Objective:To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients,gathering evidence to improve the doctor-patient relationship.Methods:This study was a cross-sectional study,in which doctors and nurses in 10 hospitals of Beijing,Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews.Results:The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97,which was much lower than the patients'.The patients' socio-demographic characteristics,social economic status(SES) and behavior characteristics influence the interaction of the doctors and the patients.The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust.Conclusion:The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship.The patients' characteristics have important influence on the doctor-patient relationship.It's necessary to take action on the patients to improve the doctor-patient relationship.

Aim To explore the inhibitory effect of li-gustrazine combined with paeonol on rat liver fibrosis induced by CCl4 and its mechanisms,so as to provide new treatment strategies for liver fibrosis in clinical. Methods Cleaning laboratory male SD rats were ran-domly divided into blank control group,model group (CCl4 ),ligustrazine group,paeonol group and combi-nation group (ligustrazine+paeonol).HE staining was used to observe the pathological change.Masson stai-ning and Sirius red staining was used to observe the collagen deposition.The levels of serum ALT,AST, ALP and hydroxyproline were detected by automatic bi-ochemistry analyzer.Western blot detected the markers of liver fibrosis.HSC-T6 cell was divided into model group,ligustrazine group,paeonol group and combina-tion group.The protein and gene expression of inflam-mation and apoptosis pathway was analyzed by Western blot and real time-PCR.Results Ligustrazine com-bined with paeonol could significantly improve liver tis-sue pathology changes caused by CCl4 .It could reduce serum ALT, AST, ALP and hydroxyproline levels. Moreover,it could also inhibit liver fibrosis marker protein expression,and thus reduce the deposition of collagen fibers.The effect was better than that in sin-gle intervention group.Combination group could inhib-it the inflammatory pathways related protein expression in HSC cells and promote the apoptosis of HSC cells. Conclusion Ligustrazine in combination with paeonol has significant anti-fibrosis effect,and the effect is bet-ter than both single intervention.The effect may be due to the interference with TNF-α/NF-κB pathway in the HSC cells,which promotes its apoptosis and inhib-its the generation of extracellular matrix.

Objective To introduce the treatment efficacy of using allograft muscle ligament anatomical to rebuild anterior cruciate ligament (ACL) of knee joint under the arthroscopy.Methods Sixty-two cases patients with ACL rupture in anterior cruciate ligament reconstruction under arthroscopy.Allograft ligaments were used as graft,a bone tunnel was established in the proximal tibia and distal femur,and the graft was fixed by the extrusion screw.After the operation,the knee joint was fixed for 12 weeks,and the subjective evaluation was carried out according to the Lysholm and Larson knee score standards;in order to assess the stability of the ligament and the functional recovery of the knee joint,objective evaluation was carried out according to Lachman test in patients.Results The preoperative average Lysholm scale was (43.1±2.1) points,the final average score of 2 years after the reconstruction of the ligament was (91.0+2.3) points,there was significant difference (t=3.460,P=0.001).The preoperative average Larson scale was (41.0±2.9) points,the final average score of 2 years after the reconstruction of the ligament was (90.1±3.5) points,there was significant difference (t=3.232,P=0.001).Lachman test results were negative in 62 patients at the end of the review.No serious postoperative complications occurred,no knee infection,deep vein thrombosis and stiffness.All the patients can be completely straight 1 year after operation,knees up to 120 degrees.All patients were satisfied with the function at the end of the follow-up,no joint instability,no re-rupture occurred during the follow-up period.Conclusion Using the allogeneic single beam anatomy of anterior cruciate ligament reconstruction under arthroscopy can obtain satisfactory clinical efficacy.

