This article discusses the ethical problems which appear when medical laboratory technicians deal with all kinds of interpersonal relations in the field of medicine from the point of present medical service.It advocates that medical staff should possess professional morality and the sense of duty and calls for humane spirits to set up a brand-new mode of medical ethics.

Objective To investigate problem-based learning(PBL)in clinical teaching of pediatric interns.Methods To compare and analyze the grades of pediatric interns’case writing before and after PBL.Results There was significant difference between the two groups and the grades of interns by PBL were notably higher.Conclusion PBL can improve the interns’ability of case writing,clinical thoughts,operation ability,and enhance their enthusiasm in learning.

Objective Study on fetomaternal immuno state and RHD type of a pregnant woman of weak D phenotype.MethodsThrough polymerase chain reaction (PCR)、direct genomic DNA sequencing and flow cytometry.ResultsIn both sequence specific promer (SSP) PCR and the sequencing PCR tests, the sample was detected negative in exons 3 6 of the RHD gene, whereas all other exons (exons 1 2,7 10) were tested positive. And the sequence of detected exons (exons 1 2,7 10) are the same with normal RHD in GenBank (accession no. AJ299020 1 and AJ299026 9). Serologically and genetically, the sample can be designated as D category VI type Ⅲ. Through a duce tube PCR method, the RhD zygosity of this individual was typed CD VI e/cde。In flow cytometry, a few fetal erythrocytes were detected in peripheral blood of the mother. However there were no anti D detected in sera and hemolytic disease of the newborn(HDN) observed at all.ConclusionSevere cases of HDN have occurred in D positive babies born to partial D mother with anti D, although HDN don't take place in this case. We may still consider D VI phenotype individuals as D positive donors and D negative receiptions in our transfusion practice and in clinical anti D allo immune prophylaxis and monitoring.

Objective To gain purified platelets for further research of the immune function of platelet.Methods Platelets were purified by positive(MS) and negative(LD) magnetic cell sorting(MACS) separation.The percentage of activated platelets was detected by flow cytometry and nucleated cell clearance was evaluated by white cell count.Results The percentage of activated platelets before separation was(2.39?1.10)%,and increased to(2.56?1.08)% and(16.76?4.04)%,respectively,after MS and LD MACS.The clearances of nucleated cells after MACS MS and LD were(98.44?0.24)% and(98.47?0.18)%,respectively.The recovery rate of purified platelet after MS and LD was(76.50?1.49)% and(79.20?2.61)%.Conclusion MACS LD method was more suitable for the platelet purification.

Objective The purpose of this study was to discuss the effect of visible light therapeutic equipment accompanied with electrolyzed-oxiding water (EOW) on pressure ulcer above the second phase. Methods We divided 44 patients with pressure ulcer above the second phase into the test group (23 cases, 28 spots) and the control group (21 cases, 25 spots). The test group received local decompression, debridement with EOW, exposure to visible light for 20 minutes, 10 times per day. The control group adopted local decompression, debridement with normal saline and local application of burn cream, 3 times per day. Results The effective rate of the test group was apparently higher than that of the control group (P<0.05). The healing time was also shorter than that of the control group (P<0.01). Conclusion Treatment of pressure ulcer above the second phase with visible light therapeutic equipment accompanied with electrolyzed-oxiding water proved to be an effective treatment method.

Objective To explore the expression and significance of 25-hydroxy vitamin D [25(OH)D] in rheumatic disease patients,and its association with the risk of cardiovascular disease (CVD).Methods The level of 25(OH)D,bone mineral density (BMD) test and clinical indicators of 134 rheumatic disease cases were analyzed retrospectively.T test was used for statistical analysis.Results Patients who were combined with CVD and rheumatic disease,the level of 25-hydroxy vitamin D was (13±8) ng/ml,who were without CVD the level was (14±8) ng/ml.There was no significant difference between two groups(t=0.638,P＞0.05).But patients who were complicated with CVD and rheumatic diseases,their TC,TG,high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),apolipoprotein (Apo) A,ApoB and lipoprotein levels were higher than patients who were without CVDs (t=3.314,3.397,3.092,2.159,3.621,2.011,2.066,both P＜0.05),and their BMD was lower than patients who were without CVDs (t=-16.131,P＜0.05).Conclusion To a certain extent,serum 25(OH)D levels of patients with rheumatic diseases is associated with CVD.

