Enhancing medical humanitarian activities in clinical teaching is demanded by modern medicine and education.It contains the modern values of constructing a harmonious doctor-patientrelationship and adjusting to medical education and modern medical model development.We put forward several countermeasures such as establishing concept of respect for people,improving teachers'humanistic caring ability,strengthening management to enhance students' sense of responsibility,enhancing students' doctor-patient communication skills,and abiding by relevant laws and regulations in the current situation which lacks humanistic care,doctor-patient communication and legal concept.

Assisted reproduction technologies (ART) include controlled ovarian hyperstimulation, in vitro fertilization-embryo transfer, intracytoplasmic sperm injection, in vitro maturation of oocytes, pre-implantation genetic diagnosis, etc. They have been used for the treatment of impaired fertility but may damage the health of offspring. The ART procedures may alter the epigenetic status of these offspring and DNA methylation may be a crucial mechanism. This paper summarizes epigenetic alterations in ART embryos and offspring, and discusses the risks.
Animals ; DNA Methylation ; Embryo, Mammalian ; metabolism ; Female ; Fertilization in Vitro ; Genomic Imprinting ; Humans ; Pregnancy ; Preimplantation Diagnosis

OBJECTIVEMutations of presenilin 1 (PSEN1) gene are the most frequent cause for familial Alzheimers disease (AD). This study was set to explore potential mutation of PSEN1 gene in a Chinese family featuring early-onset Alzheimers disease (FAD).

METHODSDNA was isolated from peripheral blood samples from 17 members of the FAD family as well as 10 patients with sporadic Alzheimers disease and 100 healthy subjects. With polymerase chain reaction (PCR) and Sanger sequencing, exons 113 of the PSEN1 gene were analyzed.

RESULTSDNA sequencing has revealed a heterozygous point mutation from G to A at position 1133 (Gly378Glu) of exon 11 of PSEN1 gene in 6 members from the family, among whom 5 were patients with dementia, whilst the remaining 1 was clinically normal but under onset age. The same mutation was not found in all other patients and the normal controls.

CONCLUSIONA novel missense mutation of the PSEN1 gene, Gly378Glu, probably underlies the autosomal dominant early-onset FAD in this Chinese family.

Adult ; Aged ; Alzheimer Disease ; diagnosis ; genetics ; Base Sequence ; Female ; Humans ; Male ; Middle Aged ; Pedigree ; Presenilin-1 ; genetics

OBJECTIVE: To determine the expression profile of microRNA (miRNA) in peripheral blood mononuclear cells (PBMC) and immune factors in pregnant women with hepatitis B virus (HBV) infection. METHODS: A total of 182 pregnant women infected with HBV were randomly selected, with 40 healthy pregnant women and 35 non-pregnant women as controls. High-throughput sequencing was used to detect RNA in the PBMC of all subjects. Indirect ELISA method was used to determine the changes of cytokines in peripheral blood samples. RESULTS: Compared with the control group, 18 differentially expressed miRNA were identified in those with HBV infection (P< 0.01). Among these, miR-3607-3p, miR-20a, miR-1296, miR-153-1 and miR-X4 may directly regulate the transcriptional level of target genes including IL-10, IL-18, IL-16, MCP-1, NUP50 and CCR1. Meanwhile, peripheral blood cytokines IL-10, IL-18, IL-16 and MCP-1 were significantly increased in those with HBV infection (P<0.01), with the expression level of IL-16 and MCP-1 being strongly correlated with the viral load. CONCLUSION The expression profiles of miRNA in PBMC and cytokines in peripheral blood can change significantly during pregnancy, both may be involved in the immune response to HBV infection.
Cytokines ; blood ; DNA, Viral ; Female ; Hepatitis B ; blood ; Hepatitis B virus ; Humans ; Leukocytes, Mononuclear ; metabolism ; MicroRNAs ; blood ; Pregnancy

Objective:To explore the value of a holistic communication program for inpatients developed based on the medical humanistic GLTC communication model, designed to improve patient satisfaction and medical quality, and effectively enhance doctors′ communication and clinical work capabilities.Methods:A GLTC Doctor-Inpatient Communication Program and an Inpatient Satisfaction Questionnaire for Doctor-patient Communication were customized.From August 2018 to February 2019, the communication program was used to train doctors from different departments of five tertiary public hospitals in Jiangsu province. The questionnaire was used to survey both doctors and their inpatients. 250 questionnaires were distributed each time, to compare the doctor-patient satisfaction before and after the training and influencing factors. Data so acquired were subject to descriptive analysis, t-tests and multiple linear regression analysis. Results:Since application of the program, patient satisfaction scoring was higher than that before in general( P<0.05), while the patient satisfaction for medical expenses and disease explanation communication related programs was low. The difference of both doctors and patients satisfaction scoring for doctor-patient communication was statistically significant( P<0.05). Oncologists presented a higher evaluation on the applicability of the program than those from other departments( P<0.05). Conclusions:Application of the GLTC doctor-patient communication program can effectively improve the satisfaction of inpatients. It is recommended that this communication program be integrated into the entire medical treatment of inpatients, and the implementation plan should be differentiated according to the differences of inpatients. It is necessary to strengthen the communication of medical expenses and explain medical knowledge to inpatients, while doctors′ mindset of consultation should be adapted, with the program constantly improved for higher clinical applicability.

Discipline structure, as the core of discipline construction, plays an important role in promoting the prosperity of medical humanities. By sorting out the Chinese scholars’ division of the structure of medical humanities in China, this paper preliminarily discussed the existence of the subordinate discipline of medical humanities in China, and preliminarily verified the rationality and feasibility the viewpoint of "building a first-class discipline of medical humanities under the medical category, and forming a subordinate discipline of medical humanities based on horizontal association". At the same time, this paper put forward the view that the structure of medical humanities in China should be determined according to the needs of the current social development in China, and the concepts and criteria contained in the division of the Chinese discipline catalogue, so as to pave the way for the follow-up research.

