This study explores the association between physician-patient communication and healthcare service quality,and relevant factors.The physician-patient communication belongs to medical behaviors,and plays a key role in the improvement of physician-patient relationship and the overall healthcare service quality.The consults of physician-patient communication were affected by many factors including physicians' attitude,and usage of words and behaviors,in which the positive attitude and behaviors are key solution to the improvement physician-patient relationship.Therefore the urgent matters are to strengthen standardized management of physician-patient communication,and set up related regulations and effective measure.

Reference for clinical medical education reform is provided through discussion on the research status quo of competency model,the basic information of clinical teachers in medical colleges in China,and the importance and significance of constructing competency model for clinical teachers.

Oxidative stress play a key role in the pathogenesis of diabetic peripheral neuropathy.Reactive oxidative species(ROS), derived from hyperglycemia through abnormal mitochondrial electron chain and NADPH oxidase et al, may damage lipids, DNA, and proteins by oxidation.ROS can also promote other classical mechanisms of diabetic peripheral neuropathy, and further cause apoptosis of neurons and Schwann cells, or inflammation of nerve tissue, and finally lead to nerve injury.The relationship between oxidative stress and mechanisms of diabetic peripheral neuropathy was reviewed in this article, in order to get a clue for more effective treatment strategies.

Objective To establish an HPLC method for content determination of Ginsengnoside Rg1, Ginsengnoside Rb1 and Notoginsenoside R1 inTianqi Tongjing Capsule.Methods An Agilent ZORBAX SB-C18 column (4.6 mm × 250 mm, 5μm) was used. The mobile phase was composed of acetonitrile (A) and water (B) with gradient elution (0-20 min, 19%→21%A;20-50min, 21%→36%A) at a flow rate of 1.0 mg/mL;the wavelength of detector was 203 nm;the temperature of the column was 25℃.Results The calibration curves of Ginsengnoside Rg1, Ginsengnoside Rb1 and Notoginsenoside R1 showed good linearity within the range of 0.442 4-3.981 6μg (r2=1.000 0), 0.524 8-3.673 6μg (r2=0.999 4) and 0.203 2-1.016μg (r2=0.999 2), respectively. The average recoveries (n=9) were 99.49%, 99.02% and 99.98%, and RSD were 2.44%, 2.45% and 2.14%, respectively.Conclusion The method is simple, reliable, rapid and with good repeatability, and can effectively control the quality ofTianqi Tongjing Capsule.

Objective]Summarizing the thinking and experience for pediatric diseases of Zhi Yu QiaoKe. [Method]Analyse and induce the contents of“Clear-headed of Pediatric”, which was written by Zhi Yu QiaoKe ,elaborating his characteristics in treating pediatric diseases features.[Results]Zhi Yu QiaoKe amended the treatments and academic point of views, which were not conformed to the medical principles and practice proved to be errors, proposed“the differentiation of infantile convulsion of error theory”,“not hungry theory”; he considered that clinical cure, then pathogenesis diagnosis was accurate;medication must be care of primordial qi and spleen and stomach;in addition, we still should also focus on nursing and adhere to the taboo. [Conclusion]The Clear-headed Pediatric with precise arguments and appropriate classification reflects the author ’s advanced medical theory and excellent medication principle of dialectical thinking, rigorous medication principle and exquisite nursing technique, the clinical diagnosis and treatment rules and characteristics of a certain reference value for the modern clinical, worthy of promotion.

Coptis chinensis, a traditional Chinese medicine, has been found to have multiple pharmacological effects recently. Some research showed that C. chinensis has antioxidant effects, including scavenging oxygen free radicals, alleviating lipid peroxidation, enhancing activity of antioxidant enzymes, et al. C. chinensis may inhibit several classical pathological pathways in diabetes. C. chinensis is a potential medicine to prevent and treat diabetes mellitus and its complications. This review focuses on the recent research progress in the study of antioxidant effects of C. chinensis and its major contributions to diabetes treatment/therapy.
Animals ; Antioxidants ; administration & dosage ; Coptis ; chemistry ; Diabetes Mellitus ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Lipid Peroxidation ; drug effects

