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 .

Objective To observe the learning and memory ability of rats after injection of Aβ25-35 protein in different concentrations into the lateral ventricle assessed by Morris water maze test, and to explore the optimal concentration of Aβ25-35 in the preparation of AD model rats.Methods Male SD rats were randomly divided into sham operated group and model group.The rats of model group received Aβ25-35 injection in concentrations of 2 μg/μL, 4 μg/μL and 8 μg/μL, respectively.According to the Rat Brain Stereotaxic Atlas, 5 μL of aggregation of Aβ25-35 was injected into the right lateral ventricle to establish the AD rat model.7 days after successful modeling, Morris water maze was used to test thechanges of learning and memory ability of the rats.Results There was no significant difference in the average swimming speed between the two groups (P > 0.05).The escape latency time of rats in the model group was significantly increasedcompared with the sham group (P < 0.05).In the model group, the escape latency time of rats treated with 4 μg/μL and 8 μg/μL Aβ25-35 was significantly increased compared with the rats injected with 2 μg/μL (P < 0.05), while there was no significant difference between rats treated with 4 μg/μL and 8 μg/μL Aβ25-35 (P > 0.05).The activity time and distance of target quadrant of the rats injected with different concentration of Aβ25-35in the model group were significantly reduced compared with the sham group (P < 0.05), but no significant difference amongthe rats treated with different Aβ25-35 concentrations (P > 0.05).Compared with the sham-operated group, the number of platform-crossing of rats injected with different doses of Aβ25-35in the model group were significantly reduced (P < 0.05).In the model group, the rats treated with 4 μg/μL and 8 μg/μL was significantly reduced compared with the group with 2 μg/μL injection (P < 0.05).There was no significant difference between the rats injected with 4 μg/μL and 8 μg/μL (P > 0.05).Conclusions The recommended dose and concentration of Aβ25-35 to be injected into the unilateral ventricle to establisha rat model of Alzheimer's disease is 4 μg/μL in a volume of 5 μL.

OBJECTIVETo investigate the inhibition effect of curcumin on the proliferation of the human esophageal carcinoma cell line Ec109 and its impact on PEN/PI3K/Akt signaling pathway.

METHODSEsophageal carcinoma Ec109 cells were cultured in vitro conventionally and were treated with curcumin at different concentrations. The cell proliferation level was examined by MIT colorimetry, the ultrastructure of curcumin-treated Ec109 cells were detected with transmission electron microscope (TEM) and cell apoptosis was observed by FCM with AnnexinV-FITC/PI double staining. The protein levels of PTEN, Akt, GSK3P and Caspase 3 of curcumin-treated Ec109 cells were detected by Western blot.

RESULTSMTT test showed that curcumin could inhibit the proliferation of Ec109 cells in a time and concentration-dependent manner. TEM examination indicated that curcumin could induce Ec109 cell apoptosis. FCM detection showed that Ec109 cell apoptotic rate increased significantly with the increase of drug concentration. On the other hand, curcumin could promote the expression of PTEN, GSK3beta and Caspase 3 yet reduce the expression of Akt.

CONCLUSIONCurcumin could obviously up-regulate the expression of PTEN, GSK3beta and Caspase 3, surpress PI3K/Akt signaling pathway and hence inhibit the proliferation of Ec109 cells.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Curcumin ; pharmacology ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Oncogene Protein v-akt ; metabolism ; PTEN Phosphohydrolase ; metabolism ; Phosphatidylinositol 3-Kinases ; metabolism ; Signal Transduction ; drug effects

Objective To explore the mechanism of deep brain stimulation(DBS)therapy to Parkinson's disease(PD).Methods We produced hemi-parkinsonian rat model with stereotaxically injecting 6-OHDA to right medial forebrain bundle(MFB)and stimulated ipsilateral subthalamu nucleus (STN)with platinum electrodes chronically to investigate the influence of DBS to the expression of Calbindin-28,synaptophysin and tyrosine dioxydase(TH)in Striatum by Western blot.In addition,slices of bilateral PD rats after DBS were stained to observe the expression of Calbindin-28 and synaptophysin in substantia nigra by Immunohistochemistry.Results High frequency stimulation impaired the rotational frequency 31% of unilateral PD rats triggered by apomophine;Long-term DBS increased the expression of TH in innocent striatum of unilateral PD rats 78.6%?9.5%,since the ipsilateral striatum(lesion side) was TH depleted by 6-OHDA insults;Calbindin-28 expression in ipsilateral striatum of hemi-PD rats raised up 75.4%?15.0% and long-term DBS reduced the effect by 43.0%?7.1%,meanwhile Calbindin-28 positive neurons in substantia nigra compacta in sham,PD and DBS rats were 74.5?10.2,75.7?15.6, 33.1?7.8.However,Synaptophysin expression in substantia nigra and striatum kept stable even after long- term DBS.Conclusions Consistent to the treatment to PD patients,DBS to STN alleviated the motor disorder of PD rats,the treatment might be based on regulating the expression of Calbindin-28 and TH.

