Patients in Orthopedics have different psychological features in the stages of before treatment,the stage of treatment,the stage of rehabilitation and the stage of post-discharge.The health care workers should use language and non-verbal skills to communicate with patients according to their psychological characteristics,and adopt different communication skills with different individuals.A good communication not only reduces the disputes between doctors and patients,but also promotes physiologic and psychological rehabilitation.

Objective To evaluate the biocompatibility of acellular bladder matrix patch as the pelvic floor repair alternative ma-terial .Methods The combination of in vivo and in vitro biological experiments including cytotoxicity ,haemolysis and vaginal im-plant tests were employed to evaluate the biocompatibility of this material .Results In the cytotoxicity test ,the material toxicity was the grade 0-1 .The hemolysis rate of the material extract liquid was 1 .5% .The general and histological observation showed that the material did not cause the host immunologic rejection and led to slight foreign body reaction after implanting ,which was ba-sically degraded in 12 weeks after transplantation .Conclusion Acellular bladder matrix exhibits better biocompatibility ,but needs to adjust its degradation rate in order to adapt to the requirements of pelvic floor repair operation .

Objective To study the causes of conversion to open surgery in patients receiving gynecological laparoscopic operations. Methods From January 2002 to December 2007,totally 2630 patients received gynecological laparoscopy in our hospital; 45 of them were converted to open surgery. The data of the 45 cases were analyzed. Results The causes of conversion to open surgery included uterus myoma located at specific locations (25 cases,55.6%),severe pelvic-abdominal adhesion (10 cases,22.2%),uterine horn pregnancy (3 cases,6.7%),ovarian tumors (3 cases,6.7%),surgical injury (3 cases,6.7%) ,and adenomyoma with requirement for uterus conservation (1 case,2.2%). Conclusions Peculiar locations of uterine myoma and severe pelvic-abdominal adhesion are the main causes of conversion to open surgery during gynecological laparoscopy. Detailed preoperative evaluation can decrease the rate of the conversion rate. Right timing of the conversion may reduce complication rate.

0.05). In bone defects PeroGlas granales bond to bone and new bone formation were observed 4 weeks after operation. The bone defects were repa ired by new bone 12 weeks after PerioGlas implantation. Conclusion: PerioGlas may induce new bone formation in osseous defects.

To compare the chemical change of Paeoniae Radix Alba (PRA) after vinegar-baking processing, as well as the effect of vinegar types exerted on the processing, 1H NMR-based metabolomic approach combined with multivariate statistical analysis was used to investigate the different metabolites between the raw and two vinegar-baked PRA. More than thirty metabolites were identified in the 1H NMR spectrum of PRA, and the multivariate statistical analysis showed that raw and two vinegar-baked PRA could be separated obviously. After vinegar-baking, the contents of isoleucine, lactate, alanine, arginine, albiflorin, and 5-hydroxymethyl furfural (5-HMF) elevated, while those of sucrose, paeoniflorin and its analogues (calculated by benzoate) decreased. The chemical compositions of two vinegar-baked PRA were also different. Shanxi vinegar- baked PRA showed higher levels of leucine, isoleucine, valine, and albiflorin, while rice vinegar-baked PRA contained more sucrose and paeoniflorin's analogues (calculated by benzoate). And the chemical changes in Shanxi vinegar-baked PRA were greater than those of rice vinegar-baked PRA. The results revealed the chemical differences between raw and vinegar-baked PRA, as well as the influence of vinegar type on processing, in a holistic manner, the results obtained suggested that the correlations between the chemical change and the drug action after processing, as well as the vinegar type used in processing, should be further studied.

Major breakthrough and challenge that encountered by modern western medicine were described in this article. Some standpoints about the necessity of innovative revolution for the development of traditional Chinese medicine, together with the key points should be bring to the attention during ideological emancipation have been put forward here. Chinese scientists agreed that it is the most appropriate timing for us to establish a new medicine system, which we named Holistic Systems Medicine (HSM). The concept and research contents of Holistic Systems Medicine were also introduced in this article. Finally, a proposal for setting up“China Holistic Systems Medicine development project” was proposed.

