Doctor-patient communication could assist in medical diagnosing , strengthening the confidence of patients and relieving psychological pressure of the medical staff , so that it plays an indispensable role in the process of building a harmonious doctor -patient relationship .Improve the system of doctor -patient communica-tion, set up the third-party supervition of mediation system , convert the mode of thinking with a positive attitude , improve communication skills , correct use communication methods , strengthen the humanistic care and knowledge popularization .Therefore , under the medical model of people-oriented, it should shorten the distance between the doctors and the patients with heart and soul and gradually establish a new harmonious doctor -patient relation-ship with mutual respect , mutual trust , equal communication and cooperation .

Objective:To invetigate the use of targeted anticancer drugs in our hospital during 2011-2013 to provide reference for the clinical rational drug use. Methods:The utilization of anti-tumor molecular targeted drugs in our hospital during 2011-2013 was retrospectively analyzed in respect of consumption sum, DDDs and DDC. Results:The proportion of consmption sum of anti-tumor mo-lecular targeted drugs in the total consumption sum was increased year by year, and that in 2012 and 2013 was over 60%. Protease ki-nase inhibitors accounted for 41. 29%-73. 41% in the consumption sum of anti-tumor molecular targeted drugs; monoclonal antibody accounted for 19. 40%-30. 88%; the other drugs accounted for 7. 19%-27. 83%. The consumption sum and the number of receiving medication patients of rituxan and cetuximab were not synchronized well, and the patients were born the higher cost. Conclusion:The use of anti-tumor molecular targeted drugs in our hospital is increased year by year, and the oral administration of anti-tumor molecular targeted drugs is with especially wide application.

Objective: To investigate the perinatal mortality and its causes in Lishui City, Zhejiang Province, so as to provide insights into the reduction of perinatal mortality. Methods: The perinatal mortality data were collected from three designated monitoring counties (districts) in Lishui City from 2015 to 2020. The changing trend in perinatal mortality and causes of death were analyzed, and the differences of perinatal causes of death and maternal conditions in urban and rural areas were compared. Results: There were 406 perinatal deaths in three monitoring counties (districts) of Lishui City from 2015 to 2020. The perinatal mortality showed a downward trend (χ2trend=5.078, P=0.024), and the average perinatal mortality rate was 5.93‰. The top five causes of perinatal mortality were birth defects, unknown causes, umbilical cord factors, maternal factors and preterm delivery. There was significant difference in the causes of perinatal death between urban and rural areas (χ2=25.574, P<0.001); birth defects, umbilical cord factors and unknown causes were predominant in urban areas, accounting for 75.00% (138 deaths); while birth defects, unknown causes and maternal factors were predominant in rural areas, accounting for 67.57% (150 deaths). The proportion of junior high school education and below was significantly higher in rural women than in urban women with perinatal death (54.50% vs. 26.63%; χ2=32.117, P<0.001), and the proportion of more than 5 antenatal examinations was significantly lower in rural women than in urban women with perinatal death (46.85% vs. 59.24%; χ2=6.195, P=0.012). Conclusions The perinatal mortality appeared a tendency towards a decline in Lishui City from 2015 to 2020, and birth defect was the main cause. Prenatal and postnatal care and tertiary prevention should be strengthened.

OBJECTIVE:To evaluate the compatible stability of cefpiramide sodium for injection with metronidazole in-jection.METHODS:Content,color and pH value of the mixed solution at different time within6hours after mixing under room temperature were monitored.RESULTS:There were no significant changes in content,color and pH value for the mixed solu-tion determined at different time within6hours after mixing under room temperature.CONCLUSION:The mixture of cefpi-ramide sodium with metronidazole injection can be used within6h after mixing.

Objective To investigate the source of CD147 expressing cells in joint and its corelation with rheumatoid arthritis (RA),and to study the expression of CD147 on different cells of peripheral blood and joint fluid of RA patients and normal health controls.Methods The expression rate and intensity of CD147 on lymphocyte (CD3 +T),monocyte (CD14 + Mo) and neutrophils (N) of 10 active RA patients before and after treatment and 10 normal health controls′ peripheral blood and synovial fluid were studied by bicolor immunofluorescence flow cytometry.Results ① Compared with normal control,the expression intensity of CD147 on CD3 + T and CD14 + Mo were higher (P

OBJECTIVE: To analyze the utilization and tendency of TCM injections in our hospital, and to provide reference for clinical use of drugs. METHODS: Based on hospital database, the category, consumption sum and DDDs of TCM injections in our hospital during the period of 2005～2008 were analyzed statistically. RESULTS: The proportion of consumption sum of TCM injections in the total consumption sum from 2006 to 2008 were 13.06%, 9.33%, 9.97%, 9.08% respectively. The consumption sum of TCM injections was increased year by year. Stasis-removing agent for cardio-cerebral-vascular system took up the first place in the list of category of drugs, comsunption sum and DDDs. CONCLUSION: TCM injections are widely applied in our hospital. The utilization structure of TCM injections is the reasonable basically. But great importance should be attached to the safety and effectiveness of TCM injections and reasonable choice.

