The paper discusses specifically ways of putting into practice the idea of people first in developing hospital culture by starting with its three structural layers: spiritual culture, system culture and behavior culture. These include cultivating in a practical manner humanistic core values and hospital spirit, setting up and improving systems of humanistic management and adopting; a humanistic approach to employee management, and cultivating the idea of patient-centered care and delivering humanistic medical services.

Objective To evaluate the feasibility and efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL)in the lateral position.Methods A total of 48 patients with staghorn(12 cases,2.2 to 5.8 cm in diameter)or multiple renal calculi(31)or upper ureteral stones(5)were treated with MPCNL in our hospital between July 2004 to October 2007.The patients were placed in a lateral position with the head 10? lower and the feet 20? lower.The puncture was made under the guidance of X-ray or ultrasonography,and then Holmium laser or EMS lithotripter was used for stone fragmentation.The stone debris was removed by irrigation.Results The procedure was completed in all of the 48 patients except one,who was converted to a supine position because of the difficulty in puncture.Among the 47 cases,41 were cured with the first operation,the other 6 received catheterization in the first procedure,and then underwent calculi removal in a second-stage operation.None of the patients were converted to open surgery.The mean operation time in this series was(137.5?39.6)min.The one-stage cure rate in our patients was 82.9%(34/41).None of the cases had massive blood loss,or injuries to the pleura and other organs.Follow-up was available in 21 cases for 1 to 3 months.During the period,among the 17 patients who had hydronephrosis,11 were cured and 6 were improved;and among the 4 who had residual stones,1 received ESWL in 1 months after the first operation and was cured afterwards;the other 3 were treated by traditional Chinese medicine,2 of them were cured.Conclusions The MPCNL performed on the patients in the lateral position is an effective alternative for renal calculi,and favorable to intra-operative anesthesia monitor.

Objective To investigate localization and co-existence of the tyrosine hydroxylase (TH)and calcitonin gene-related peptide(CGRP)on the cochlear spiral modiolar artery(SMA) and its branches.Methods The SMA was dissected from the modiolus so that the entire length of the vessel and many of its branches could be observed. Immunohistochemical ABC method and confocal immunoflurescence technique were employed to localize each compound and to determine whether the TH and CGRP coexist in neurons of the SMA.Results Microscopic examination of whole vessel preparation revealed numerous TH and CGRP-positive neural networks innervating the SMA and its branches.The labeled nerve fibers showed distinct arborization ,varicosities and overlap,and were of different diameters. The overall distribution of neuronal labeling suggested a gradual decrease of innervation density from proximal (cochlear base)to more distal vessels, i.e., apical cochlear vessels and lateral radiating arterioles. Confocal immunofluorescence microscopy of double-labeled TH and CGRP neurons showed that a number of the TH-and CGRP-positive neurons were co-labeled. Thus, TH and CGRP partially co-exist within the neuronal innervation of SMA.Conclusion These findings support a hypothesis that specific neuropeptide and adrenergic neurons regulate cochlear blood flow.

Objective To investigate the protective effects of combination alprostadil and dexmedetomidine preconditioning treatment on skeletal muscle ischemia reperfusion and secondary lung injuries.Methods Sixty patients aged less than 70 years old undergoing unilateral lower extremity surgery were randomly assigned into four groups:control group(group A),dexmedetomidine group(group B),alprostadil group(group C)and combined treatment group(group D) with 15 cases in each.In group C and D,10 μg alprostadil was given from vein at 15 min before tourniquet inflation,in group B and D 1 μg/kg dexmedetomidine was given from vein at 10 min before tourniquet inflation,the equal volume of normal saline was infused in control group.The blood samples were drawn from vein and artery for blood gas analysises and determination of malondialdehyde(MDA) and human pulmonary surfactant specific protein D (SP D) concentrations at the time before oxygen inhalation(T1),2 h after tourniquet deflation(T2),6 h after tourniquet deflation(T3) respectively.Results In group B,C and D,the alveolar arterial oxygen pressure difference(PA-a DO2)and respiratory index(R1) were significantly lower than those in group A at T2(P＜0.05).PA-aDO2 and R1 were significantly higher at T3 than those at T1 in every groups(P＜0.05);In group B,C and D,MDA and SP D were significantly lower than those in group A at T2 and T3(P＜0.05).In group D,MDA and SP D were significantly lower than those in group B and group C at T3(P＜0.05).Conclusion Alprostadil and dexmedetomidine are infused from vein preconditioning can attenuate the damages of skeletal muscle ischemia reperfusion and secondary lung injuries.The combination of alprostadil with dexmcdetomidine can produce stronger effects.