Objective:To develop an HPLC method for the determination of nintedanib in rabbit plasma and study the pharmacoki-netics of nintedanib in rabbits. Methods:The separation was performed on an Agilent ZORBAX SB-C18 column. A mixture of acetoni-trile-0. 1% trifluoroacetic acid-water (35∶ 20∶ 45) was used as the mobile phase at a flow rate of 1. 0 ml·min-1. The detection wavelength was set at 286 nm. Carbamazepine was used as the internal standard and nintedanib was extracted by ethyl acetate from plasma under basic condition. Totally 6 rabbits were given 20 mg·kg-1 nintedanib with intravenous administration. The blood samples were collected from the auricular vein at different time points after the administration. The concentration of nintedanib in plasma was detected by the HPLC method. The pharmacokinetics parameters were analyzed by DAS program. Results: An excellent linear rela-tionship was obtained within the range of 0. 05-10. 00 μg·ml-1(r=0. 999 8). The intra-day RSD was 5. 55%, 4. 53% and 2. 74%and inter-day RSD was 6. 15%, 5. 45% and 3. 15%, respectively for the three concentrations(0. 10, 2. 50 and 7. 50μg·ml-1), and the relative recovery was (98. 50 ± 5. 47)%, (100. 25 ± 4. 54)% and (99. 94 ± 2. 74)%, respectively. The main pharmacokinetics parameters of nintedanib were as follows: Cmaxwas (3.01 ±0.35) μg·ml-1, t1/2 was (4.38 ±1.53) h and AUC0-t was (11.67 ± 1. 71) μg·h·ml-1 . Conclusion:The method is simple, rapid and accurate, and can be used to determine the nintedanib concentra-tion in rabbit plasma and study its pharmacokinetics. Nintedanib is fitted the first-order elimination kinetics in rabbits.

Objective To investigate the MRI characteristics of low grade fibromyxoid sarcoma (LGFMS).Methods The MRI imaging of 13 cases with operation and pathology proven low grade fibromyxoid sarcoma were retrospectively analyzed.Comparative study of the relationship between the signal,boundary,cystic,and the enhancement degree with tumor tissue components was performed.Results The tumors were located in thigh (n=7),lower leg (n=3),elbow,shoulder and upper arm (n=l for each).The average diameter of tumor was (7.01 ±2.89) cm (range from 2.5 to 12.0 cm).The tumors with maximal diameter larger than 5 cm were seen in 11 patients.All tumors had well-defined margin.Necrosis and cystic change was seen in 5 tumors,tumor compartment in 3 cases,intratumoral fluid fluid level in 2 cases,and peritumoral edema in 3 cases.T1WI showed hypointensity in 6 cases,iso-,hopointensity in 4 cases,isointensity with slightly hyperintensity in tumor center in 4 cases,heterogeneous intensity in 1 case.T2WI showed hyperintensity in 6 cases,central higher intensity in 4 cases,hyper-,iso-,hypo-intensity in 4 cases,and hyper-,hypo-intensity in 3 cases.T2WI with fat suppression sequence showed hyper-,iso-,hypo-intensity in 8 cases and high intensity solid part and much higher intensity in tumor center in 5 cases.Heterogeneous enhancement of the tumors was noted,including mild enhancement in 8 cases,moderate enhancement in 4 cases,and marked enhancement in one case.Pathological results showed that the tumors were gray and white or yellow,well-defined,and hard texture,in which 5 cases cystic degeneration with tremelloid material can be seen in 5 cases.Microscopy results showed alternating distribution of fibrous and myxoid areas.Nine cases had rosettes formation and characteristic arcuate vessels were seen in 2 tumors.Immunohistochemical results showed negative Vimentin,Desmin,and S-100 in 5 patients,while 3 patients were positive for SMA and CD34.Conclusions LGFMS has some characteristic MRI finding.Combination of MRI and the clinical findings can suggest the diagnosis of LGFMS,however,the final diagnosis depends on pathological examination.