Objective To observe the effect of extract of Coprinus comatus on small intestinal propulsion and gastric emptying function in mice.Methods Effect of extract of Coprinus comatus at different doses on small intestinal propulsion and gastric emptying function was observed in normal mice,neostigmine-load mice and epinephrine-load mice by charcoal powder method and by modified phenol red method respectively.Results The small intestinal propulsion of normal mice was promoted by the extract of Coprinus comatus at the doses of 3.0,6.0,9.0 and 12.0 g/kg,and the gastric emptying function of normal mice was promoted by the extract of Coprinus comatus at the doses of 1.5,3.0,6.0,9.0 and 12.0 g/kg,the difference being significant as compared with the normal group (P

BACKGROUND:Culture supernatant containing myocardiocyte has been demonstrated to induce differentiation of bone marrow-derived mesenchymal stem cel s into myocardiocyte-like cel s. This may associate with some or several cytokines in the culture supernatant.
OBJECTIVE:To explore if the supernatant of myocardiocyte induces bone marrow-derived mesenchymal stem cel s to differentiate into myocardiocyte-like cel s is associated with the different cytokine content in the supernatant of myocardiocyte.
METHODS:Bone marrow-derived mesenchymal stem cel s were isolated and cultured in vitro by the whole bone marrow adherent culture. Cardiocytes were isolated and cultured by enzyme digestion. Bone marrow-derived mesenchymal stem cel s (1×108/L) and cardiocytes (1×105/L) were cultured for 72 hours and the supernatant was col ected. Hepatocyte growth factor, insulin-like growth factor 1, platelet-derived growth factor, stem cel factor, fibroblast growth factor and vascular endothelial growth factor levels in culture supernatant of bone marrow-derived mesenchymal stem cel s and cardiocytes were detected by enzyme-linked immunosorbent assay.
RESULTS AND CONCLUSION:The content of insulin-like growth factor 1, platelet-derived growth factor and fibroblast growth factor in the supernatant of cardiocytes was significantly higher in cardiocytes group compared with bone marrow-derived mesenchymal stem cel s group (P<0.01). Results indicated that insulin-like growth factor 1, platelet-derived growth factor and fibroblast growth factor in the supernatant of cardiocytes may have capability to induce bone marrow-derived mesenchymal stem cel s to differentiate into myocardiocyte-like cel s, and insulin-like growth factor 1 may serve as the main cytokine.

Objective To investigate the effect of intracoronary application of tirofiban on coronary slow flow patients with acute myocardial infarction during primary percutaneous coronary intervention (PPC1).Method It was a retrospective analysis of 187 patients with acute myocardial infarction treated with PPCI in the emergency department of Beijing Anzhen Hospital enrolled in this study from January,2008 through January,2011.The patients divided into 2 groups in terms of intra-coronary administration of tirofiban (tirofiban group) and intra-coronary use of nitroglycerol (control group).Data were statistically analyzed by using SPSS 13.0 software.Categorical variables were analyzed using x2 test and continuous variables were compared by t test.Results Between two groups,there were no differences in preoperative systolic pressure (P =0.245),the rate of TIMI flow 3 (P =0.568) after PPCI and ST segment resolution (P =0.824),LVEF (P =0.275) and in-hospital mortality (P =0.502).Compared with tirofiban group,the systolic pressure was lower and the rate of using intra-aortic counter-pulsation was higher in control group.Although the incidence of slight bleeding in the control group was lower than that in the tirofiban group,no severe bleeding was observed in both groups.Conclusions The effect of intracoronary use of tirofiban was similar to that of nitroglycerol in terms of improving slow flow of coronary artery.It could safely and effectively reduce the incidence of the coronary slow flow in the patients after PPCI,but it produced a little impact on systolic pressure.It may be a better method of choice for AMI patient with low blood pressure.

The application of continuous quality improvement program in standardized residency training examination in the central Hospital of Shanghai Jiading was introduced to inquire into the way to improve the quality of standardized training of resident doctors. Through the steps of FOCUS-PDCA, we continuously improved the examination content and quality compliance training personnel, and developed the examination process including test, training, supervision, learning and using. After the implementation of the project, the percentage of the departments that meet the residency training examination requirements has been increased from 33.3%to 100%in our hospital. The percentage of the students that passed the licensed medical skills examination was 96.6%in that year. 100%of the students passed the graduation comprehen-sive examination. Year-end evaluation showed that the students' satisfaction degree to the teachers increased from 94.5%to 98.2%. Thus, through the implementation of CQI project, we achieved the goal of promoting teaching and promoting learning.