Objective:This article aimed to discusse the feasibility and effects of humanistic service using Kano model in outpatients .Methods:Using a self-designed Kano model outpatient humanistic service demand question-naire investigated clinic patients by using the Kano model analysis method , implementing humanistic service in the outpatient on the base of analyzing the starting point , and compare the satisfaction situation before and after the im-plementation .Results:There are service items including necessary quality , expected quality , attractive quality in Kano model analysis , 9, 8, 2 items respectively.After the implementation of humanistic service , patient's satisfac-tion increased significantly .Conclusion:The Kano model can be used in the outpatient services .The outpatient hu-manistic service could get the approvals from most outpatient patients .Outpatient humanistic service can improve the satisfaction of patients , so as to reduce medical disputes , alleviate conflicts between the doctors and patients , and improve the hospital popularity .

Female ; Humans ; Middle Aged ; Multiple System Atrophy ; diagnosis ; pathology

AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis.
●METHODS:Retrospective study. A total of 57 cases (57 eyes ) with complicated cataract with uveitis were involved in the study from Jan. 2015 to Dec. 2015. All cases underwent phacoemulsification and intraocular lens implantation surgery successfully. The postoperative reaction, effect, complications and so on were retrospectively analyzed after phacoemulsification and intraocular lens implantation surgery. The date of visual outcome was analyzed using Non - parametric Wilcoxon test.
●RESULTS: lris were bleed in 21 eyes ( 37%) , 4 eyes ( 7%) with posterior capsule rapture and posterior chamber intraocular lens was not implanted in 4 eyes ( 7%) . The uncorrected visual acuity ( UCVA ) was significantly increased after surgery. The UCVA of 8 eyes (14%) were 0. 1 or better before surgery, and the UCVA of 42 eyes (74%) were 0. 1 or better 3mo after surgery, the difference was statistically significant ( Z=23. 42, P<0. 001). The corneal edema (17 eyes, 30%), uveitis (2 eyes, 4%) and intraocular hypertension ( 1 eyes, 2%) were appeared in postoperative 1d. The corneal edema (3 eyes, 5%) was appeared in postoperative 1wk. The uveitis ( 1 eyes, 2%) was appeared in postoperative 1mo. The corneal edema (1 eyes, 2%), uveitis (2 eyes, 4%) , intraocular hypertension ( 1 eyes, 2%) and after-cataract ( 3 eyes, 5%) were appeared in postoperative 3mo.
● CONCLUSION: The phacoemulsification combined intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis has good effect and fewer complications.

Objective To evaluate the feasibility and principle of direct reduction and fixation through the pedicle of fractured vertebra in treatment of thoracolumbar burst fractures.Methods Between June 2001 and November 2005,24 cases of one level thoracolumbar burst fracture,16 males and eight females,were treated in our department.Their average age was 32.5 years old.The fractured vertebrae were as follows:T11 in two cases,T12 in nine cases,L1 in 11 cases and L2 in two cases.According to the ASIA(American Spinal Injury Association) neurological function grading system,there were one grade A,two grade B,five grade C,three grade D anti 13 grade E.The vertebral canal area blocked was rated as gradeⅠ(＜1/4)in three cases,gradeⅡ(1/4～1/2)in nine cases,gradeⅢ(1/2～3/4)in 10 cases and gradeⅣ(＞3/4)in two cases.The pedicle-screws were im- planted into the pedicles of the fractured vertebra and its adjacent ones.The connective rod was pre-bent according to the normal sagittal curvature of the fixation segment.After necessary decompression of the vertebral canal,the pedicle-screws stabilized the rod which was rotated to prop open upper and lower pedicle screws and push the burst vertebra so that the kyphosis and lateral dislocation were corrected.The graft bone was implanted between the transverse processes.Results On average,the height of fractured vertebra was restored from 48.3% of the normal value before operation to 93.6% after operation,the lateral dislocation from 17.1% to 0.6%,the Cobb's angle on the sagittal plane from 26.5?to 3.1?,and the Cobb's angle on the frontal plane from 9.5?to 0?.The area of vertebral canal was enlarged from 44.6% of the normal value to 92.1%.There were no complications.For in- complete neurological injuries,improvement of one to two grades was made in neurological functions.Conclusion Direct reduction and fixation through pedicles of fractured vertebrae is a safe and effective therapeutic option to treat the thoracolumbar burst fracture,for it can improve the stabilization and stress distribution.