Objective A computerized clinical scenario imitating patients and clinical course variation for situation simulating teaching were established due to lack of typical patients,inadequacy of resourees in pediatric teaching probation and simplification in traditional teaching pattern.Methods Data of clinical typical patients were collected and recorded into video,and then these data were synthesized and put into computer,designing a computerized clinical setting imitating patients' set.216 uodergraduate students from grade 2008 were randomly divided into 2 groups.The patients in experimenial group were taught with computerized clinical scenario imitating patients,while traditional clinical probation in the hospital ward was carried out for those in the control group.Examination and questionnaire survey were performed at the end of the study.t test was used in statistical analysis.Results Comparison between the two groups using questionnaire survey showed that the learning motivation encouragement,active participation in teaching,guidance of clinical logical thinking and judgment,improvement of clinical thinking capacity,acceptance rate in classroom,preference rate were better in the experimental group than those in the control group (P ＜0.05).Student's performance in examination in the experimental group was higher than those in the control group ( P ＜ 0.05).Conclusion Teaching with computerized clinical scenario imitating patients is a teaching method closely related to clinical situation.It can significantly activate student's learning enthusiasm,improve clinical thinking and judgment capability,avoid risk of medical care and establish a new teaching setting for clinical pediatric teaching.

Objective To investigate the role of Toll-like receptor4 (TLR4) activation in spinal cord in a rat model of persistent postoperative pain evoked by skin/muscle incision and retraction(SMIR).Methods Ninetysix male SD rats weighing 200-250 g were randomly divided into 4 groups(n =24 each):group sham operation; group SMIR; group SMIR + IT scramble siRNA and group SMIR + IT TLR4siRNA.The rat model of persistent postoperative pain evoked by SMIR was established according to the method described by Flatters.The TLR4 siRNA were administered intrathecally for 7 days starting from 1 day beforc surgcry.Pain behavior was assessed by paw mechanical withdraw threshold (MWT) to Electronic von Frey Anesthesiometer stimulation at 1 day before and 1,3,7,12,and 22 days after operation.Four animals were sacrificed at each time point in each group for detection of the expression of TLR4 protein in the spinal cord by Western blot analysis.Results Compared to group sham group,MWT was significantly descreased at 3,7,12,and 22 days after operation,while the expression of TLR4 protein in the spinal cord were significantly increased at 3,7,12 days after operation in group SMIR and group SMIR + IT scramble siRNA ; IT TLR4siRNA significantly attenuated the hyperalgesia induced by SMIR and descreased the expression of TLR4 protein at 3,7,12 days after operation in group SMIR + IT TLR4siRNA.Conclusion TLR4 activation in spinal cord plays an important role in the development of SMIR-evoked persistent postoperative pain in rats.

