Objective　To study the alterations of surfactant protein A (SP-A) and B (SP-B) in rats in the early stage of acute lung injury induced by oleic acid. Methods　An acute lung injury model was established by injecting oleic acid into the superior vena cava of rats and the levels of SP-A and SP-B in branchoalveolar lavage fluid (BALF) were determined with Western Blot and ELISA. Results　The levels of SP-A and SP-B in BALF were significantly decreased in the injured group 1 h after acute lung injury (P<0.01) and remained low in the next 6 h. Conclusion　The levels of SP-A and SP-B were decreased in the early stage of acute lung injury. The methods used for detecting SP-A and SP-B we adopted are specific and sensitive, and might be helpful for other experimental study.

All organisms regulate their life activities through the biological clock, which makes a variety of activities regular.For example, many physiological activities such as sleep-wake cycle, temperature, heart rate, blood pressure, endocrine and metabolic activity of the kidney and liver are subject to the regulation of circadian rhythms, that is to say they are all under the control of circadian pacemaker.Physiological activity of cell cultured in vitro also possess rhythms.This paper conducts a brief overview of biological clock of cell cultured in vitro and analyzes the molecular mechanism of the biological clock of the neurons and peripheral tissue cell as well as the existing problems, which provide reference for comprehensive interpretation of the molecular mechanism of biological clock.

OBJECTIVE: To study the chemical constituents of Scirpus yagara Ohwi. METHODS: Column chromatography techniques were applied to isolate the constituents. The chemical structures of the constituents were elucidated on the basis of physicochemical properties and spectral data. RESULTS: Forteen compounds were isolated and identified as sanleng diphenyllactone (1), β-sitosterol (2), ferulic acid(3), succinic acid(4), azelaic acid(5), docosanoic acid (6), 6, 7, 10-trihydroxy-8-octadecenoic acid(7), 4, 4-dime-thyl-1, 7-pimelic acid(8), vanillic acid(9), 3, 5-dihydroxy-4-methoxy-benzoic acid(10), p-hydroxybenzaldehyde(II), 3, 4-dihydroxy-benzoic acid(12), 2, 7-dihydroxy xanthone(13) and daucosterol(14). CONCLUSION: Compounds 1-10 and 12-14 are obtained from this plant for the first time, and compounds 1 and 13 were obtained from the genus Scirpus for the first time.

Objective To investigate the mastery of clinical students' doctor-patient communi-cation skills and to assess the teaching effectiveness about the doctor-patient communication, and then propose some improvement ideas. Methods We conducted a study in students of clinical medicine of Nanjing Medical University in Grade 2009, using Objective Structured Clinical Examination (OSCE) after internship, which included graduation assessment of doctor-patient communication skills. Then we analyzed the doctor-patient communication skills and related scores of students trained in different clinical medical programs. Results The average score of doctor-patient communication skills of 549 students was (82.72±4.23), of which, the average score of 329 five-year students of clinical medicine was (81.88±4.23) and the average score of seven-year students was (83.96±3.91) in. The average score of seven-year students of clinical medicine was significantly higher than five-year students (P=0.000). Moreover, there was a significant positive correlation between the total score of OSCE and the score of doctor-patient communication skills in both five-year and seven-year students of clinical medicine (five year program students' score correlation coefficient was 0.520, P=0.000;seven year pro-gram students' score correlation coefficient 0.416, P=0.000). Conclusion The teaching effectiveness of doctor-patient communication has proved to be quite effective, and it is definitely of great significance in improving clinical students' doctor-patient communication skills. The score of the assessment of the doctor-patient communication reflects not only the training effectiveness of the communication skills, but also the comprehensive capacity.

This paper reviews and analyzes 50 articles concerning the treatment of climacteric syndrome by acupuncture and moxibustion therapries. The therapies were single acupuncture, acupuncture combining other methods, auricular-plaster therapy, and some other therapies. Clear diagnostic criteria were found in 39 articles, and the most common-used criteria were Combination of TCMand Western Medicine Diagnostics and Therapeutics, Kupperman Index Scoring and Criterion of Diagnosis and Treatment Effect of TCM Diseases and Syndrome. All together 2946 cases were treated, and the therapeutic effect rates ranged from 58.1% to 100%. There were control group in 16 articles. The syndromes have been classified as 27 types in 15 articles, including type of yin-deficiency of the liver and the kidney, yang-deficiency of the spleen and the kidney, yang-deficiency of the kidney, yindeficiency of the kidney, disharmony between the heart and the kidney, and the liver stagnation, etc.Some effects have been got in treating female climacteric syndrome with acupuncture and moxibustion therapy, however, there were fewer strict randomized controlled trials (RCT).