To evaluate the influence of phacoemulsification on corneal endothelium of senile cataract with lupus nephritis (LN).
●METHODS:This clinical trial involved 40 cataract patients with lupus nephritis (40 eyes), and 50 cases (50 eyes) without lupus nephritis. All of them underwent phacoemulsification+lOL implantation. The parameters of corneal endothelial cell including central corneal endothelium cell density ( CED ), average area of endothelial cell ( AVE) and coefficient of variation ( CV) were recorded by corneal endothelial microscope pre -operation and at one month after operation. The data were analyzed by SPSS 13. 0 statistical software.
● RESULTS: Both LN group and control group, the morphology of coneal endothelial was statistical significant differences between pre - operation and 1mo postoperation. The CED was lower, AVE and CV were higher ( P < 0. 05, respectively). A significant decrease in CED was seen in the LN group than did in the control group (P < 0. 05). Compared to control group,the post -operative AVE and CV in LN group was significantly increased (P<0. 05).
● CONCLUSlON: The corneal endothelial cell in lupus nephritis patients is more fragile. Safe and reliable operation should be selected for these patients.

ObjectiveTo investigate the epidemic situation of brucellosis in Datong city, and to provide scientific evidence for making appropriate prevention and control measures. MethodsSurveillance data of human brucellosis in 7 countris and 4 districts in Datong city between 2006 and 2009 were collected, throng the national network straight quote system in an infectious diseases. Excel database was established and all data were statistically analyzed. Incidence of brucellosis in local population was analyzed. The regional distribution, time distribution,occupation, age and sex distribution were analyzed. Epidemic characteristics and trend of brucellosis in Datong city were summarized. Results A total of 5195 cases of brucellosis patients in Datong were found between 2006 and 2009, the average incidence rate was 57.51/10 million. All counties had the disease, and the onset of the disease mainly in the spring and summer. Most cases were young males. Farmer case was 81.67％(4243/5195) of the total patients. ConclusionsFrom 2006 to 2009, epidemic characteristic of Datong human brucellosis ishigh-low-high(incidence). We suggests the Department concerned to strengthen the prevention and control of the disease in some counties, focusing on spreading of disease prevention and control knowledge among farmers and increase their self-protection awareness.

Objective To investigate the protective effect and possible mechanism of adiponectin (ADPN) and its receptors in diabetic nephropathy (DN). Methods A total of 64 Sprague-Dawley female rats were equally divided into diabetes mellitus (DM) group with streptozotocin(STZ) 60 mg/kg injection, and normal control (NC) group with the same dose of citric acid buffer randomly. At the end of 2, 6, 10 and 12 weeks, weight, fast blood glucose, 24-hour urinary albumin excretion, serum creatinine and serum fast blood insulin were measured. The level of adiponectin in urine and serum was examined by ELISA. The pathological change of kidney tissue was studied by periodic acid-Schiff's staining (PAS) and the expression of adiponectin receptor 1 (adipoR1), adiponectin receptor 2 (adipoR2) was determined by immunohistochemistry.The NRK-52E cells were cultured with 5 mmol/L glucose (control group), 30 mmol/L glucose (high glucose group), 30 mmol/L glucose+different concentrations of adiponectin (1 mg/L, 5 mg/L, 10 mg/L, ADPN groups), respectively. The mRNA expression of monocyte chemoattractant protein 1 (MCP-1) was measured by RT-PCR after 12 h. Results (1)Both in urine and serum, the levels of ADPN in DM group were higher than that in NC group after 6 weeks (P＜0.01) and increased gradually during the whole experiment. (2)Compared with NC group, the expressions of AdipoR1 and AdipoR2 in kidney tissues were elevated gradually in DM group. There was a significant positive correlation of ADPN with AdipoR1 and AdipoR2 in DM group(r=0.666, P＜0.01;r= 0.684, P＜0.01). (3)The expression of MCP-1 increased in high glucose group, but decreased in 1 mg/L, 5 mg/L, 10 mg/L adiponectin group. Conclusions The level of ADPN in urine and serum is positively correlated with its receptors and elevates with the process of diabetic kidney disease. High level of serum adiponectin plays a protective role through the direct action of AdipoR and the alleviation of MCP-1 expression in renal tubules.

