Narrative medicine adds new elements for the development of medical humanistic education .It pro-vides a new perspective to re -examine the doctor -patient relationship .From medical humanities and narrative and narrative ability is medical students overall development reality needs two aspects analyzes the narrative ability training medical students is a new requirement , medical humanities education narrative medical practice signifi-cance is not only reflected in promoting the medical work of humanity , but also in the training process for medical students through the narrating ability .

ObjectiveTo investigate environmental factors of the relapse of alcohol dependence.MethodsOne hundred and seventeen in-patients with alcohol dependence were assessed with a home-designed questionnaire,Family Environment Scale Chinese Version (FES-CV),Clinic Institute Alcohol Withdrawal Syndrome Scale Chinese Version(CIWA-Ar) and the Scale of Personality Change Post-Traumatic Brain Injury(SPCPTBI).One hundred and five patients reassessed with alcohol dependence syndrome diagnostic criteria 1 year after hospitalization.t -test,chi-square and logistic regression were used for analysis.Results 57 of 105 were relapse and 48 of them were not relapse.The results showed that relapse group had a higher divorce or separated or remarried rate (21/36) than the no-relapse one (7/41 ) ( chi-square =6.60,P =0.010) ; a less number of years of education (5.2 ± 1.8 vs 7.2 ± 1.7,t =5.64,P =0.000) ; a bigger daily drinking ( (512 ± 186) ml vs (396 ± 109) ml,t =3.93,P =0.000) ; a higher drinking frequency in relapse group ( (2.6 ± 0.9 ) vs ( 1.8 ± 0.6) times,t =5.38,P=0.000) ;a higher rates in personality change(47/57 vs 15/48 ),brain damages (27/57 vs 13/48 ) and mood disorders (35/57 vs 17/48 ),They also showed that relapse group had more problems on intimate degree (5.66 ±1.40 vs 6.20 ± 1.20),emotional expression (4.59 ± 1.54 vs 5.41 ± 1.26,independence (3.61 ± 1.29 vs 4.64± 1.49),organization (4.26 ± 1.56 vs 5.22 ± 1.18 ),and self-controlling (4.21 ± 1.43 vs 5.12 ± 1.12 ),the differences were significant (P＜0.05) ;a higher contradiction score(4.35 ± 1.73 vs 3.64 ± 1.22,t =2.42,P =0.017).Logistic regression analysis showed that the number of daily drinking,intelligent damaged,emotional problems,arid dependence were the risk factors for the alcoholic relapse ( OR =7.44,3.99,3.92,2.96) ;Self-controlling was the protective factors for the alcoholic relapse ( OR =0.19).ConclusionProblem marital status,less education,and heavy drinking,and the number of drinking times,personality change,intellectual impairment and mood change,and poor family environment were the risk factors for the relapse of alcohol dependence.

Objective To investigate the clinical features of and gene mutations in a Chinese Han pedigree with piebaldism. Methods Clinical data were collected with informed consent from a pedigree with piebaldism, processed and documented. A clinical genetic analysis was conducted and pedigree chart was drawn. Genomic DNA was extracted from the peripheral blood of 14 patients and 40 unaffected individuals in the family as well as 50 unrelated human controls, and subjected to the amplification of 21 exons and flanking sequences of the KIT gene by PCR. Sequence analysis was performed by Mutation SurveyorTM. Results There were 73 members in the family, and of them, 14 were diagnosed with piebaldism according to typical clinical features. Piebaldism was inherited in an autosomal dominant pattern in this family. A heterozygous 4-base insertion mutation 1900insATGA in exon 13 of KIT gene was identified in all the 14 affected family members, which resulted in a frame-shift mutation at codon 634 and produced a premature translation termination codon. This mutation was undetected in either the unaffected family members or unrelated controls. Up to the time of this writing, this mutation had not been previously reported. Conclusion The novel mutation 1900insATGA in the KIT gene may be the cause of clinical phenotype of piebaldism in the family.

ADAM Proteins ; blood ; immunology ; ADAMTS13 Protein ; Adult ; Female ; Humans ; Male ; Middle Aged ; Plasma Exchange ; Purpura, Thrombotic Thrombocytopenic ; blood ; pathology ; therapy

BACKGROUND:With increased age,bone marrow mesenchymal stem cells(BMSCs)are influenced with regard to quantity and quality,which will induce great damages to the donors.Many studies have focused on seeking substitute MSC source.In contrast it remains controversial whether umbilical cord blood contains MSCs.OBJECTIVE:To isolate MSCs from human umbilical cord blood,and to detect their biological properties.METHODS:Umbilical cord blood samples were sterilely isolated using Percoll density gradient centrifugation to harvest intermediate layer cells.DMEM medium containing fetal bovine serum,penicillin,streptomycin and L-glutamine was added.Following several adherences and purification,the floating cells were discarded.Thus,many adherent cells with a confluence were collected.When cells were 60% 80% confluent,cells were digested by trypsin for subculture.Cells at passages,1,5 and 9 were obtained and their morphological changes were observed.Cell surface antigens were measured using flow cytometry.Growth curves were drawn,and cell viability was determined utilizing MTT.RESULTS AND CONCLUSION:Isolated umbilical cord blood MSCs presented an even size,showing spindle or star-shape fibroblasts-like cells.Umbilical cord blood MSCs at 1,5,9 passages were greatly positive for CD29,CD105 and CD166,but weakly positive for CD34 and CD45.Following 5 days of incubation,cells entered logarithmic growth phase.The number was decreased at day 9.Population doubling time was(53.5±8.32)hours.Cells grew well.Cells at 1-7 passages showed similar viability(P ＞ 0.05).Till passage 9,cell proliferation viability was decreased,but no significant difference was determined(P ＞0.05).Results verified that MSCs can be successfully isolated from umbilical cord blood in vitro.Cells at passages 1-9 presented a good reproductive activity.

