Relations between doctor and patient are basic and important human relation in medical practice.Because of some reasons,the relations appear tense status in our country,moreover the market economy flourishingly develops,as the result of medical organizations suffering more and more existent pressure.It is an important subject faced for people,especially for medical worker,to righly think the existed defects,and set up the mutual action between doctor and patient.

Angiotensin-converting enzyme 2 (ACE2)-angiotensin (1-7) [Ang (1-7)]-Mas constitutes the vasoprotective axis and is demon-strated to antagonize the vascular pathophysiological effects of the classical renin -angiotensin system .We hypothesize that upregulation of ACE2-Ang (1-7) signaling protects endothelial function through reducing oxidative stress , thus resulting in beneficial outcome in di-abetes.Ex vivo treatment with Ang (1-7) augmented endothelium-dependent relaxation (EDR) in renal arteries from diabetic patients . Both Ang (1-7) infusion via osmotic pump (500 ng? kg -1? min-1 ) for 2 weeks and exogenous ACE 2 overexpression mediated by ad-enoviral ACE2 via tail vein injection rescued the impaired EDR and flow-mediated dilatation ( FMD) in db/db mice.Diminazene acetu-rate treatment (15 mg? kg-1? d-1 ) activated ACE2, increased the circulating Ang (1-7) level, and augmented EDR and FMD in db/db mouse arteries.In addition, activation of the ACE2-Ang (1-7) axis reduced reactive oxygen species (ROS) overproduction de-termined by dihydroethidium staining , CM-H2DCFDA fluorescence imaging , and chemiluminescence assay in db/db mouse aortas and also in high-glucose-treated endothelial cells .Pharmacological benefits of ACE 2-Ang ( 1-7 ) upregulation on endothelial function were confirmed in ACE2 knockout mice both ex vivo and in vitro.We elucidate that the ACE2-Ang (1-7)-Mas axis serves as an important signal pathway in endothelial cell protection in diabetic mice , especially in diabetic human arteries .In summary, endogenous ACE2-Ang (1-7) activation or ACE2 overexpression preserves endothelial function in diabetic mice through increasing nitric oxide bioavail -ability and inhibiting oxidative stress , suggesting the therapeutic potential of ACE 2-Ang(1-7) axis activation against diabetic vasculop-athy.

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTL) is an aggressive non-Hodgkin lymphoma and there are no standard treatment options for ENKTL. For localized patients, radiotherapy alone or radiotherapy combined with chemotherapy could be took into consideration. Systemic combination chemotherapy remains the primary treatment for patients with advanced ENKTL. The efficacy of anthracycline based conventional chemotherapy in ENKTL is unfavorable. This paper reviews the treatment progress of ENKTL in recent years.

Endothelial Cells ; metabolism ; physiology ; Stem Cells ; metabolism ; physiology

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Heart Failure ; therapy ; Humans

As understanding the biology of multiple myeloma (MM) and application of new drugs, regimens containing new drugs deepened therapeutic response and prolonged the survival of MM patients. This article updates the therapeutic response of regimens reported in the 57th American Society of Hematology annual meeting, containing immunomodulatory agents, proteasome inhibitors, histone deacetylase inhibitors and other new drugs including monoclonal antibodies and the others. In the same time, minimal residual disease (MRD) is also used to evaluate the remission depth of MM. In order to achieve durable long-term remission and higher quality of life, new drug combination regimens have been recommended, especially for the relapsed or the high risk MM patients.

Multiple myeloma (MM) is a unique cancer paradigm for investigating the mechanisms involved in the transformation from a premalignant condition (unknown monoclonal gamma globulin,MGUS) into a malignant disease (MM).In its pathogenesis,genotype characteristics of tumor clones which are highly complex and heterogeneous,as well as the dialogue between plasma cells and their microenvironment are equally important and both play a key role in the outcome of the disease.MM will soon no longer be considered as a single disease.A large number of new drug emergence and applications will increase the need for monitoring minimal residual disease (MRD) in prognosis and treatment of MM.New drugs and high-dose chemotherapy with autologous stem cell transplantation applications have been significantly improving the prognosis of MM in the past 20 years.Re-examining the early MM diagnostic criteria and the possibility of early intervention will open up a new therapeutic approach.It is important to find a balance of efficacy,toxicity and cost in order to achieve a cure for this disease.

