With the progress of our times and health standard,the professional ethics of doctor is pushed forward continuously.Basing on the modern human rights,the doctors' professional ethics is considered as moral standard,which reflects the characteristics of our society and our times.It should follow the development of society as well as the steps of our times.And this means that doctors and the like should do more business in this field.Including the following points: strengthening the capability of communication between doctors and patients,taking patients into consideration wholeheartedly,restricting the power of the doctor,ect.

The ulnar collateral ligament (UCL) of the elbow is the primary stabilizer to resist valgus stress. Its injury is common in overhead throwing athletes, mainly caused by repeated valgus forces, and can cause elbow pain and affect the career of athletes. A common treatment of ulnar collateral ligament injury for overhead throwing athletes is ulnar collateral ligament reconstruction (UCLR). At present, the UCLR techniques have been constantly improved, mainly in graft structure, incision exposure, management of the ulnar nerve, and methods of humeral and ulnar fixation. This paper is to review the anatomy and biomechanics of UCL, as well as techniques, key points, postoperative complications and rehabilitation of UCLR so as to deepen the understanding of UCLR in clinicians.

Objective To investigate the clinical distribution and the drug resistances of Pseudomonas aeruginosa (PAE) during past 3 years in the 1st Affiliated Hospital of Kunming Medical University, and to provide evidence for clinical treatment of PAE infection.Methods The isolated PAE strains from 2010 to 2012 in the 1st Affiliated Hospital of Kunming Medical University were identified and antimicrobial susceptibility tests were performed using the MIC and the KB method,and thus, the ward distribution and the drug resistance rates and the changing trend were respectively analyzed by WHONET 5.5 software, and statistically analyzed with SPSS 17.0 SOFTWARE. Results Within the three years, a total of 208 strains, 260 strains and 280 strains of Pseudomonas aeruginosa were isolated separately in 2010,2011and 2012. A total of 746 PAE strains were isolated in 3 years,in which the most common specimens were sputum (79.8%), followed by the throat swab (7.6%) and the urine (6.2%) . When it came to the ward distribution , ICU was the primary, which accounted for (32.4%), followed by the department of cadre sanatorium (27.7%), the department of respiratory medicine (12.2%) and the department of neurosurgery (6.8%) . Besides imipenem, Cefoperazone-sulbactam and aztreonam, the others were obviously in a decreasing trend in drug resistances. In 2010, 2011 and 2012, the resistances rates of imipenem were ( 65.2%) , ( 74.2%) and ( 69.5%) , respectively, the resistances rates of Cefoperazone-sulbactam were (48.0%), (48.7%) and (55.8%), and the the resistances rates of aztreonam were (72.2%), (78.2%) and (72.4%) . Amikacin,piperacillin-tazobactam,Cefoperazone-sulbactam were the most active antimicrobial agents against P.aeruginosa. Conclusions The PAE is an important source of infection, ICUs are the focus of interest for resistance monitoring and control. Antimicrobial resistance of PAE is fairly serious. Clinicians should select appropriate antibiotic therapy based on sensitivity testing.The therapeutic strategy should he adapted according to the local ecology of resistance to control the epidemic of the drug- resistance strains and hospital infection.

Objective To summarize the clinical experience of diagnosis and arthroscopic treatment of intratment of intra ular osteoid osteoma.Methods Seven patients(average 22.4 years old with range from 11～32 years)with intra-articular Osteoid osteoma who underwent arthroscopy treatment from March 2006 to June 2009 were studied respectively.Thin-section CT scanning was used to confirm diagnosis and determine surgery location.Results The time span between the appearance of clinical symptoms and confirmed diagnosis was 26.0 months on average(range from 18 to 36 months).At a mean 19-month follow-up,all patients showed significant improvements including VAS decrease,no recurrence,pain relief and normal range of motion.Conclusion The atypical clinical features and radiographic findings of osetoid osteoma might lead to the delayed diagnosis.Using arthroscopy to remove intro-articular osteoid ostema was a safe and effective way.

Objective To explore the clinical effect of percutaneous vertebroplasty (PVP) in the treatment of old unstable osteoporotic vertebral fracture.Methods Twenty cases of old unstable osteoporotic single vertebral body fracture were divided into the stable group and unstable group according to the imaging results,10 cases in each group.PVP was performed in all 20 cases.The VAS scores of waist bending activity at preoperative 30 min,postoperative 6 h,3,30 d were observed.The changes of anterior edge height of spinal body in the injured vertebral segment of erect position and horizontal position were compared before and after operation.Results The VAS score of waist bending at preoperative 30 min had statistical difference between the two groups (P＜0.05).Compared with at preoperative 30 min,the VAS scores at postoperative observation points in the two groups were significantly decreased with statistical difference (P＜0.05).The VAS scores at postoperative 6 h,3,30 d had no statistical difference between the two groups(P＞0.05).The changes of posterior edge height of spinal body in the stable groups had no statistical difference before and after operation (P＞0.05);the anterior edge height of spinal body after treatment in the unstable group were significantly changed compared with before operation,and the difference was statistically significant(P＜0.05).Conclusion Preoperative pain in the patients with unstable osteoporotic vertebral fracture is more obvious than that in the patients with stable osteoporotic vertebral fracture.But all have similar effect after PVP therapy;the postoperative height in unstable osteoporotic vertebral fracture can obtain a certain recovery after PVP.

