Objective:To understand the current situation of medical students' professional attitude,find out the exiting problems and put forward some corresponding suggestions.Methods:The medical students' professional attitude was investigated using questionnaire in Shanghai.FResults:Some medical students lacked of professional confidence;the students expected highly towards compensation benefit;the professional satisfaction was low.There existed a correlation between professional values,expect and satisfaction.Conclusions:Perfecting pre-service training is a necessary prerequisite to improve medical students' professional confidence;compensation benefit is one of the referred factors for medical students to choose an occupation;improving medical students' professional view is the foundation of long-term development of medical enterprise;the professional counterpart is the key to ensure medical students' professional satisfaction.

Objective To investigate the effect of Calcium Dobesilate Capsules in the treatment of diabetic retinopathy ( DR ) and its effect on hemorheology, vascular endothelial function and thrombin.Methods According to the random number table the 80 cases of DR patients admitted in our hospital from September 2014 to August 2016 were divided into observation group and control group, 40 cases in each group, two groups of patients were treated with conventional therapy, the observation group was treated with Calcium Dobesilate capsules.Two groups of treatment were three months.Compared of the therapeutic effects, the before and after treatment changes of visual acuity, hemorheology, vascular endothelial function and thrombin index.Results The total efficiency of the observation group 92.50% was higher than the control group 72.50% (P<0.05);After treatment, two groups visual acuity increased, and the observation group after treatment higher than the control group (P<0.05); Plasma viscosity, whole blood viscosity at high shear and low shear whole blood viscosity, erythrocyte aggregation index in two groups were decreased, and observation group lower than the control group (P<0.05);Plasma NO and ET-1 levels in two groups were reduce, and observation lower than the control group after treatment (P<0.05); After treatment, two groups PT, TT and APTT increased, and observation group PT, TT and APTT higher than the control group (P<0.05) .There were no obvious adverse reactions in the two groups during the treatment period.Conclusion The effect of calcium dobesilate capsules in the treatment of patients with DR is obvious, and it can improve hemorheology.

Objective To investigate the effect of dexmedetomidine pretreatment on the expression of caspase-12 in lung tissues undergoing one-lung ventilation (OLV) in rats.Methods Thirty male Sprague-Dawley rats, aged 6-8 weeks, weighing 180-220 g, were randomly allocated into 3 groups (n=10 each) using a random number table: two-lung ventilation (TLV) group, OLV group and dexmedetomidine group (Dex group).Bilateral lungs were ventilated for 2 h in group TLV.In OLV and Dex groups, unilateral lung was ventilated for 1.5 h followed by 0.5 h TLV.In group Dex, dexmedetomidine was infused intravenously at a rate of 3.0 μ g · kg-1 · h-1 over 60 min starting from 60 min prior to OLV.The equal volume of normal saline was given instead of dexmedetomidine in OLV and TLV groups.Peak airway pressure (Ppeak) and mean airway pressure (Paw) were recorded at 45 min of OLV and 15 min of TLV in OLV and Dex groups, and at 15 min of TLV in group TLV.The rats were then sacrificed, and left lungs were removed for microscopic examination of the pathologic changes (using HE staining) and the ultrastructure of lung tissues (with transmission electron microscope) and for determination of wet to dry lung weight ratio (W/D ratio), cell apoptosis in lung tissues (by TUNEL), caspase-12 mRNA expression (using real-time reverse transcriptase-polymerase chain reaction), and caspase-12 expression (by Western blot).Results Ppeak and Paw were significantly lower at 15 min of TLV than at 45 min of OLV in OLV and Dex groups (P＜0.05).Compared to group TLV, W/D ratio and AI were significantly increased, and the expression of caspase-12 protein and mRNA was up-regulated in OLV and Dex groups (P＜0.01).Compared to group OLV, W/D ratio and AI were significantly decreased, and the expression of caspase-12 protein and mRNA was down-regulated in group Dex (P ＜ 0.01).The pathologic changes of lung tissues were significantly alleviated in group Dex as compared with group OLV.Conclusion The mechanism by which dexmedetomidine pretreatment alleviates acute lung injury caused by OLV is associated with down-regulated expression of caspase-12 and inhibited cell apoptosis in rats.