Objective To explore the effects of human menopausal gonadotropopin(HMG) supplementation on the outcome of women underwent in vitro fertilization-embryo transfer(IVF-ET) .Methods The data of 406 IVF-ET cycles in Reproductive Medi-cine Center of the 105th Hospital of PLA were analyzed retrospectively .All cases underwent long down regulation protocol with gonadotropin releasing hormone agonist(GnRH-a) in the mid-luteal phase and controlled ovarian stimulation(COS) was carried out with follicle stimulation hormone(r-FSH) on the days 3 -5 of the menstrual cycle .Then 75 -150 U HMG was administrated in group A(257 cycles) when a dominant follicle reached a diameter of 14 mm ,while the remaining cases(149 cycles) underwent HCG still with r-FSH were served as group B .Based on the LH levels on the day of HMG administration ,the cases in group A were sub-divided into :group A1(99 cycles) ,LH<1 U/L ;group A2(96 cycles) ,1 U/L≤LH≤2 U/L ,and group A3(62 cycles) ,LH>2 U/L .Clinical outcomes of all groups were analyzed and compared .Results The durations and doses of gonadotropin(Gn) ,the rates of fertilization and pregnancy were higher and the abortion rate was lower in group A than that in group B (P<0 .05) .There were no significant difference in serum LH concentrations on the days of HMG and HCG administration ,oocytes retrieved ,the rates of cleavage and embryo implantation between group A and group B(P>0 .05) .There was significant difference in serum LH levels on the day of HMG supplementation among group A1 ,A2 and A3(P<0 .05) and the doses of HMG supplemented reduced gradually from group A1 to group A3(P<0 .05) .The duration of Gn was significantly lower and the fertilization rate was significantly higher in group A3 compared with group A1 and A2(P<0 .05) .The pregnancy rate in group A2 and A3 was higher than that in group A1 ,which showed significant difference between group A2 and A1(P<0 .05) .Meanwhile ,there were no significant difference in doses of r-FSH ,serum LH concentrations on the day of HCG administration ,oocytes retrieved ,the rates of cleavage ,implantation and abortion among the three groups(P>0 .05) .Conclusion HMG supplementation in the middle and late follicle phases in stand-ard long down-regulation protocol during IVF could obtain higher pregnancy rate and lower abortion rate ,especially when their ser-um LH level was between 1 U/L and 2 U/L without obvious increase of LH .

The objective of this study is to fully investigate the therapeutic effect and mechanisms of action of Gegen Qinlian decoction (GD) on type 2 diabetes mellitus (type 2 DM). A rat model of type 2 DM was established with the combination of high-fat diet and multiple low doses of streptozotocin (STZ). Biochemical indicators related to glucose metabolism disorders, insulin resistance, oxidative stress were observed. The type 2 DM rats were administrated with GD for 80 days, the above-mentioned indexes were detected. The results indicated that the hepatic glycogen synthesis level was promoted, fasting blood glucose level and fasting blood insulin level were significantly reduced, insulin sensitivity index was significantly improved; the level of superoxide dismutase (SOD) was increased and the level of malondialdehyde (MDA) was reduced; pathologic morphology of pancreas and kidney was ameliorated in the GD group. It was indicated that the therapeutic mechanisms of action of GD on type 2 DM might be related to its effect of ameliorating glucose metabolism disorders, relieving insulin resistance, increasing the tissues' sensitivity to insulin, improving the antioxidative ability of living system, GD has therapeutic effect on type 2 DM and protective effects against damaged pancreatic function.

The origin of precision medicine was discussed in this article,as well as its advantages and deficiencies at this stage.Tangshen formula was taken as an example to explain a rational and ideal mode of traditional Chinese medical (TCM) precision medicine research under the guidance of TCM theory.In view of the two major problems existing in the TCM modernization research,including the separated strategy among formula-disease-syndrome and independent research approach using genomics,proteomics and metabonomics,critical scientific issues on developing the drug system to biological system research mode and solutions for integrating formula-disease-syndrome were proposed here,and the roadmap and total framework of top design were also provided.The specific methods and the corresponding research results on Tangshen formula at the three stages concluded as formula-disease related,disease-syndrome combinated and formula-disease-syndrome integrated were introduced and summarized.At this time for the innovative breakthrough development of TCM,precision medicine will promote the TCM modernization research,and also will provide a powerful driving force for the establishment of holistic systems medicine.

Water soluble extract (WSE) is an important index for the quality evaluation of Astragali Radix (AR). In this study, the WSE of the wild AR from Shanxi province (SX) and the cultivated AR from Gansu Province (GS) were compared. The WSEs of two types of AR were determined according to the appendix of Chinese pharmacopoeia. Then the WSEs were subjected to NMR analysis, and the obtained data were analyzed using HCA, PCA, OPLS-DA, microarray analysis, and Spearman rank analysis. In addition, the Pearson correlation of differential metabolites were also calculated. The results showed that the WSE content of GS-AR (37.80%) was higher than that of SX-AR (32.13%). The main constituent of WSE was sucrose, and other 18 compounds, including amino acids, organic acids, were also detected. Multivariate analysis revealed that SX-AR contained more choline, succinic acid, citric acid, glutamate, taurine and aspartate, while GS samples contained more sucrose, arginine and fumaric acid. In addition, the Pearson correlations between different metabolites of the two types of AR also showed apparent differences. The results suggested that the WSE of two types of AR differs not only in the content, but also in the chemical compositions. Thus, the cultivation way is important to the quality ofAR. This study supplied a new method for the comparison of extract of herbal drugs.