BACKGROUND: It is a hot investigation to many scholars that how to cure and prevent renal ischemic reperfusion injury in a utility way, but the mechanism is unclear at present. The investigation indicates that aquaporiin-1 plays an important role during this process. OBJECTIVE: To research the correlation between aquaporin-1 expression and renal function change following renal ischemic reperfusion injury. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at Histology and Embryology Laboratory of Dalian Medical University from June 2007 to December 2008. MATERIALS: A total of 80 healthy female adult Wister rats were randomly divided into control group and ischemia-reperfusion group. Rats in each group were observed at days 1, 2, 3, 5, and 7 after operation, with 8 rats for each group. The ischemia-reperfusion injury was established on the left kidney. METHODS: Right kidney was removed. The left renal pedicle was freed and occlused to establish ischemia-reperfusion injury model. After 40 minutes, the blood was re-flowed. If the kidney colored from dark red to bright red within 2-5 minutes, the ischemia-reperfusion injury models were successfully established, and the thrombus was not formed in the kidney vessels. If the kidney was still dark red after 5 minutes, the thrombus was formed, and the rats were excluded from the ischemia-reperfusion group. The abdomen was sutured after 40 minutes.MAIN OUTCOME MEASURES: Rats were sacrificed at days 1, 2, 3, 5, and 7 after ischemia-reperfusion injury. Samples of urine, serum, and kidney were performed with the examinations of urine, renal function, renal pathology and morphology, immunohistological assay of aquaporiin-1, and RT-PCR assay. RESULTS: After ischemia-reperfusion injury, the rats had hydrouria, urine osmotic pressure depress, symptoms of carnine and urea nitrogen increasing. HE staining demonstrated that renal tubular epithelial cells were swelling, necrosis, and desquamate. Aquaporin-1 expression and its mRNA level was decreased; in particular, the expression and level were the lowest at day 1 after ischemia-reperfusion injury and recovered to normal value at day 5 after ischemia-reperfusion injury. CONCLUNSION: The down expression of aquaporin-1 maybe one of the important indicators to reflect renal functional changes of acute renal failure following renal ischemia-reperfusion injury.

Objective To investigate the efficacy and safety of regional citrate anticoagulation (RCA) for continuous veno-venous hemofiltration (CVVH) in patients with severe trauma.Methods Sixty-four patients with severe trauma who needed to apply continuous renal replacement therapy (CRRT) and were admitted into the department of critical care medicine in Tianjin Hospital from June 2013 to August 2015 were enrolled in the study.According to the patient's actual condition,they were divided into two groups:no anticoagulant group (29 cases) and RCA group (35 cases).The filter lifetime,after treatment the activated partial thromboplastin time (APTT),acid-base balance,free calcium ([Ca2+]i) and serum sodium (Na+) concentrations,bleeding episodes were compared between the two groups.Results The average filter lifetime in RCA group was longer than that in no anticoagulant group (hours:50.7 ± 11.3 vs.4.9 ± 1.2,P ＜ 0.01).After the end of treatment,the levels of APTT (s:30.7 ± 8.8 vs.32.1 ± 7.3),pH value (7.41 ± 0.09 vs.7.40 ± 0.07),[Ca2+]i (mmol/L:2.13 ± 0.20 vs.2.21 ± 0.17),and Na+ (mmol/L:139 ± 8 vs.141 ± 6) were ofno significant differences between the RCA group and the no anticoagulant group (all P ＞ 0.05).The incidence of clinicalbleeding in RCA group was lower than that in no anticoagulant group [2.9％ (1/35) vs.13.8％ (4/29)],but the differencewas not statistically significant (P ＞ 0.05).Conclusions RCA-CVVH is a safe and effective therapeutic method inpatients with severe trauma who need for CRRT,the stability of internal environment is not affected and no incidence ofclinical bleeding event is increased.

Anoctamin 1 (ANO1) is a kind of calcium-activated chloride channel involved in nerve depolarization. ANO1 inhibitors display significant analgesic activity by the local peripheral and intrathecal administration. In this study, several thiophenecarboxylic acid and benzoic acid derivatives were identified as novel ANO1 inhibitors through the shape-based virtual screening, among which the 4-arylthiophene-3-carboxylic acid analogues with the best ANO1 inhibitory activity were designed, synthesized and compound