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 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 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 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 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 To observe the protective effect of sufentanil pretreatment on the rats with acute gastric mucosa lesion (AGML) induced by water immersion and restrain stress (WIRS) and its effect on TRPV1 mRNA expression in the hypothalamus and gastric mucosa. Methods Thirty male Wistar rats were randomly designed into 3 groups, including the normal control group (Group NC, n = 10), the group treated with WRIS for 6 h (Group WIRS, n = 10) and the group pretreated with sufentanil (Group SF, n = 10). The model of AGML was established by the classic WIRS method , and observed for the general extent of gastric mucosal injury at WIRS for 6 hr, and calculated gastric mucosal injury ulcer index (UI) and the PH value of gastric juice; The quantification of TRPV1 mRNA expression in hypothalamus and gastric mucosa was performed using quantitative real-time PCR; In addition, the activity of super oxide dismutase (SOD) and the level of malondialdehyde (MDA) in serum were detected. Results Compared with group NC, gastric mucosal in Group WIRS was injured more seriously , and the UI and the activity of MDA were also obviously increased , but the change of SOD activity was not apparent; The TRPV1 expression in gastric mucosal decreased apparently. Sufentanil pretreatment could effectively relieve gastric mucosal injury induced by WIRS , and make the UI and the activity of MDA decreased , and up-regulate TRPV1 mRNA expression in the hypothalamus and gastric mucosa. Conclusions Sufentanil pretreatment can effectively relieve AGML induced by WIRS , which may be related to the control of oxidative stress response , the reduced gastric acid secretion , and the upregulation of the TRPV1 mRNA expression in the central and periphera nerve.

Objective To evaluate the role of p38 mitogen-activated protein kinase (p38MAPK) in the spinal cord in the development of persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR) and the relationship with Toll-like receptor 4 (TLR4).Methods One hundred and twenty male SpragueDawley rats,weighing 200-250 g,aged 2 months,in which intrathecal catheters were successfully implanted,were randomly divided into 5 groups (n =24 each) using a random number table:sham operation group (group S),SMIR group,SMIR + dimethyl sulfoxide (DMSO) group (group DMSO),SMIR + p38MAPK inhibitor SB203580 group (group SB203580) and SMIR + TLR4 small interference RNA (siRNA) group (group TLR4siRNA).The rats were anesthetized with intraperitoneal chloral hydrate 400 mg/kg.The skin and superficial muscle of the medial thigh were incised and a small pair of retractors inserted.This tissue was retracted for 1 h causing potential stretch of the saphenous nerve.2％ DMSO 10 μl and SB203580 5 μg were injected intrathecally at 30 min before operation and 1-12 days after operation in DMSO and SB203580 groups,respectively.TLR4siRNA 2 μg was administered intrathecally at 1 day before operation and 1-12 days after operation once a day in group TLR4siRNA.Mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) was measured at 1 day before operation and 1,3,7,12 and 22 days after operation.Four rats in each group were sacrificed after measurement of MWT at each time point,and the L4-6 segments of the spinal cord were obtained for detection of the expression of phosphorylated p38MAPK (p-p38MAPK) by Western blot analysis.Results Compared with group S,MWT was significantly decreased after operation,and the expression of p-p38MAPK was up-regulated after operation in SMIR and DMSO groups.Compared with group SMIR,MWT was significantly increased after operation,and the expression of p-p38MAPK was down-regulated after operation in SB203580 and TLR4siRNA groups,and no significant changes in MWT and p-p38MAPK expression were found at each time point in group DMSO.Conclusion TLR4-triggered activation of p38MAPK in spinal cord is involved in the development of SMIR-evoked persistent postoperative pain in rats.

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.

The computerized imitating system constructed by the Second Affiliated Hospital of Guangzhou Medical University contains four blocks:administration of student infomation,administration of question bank,on-line tests and administration of score inquiry.It's designed to imitate typical pediatric cases,so that the medical students may put themselves into the practical clinical scenario and solve the challenges step by step in one-direction procedure.Teaching with computerized clinical scenario imitating patients can improve students' test resuhs and activate students' learning enthusiasm significantly.It not only helps to solve the contradiction between increasing number of medical students and clinical typical teaching case shortage but also improves the clinical thinking ability of the medical students.This system can also be used as a test bank for pediatric technical skills examination.

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).