Objective To explore the possible mechanism of SchA ,which decreases MPP+induce SH-SY5Y cell damage .Meth-ods Cultured cells were divided into 5 groups ,one as control group ,cultured by free-blood serum media;the other 4 groups were treated with different concentrations of SchA(1 ,3 ,5 μmol/L) and MPP+ (1 mmol/L) for 48 h named model group ,1 ,3 ,5 μmol/L SchA group respetivly .The content of nitric oxide(NO) were measured by NO kit ;The expression levels of total Akt and p-Akt proteins were detected by Western blot .Results Compared with the control group ,the content of NO in group significantly in-creased after MPP+stimulating(P<0 .05);compared to the control group ,the content of NO in 5μmol/L SchA group significantly decreased(P<0 .05) .The expression levels of total Akt in all groups had no significant difference(P>0 .05) .The expression levels of p-Akt in model group significantly lowered ,while SchA(1、3、5 μmol/L) significantly increased the expression levels of p-Akt in comparision with cells in model group .Conclusion Decreasing MPP+ induced SH-SY5Y cell damage of SchA may be related to the content of NO and p-Akt expression .

Objective:To observe the bone regeneration capacity of bone defects around BLB implants covered with or without membranes.Methods:Implants were installed into femoral bone of grown-up dogs.Near implants,3 mm horizontal width,5 mm vertical depth and 1,2,3,4 mm horizontal length(along the macroaxis of femoral bone) standard gradient bone defects were made.On one side,the incisions were directly sutured by lamination,and on the other side the incisions were sutured by lamination after using collagen membrane to cover on the defects.Three months after the operation the specimens were observed by stereomicroscopy.Results:In the groups with 1,2 and 3 mm defects,the defect areas had been filled completely with new bone which was mainly compact cortex.In the group with 4 mm defects,the defect areas were filled with new bone which was mainly trabecular bone.Bigger lacunes could be observed in the groups without membranes.Conclusion:If the defect is less than 3 mm,whether bioresorbable collagen membrane is used or not,osseointegration is well in the implant-bone interface.Improving bone regeneration should be done when the bone defect extension is bigger.

Objective To observe the clinical effect of edaravone combined with fibrinolysin for treating acute cerebral infarc-tion .Methods 80 cases of acute cerebral infarction were randomly divided into the two groups .The treatment group(40 cases) was treated by edaravone injection 30mg plus normal saline 100 mL by intravenous drip ,twice daily ,fibrinolysin injection 100 U plus 5%glucose injection 250 mL by intravenous drip on 1 d ,subsequently 200U plus 5% glucose 250 mL by intravenous drip from the next day ,for 14 d;the control group(40 cases ) used fibrinolysin alone ,the dose and usage were same to the treatment group .The neuro-logical impairment scale scores(NIHSS) were monitored before and after treatment in the two groups .Results The NIHSS scores and Barthel index on 7 ,14 ,30 ,90 d after treatment in the treatment group were superior to those in the control group (P<0 .05) ,no statistical difference before treatment between the two group existed .Conclusion Edaravone combined with fibrinolysin has better effect for treating acute cerebral infarction .