Objective To develop a new type of Raman-enhanced substrate for rapid detection of E.coli based on label-free surface-enhanced Raman scattering( SERS) technology.Methods Stober’ s improved method was used to prepare 360 nm silica ( SiO2 ) nanospheres.Prepared gold core-silver shell nanoparticles( Au@Ag) of different size were attached to 360 nm SiO2 to fabricate the nanocomposites ( SiO2-Au@Ag ) that were characterized by transmission electron microscopy (TEM) and UV-visucl light adsorption spectra (UV-Vis).PATP was detected to select SiO2-Au@Ag with optimal SERS effect.This optimal SiO2-Au@Ag was used to obtain the sensitivity of PATP and E.coli detection after a simple mixed culti-vation.Results TEM images showed that Au@Ag aggregated with the size of Au@Ag attached to 360 nm SiO2 .UV-Vis spectra indicated that the maximum absorption of Au@Ag and SiO2-Au@Ag had a red shift with the invrease of Au@Ag size.The experiment results suggested that detection sensitivity of PATP by SiO2-100 nm Au@Ag 10 -10 mol/L, while the lowest detectable E.coli concentration was 105 CFU/ml.Conclusion The 360 nm SiO2 binding with 100nm Au@Ag exhibits great potential for SERS applications.

Objective To assess the influence of timing of tracheostomy performed on ICU patientswith mechanical ventilation support for long-term.Methods A retrospective study was carried out in 94 patients under mechanical ventilation support with tracheostomy from January 2012 to October 2014.The patients were divided into early stage group (group A) in which the tracheostomy was done within 7 days after endotracheal intubation and late stage group (group B) in which the tracheostomy was performed at above 7 days after endotracheal intubation.The differences in lengths of mechanical ventilation support (MVS),ICU stay,and hospital stay,incidence of ventilator-associated pneumonia (VAP) and mortality were compared between two groups using nonparametric statistics.Results Compared with group B,there were statistically significant reduction in duration of mechanical ventilation (7d vs.17 d;P ＜ 0.05),shorter length of ICU stay (10 d vs.19 d;P ＜ 0.05),and lower incidence of VAP (21.05％ vs.36.84％;P ＜ 0.05) in group A.There were no significant differences in hospital stay and mortality between two groups (P ＞0.05).There was a correlation between the duration of mechanical ventilation and timing of tracheostomy (R2 =0.680) and a correlation between the length of ICU stay and the timing of tracheostomy (R2 =0.662) was found.Conclusions Early tracheostomy has a significant positive impact on critically ill patients hospitalized in this ICU.These results support the tendency to balance the risk-benefit analysis in favor of early tracheostomy.

OBJECTIVE:To prepare nanostructured lipid carrier of adefovir dipivoxil(ADV-NLC),and optimize the formula-tion. METHODS:Using stearic acid and glycerin monostearate as solid lipid,oleic acid as liquid lipid,Gemini surfactant and poly-sorbate 80 as emulsifier,sodium dodecyl sulfate (SDS) as stabilizer,solvent dispersion ultrasonic method was used to prepare ADV-NLC. And using particle size,polydispersity index,Zeta potential,encapsulation efficiency as indexes,single factor test was conducted to screen Gemini surfactant-polysorbate 80 ratio,emulsifier dosage(ratio of emulsifier to water phase),drug-lipid ratio, solid-liquid lipid ratio. RESULTS:The formula was as follow as 3% emulsifier (Gemini surfactant-polysorbate 80 ratio of 1:2), 4.5% drug-lipid ratio,solid-liquid lipid ratio of 6:5. The average particle size of the prepared ADV-NLC was(48.83±2.65)nm, polydispersity index<0.3,Zeta potential was(-28.7±1.8)mV,encapsulation efficiency was(77.65±0.03)%(n=3). CONCLU-SIONS:ADV-NLC is successfully prepared,and the formulation is reasonable and feasible.

