneumoniae.Artificial infection to mice about R1 was also conducted in this study.R1 had strong pathogenicity to mice and the LD50 is 6.5 × 104 CFU/mL.Moreover,the clinical and pathological features of the dead mice were consistent with that of the Ailurus fulgens.To find effective therapeutic drugs of curing other Ailurus fulgens,antibiotic sensitivity test of R1 was conducted,and the results revealed that R1 was highly sensitive to cefotaxime et al,moderately sensitive to amikacin and resistant to penicillin.These data showed that K.peneumoniae was bacterial pathogen leading to death of the Ailurus fulgens and it had strong resistance to penicillins,macrolides and virginiamycin and it had broad drug resistance spectrum.However,R1 is sensitive to cephalosporins and aminoglycoside antibiotics.

Objective To investigate effects of complement C5a receptor and P38-MAPK on myocardial injury brought about by septic shock in rats. Method The early septic shock models were established by the method of cecal ligature and incision (CLI). A total of 30 Sprague-Dawley rats were randomly( random number) divided into normal control group ( n = 6 ) and model group ( n = 24 ) and the model group was further 12 hours later divided into 12 h subgroup (n = 12) and 24 h subgroup (n = 12). The arterial blood samples were collected 12 hours later for detecting the levels of lactate dehydrogenase (LDH) and creatine kinase (CK), and then the rats were sacrificed and the myocardial tissues were taken to assay the expressions of C5a receptor and P38-MAPK by using immunohistochemistry after HE staining. And the above procedure as did in 12 h subgroup was done 24 hours later. Results Compared with the control group, the levels of LDH and CK in rats of Model group were significantly higher (P ＜ 0. 05). There were significant differences in LDH and CK between 24 h subgroup and 12 h subgroup [(2 568.9 ± 280) vs. (2 201.2 ± 149)] and [(5 029.7±458) vs. (2 629.4±140)] ,P＜0. 05, P＜0.05. The analysis of C5aR and P38-MAPK gray values showed that there were significant differences between the model group and normal control group [(702.77 ±122) vs. (388.36±113)], P＜0. 05 and [(646.40±181) vs. (307.32 ±61)] ,P＜0.05,and those differences also found between the 24 h subgroup and 12 h subgroup. There was a significant positive correlation between C5aR and P38-MAPK (P＜0.05 ), and also the P38-MAPK had significant positive relationships with LDH(P＜0.05) and CK (P＜0.05). Conclusions The C5aR strongly potentiates the P38-MAPK to induce myocardial injury by septic shock.

Objective To study the characteristics of heterotopic heart transplantation by echocardiographyand evaluate the heart function and acute rejection.Methods Five male 49-61 years old patients with heterotopic heart transplantation were studied using echocardiography pre-,intra-,post～operation and at follow-up.The anastomoses of great vessels of recipient with donor heart,chamber size,left ventricular wall thickness with wallmotion.left ventricular ejection fraction(LVEF),valvular function,pulmonary artery pressure,pericardial and pleural effusion were observed.Results All patients were end-stage coronary artery disease with NYHA class of received heterotopic heart transplantation with coronary artery bypass grafting.Some patients received mitral valvuloplasty,ventricular aneurysmectomy and stem cell transplantation simultaneously.During the operation,intra-operation transesophageal echocardiography was used to monitor and evaluate the surgical procedure with chamber sizes,anastomoses,native with donor heart ventricular and valvular function,and air bubble in chambers.The cardiac functions of donor heart backed to normal post operation,while the functions of recipient heart were increased gradually.All patients survived in 6 months and one year follow-up,with significantly improved functions of heart in situ[LVEF(44.0±15.6)%].The main reject reaction was small pericardial perfusion and pleural effusion.Conclusions Heterotopic heart transplantation has distinctive characteristics with echocardiography study,which is also an important technique in evaluation at pre-,intra-,post-operation and also at follow-up.

The information-knowledge-intelligence transformation rules were introduced as the theory for the transformation of information service main body for evidence-based medicine according to the analysis of domestic and foreign institutional main body and personal main body for the information service of evidence-based medicine.It was proposed that medical library as the institutional main body should be transformed into information repository + thinking library and clinical medical librarians as the personal main body should be transformed into evidence witness + decision making adviser with associated literacy.