Objective To analyze drug resistance and epidemic features of Acinetobacter baumannii in two hospitals of Rushan city .Methods Acinetobacter baumannii strains were collected from Rushan People′s Hospital and Chinese Medicine Hospital of Rushan in 2015 .Antimicrobial susceptibility test was carried out by Kirby-Bauer(K-B) method .Homology analysis were conducted by pulsed-field gel electrophoresis(PFGE) in 50 Acinetobacter baumannii strains .Results There were 158 Acinetobacter baumannii strains were isolated ,108 strains were from Rushan People′s Hospital ,50 strains were from Chinese Medicine Hospital of Rushan . 59 .9% strains was from sputum specimens .The most strains were from Respiratory department (39 .8% ) and ICU (25 .3% ) .All strains were resistant to aztreonam ,ampicillin and cefoxitin ,but sensitive to polymyxin B and tigecycline .50 strains could be divided into five types(A -E) .A typewas the predominant type ,including A1 ,A2 ,A3 three subtypes .Conclusion The resistance of Acine-tobacter baumannii was serious in the two hospitals in Rushan city .It mainly cause respiratory infections ,and could spread among different departments .The most strains were from Respiratory Department and ICU .

OBJECTIVETo investigate the molecular subtypes of 73 strains of Yersinia enterocolitica biotype 1A isolated in Shandong province by PFGE, and thereby to analyze the relationship between PFGE typing and biological characteristics.

METHODSSeventy-three strains of Yersinia enterocolitica biotype 1A were isolated from animal feces and meat products in Gaomi city and Wulian county in Shandong province from 2008 to 2009. Motility test, serum agglutination and virulent genes detection by PCR were used to learn the biological characteristics of the isolated strains. The molecular subtypes were determined by PFGE, whose relationships with motility, serotypes and virulent genotypes were also analyzed.

RESULTSOut of the 73 strains of Yersinia enterocolitica, 5 showed medium-active motility while the other 68 showed well-active motility. The dominated serotypes were O:5(17/73) and O:8(14/73), followed by O:9(5/73) and O:7, 8(1/73), and there was no O:3 serotype found. Meanwhile, 36 strains couldn't be serotyped. All the strains were negative with the gene ail, ystA, yadA and virF, yet the positive rate of ystB gene was 72.6% (53/73). The 73 strains of Yersinia enterocolitica isolated could be subtyped into 54 PFGE patterns (K6GN11SD0001-K6GN11SD0054), most of which only had 1 or 2 isolated strains, and no pattern was dominant. The strains in the same or similar cluster were from different hosts; each serotype and toxic genotype scattered in the clustering trees, without specific correlation with PFGE subtypes. 4 out of 5 strains, which showed medium-active motility, belonged to one branch, with the similarity coefficient at 80.9% - 100.0%; while all the toxic genotype belonged to type B.

CONCLUSIONBiotype 1A Yersinia enterocolitica has many clones, whose PFGE types had relations with motility, but no relations with virulent genotype and host.

Bacterial Typing Techniques ; DNA, Bacterial ; genetics ; Electrophoresis, Gel, Pulsed-Field ; Genes, Bacterial ; Genotype ; Meat Products ; microbiology ; Yersinia enterocolitica ; classification ; genetics ; isolation & purification

OBJECTIVETo sum up the experience in treating very severe traumatic brain injuries.

METHODSRetrospective analysis of 68 patients with very severe traumatic brain injuries treated in our hospital from 1997 to 2002 was done.

RESULTSForty-one (60%) patients died. In the 50 patients treated surgically 27 (40%) survived, 8 recovered well, 9 had moderate disability and 10 had severe deficits. The 18 patients treated non-operatively all died.

CONCLUSIONSMuch attention should be given to the observation of the changes of severe brain injuries with cranial base injury. Timely operative decompression, basic life support, keeping effective brain blood perfusion and effective oxygen supply, improving cerebral microcirculation and preventing or controlling complications are the main methods to raise the successful rate of treating very severe brain injuries and the life quality of the patients.

Adolescent ; Adult ; Aged ; Brain Injuries ; diagnosis ; mortality ; therapy ; Cohort Studies ; Combined Modality Therapy ; Craniotomy ; Critical Care ; methods ; Decompression, Surgical ; Drug Therapy, Combination ; Female ; Glasgow Coma Scale ; Humans ; Injury Severity Score ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Oxygen ; therapeutic use ; Prognosis ; Retrospective Studies ; Risk Assessment ; Survival Analysis ; Treatment Outcome

OBJECTIVETo study the safety, effectiveness and feasibility of suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) in the treatment of varicocele.

METHODSThis study included 80 varicocele patients aged 24 - 44 (mean 28.5 +/- 2.6) years, 25 cases of grade I, 45 cases of grade II and 10 cases of grade III, 58 cases in the left side, 6 in the right and 16 in both sides, and all with asthenospermia. The patients were treated by SAU-LEMDS under subarachnoid anesthesia combined with general anesthesia in a supine position with a head-down-feet-up slope of 15 degrees. Two 5 mm trocars were inserted bilaterally at the umbilical edge, one with a 5 mm 30 degrees laparoscope placed in it, and another into the abdominal cavity below the pubic hairline with a 5 mm laparoendoscopic clipper placed in it. The operation procedure was similar to that of standard laparoscopic ligation of spermatic veins, with reservation of the spermatic artery and double-ligation of spermatic veins. And the procedure was repeated for the contralateral lesion in the bilateral cases. Postoperative follow-up was conducted for the incidences of orchiatrophy and testicular hydrocele and changes of seminal parameters.

