The paper analyses five medical moral conflicts of medical health reform. It indicates that connotation of the guide of value is collectivism and service to patients heart and soul. In order to guide value positively. 5 points should be noticed :a) To correctly recognize the dialectical relationship of medical health reform and medical moral engineering and keep equal engineering on them) b) To fully exert Medical education function of guiding benefits; c) To insist on socialist justice principle; d) To lead socialist competction into the reform; e) To carry out principle of "cutting benefits apart" and set up mechanism of dredging the tendency of benefits.

Objective To investigate the preventive effect of low molecular weight heparin or tranexamic acid in the rabbits with hypercoagulation induced by impact injury and intravenous infusion of the endotoxin. Methods Combination of impact injury and endotoxin was created by strike on rabbit chest with type BIM-Ⅱ biological impact machine and injection of endotoxin via vein.Thirty-two male New Zealand rabbits were divided into four groups in a completely random design as follows:impact injury combined with endotoxin without treatment group(control group),treatment with low molecular weight heparin(L group),treatment with tranexamic acid(TA group),and treatment with low molecular weight heparin and tranexamie acid(L+TA group).The changes of interleukin-1β(IL-1β)and interleukin-6(IL-6)were observed by using the enzyme-linked immunosorbent assay;changes of antithrombin-Ⅲ(AT-Ⅲ)activity,tissue factor(TF)and tissue factor pathway inhibitors(TFPI)were detected by the chromogenic substrate method chromozym P:the content of fibrinogen was observed by coagulation analyzer.The lung and kidney were removed from the experimental animals at 24 hours post impact injury forhistopathologic observation. Results In the control group,the activity of AT-Ⅲ was decreased obviously.while the content of fibrinogen and the activity of TF and TFPl were increased,with formation of the thrombosis in the kidney after injection of PLS.Compared with control group,the activity of TF and the content of IL-1β and IL-6 were reduced but the TFPI was increased in the L group,which resulted in a decrease of TF/TFPI ratio.with decrease of formation of the micro-thrombosis in the organs.The content of IL-1β and IL-6 in the TA group were reduced,which was still higher than that in tIle L group.In the TA group.the activity of IF and TFPI Was lower than that in the L group and control group,with higher TF/TFPI ratio than the L group.The frequency of thrombosis increased in pulmonary artery and other important organs.The content of IL-1β and IL-6 in the L+TA group wag lower than that in the L group.In the L+TA group.the activity ofTF was lower than that inthe L group and control group,but the activity of TFPI was higher than that in the L group and control group.with lower TF/TFPI ratio than the L group.There found no increase of thrombus in the pulmonary arterial and other important organs. Conclusions Besides anticoagulation function,the low molecular weight heparin can inhibit the inflanunation reaction,reduce the release of TF and attenuate the coagulation reaction.On the basis of treatment with low molecular weight heparin,application of the tranexamic acid will not lead to the formation of thrombus,but the only use of the tranexamic acid would have the contrary results.The rtsults of the study provide a theoretical and experimental basis for clinical diagnosis and prevention of hypercoagulation induced by injury and infection.

Objective To evaluate the effect of hydrodistension on interstitial cystitis and the psychological changes after hydrodistension.Methods Thirty two patients with interstitial cystitis underwent hydrodistension from May 2011 to Jun 2012 in Department of Urology,Beijing Hospital.Interstitial cystitis symptom index(ICSI),Visual onalogue Scale (VAS) pain score,quality of life questionnaire(QOL) score,self-rating anxiety scale(SAS) score,self-rating depression scale(SDS) score were recorded and analyzed before and at 1-3 month after hydrodistension surgery.The voiding diary and postoperative complications were cared.Results Symptoms were improved in twenty nine patients,the efficiency rate was 90.6％ (29/32).There were significant differences in ICSI score,VAS pain score,QOL score,SAS score,SDS score between pre and 3 month post-surgery [(26.7± 2.3) vs.(15.2±1.9),(4.6±2.5) vs.(1.8±1.1),(4.3±2.2) vs.(2.2±1.6),(53.8±3.7) vs.(40.8±2.3),(54.8±2.3) vs.(42.4±1.5),t=8.33,7.94,6.54,7.20,8.52,respectively,all P ＜0.05].No complication was found after surgery.Both the clinical symptoms and the anxiety and depression symptoms in patients were relieved,and QOL was improved.Conclusions For the patients with interstitial cystitis,the undergoing of hydrodistension surgery can relieve the anxiety and depression symptoms and improve quality of life.

Objective To study the changes of coagulation and fibrinolysis in rabbit model of non-overt disseminated intravascular coagulation induced by low-dose endotoxin and therapeutic effects of anticoagulation by heparin.Methods Twelve male rabbits were randomly divided into 2 groups,one receiving endotoxin intravenously(10 ?g/kg,n=6),one receiving endotoxin intravenously and 100 U/kg Heparin simultaneously(n=6).The blood sample obtained before experiment was used as control.Coagulation parameters including prothrombin time(PT),activated partial thromboplastin time(aPTT),thrombin time(TT),fibrinogen concentration,D-dimers,thrombelastography(TEG)were measured during 6 h after endotoxin induction.Tissue specimens of lungs and kidneys were examined.Results Parameters of coagulation deteriorated significantly in the endotoxin-induced rabbits,but was not altered in heparin-treated rabbits.TEG monitoring in the endotoxin-induced rabbits reflected consumption of clot factors and platelet dysfunction,and hypocoagulation status in heparin-treated rabbits.In endotoxin-induced group,fibrin deposition was found in lungs and kidneys.Conclusion Non-overt disseminated intravascular coagulation induced by low-dose endotoxin in rabbits is improved by heparin.