Objective To compare the difference of procalcitonin (PCT)level between serum and plasma in children so as to in-vestigate whether ethylenediamine tetraacetic acid dipotassium (EDTA-K2 )anti-coagulation plasma could replace serum to be an al-ternative material for PCT testing.Methods The PCT concentrations in the serum and EDTA-K2 anti-coagulation plasma from 90 children patients were detected by using the mini-VIDS-GB automatic enzyme linked fluorescence analyzer and the plasma PCT au-tomatic quantitative detection method.The correlation between the two sets of data was analyzed.And the data were assigned into the 3-level groups for conducting statistic analysis.At the same time the influence of child′s age and gender on the PCT level was al-so discussed.Results The PCT level in serum was well correlated with that in EDTA-K2 anti-coagulation plasma (r=0.812,P <0.05).There were no statistically significant differences in PCT levels between serum and plasma measured in the low level groups (P >0.05).However,the differences of the PCT levels between serum and EDTA-K2 anti-coagulation plasma in the middle level group and high level group were statistically significant (P <0.05).Child′s gender and age have significant effect on the PCT level. Conclusion There is statistically significant difference between serum and plasma PCT detection levels in children,which has an important guiding role for further systematic study of PCT level difference in serum and EDTA-K2 anticoagulation plasma and its clinical significance.

OBJECTIVETo investigate development of a cell extraction process for preparing human meniscus acellular matrix, and morphology and biomechanical properties.

METHODSHuman meniscus were subjected to modified eight-step detergent, then, the specimens were assessed by staining with haematoxylin-eosin, toluidine blue, sirius red, saffron O, alcain blue and hoechst-33258, et al. The ultrastructure of the specimens was observed with scanning electron microscope. Transient recovery rate of deformation, maximal recovery rate of deformation and maximal compressive strength were tested to determine the biomechanical properties of the scaffold.

RESULTSEvery stain confirmed that the celluar constituents of the specimens were removed. The specimens stained positively by staining with sirius red. Lacuna were found irregularly not only on the surface of the meniscus,but also in the meniscus with scanning electron microscope. Pores in the specinmens were large, the diameter of pores was 80 to 760 microm, porosity was over 67%. The transient recovery rate of deformation was (89.62 +/- 1.04)%, the maximal recovery rate of deformation was 100% and the maximal compressive strength was (3.04 +/- 0.13)N, when the specimens were compressed 30%.

CONCLUSIONThe modified eight-step detergent can remove the immunogenic cell components from human meniscus, in addition, 3D extracellular matrix can be retained. The scaffold has good biomechanical properties. This scaffold stands a good chance to be an implant for future tissue engineering of the human meniscus.

Adult ; Cell Separation ; methods ; Cells ; chemistry ; cytology ; Cells, Cultured ; Humans ; Male ; Menisci, Tibial ; cytology ; Staining and Labeling

Objective To further clarify the pathogenesis of different types of Kaposi′s sarcoma (KS) by measuring the protein expressions of caspase-3 and E-cad in tumor tissues of Xinjiang Uygur patients with acqured immunodeficiency syndrome (AIDS)-Kaposi′s sarcoma (KS) and classical KS.Methods From July 2011 to October 2014, 38 patients with KS at the First Affiliated Hospital of Xinjiang Medical University and Urumqi Infectious Disease Hospital were enrolled, among whom 28 were male and 10 were female, and all of them were uygur.Immunohistochemical and Western blot methods were used to detect the expressions of caspase-3 and E-cad proteins in 22 cases of AIDS-KS patients and 16 cases of classic KS.The quantitative data of normal distribution were analyzed by t test, while count data were compared with χ2 test with R × C table.Results KS lesions in patients with classic KS were confined to the skin, without mucosal, lymph node or visceral involvement.Lesions in AIDS-KS patients were not only confined to the skin and superficial lymph nodes, but also oral mucosa involved in 12 cases and internal organs involved in 7 cases.Liver and lung involvement was more common.The CD4+T lymphocyte count in patients with AIDS-KS was (200.8±166)/μL.All 15 AIDS cases with CD4+ T cell count less than 200/μL developed opportunistic infections.CD4+ T lymphocyte count of patients with classic KS was (562.52±222.66)/μL and the 16 patients with CD4+T lymphocyte count greater than 350/μL had no opportunistic infections.The results of immunohistochemistry showed that the positive expression rate of caspase-3 protein in KS tissues in patients with AIDS-KS was 68.2%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=7.37, P=0.01).The positive expression rate of E-cad protein in KS tissues in patients with AIDS-KS was 72.7%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=5.18, P=0.03).Western blotting showed that the gray value of caspase-3 in the KS tissue of patients with AIDS-KS was 0.55±0.36, and that in patients with classic KS was 0.86±0.56, with significant difference between two groups (t=-2.070, P<0.05).The gray value of E-cad in the KS tissue of patients with AIDS-KS was 0.54±0.41, and that in patients with classic KS was 0.85±0.45, with significant difference between two groups (t=-2.060,P<0.05).Conclusions There are differences in the protein expressions of caspase-3 and E-cad in tumor tissues of patients with AIDS-KS and classical KS in Xinjiang Uygur patients with Kaposi's sarcoma, which may correlate with a faster progression and a higher mortality rate for AIDS-KS.