【Objective:】 To explore the cognition of medical staff in public hospitals regarding the medical humanistic service ability, and to discuss, analyze, and put forward targeted suggestions based on statistical data. 【Methods:】 A self-designed questionnaire survey was conducted among 825 medical staff randomly selected from public medical institutions in Nanjing, Central, Northern and Southern Jiangsu Province. SPSS21.0 was used to analyze the data. 【Results:】 The average score of medical staff’s familiarity with medical humanities was 3.64 points. In the cognition of the components of medical humanistic service ability, the doctor-patient communication ability accounted for the highest proportion (90.82%). There were differences in the cognition of medical staff with different demographic characteristics on the dimensions of appearance and behavior ability, doctor-patient communication ability, and patient care ability (P<0.05). The surgeon’s cognition of the importance of medical humanities was lower than that of the other four departments (P<0.05). 【Conclusion:】 Medical staff needed to improve their medical humanistic service abilities, and the cognition of humanistic differences among different categories of personnel needed to be adjusted. Public hospitals were suggested to clarify the evaluation elements and standards of medical humanistic services, and focus on solving cognitive differences to improve medical humanistic service abilities, speeding up the construction of humanistic hospitals, promoting medical humanistic service abilities. In addition, it was also necessary to improve the quality of medical humanistic education in colleges and universities through ideological and political courses.

OBJECTIVETo study the relationship between the TCM Syndrome Differentiation-types of congestive heart failure (CHF) and thyroid hormones, including triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH), and atrial natriuretic peptide (ANP), as well as cardiac function parameters, including left ventricular ejection fraction (LVEF), mean velocity of circumferentid fiber shortening (mVcf) and A peak/E peak (A/E).

METHODSOne hundred patients with CHF were divided into 4 Syndrome Differentiation-type groups, their cardiac function parameters, ANP and thyroid hormones were determined and compared with those in the 23 subjects in the control group.

RESULTSIn CHF patients with edema and blood stasis Syndrome type, the level of plasma ANP was significantly higher than that in the control group (P < 0.05); level of T3 was significantly lower than that in the control group and in CHF patients of other three (Xin-qi deficiency, Yin-deficiency and blood stasis) Syndrome groups (P < 0.01, P < 0.01, P < 0.05 and P < 0.01); levels of LVEF and mVcf were significantly lower than those in the other three Syndrome groups (all P < 0.01). Level of T4 in other three Syndrome groups significantly increased than that in the edema and blood stasis Syndrome type. A/E value showed a higher level in patients of all TCM type than that in the control (P < 0.01). Correlation analysis showed that T3 was positively correlated with LVEF and T4 (r = 0.200, P < 0.05, and r = 0.293, P < 0.01), and negatively correlated with ANP (r = -0.263, P < 0.01); T4 was negatively correlated with A/E (r = -0.226, P < 0.05).

CONCLUSIONThe lowering of T3 and T4 and increasing of ANP may be one of the important reasons for lowering of LVEF in CHF patients with edema and blood stasis Syndrome-type. The decrease of T4 may be one of the important reasons for elevation of A/E and aggravation of left ventricular diastolic dysfunction in CHF patients of all the 4 TCM Syndrome-types.

Adult ; Aged ; Atrial Natriuretic Factor ; metabolism ; Diagnosis, Differential ; Female ; Heart Failure ; blood ; physiopathology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Myocardial Contraction ; Stroke Volume ; physiology ; Thyroid Hormones ; blood ; Thyrotropin ; blood ; Thyroxine ; blood ; Triiodothyronine ; blood ; Ventricular Dysfunction, Left ; physiopathology ; Ventricular Function, Left

On August 2-4,2023,the"Third Summit Forum on'Building a Community of Shared Future for Doctors and Patients'"was jointly organized by institutions such as the Chinese Medical Ethics,the Hospital Humanities Management and Talent Training Special Committee of the China Population and Culture Promotion Association,Center for Ethical Studies of Renmin University of China,the Newspaper for China's Physicians,the China Health Law Society,the China Anti-Cancer Association,and the China Association For Ethical Studies in Harbin.The conference arranged a sub-forum for the"Seminar on the Construction of Chinese Medical Humanities",with domestic medical humanities scholars attending the conference.After heated discussions at the seminar,the Scholars'Consensus on the Construction and Development of Chinese Medical Humanities was formed.It was proposed that in the new era,it is urgent to build the medical humanities discipline,as well as lead the academic integration and development of medical humanities under the core socialist values.At the same time,for the construction of the medical humanities discipline,it is necessary to optimize the organizational mechanism,prosper and develop the overall framework of the medical humanities discipline,accelerate the construction of a professional teaching team for the medical humanities discipline,promote the establishment of a new carrier medical humanities education and teaching in cultivating morality and nurturing talents,as well as focus on solving problems related to the cultivation of medical humanities graduate students.

Assisted reproductive technology (ART) employs superovulation,culture and other micromanipulation to complete oocyte maturation, fertilization and early embryo development. Although these techniques have been successfully applied to solve infertility problems, the process may interfere in cell proliferation, differentiation and growth. The clinical and laboratory studies on the safety issue of ART are reviewed in this article. Studies found that the incidence of birth defects increased in ART offspring. Superovulation,culture and intracytoplasmic sperm injection may induce epigenetic aberrations during embryo development, which would influence the development of ART conceived children. The epigenetic susceptibility related to ART might be transmitted to subsequent generations, and the potential impact on ART offspring still need further investigation. In addition, ART treatments may also increase the risk of genetic diseases.