Objective To investigate the expression pattern of transcription factor Olig 2 in cuprizone-induced mouse model of acute demyelination .Methods C57BL/6 mice were fed with 0.2%cuprizone to induce acute demyelina-tion.Immunofluorescence and qRT-PCR were used, and Olig2, MBP and GFAP were detected in the brain tissues of con-trol group and cuprizone-treated groups for 6 weeks and recovery for 2 weeks.Results Severe demyelination occurred in the corpus callosum following 6-weeks exposure to cuprizone , while remyelination was detected in the white matter after the mice were given diet without cuprizone .In the normal mice , Olig2 was expressed in a low level , while the experessions of Olig2 and GFAP were significantly increased , and Olig2 +/GFAP+cells were detected after demyelination .But the expres-sion of MBP was below the normal level with demyelination .After recovery for 2 weeks, the experession of Olig2 was lower, but the experessions of MBP and GFAP were increased .Conclusions Olig2 may play an important role in the glial differ-entiation from neural progenitor cells into active astrocytes , and in the glial scar formation .

Objective To determine the clinical significance of hepatocyte growth factor receptor (Met) and epidermal growth factor receptor (EGFR) in the clinicopathology and prognosis of pancreatic cancer.Methods 70 patients admitted with pancreatic cancer from 1995 to 2005 were retrospectively analyzed with clinicopathological and follow-up data.Expression of Met and EGFR in cancer nest embedded with paraffin were detected by immunohislostaining (EnVision method) and correlation with clinicopathologic parameters and mutual correlation between these two receptors were further analyzed.Prognosis and related risk factors were analyzed by Kaplan-Meier survival analysis and Cox regression analysis,respectively.Results Both Met and EGFR significantly correlated with TNM staging,tumor size and superior mesenteric vessels invasion (P＜0.05).Expression level of Met positively correlated with that of EGFR (r9 =0.658,P＜0.05).Both Met and EGFR significantly correlated with patients' survival (P＜0.05) and Met was an independent prognostic risk factor for pancreatic cancer.Conclusions Both Met and EGFR significantly affect development and prognosis of pancreatic cancer and correlate with each other.Simultaneously targeting both Met and EGFR pathways may provide an advisable strategy of targeted therapy in pancreatic cancer.

Objective To analyze the differential expression of proteins among patients with pancreatic cancer,chronic pancreatitis and choledocholithiasis in order to find potential biomarkers for diagnosis of pancreatic cancer and to differentiate pancreatic cancer from chronic pancreatitis. Methods The pancreatic juice were connected from 5 pancreatic cancer patients,6 chronic pancreatitis patients and 3 choledocholi-thiasis patients by naso-pancreatic drainage using endoscopic retrograde cholanglopancreatography(ERCP).The proteins in pooled pancreatic juice were separated by two-dimensional gel electrophoresis (2-DE).The differential expression of proteins were analyzed by image analysis software and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF-MS).Results ①There were 35-200 ml of pancreatic juice collected,and protein concentration were ranged from 0.8 to 4.6 μg/μl.The 2-DE showed that the protein spots in pancreatic cancer,chronic pancreatitis and choledocholithiasis juice were 196±12,209±15 and 199±10,respectively.The matched proteins among three groups all exceeded 75%.②MALDI-TOF-MS revealed that the expression of chain A of a covalent dimer of transthyretin in pancreatic cancer was up-regulated(＞2-fold)while the expressions of chain A of crystal structure of lipid-free human apolipoproteinA-1,chain of human lithostathin and regenerating islet-derived 1 beta precursor were down-regulated. Conclusions Protein spectra are different in patients with pancreatic cancer,chronic pancreatitis and choledocholithiasis.Transthyretin,apolipoproteinA-1,human lithostathin and regenerating islet-derived 1 beta might be the biomarkers of human pancreatic cancer and may be useful in distinguishing pancreatic cancer from chronic panceatitis.