RESULTSAll the operations were successful, with the mean operation time of (10 +/- 5.0) min (range 8 to 25 min) for the unilateral cases and (18 +/- 6.5) min (range 15 to 30 min) for the bilateral cases, the mean blood loss of (1.5 +/- 0.5) ml (range 1 to 2 ml), and the mean postoperative hospital stay of (2 +/- 0.5) d (range 1.5 to 3 d). The patients were followed up for 6 -24 (12 +/- 2.5) months, which showed significant improvement in sperm motility as compared with the baseline ([28.53 +/- 5.21] vs [19.62 +/- 3.56]%, P < 0.05), with 28 cases (35.0%) restored to normal. Recurrence was found in 4 cases (5.0%). Testicular hydrocele occurred in 7 cases (8.75%), but orchiatrophy in none. The scars in the umbilicus and suprapubis were invisible because of the wrinkles and pubic hair.

CONCLUSIONSAU-LEMDS is safe, effective and feasible for the treatment of varicocele. It is superior to umbilical laparoendoscopic single-site surgery (U-LESS) for its less invasiveness, simpler operation, and better cosmetic appearance.

Adult ; Asthenozoospermia ; Humans ; Laparoscopy ; adverse effects ; methods ; Length of Stay ; Ligation ; methods ; Male ; Operative Time ; Postoperative Period ; Recurrence ; Spermatic Cord ; blood supply ; Testicular Hydrocele ; etiology ; Treatment Outcome ; Umbilicus ; Varicocele ; surgery ; Veins

OBJECTIVETo evaluate the effect of testis homotransplantation in the treatment of androgen deficiency and infertility.

METHODSWe retrospectively analyzed 12 cases of testis homotransplantation.

RESULTSSurgical success was achieved in 11 cases, all with a significantly increased level of serum testosterone, and markedly improved secondary sex characteristics and sexual function.

CONCLUSIONTestis homotransplantation is highly effective for the treatment of androgen deficiency in males, but has little effect on spermatogenesis.

Adolescent ; Adult ; Humans ; Living Donors ; Male ; Retrospective Studies ; Testis ; transplantation ; Testosterone ; blood ; deficiency ; Transplantation, Homologous ; Treatment Outcome

OBJECTIVETo evaluate causes and clinical management of postoperative pain after total knee arthroplasty (TKA).

METHODSFrom January 2004 to June 2009, 41 patients (44 knees) with knee pain post TKA were treated. There were 9 male and 32 female patients aging from 51 to 84 years with a mean of 63.5 years. The diagnosis followed to Brown diagnostic system. One case of extraarticular pain was complex regional pain syndrome type 1 (CRPS-1) and underwent conservative treatment, the remaining 5 cases were treated by surgery. Three cases of joint instability, 1 case of patellar baja, 2 cases of soft tissue impingement caused by overhang of the prosthesis, 1 case of popliteal tendon impact underwent conservative treatment, the other 27 cases underwent surgical intervention. The patients were followed up and the Knee Society Score (KSS) knee score, pain visual analog scale (VAS) score were recorded.

RESULTSForty-one cases were followed up for 1 to 6 years. At the last time of follow-up, the 5 cases received surgical treatment to extra-articular pain showed VAS score as 2.5 ± 0.2, KSS clinical and functional score as 92.8 ± 2.6 and 89.0 ± 3.4. There was significantly difference compared with preoperative (P < 0.05). One case of CRPS-1 performed conservative treatment, the therapy was effective. In the infected 12 cases of intra-articular pain, 1 case received amputation, 3 cases received antibiotic bone cement insert, 8 cases received two stage revision. All infections were cured, and VAS score was 3.8 ± 0.2, KSS clinical score was 88.3 ± 4.6, function score was 85.0 ± 4.6 postoperatively, with significantly difference compared with preoperative (P < 0.05). In the 8 cases received conservative treatment in non-infected group, at the last time of follow-up, VAS score was 4.5 ± 0.4, KSS clinical and functional score was 85.4 ± 4.2 and 84.2 ± 2.3, with significantly difference compared with preoperative (P < 0.05). Fifteen cases underwent surgical treatment, at the last time of follow-up, VAS score was 3.4 ± 0.1, KSS clinical and functional score was 86.6 ± 5.4 and 87.1 ± 2.4, with significantly difference compared with preoperative (P < 0.05).

CONCLUSIONSPatients with knee pain post TKA need systematic assessment to identify the causes. Appropriate treatment due to the positive diagnosis generally lead to satisfactory results, surgical intervention with indefinite causes is strictly prohibited.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; etiology ; therapy ; Retrospective Studies