Objective To investigate the risk factors of post-pancreaticoduodenectomy complications.Methods The clinical data of 207 patients with pancreatic carcinoma or peri-ampullary carcinoma who underwent pancreaticoduodenectomy at the Anhui Provincial Hospital from Dec.2007 to Dec.2012 were studied.Seventeen clinicopathologic factors to correlate with the postoperative mortality and methods were selected for univariate analysis and multivariate analysis using logistic regression.Results Univariate analysis showed the major risk factors of postoperative mortality and morbidity were a history of previous operation,pre-operative drainage,total serum bilirubin level,alanine aminotransferase level,serum albumin level,serum pre-albumin level,parenchyma texture and pancreatic duct diameter (P＜0.05).Multivariate analysis showed alanine aminotransferase level,parenchyma texture and pancreatic duct diameter were independent risk factors of postoperative complications.Pancreatic duct diameter was the independent risk factor of pancreatic fistula.Pancreatic fistula was the independent risk factor of hemorrhage.Conclusion The postoperative complications of pancreaticoduodenectomy was closely related to alanine aminotransferase level,parenchyma texture and pancreatic duct diameter.

Gliomas harbor a small population of cells termed glioma stem-like cells (GSC),which have the ability to undergo self-renewal and initiate tumorigenesis.GSCs are resistant to a wide variety of chemotherapeutic agents and possess a remarkable ability to recover from cytotoxic therapy.Furthermore,GSCs play a crucial role in RT failure,as tumors surviving RT are enriched in GSCs.Therefore,an alternative strategy involving selective targeting of this functionally distinct chemo-and radiation resistant small group of GSCs rather than the bulk of the tumor may be more successful in treating this deadly disease.GSC exhibit various alterations to signaling pathway activity,which are associated with self-renewal and neoplastic proliferation.These altered pathways may represent possible targets for GSC.

Objective To explore the effect of microsurgery for refractory temporal lobe epilepsy . Methods A retrospective analysis was made in 102 patients with refractory temporal lobe epilepsy from January 2005 to December 2011.The patients received comprehensive preoperative localization , intraoperative frontotemporal pterional incision , and microsurgical resection of epileptogenic focus .The efficacy was evaluated according to the Engel standards .Indications such as self-care ability, learning ability, and working ability were used to evaluate the quality of life , which were recorded and compared before and after operation . Results Follow-up was accomplished in all the 102 cases for a duration of 1 year and 9 months to 7 years.There were no mortality and serious complications .The effects evaluations at 1 year after operation showed complete disappearance of symptoms ( levelⅠ) in 61 cases (59.8%), almost disappearance (level Ⅱ) in 17 cases (16.7%), symptoms improvement more than 75% (level Ⅲ) in 13 cases (12.7%),and ineffective (level Ⅳ) in 11 cases (10.8%), bearing an effective rate of 89.2% (91/102) and a good-and-excellent rate of 76.5%(78/102).At one year and nine months postoperatively , 6 patients could not take care of themselves , 32 patients obtained partial self-care, and 64 patients had complete self-care,as compared with which there were 21 patients, 67 patients, and 14 patients preoperatively, respectively, having significant differences before and after surgery (Z =-7.001, P =0.000). Statistical significances were obtained before and after operation in 67 cases of children and adolescents with learning ability ( Z=-3.747, P =0.000) and in 35 adult cases with working ability ( Z =-2.564, P =0.010). Conclusions Microsurgical treatment is an effective method for refractory temporal lobe epilepsy .Patients ’ quality of life can get significant improvement after surgery.