The effects of Guizhi Fuling capsule and its active ingredient combination within different concentration on SPL proliferate were observed by MTT method. The ratio of CD80/86, CD3CD25 and CD3CD69 was used to evaluate cell activation effects of Guizhi Fuling capsule and its active ingredient combination by FCM. Guizhi Fuling capsule with concentration of 400 mg · L(-1)can promote spleen lymphocyte proliferation, as well as the active ingredient combination, which showed the obvious dose-effect relationship. Compared with control group, the difference has statistical significance (P≤0.01). The result of FCM showed that Guizhi Fuling capsule and its active ingredient combination can promote CD80 and CD86 expression on spleen lymphocyte, and also can increase CD25 and CD69 ratio between spleen CD3+ cells. Compared with control group, the difference has statistical significance (P≤0.01). Thus, Guizhi Fuling capsule and its active ingredient combination may have immune-modulate effects, and the mechanism may have a close relationship with the lymphocyte activation.
Animals ; Capsules ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Immunologic Factors ; pharmacology ; Lymphocyte Activation ; drug effects ; Male ; Mice ; Mice, Inbred BALB C ; T-Lymphocytes ; drug effects ; immunology

Objective: To observe the effects of manganese( Ⅲ ) meso-tetrakis (N, N'-diethylimidazolium-2-yl) porphyrin (MnTDM) in treatment of early Parkinson's disease(PD) mouse model induced by subcutaneous injection of 1-methyl-4-phenyl1, 2, 3, 6-tetrahydropyridine(MPTP) and to discuss its possible mechanism. Methods:Forty male C57BL/6 mice were evenly randomized into 4 groups: MPTP model group(subcutaneous injection of 25 mg/kg MPTP for 3 days), MnTDM+ MPTP group (15 mg/kg MnTDM was subcutaneously injected 1 h before MPTP injection), MnTDM control group, and normal saline group. Performance of animals in the pole and swimming test was observed 3 days after the last injection. Levels of dopamine (DA) and its metabolites(3,4-dihydroxyphenylacetic acid [DOPAC] and homovanillic acid [HVA]) in the striatum of animals were measured by high-performance liquid chromatography with an electrochemical detector(HPLC-ECD). Thiobarbituric acid (TBA) method was used to examine the levels of malondialdehyde(MDA). Results: Acute injection of MPTP could be used for establishment of PD model. The striatal levels of DA, DOPAC and HVA in MPTP group were significantly lower(P＜0.01)and the striatal level of MDA was significantly higher(P＜0.05) than those of the control group. MPTP had no obvious effect on the behavioral performance of the animals in a short term. MnTDM could partly inhibit the above effects of MPTP. Compared with MPTP group, MnTDM+ MPTP group had significantly higher DA, DOPAC, and HVA levels and significantly lower MDA level(all P＜0.05). There was no significant difference in the behavioral indices of animals between the 4 groups. Conclusion:MnTDM can inhibit lipid peroxidation and promote DA production; it has preventive and therapeutic effects on MPTP induced PD.

?AIM: To evaluate the effects on recovering of corneal wound and postoperative discomfort of different methods for primary pterygium.?METHODS: Forty-seven cases ( 60 eyes ) of primary pterygium were excised under microscope with limbal epithelial transplantation, with sharp dissection ( 24 cases, 30 eyes, Group A) and blunt dissection (23 cases, 30 eyes, Group B).All cases were followed up for 1d to 1mo.?RESULTS: The recovering of corneal wound was better in Group B on 1st day and 3rd day after surgery.Pain, photophobia and tears, foreign body sensation were more serious in group A on 1st day after surgery with a statistically significant difference (P=0.005,0.015,0.012). Pain, photophobia and tears, foreign body sensation were more serious in Group A on 3rd day after surgery with a statistically significant difference ( P=0.019,0.018, 0.015).There was no statistically significant difference on 1wk and 1mo after surgery (P>0.05).? CONCLUSION: Compared with sharp dissection, primary pterygium excised with blunt dissection can significantly improve recovering of corneal wound and postoperative discomfort.