By analyzing the medical ethics and medical behaviors of the distinguished doctor Qiufazu,we can draw the conclusion that his medical ethics is the comprehensive outcome of his personal experience,the cultivation of traditional Chinese culture,and his interactions and exchange with medical teachers and fellow-students,all of which play a critical role in shaping his value of medical ethics.The medical ethics of Qiufazu can be regarded as precious spiritual treasure in medical field,which still has rich enlightenment on the self-cultivation and professional development of modern medical staff.

Objective To find a procedure for facial rejuvenation w hi ch is simple, safe with lasting aesthetic results and to make it popularized eas ily. Method We performed complete face lifting first by extens ive subcutaneous detatchment. Secondly we plicated the superficial musclo-apon eurofic system (SMAS), including the superficial temporal fascia and the SMAS su perior to the parotid fascia, 1 cm anterior to the incision line by No.1 silk su tures. The distance of plication was about 1-2 cm. Interval of suture was 1 cm. After dissection under the platysma for 1-2 cm, we pulled the posterior edge of platysma postlaterally, and sutured it to the sternocleiodomasoid fascia. The n we suspended the obiculoris oculi and the SMAS lateral to the nasoalar and com issura oris by 4-0 absorbable surtures. If necessary, we plicated the platysma near the anterior border of the detachment. Results We performe d rhytidectomy on 48 patients by extesive subcutaneous detachment and multiple S MAS suspension in the past two years. The results were satisfactory after 3-16 months follow -up. There were no serious complications (including injury of fa cial nerve and skin necrosis and severe bleeding which needed another operation to clean up the hematoma). The aesthetic results were lasting. Complications in cluded temporal hair loss in 3 cases, in which one patient accepted hair transpl antation, and in another two patients alopecia zone were incised and sutured pri marily. Two cases had scar hyperplasia behind the ear, who required revision. Tw o cases had temporary asymmetry which were given no treatment and recovered 3 mo nths after operation. Conclusion This procedure overcomes the s hortcoming caused by simple subcutaneous rhytidectomy, in which improvement is t emporary. The SMAS is well perserved to avoid the facial nerve injury, the most severe complication of rhytidectomy. Therefore, rhytidectomy by extensive subcu taneous detachment and multiple SMAS suspension is a simple and safe procedure w ith lasting aesthetic results.

ObjectiveTo investigate the correlation between the level of resistin and the insulin resistance(IR) and the incorporation of microamount albuminuria(MA) of type 2 diabetes mellitus (T2DM).MethodsTwo hundred and twenty T2DM patients and 40 normal subjects (control group) were enrolled in this study.Two hundred and twenty T2DM patients were divided into 4 groups,IR group (group A,79 cases),non-IR group (group B,48 cases),IR complicating MA group (group C,51 cases),non-IR complicating MA group(group D,42 cases).The fasting serum resistin was measured by enzyme-linked immunosorbant assay (ELISA),and the fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) was also determined.ResultsThe level of fasting serum resistin in group A,B,C and D was higher than that in control group [(33.45 ± 1.37),(23.36 ± 1.47),(44.45 ± 1.39),(37.45 ±1.57) μ g/L vs.( 17.44 ± 1.26 ) μ g/L],and there was significant difference among 5 groups (P ＜ 0.01 ).The level of fasting serum resistin in group A was higher than that in group B (P ＜ 0.01 ),and the level of fasting serum resistin in group C was higher than that in group D (P ＜ 0.01 ).The level of fasting serum resistin was both higher in group C and D than that in goup A and B (P＜ 0.01 ).Correlation analysis showed the fasting serum resistin was positively correlated with body mass index(BMI),FPG,HbA1c and FINS in group A(r =0.35,0.46,0.37,0.49,P ＜0.05),and the fasting serum resistin was positively correlated with HbA1c,BMI,systolic blood pressure and diastolic blood pressure in group C(r =0.45,0.32,0.37,0.29,P ＜ 0.05 ).ConclusionsSerum resistin may participate in the process of IR and the formation of MA.It may become one of the diagnostic standard of the IR and one of the important index to estimate the MA.

ObjectiveTo compare and evaluate the effectiveness of Airtraq laryngoscope combined with a Bougie and Airtraq laryngoscope alone for tracheal intubation in simulated difficult airway.Methods Four anesthetists and 4 clinical physicians of standardized training were enrolled in the study.The participants intubated the trachea of the ALS simulator manikin in 5 tongue edema scenarios simulating modified Cormack-Lehane grade 1,2a,2b,3,and 4 views and 1 cervical immobilization scenario.Results No significant difference in the rate of successful intubation was detected between two techniques(P＞ 0.05 ).In Cormack-Lehane grade 1,2a views,the duration of successful intubation in Airtraq laryngoscope alone [ ( 14.3 ± 1.3),( 17.1 ± 2.9) s] was shorter than that in Airtraq laryngoscope combined with a Bougie [ (26.6 ± 3.8),(36.4 ± 3.6) s ] with significant difference (P ＜ 0.01 ).Cormack-Lehane grade 2b,3,4 views,the duration of successful intubation in Airtraq laryngoscope alone[ (74.5 ± 6.5 ),(116.3 ± 9.8),(53.0 ± 6.1 )s] was longer than that in Airtraq laryngoscope combined with a Bougie [ (35.4 ± 4.3 ),(52.3 ± 5.0),(40.4 ± 3.8 ) s ] with significant difference (P ＜ 0.05).ConclusionAirtraq laryngoscope combined with a Bougie can be quickly intubated in simulated difficult airway compared with Airtraq laryngoscope alone.