OBJECTIVE To explore the effect of plasma endotoxin on the prognosis of multiple organ dysfunction syndrome(MODS).METHODS Retrospective analysis was carried out on 60 patients of MODS.They were 23 patients in survival group and 37 patients in death group,compared the level of plasma endotoxin on the dd 1,3,5,and 7 after admitted in both groups,and analyzed the relationship between the plasma endotoxin and lethal outcome.RESULTS The level of plasma endotoxin in death group was higher than that of survival group on the dd 1,3,5,and 7(P

AIM: To study the effect of Baixiangdan Capsule (Radix paeoniae alba and Rhizoma cyperi) on expression and behavior and sex hormone of rhesus monkey with premenstrual syndrome (PMS) and liver-qi invasion. METHODS: Twenty-four young rhesus monkeys in high rank and in the ovalatory menstrual cycle were isolated and squeezed 7 h a day for 5 d by specifically designed isolating-cage. At the same time Baixiangdan Capsule orally administed was compared with the control group of Jingqianping Granule. The expression and behavior changes of rhesus monkeys were observed and evaluated by The Measure Table of Emotion Evaluation of Female Experiment Macaque. And the levels of prolactin (PRL),estradiol (E2) and progesterone (P) in serum were investigated by radioimmunoassay. RESULTS: The scores of anxiety factors of the model monkeys were higher than the normal and the serum E2,and P levels decreased and PRL level increased significantly in the control group. As compared with the model group,Baixiangdan Capsule reduced the enhancing anxiety factor scores and also could increase the lower E2 and P levels in serum obviously and decrease PRL level. CONCLUSION: The above findings suggest that Baixiangdan Capsule has good regulative effects and makes it to the normal state on the abnormal expression and behavior and serum sex hormones of rhesus monkey with PMS and liver-qi invasion.

Objective To investigate the best exposure condition for reducing the radiation dose of the chest radiography and obtaining the good quality of images. Methods With different tube voltage (kVp), tube current & time (mAs), and focus-film distance(FFD) adopted, X-ray detecting phantom was exposed by means of automatic exposure control(AEC). The dosage absorbed in skin was detected; Spatial resolution capacity, low contrast resolution capacity and low contrast sensitive degree were tested. The space and density resolution capacity were tested. The chest image quality was appraised by the way of visual observation and the measure of film density. Results The different kVp and FFD were related to the emitting skin dose (ESD), the higher kVp and the farther FFD follows the lower ESD; the higher or lower mAs has no effect on the image resolution capacity , but it had effect on image noise. The density value and seeing effect of chest film with low dose had reached good image density and needs of diagnostics. Conclusion Under the condition of 120 kVp high voltage, FFD150cm, AEC reduced density and adjusting to the processing parameters of the CR chest images, the radiation dosage of the chest computed radiography can be reduced efficiently and the good quality of images can be obtained.

In practice of forensic medicine, potential disease can be associated with fatal asphyxia in re-straint position. Research has demonstrated that nitric oxide (NO) and nitric oxide synthase (NOS) are plentifully distributed in skeletal muscle, contributing to the regulation of contractile and relaxation. In the current study, respiratory functions, indices of diaphragmatic biomechanical functions ex vivo, as well as NO levels in serum, the expressions of diaphragmatic inducible NOS (iNOS) mRNA, and the effects of L-NNA on contractility of the diaphragm were observed in sepsis induced by cecal ligation and punc-ture (CLP) under the condition of restraint position. The results showed that in the CLP12-18 h rats, respiratory dysfunctions; indices of diaphragmatic biomechanical functions (Pt, +dT/dtmax, -dT/dtmax, CT, Po, force over the full range of the force-frequency relationship and fatigue resistance ) declined progressive-ly; the NO level in serum, and iNOS mRNA expression in the diaphragm increased progressively; force increased significantly at all stimulation frequencies after L-NNA pre-incubation. Restraint position 1 h in CLP12 h rats resulted in severe respiratory dysfunctions after relative stable respiratory functions, almost all the indices of diaphragmatic biomechanical functions declined further, whereas little change took place in NO level in serum and diaphragmatic iNOS mRNA expression; and the effects of L-NNA were lack of statistical significance compared with those of CLP12 h, but differed from CLP18 h group. These results suggest that restraint position and sepsis act together in a synergistic manner to aggravate the great reduction of diaphragmatic contractility via, at least in part, the negative modulation of NO, which may contribute to the pathogenesis of positional asphyxia.