Objective To study clinical results of arthroscopically assisted mini-open rotator cuff repair.Methods Twenty-two patients with rotator cuff tears were treated with arthroscopically assisted mini-open rotator cuff repair from March 1999 to March 2004.Thirteen patients underwent arthroscopic inspection,mini-open subacromial decompression,and rotator cuff repair.Nine patients underwent arthroscopic subacromial decompression and mini-open repair.The UCLA scoring system was used for outcome assessment.Results The 22 patients were followed for 12-72 months(mean,47 months).The UCLA scores were increased from 14.8?3.8 preoperatively to 32.0?4.7 postoperatively(t=15.086,P=0.000).The results were classified as excellent in 7 patients,good in 13 patients,fair in 1 patient,and poor in 1.Twenty patients were satisfied with the operative outcomes.Conclusions Arthroscopically assisted mini-open rotator cuff repair is an effective procedure for rotator cuff tears,with simplicity of performance and little invasion.

Objective To discuss the diagnosis and treatment of partial-thickness rotator cuff tears.Methods A total of 14 cases of partial-thickness rotator cuff tears from April 1999 to January 2004 were surgically treated in this hospital.Before operation,X-ray examinations at anteroposterior view and at scapular outlet view were conducted in all cases,B-ultrasonography was conducted in 11 cases,and magnetic resonance imaging(MRI) or magnetic resonance arthrography(MRA),in 14 cases.Subacromial decompression and tear debridement was performed in 5 cases,while subacromial decompression and rotator cuff repair was performed in 9 cases.The University of California Los Angeles(UCLA) shoulder scoring system was used to evaluate the outcomes.Results The partial tears were identified at bursal-side in 7 cases and at articular-side in 7 cases.The 14 cases were followed for 1~6 years(mean,38 months).The UCLA scores were elevated from 15.9?3.9 preoperatively to 30.9?5.2 postoperatively(t=15.000,P=0.000).The curative results were classified as "good" in 13 cases and "poor" in 1 case.Conclusions Arthroscopy is a reliable method for the diagnosis of partial-thickness rotator cuff tears,which can be effectively treated with rotator cuff repairs.Arthroscopic repair gives little invasion and quick recovery.

Firstly the authors expound the management attribute of hospital management ethics, clarifying the connotation of hospital management ethics, the basic issues in the study of hospital management ethics, and the eight functions, tasks and goals of hospital management ethics. Secondly they discuss the relationship between hospital management and hospital management ethics. Thirdly they offer a preliminary account of the application of hospital management ethics in hospital management: ①illustrating via a diagram the application of hospital management ethics in hospital decision-making; ②presenting ways of judging “good” and “evil” activities in the hospital; and ③describing the application of hospital management ethics to the monitoring and assessment of medical programs. Finally they propose some methods for cultivating the capability of the entire staff of the hospital to fulfill the obligations of moral excellence.

The authors give an account of the changes in both internal and external environments that hospitals confront in the new century, emphasizing that it is imperative for hospital managers to manage their hospitals with new concepts and means so as to meet the needs of the times. The paper is focused on 10 ways of management, namely, knowledge management, human resources management, operational management, efficiency and benefit management, new medical quality content management, fuzzy management, information management, image management, humanistic management, and hospital culture management.

The activity of colony stimulating factor ( CSF) in the conditioned medium ( CM ) was studied with combination method of 3H-TdR incorporation assay and agar colony assay. These two assays were demonstrated to be replaceable each other. The mice were administered with nontoxic monophosphoryl lipid A(MPLA) which was derived from a Re mutant of Salmonnella Minnesota Re595. The results showed a significant elevation of CSF in the serum and reaching the top at 12th h and returning to normal by 24th h. There is a significant dose-resoonse relationship. The CSF was induced with accompany of formation of colony inhibiting factor (GIF), some of which were heat sensitive factors. It is suggested that the MPLA may be a potent CSF-inducer.