10.3969/j.issn.2095-4344.2013.24.005

OBJECTIVE To know the antibacterial activity of cefotaxime/sulbactam against 4 kinds of Gram- negative bacilli in vitro in general clinics. METHODS By double-disk test to detect the ESBLs of Escherichia coli and Klebsiella pneumoniae and the metallo-?-lactamase of Pseudomonas aeruginosa and Acinetobacter baumannii. And all the tested bacilli were tested by 14 kinds of general antibacterial drugs through K-B experiment. RESULTS Fifty one of 164 Enterobacteriaceae strains were ESBLs positive, including 23 E. coli strains with positive rate of 26.3% and 28 K. pneumoniae strains with positive rate of 35.9%. The metallo-?-lactamase was produced in 33 of 85 P. aeruginosa strains and the positive rate was 38.8%, and none in A. baumannii. The result showed cefotaxime /sulbactam was very sensitive to Enterobacteriaceae, no matter it had enzyme or not. These drugs had a special high sensitivity to ESBLs producing E. coli and K. pneumoniae, and their sensitivity rate was 87.0% and 89.3%. The sensitivity rate to P. aeruginosa, produced enzyme or not was 56.7% and 92.3%. CONCLUSIONS Cefotaxime/sulbactam has a powerful antibacterial activity against 4 kinds of Gram-negative bacilli in vitro in general clinics, especially to the infection caused by ESBLs-producing or metallo-?-lactamase-producing bacteria, and can be taken as the preferred drugs.

Objective To explore pre-thrombosis state in patients with cor pulmonale and the efficacy of anticoagulant treatment with low molecular heparin(LME). Methods 54 patients with cor pulmonale were divided into LMH treatment group and routine treatment group, each group containing 27 patients. The concentrations of Von Willlebrand factor (VWF),prethrombin F 1+2 fragment(F 1+2 ),Fibrinogen(Fg),granule membrane protein(GMP-140)and D-dimer fragment(DD)were measured before and after treatment. Results The concentrations of WF,F 1+2 ,Fg,GMP-140 and DD in the patients with cor pulmonale were significantly higher than those in the controls. In LMH treatment group, the above indices and PaCO 2 markedly decreased and PaO 2 obviously increased, while in routine treatment group, PaCO 2 and PaO 2 slightly improved, and no change was observed in coagulation indices. Conclusion Early detection and diagnosis of pre-thrombosis state in patients with cor pulmonale and immediate treatment with LMH can be beneficial to the prognosis of these patients in acute stage.

Aged ; Coronary Disease ; Coronary Sinus ; pathology ; Female ; Heart Atria ; pathology ; Humans ; Middle Aged

Objective To investigate the correlation between high myopia and MMP-2 in aqueous humor (AH), by comparing the protein level of MMP-2 in AH from patients with cataract combined with high myopia and with emmetropia. Design Experimental study. Participants 30 AH samples of patients with age-related cataract. Methods AH samples were collected from the patients with age-related cataract during phacoemulsification, including 15 AH samples from patients combined with high myopia (experimental group) and 15 AH samples from patients with emmetropia (control group). The expression of pro-MMP-2 and MMP-2 in AH were ana-lyzed by Western blot technique. Main Outcome Measures The gray value of MMP-2 protein band detected by Western blot. Results The level of pro MMP-2 was statistically higher than that of MMP-2 in experimental group (430.4±57.3 versus 294.5±35.2, t=10.400, P= 0.000) and control group (402.8±57.7 versus 280.3±49.7, t=8.400, P=0.000). There was no statistically difference in the level of pro-MMP-2(t=1.320, P=0.200)and MMP-2 (t=0.900,P=0.375) between the two groups. Conclusions No abnormal expression of MMP-2 was detected in AH from patients with high myopia, according to this study based on limited samples. Pro-MMP-2 was the main form of MMP-2 in AH of patients with cataract combined with high myopia or emmetropia, which possessed potential ability of transferring into form of active MMP-2. (Ophthalmol CHN, 2009, 18: 260-264)

OBJECTIVE: To explore the effects of Gymnadenia conopsea alcohol extract (GcAE) on the collagen synthesis in rat lungs exposed to silica and the influence on antioxidase activities, level of lipid peroxidation (LPO). METHODS: One hundred and twenty rats were randomly divided into control group, silica group, and GcAE-treated group. Silicotic animal models were established by direct tracheal instillation of silica into rat lungs surgically. From the second day of model establishment, rats in GcAE-treated group were orally given GcAE [8 g/(kg x d) corresponding to raw herb]. At 7, 14, 21, 28 and 60 days after establishment of the animal model, eight rats in each group were sacrificed, and samples were collected. The malondialdehyde (MDA) content, superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities in plasma were assayed by a spectrophotometer. Types I and III collagen were detected by Sirius red polarization and microscopy, and measuered by Image-Pro Plus Version 4.5 for Windows software. RESULTS: GcAE could reduce the lung/body weight ratio of rats exposed to silica, the synthesis of types I and III collagen of the lungs and the level of lipid peroxidation, increase the activities of SOD and GPx. CONCLUSION: GcAE can ameliorate the silica-induced pulmonary fibrosis by increasing the activities of antioxidase and alleviating the damage of lipid peroxidation to the lungs.