Objective To investigate the staging significance of PET-CT in multiple myeloma,and to observe the relationship between baseline PET-CT and clinical parameters in multiple myeloma.Methods 78 cases newly diagnosed MM patients were selected from the Department of Hematology,the Xinjiang Uygur Autonomous Region people's Hospital from March 2007 to February 2014,with average age 61.24 years old.The levels of hemoglobin,albumin,beta 2 microglobulin and lactate dehydrogenase were detected before the treatment.PET-CT was performed to measure SUVmax in the spine,pelvis and rib with an average of the SUVmax in each case,and the number of FDG-avid focal lesions in every patient was counted.The difference of the SUVmax or FLS in different stages and the relationship between SUVmax or FLS and clinical parameters in MM were observed.Results All the patients were divided into 3 stages depending on ISS staging.The average SUV values in 10 cases of stage Ⅰ,45 cases of stage Ⅱ and 23 cases of stage Ⅲ were 1.84±0.28,3.74±0.42 and 6.02±0.93,respectively,and SUV values was significantly different among different groups (P ＜ 0.05).SUV values were positively correlated with levels of beta 2 microglobulin (r =0.862,P ＜ 0.001) and lactate dehydrogenase (r =0.592,P ＜ 0.001),and negatively correlated with albumin (r =-0.762,P ＜ 0.001) and hemoglobin levels (r =-0.685,P ＜ 0.001).The number of lesions had a correlation with low hemoglobin,high lactate dehydrogenase and high beta 2 microglobulin (P ＜ 0.05).Conclusion PET-CT can reflect tumor burden to some extent,and has the guiding significance for MM stage,which contributes to developing individualized treatment programs.

Objective:To evaluate the efficacy and safety of pegylated liposomal doxorubicin (PLD) in CHOP regimen for un-treated elderly patients with advanced diffuse large B-cell lymphoma (DLBCL). Methods:In a prospective phase II study, we analyzed the feasibility of PLD-modified CHOP regimen in elderly patients with advanced stages of DLBCL. PLD was administered at 30 mg/m2 in combination with cyclophosphamide, vincristine, and prednisone at standard doses every 21 d for six cycles. CD20 positive patients were given option for rituximab treatment. Results:From November 2011 to March 2014, 30 patients with a median age of 70 years (range:63 to 80) were enrolled in this study. Up to 24 cases (80.0%) obtained an International Prognostic Index of≥3. The overall re-sponse rate was 86.7%, and the complete remission rate was 66.7%. With a median follow-up of 20.1 months, the 18-month overall and progression-free survival rates were 82.4%and 70.1%, respectively. The main toxicity was neutropenia, reaching grades 3 to 4 in the 24 cases (80.0%). No significant changes existed in patients' left ventricular ejection fraction and serum troponin-T during the study. Four patients (13.3%) showed asymptomatic abnormal changes in electrocardiogram after PLD infusion. Conclusion:CHOP regimen with PLD is an effective alternative for the treatment of DLBCL in elderly patients, exhibiting an acceptable toxicity.

Objective To investigate optimal extraction process of Piper puberulum ( Benth.) Maxim.and qualitative analyze the chemical component of the extracts.Methods Method of solvent heating reflux was used for extraction.On the basis of single factor experiment, L9 (34 ) orthogonal experiment was designed with the variants of extraction frequency, time, material-liquid ratio, and immersion time.Extraction rate as index, extraction processes were optimized to achieve best extraction.The extracts, including total extract, water elution, and ethanol elution, were physiochemically analysed to achieve an initial qualitative result.Results The optimal extraction process was: extractions 3 times for 2 hours, with an 1︰30 material -liquid ratio and 2 hours of immersion, Initial qualitative analyzed the total extracts containing amino acids, polypeptides, proteins, alkaloids, steroids or triterpenes, flavones, saponins, polysaccharides, reducing sugars or glucosides, cumarins, terpene lactones, phenols, and tannins.The water elution containing: amino acids, polypeptides, proteins, saponins, polysaccharides, reducing sugars or glucosides, cumarins, and terpene lactones.The ethanol elution containing: amino acids, polypeptides, proteins, alkaloids, steroids or triterpenes, flavones, polysaccharides, reducing sugars or glucosides, phenols, and tanins.Conclusion The experiments show that optimal extraction process can achieve high extraction yield, stable and practical.

Objective To investigate the anti-inflammatory mechanism by which curcumin affects TNF-αand IL-8 production in Propionibactierium acnes-induced THP-1 cells. Methods THP-1 cell viability was determined by CCK8 assay. The productions of TNF-α and IL-8 were detected by ELISA assay. Total RNA and proteins were collected for real-time PCR and Western blot analysis, respectively. Results Curcumin didn′t significantly affect the cell viability at 12 h. It decreased Propionibactierium acnes-induced productions of TNF-αand IL-8 in THP-1 cells. Moreover, it decreased TLR2, NF-κB p65, and P-NF-κB p65 expressions in THP-1 cells. Conclusions Curcumin may reduce TNF-α and IL-8 expressions in Propionibactierium acnes-induced THP-1 cells by inhibiting TLR2/NF-κB signaling pathway.