Education should include two parts:teaching and learning.Therefore,during the course of medical ehtics teaching,if we want to get better teaching effect,besides the factor of teachers,we must make the students get interest in the studying of medical ethics and arouse the students' initiative and enthusiasm of studying.This thesis would discuss that in the following respects:enhancing the students'initiative and enthusiasm of studying;teacher's deep love for education enterprise and for students;person of exemplary virtue,example is better than precept;performing elicitation teaching method of developing the student's initiative and strictly avoiding cramming method of teaching

Objective To investigate the clinicopathologic characteristics and prognosis of triple negative breast cancer patients. Methods A retrospective analysis was performed for 1042 primary breast cancer patients admitted in the First Affiliated Hospital of Nanjing Medical University from January 2003 to December 2009.All breast cancer patients were categorized into three subgroups by immunohistochemistry:ERBB2 +,HR +/ERBB2 - and triple negative. Results Of 1042 breast cancer patients recruited,183 patients were in triple negative group.The rate of larger tumors ( greater than 2 cm in diameter) and grade Ⅲ in triple negative patients was higher than that in ERBB2 + and HR +/ERBB2 - patients (P ＜0.01 ).The positive rate of p53 status in ERBB2 + patients was higher than that in triple negative and HR +/ERBB2- patients (P ＜ 0.01 ).No significant differences were observed in other clinical variables.In survival analysis,more bone metastases were observed in HR +/ERBB2 - patients than in ERBB2 + and triple negative patients (P =0.006).However,no significant difference was observed in visceral metastases among the subgroups.There were significantly different recurrence-free survivals (RFS) among the three subgroups throughout the follow-up period ( P =0.029),the 5-year RFS of ERBB2 + was 80.3％,which was the worst in three groups. Conclusions Triple negative patients had higher rate of larger tumors (greater than 2 cm in diameter) and grade Ⅲ than that in ERBB2 + and HR +/ERBB2 - patients,while its 5-year RFS was higher than ERBB2 + patients.

Objective To detect the expressions of osteopontin (OPN) and inerleukin-18 in patients with bullous pemphigoid (BP),and to analyze their relationship with clinical and laboratory indices.Methods Enzyme linked immunosorbent assay (ELISA) was performed to quantify the serum levels of osteopontin (OPN) and inerleukin (IL)-18 in 30 patients with BP and 30 health controls.Results The serum level of OPN was statistically higher in the patients than in the healthy controls ((8.29 ± 2.76) vs.(3.88 ± 1.41 ) ng/ml,P ＜ 0.01 ),and was positively correlated with the severity of BP (r =0.658,P ＜ 0.01 ) and with some laboratory indices in the patients.Increased serum IL-18 level was observed in patients complicated by cardiovascular diseases compared with those without cardiovascular diseases ((37.49 ± 6.43) vs.(31.10 ± 5.40) pg/ml,P ＜ 0.01).Moreover,the BP patients with diabetes,tumor,hepatic and renal impairment displayed an enhanced level of serum OPN and IL-18 than those without (all P ＜ 0.05).Conclusions OPN may be positively correlated with the severity of BP,while IL-18 may be involved in the development of complications of BP.

With the widespread adoption of the internet and big data technology,the integration of"Internet Plus"medi-cal applications with traditional healthcare services has become increasingly close.This paper aims to analyze the current status of"Internet Plus"applications in outpatient healthcare at West China Hospital,Sichuan University.It covers aspects such as elec-tronic medical record writing and management,online consultation platforms,mobile healthcare applications,and the use of med-ical data.The study outlines the characteristics of the"Internet Plus"healthcare service process model,emphasizing patient-cen-tered design and the integration of remote monitoring.It also showcases the practices of healthcare institutions in this model and i-dentifies existing issues,proposing further improvement methods to enhance the transformation of medical diagnosis and service process models.

Objective To investigate the effect of etimicin combined with thymopeptide α1 on intestinal flora,circulatory function and renal function in patients with sepsis.Methods A total of 80 patients with sepsis treated in Wenzhou Central Hospital from March 2021 to June 2022 were selected and divided into control group and study group according to treatment methods,with 40 cases in each group.The control group was treated with thymopeptide α1 on the basis of conventional treatment,and the study group was treated with etimicin on the basis of control group treatment,and both groups were treated for 2 weeks.The intestinal flora,circulatory function,renal function,mechanical ventilation duration,hospital stay,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores and clinical efficacy of two groups were compared.Results After treatment,Bifidobacterium,central venous pressure(CVP),mean arterial pressure(MAP)and urine volume of patients in both groups were significantly higher than before treatment,Enterobacter,Enterococcus,Staphylococcus,Bacterioid,Obligate anaerobe,Pseudomonas,heart rate,serum creatinine and blood urea nitrogen were significantly lower than before treatment(P<0.05).Bifidobacterium,CVP and MAP of study group were significantly higher than those of control group,and Enterobacter,Enterococcus,Staphylococcus,Bacterioid,Obligate anaerobe,Pseudomonas,heart rate,and scores of APACHE Ⅱ were significantly lower than those of control group(P<0.05).The mechanical ventilation time and hospital stay in study group were significantly shorter than those in control group(P<0.05).The total effective rate of study group was significantly higher than that of control group(χ2=6.275,P=0.012).Conclusion Etimicin combined with thymopeptide α1 in the treatment of sepsis can effectively regulate the intestinal flora and circulatory function of patients,and has little effect on renal function,which is worthy of clinical promotion and application.