Objective To study the coagulation of patients with lung cancer or esophagus cancer in thoracotomy during perioperative period.Methods Variables [reaction time(R),clotting time(K),? angle,maximum amplitude(MA)]detected by thrombelastography were measured in 10 cases of lung cancer and 10 cases of upper or median esophagus cancer before anesthesia(T0),at the end of 1 h after operation beginning(T1)and 30 min after operation(T2).The control group consisted of 10 healthy volunteers.Results In lung cancer group and esophagus cancer group,R was shorter than control group(P

Thirty six patients aged 50-70 years with benign prostatic hyperplasia (BPH) received doxazosin and desmopressin treatment for 4 weeks.After treatment the International Prostate Symptom Scores (IPSS) and Quality of Life (QoL) scores of patients were significantly improved (17.4 ± 2.5 vs.11.8 ± 1.1 and 3.9 ±0.6 vs.1.8 ± 1.3,respectively;both P ＜ 0.01).The nocturia frequency was decreased from 4.6±1.5 to 2.1±1.6 (P＜0.01);nocturnal urine output from (564±73) to (348±45) ml (P＜0.05);the hours of undisturbed sleep increased from (88.6 ± 17.5) min to (146.2 ± 12.8) min (P ＜0.05).There were no significant differences in serum levels of sodium,potassium and chlorine,and osmoticpressure before and after treatment.The results indicate that doxazosin combined with desmopressin is safe and effective for treatment of nocturia in patients with BPH.

ObjectiveTo investigate the association between the common variant rs1512268 single nucleotide polymorphism(SNP) of NKX3.1 gene and the risk of prostate cancer,and to explore its interaction with related risk factors.MethodsTotally 122 patients with prostate cancer and 105 age matched male people (prostatic specific antigen ＜ 4 μg/L,without family history of prostate cancer) as control group were enrolled.Polymerase chain reaction - high resolution melting curve(PCR - HRM) combined with gene sequencing methods were used to determine the distribution of allele and genotype frequencies of the rs1512268 SNP.ResultsThe distributions of GG,AG,AA genotypes were 42 cases(33.4％),66 cases(54.1％),14 cases(11.5％) in patients with prostate cancer,and 45 cases(42.9％),51 cases(48.6％),9 cases(8.6％) in healthy control,respectively.There were no significant differences in the distribution of genotype(x2 =1.70,0.69,0.52) and allele frequency (x2 =1.575) between the two groups(P＞ 0.05).The different genotypes of rs1512268 of NKX3.1 gene were not associated with age,Gleason score,PSA levels and clinical stage of prostate cancer (P＞0.05). Conclusions rs1512268 SNP of NKX3.1 gene is not obviously associated with prostate cancer and may be not the genetic risk factor in Chinese.

Objective To investigate the value of carotid and lower limbs arteries atherosclerosis in prediction of intracranial atherosclerosis combined with type 2 diabetes (T2DM). Methods Seventy-four patients with T2DM received the carotid artery , lower limbs arterial color Doppler ultrasound and cranial MRA examination. The data was analysised by Pearson correlation and Binary Logistic methods. Results With the increasement of degree of peri-arterial atherosclerosis , the intracranial arteriosclerosis was in a trend of increase. The correlation coefficients, OR values and AUC of LLAS and CAS + LLAS for intracranial atherosclerosis were 0.28 (P < 0.05) and 0.33 (P < 0.05), 0.14 (P < 0.05) and 9.28 (P < 0.05), 70.30% (P < 0.05) and 70.60% (P < 0.05), respectively. The cut-off point of LLAS and CAS + LLAS was lever 2. Conclusion The LLAS and CAS + LLAS with T2DM are independent risk factors for intracranial atherosclerosis , owning certain forecast values.

Objective To construct the performance evaluation framework for China′s health system,and provide evidences for enhancement of such evaluation and the health system.Methods Literature review and empirical research were combined with expert consultation to construct such an evaluation index system.Results In view of both international experiences and China′s specifics,an evaluation index system is built based on the generalized concept model of the health system,consisting of 4 class-1 indicators, 1 5 class-2 indicators and 6 9 class-3 indicators.Conclusions The generalized framework of health system performance evaluation fits such evaluation in China,and indicator optimization and understanding of the shortcomings with cautious explanation are of critical importance.This evaluation remains in its infancy in China,and there is a long way to go before a health system performance evaluation system can be built in China.

One hundred and seventy-one cases of hyperlipidemia were treated by moxibustion on Shenque (CV 8) and bilateral Zusanli (ST 36). After moxibustion, the blood-lipid contents of the patients with hyperlipidemia of various types were all lower than those before moxibustion.There was a significant difference between them. It is indicated that moxibustion on Shenque (CV 8) and bilateral Zusanli (ST 36) had the functions of reinforcing the spleen and kidney,warning yang, removing the stasis and treating both the principal and the secondary aspects of a disease for hyperlipidemia, which embodied the advantage of the function of regulating organism of moxibustion. The treatment by regulating can mobilize the regulating function of self to get the benign and bi-directional regulating effect for the various indexes of lipid metabolism and reach the intention of lowering blood-lipid.