BACKGROUND: Hyperlipemia is one of the important risk factors of coronary atherosclerotic cardiopathy. Great attention has been paid on how to explain the correlation between blood lipid and coronary heart disease and the correlation of characteristics and level of blood lipid with coronary heart disease.OBJECTIVE: To probe into the correlation among the characteristics, the level of blood lipid and coronary heart disease in senile people.DESIGN: Case-control observation and stratified analysis.SETTING: Second Cadre Ward of General Hospital of Shenyang Military Area Command of Chinese PLA.PARTICIPANTS: Totally 105 inpatients were selected in coronary heart disease group, diagnosed as coronary heart disease, tallied with WHO Diagnostic Standard on Coronary Heart Diseases, in Second Cadre Ward of General Hospital of Shenyang Military Area Command of Chinese PLA from January 2001 to January 2002. Totally 99 inpatients, by checked, without coronary heart disease and cerebral vascular disorder were selected in the control in the same period.METHODS: 2 mL venous blood was collected in fasting in the morning and the serum was collected after centrifuged at 3 000 r/minute, for 5 minutes. Auto-biochemical analyzer and enzyme kit were used to determine cholesterol, triglycerin, high density lipoprotein cholesterol and low density lipoprotein cholesterol. Compared with the data in the control, the ranges of cholesterol, triglycerin and low density lipoprotein were calculated successively and divided by 10; at the class intervals of 0.53, 0. 39 and 0.29 mmonl/L, the frequency table was worked out. According to the frequency table, P25 (the 25th percentile), P50 (the 50th percentile), P75 (the 75th percentile) and P90 (the 90th percentile) of cholesterol, triglycerin and low density lipoprotein cholesterol were calculated successively. The stratified groups were divided based on P ＜ 25, P25 to PS0, PS0 to P75, P75 to P90 and ＞ P90, by which, the cases belonging to 5 groups were determined in coronary heart disease group and the control respectively. The exposure factor was determined by ＞ P90, compared with other 4 groups, Menta-Haensecel method was used to calculate x2. If the exposure factor was related with coronary heart disease, the relevant coefficient and 95% confidence interval should be calculated. In accordance with the standards (Proposal on Prevention of Abnormal Blood Lipid and Targets of Abnormal Blood lipid on 2-grade Prevention of Coronary Heart Disease), the cases beyond the targets and morbidity were determined in two groups.MAIN OUTCOME MEASURES: Determination of blood lipid, abnormal cases and morbidity in two groups; cases beyond targets of blood lipid and morbidity; stratified comparisons of percentiles in two groups.RESULTS: According to intention measurement, 204 cases entered result and the control, there was no significant difference in cholesterol, triglycerin cases presented hypercholesterolemia, 34.3% cases hypertriglycerlipidemia and 11. 4% cases low density lipoprotein-hypercholesterolemia. It was indicated that the blood lipid was in the normal range among 64. 8% to 88.6% comparison between the cases with cholesterol ≥5.47 mmonl/L and the cases with cholesterol varied from 3.85 to 4.63 mmol/L, the morbidity of coronary heart disease in the former was 2.98 times as high as the latter (x2 = 6.29, 95% confidence interval was 1.27 -6.98) . In the comparison between the cases with cholesterol ≥ 5.47 mmol/L and the cases with cholesterol varied from 4.64 to 5.05 mmol/L, the correlation with coronary Lipid for 2nd Prevention of Coronary Heart Disease, among the patients with coronary heart disease, cholesterol ≥ 4.68 mmonl/L in 54. 2% cases,triglycerin ≥ 1.70 mmol/L in 34. 3% cases and low density lipoprotein ≥ 2.6 mmol/L in 52. 3% cases.CONCLUSION: For senile patients with coronary heart disease, the satisfactory level of cholesterol is 3.85- 4.63 mmol/L. For those with cholesterol ≥ 5.47 mmol/L, compared with those varied from 3.85 to 4.63 mmol/L, the morbidity of coronary heart disease in the former is possibly 2.98 times as same as the latter(x2 = 6.29, 95% confidence interval was 1.27 - 6.98).

Objective To investigate the effects and mechanism of zinc on airway inflammation in asthmatic rats.Methods Animal model of asthma was established by OVA challenging,zinc-deficient and zinc-supplementary diet were given accordingly.Thirty-two SD rats were divided into four groups according to weight: zinc-deficient diet with OVA challenge group(group A),zinc-supplementary diet with OVA challenge group(group B),zinc-normal diet with OVA challenge group(group C) and zinc-normal diet with saline challenge group(group D).Twenty-four hours later asthma was induced,right side lungs were harvested for HE staining to observe histomorphological changes and the respective numbers of eosinophirs,neutrophils and macrophage in the bronchial mucus were counted.The contents of interferon-?(IFN-?),interleukin-4(IL-4),superoxide dismutase(SOD),malondialdehyde(MDA) and glutathione peroxidase(GPX) in lung homogenate were detected.Results Compared with group C,the number of eosinophils,neutrophils and macrophage,and the contents of SOD increased in group A,but significantly decreased in group B(P