AIM: To investigate killing effect of herpes simplex virus thymidine kinase/ganciclovior system(HSV-TK/GCV) on osteosarcoma cell and its mechanisms.METHODS: Recombinant retroviral vector (DORHyTK) containing hygromycin phosphotransferase-thymidine kinase fusion gene(HyTK) was constructed and introduced into human osteosarcoma cell line OS732 with DOTAP. DNA and total RNA extracted from HyTK expressing cells (OS732TK) were tested by PCR and RNA dot blot analysis. A chemosensitivity of OS732TK cells to GCV and "bystander effect" were measured by means of MTT colorimetric assay. Hoeschst 332258 staining and flow cytometric analysis were performed for mechanism of HSV-TK/GCV system gene therapy. RESULTS: DORHyTK was constructed successfully; the HyTK gene existed and expressed in OS732TK cells; All OS732TK cells were killed after 5 days of exposure to 5 mg/L GCV. The "bystander effect" was observed in both a high population and a low population, but the former was stronger than the latter. Hoeschst 332258 staining revealed the characteristic hallmarks of apoptosis, however necrosis also existed. Flow cytometric analysis of DNA content showed a G 0-G 1 phase blockade. CONCLUSION: HSV-TK/GCV gene therapy system showed its strong killing effects on osteosarcoma cells OS732; The phenomenon of "bystander effect" was also very apparent. GCV exposure induced both necrotic and apoptotic death in HSV-TK expressing cells, and perturbed the cell cycle. HSV-TK/GCV gene therapy system may provide a new therapeutic approach for treatment of osteosarcoma.

Objective To assess the value of CTA and DSA in neurovascular diseases.Methods 20 cases with suspected neurovascular disorders who received CTA and DSA examination between March 1999 and August 2000 were retrospectively collected.The sensitivity,specifility and accurate rate of CTA were analysed compared with DSA as gold standard.Results In 20 cases,neurovascular disorders were found in 17 on CTA.18 lesions were detected,including 6 aneurysms,9 arteriovenous malformations(AVM),2 carotid cavernous fistulae(CCFs)and 1 arterial stenosis.By contrast,19 lesions in 17 cases were detected by DSA,including 7 aneurysms,8 AVMs,2 arterial stenoses and 2 CCFs.The sensitivity,specificity and accuracy of CTA in the detection of neurovascular disorders were 90.6%,95.2% and 90.6% respectively.Conclusion 3D-CTA is a new modality with high sensitivity and specificity in the detection of neurovascular disorders.As it can be obtained simply,conveniently and safely with mild injury to the patient,CTA can be used in the diagnosis of neurovascular diseases,especially in the AVMs.

Objective: To investigate activities of lipo-related enzymes in ventromedial hypothalamic obese rats at acute phase in fed state. Methods: Female SD rats were divided into two groups, one group received bilateral electrolytic lesions of ventromedial hypothalamus(VMH), and another one was used as sham control. Samples of blood, livers, and subcutaneous, parametric and mesenteric adipose tissues ,and gastrocnemius were collected one week after VMH lesions and sham operations in fed state. Results: Serum insulin in VMH group was higher than that in sham group, meanwhile serum free fatty acids in VMH group were lower (P

Objective To investigate and confirm the value of minimal invasion of separation between specific subcutancous layers of rats.Methods Thirty-two male SD rats were randomized into four groups,group 1:normal incision plus separation beneath superficial fascia; group 2:normal incision plus subdermal separation; group 3:normal incision plus extended separation beneath superficial fascia ; group 4:extended incision plus separation beneath superficial fascia.Blood sampling was taken preopeatively,2 h,12 h,24 h and 48 h postoperatively.The increase of serum IL-6 and neutrophil elastase levels were compared between different groups.Results Compared with each other,the increase of serum IL-6 and NE levels in group 1 vs 3 and group 2 vs 4 was not different significantly (P value was 0.074,0.096 and 0.747,0.897,respectively).However,the increase of serum levels in group 1 vs 2,1 vs 4,3 vs 2 and 3 vs 4 was different significantly (P ＜ 0.01).Conclusion Operation of separating beneath superficial fascia plus small skin incision in rats conduces to relatively minimal invasion.