Adult ; Humans ; Male ; Oils ; Pneumonia, Aspiration ; chemically induced

Objective To investigate the intervention of Chinese herb Shengjiang San(SJS)for the imbal-ances of serum Th1/Th2 cells and related regulatory factors in sepsis patients. Methods Fifty-five sepsis patients were randomly divided into two groups:conventional treatment group of 27 cases and SJS group of 28 cases. Nine cases of healthy volunteers were enrolled as control group in the study. Cases of conventional group were treated with western medicine only and cases of SJS group were treated with both western medicine and Chinese herb SJS (100 mL twice one day). The therapy course of both groups was 3 days. Score of Chinese medical syndromes ,se-rum level of leukocyte count,C reactive protein(CRP)and procalcitonin(PCT),serum T-bet,GATA-3,Th1&Th2 cells in the proportion of whole CD4+Th cells and Th1/Th2 ratio were compared respectively in each group be-fore and after treatment. Results There were significant differences between SJS group and conventional group in score of Chinese medical syndromes,serum level of leukocyte count,T-bet,GATA-3,Th1&Th2 cells in the pro-portion of whole CD4+Th cells and Th1/Th2 ratio(P<0.05 or P<0.01). There were no significant differences be-tween the two groups in serum level of CRP,PCT and GATA3. Compared with control group,there were signifi-cant differences in all indicators except GATA3 of the two groups(P<0.01). Conclusion Chinese herb Shengji-ang San has an effective benefits to Chinese medical syndromes,inflammatory reaction,the imbalance of serum Th1/T2 and related regulatory factors(T-bet&GATA-3)in sepsis patients.

ObjectiveTo retrospectively analysis the role of intercostal artery reconstruction in spinal cord protection for patients with extent thoracoabdominal aotic aneurysm (TAAA) repair.MethodsFrom August 2003 to August 2010,extent Crawford Ⅱ TAAA repair were performed in 81 consecutive patients with mean age (39.4 ± 10.3) years and 61 (75.3％)were males.All the procedures were performed under profound hypothermia with interval cardiac arrest.Patientswere opened with a thoracoabdominal incision.Extracorporeal circulation was instituted with two arterial cannulae and a single venous cannula in the right atrium.T6 to T12 intercostal arteries and L1,2 lumbar arteries were formed to a neo-intercostal artery in place and were connected to an 8mm branch for keeping spinal cord blood perfusion.Visceral arteries were joined into a patch and anastomosed to the end of the main graft.Left renal artery was anastomosed to an 8mm branch or joined to the patch.The other 10mm branches were anastomosed to iliac arteries.ResultsWith 100％ follow-up,early mortality was 7.4％ (6/81),one patient was dead result from cerebral hemorrhage,three from renal failure,one from heart failure because of myocardial infarction and one from rupture of cliac artery dissection.Postoperative spinal cord deficits was 3.7％ (3/81),temporary paraplegia were observed in 2 patients and paraparesis occurred in 1 patient,but all of them were without bladder or rectum deficits.Neo- intercostal arteries were clogged in 12 patients within follow-up,and two of those patients with Marfan syndrome underwent pseudoaneurysm after intercostal arteries reconstruction.The mean survival time in this group is (54.22 ± 3.03 )months (95％ CI:44.37 months,59.90 months)with survival rate 92.37％ after 1 year,89.02％ after 2 years,85.54％ after 5 years.Three patient were dead with long term follow-up,one were resulted from cerebral hemorrhage at 20th month,one from rupture of ascending aorta at 23rd month and the last from rupture of aorta ulcer.ConclusionIntercostal artery reconstruction is a reliable method in spinal cord protection for patients with TAAA repair.It is a feasible method with acceptable surgical risks and satisfactory results.It can achieve long term result with less risk of spinal cord deficits and good quality of daily life.

Objective Retrospectively analyze the mid-term clinical results of single-stage repair of extensive aortic aneurysms with total or subtotal aortic replacement(T/STAR).This study describes our experience in this operation in single center of aortic disease at Fuwai Hospital.Methods From February 2004 to February 2011,21 patients with hypertension or Marfan syndrome underwent one-stage total or subtotal aortic replacement for aortic dissection or aortic aneurysms.16 male and 5 female,aged (34 ±9) years.Operations wore performed under circulatory arrest with profound hypothermia.Patients were opened with a mid-sternotomy and a thoracoabdominal incision.Extracorporeal circulation was instituted with two arterial cannulae and a single venous cannula in the right atrium.During cooling,the ascending aorta or aortic root was replaced.At the nasopharyngeal temperature of 20 ℃,the aortic arch was replaced with selective antegrade cerebral perfusion.Staged aortic occlusions allowed for replacement of descending thoracic and abdominal aorta.T6 to T12 intercostal arteries and L1,2 lumbar arteries were formed to a neo-intercostal artery in place and were connected to an 8 mm branch for keeping spinal cord blood perfusion.Visceral arteries were joined into a patch and anastomosed to the end of the main graft.Left renal artery was anastomosed to an 8mm branch or joined to the patch.The other 10 mm branches were anastomosed to iliac arteries.Results Early mortality was4.8％ ( 1/21 eases),the only one patient was dead result from renal failure and multiple organ failure.There were no postoperative spinal cord deficits occurred,two patients were stroked at day 5th and 7th respectively.Three patients were operated with tracheotomy because of respiratory insufficiency.Operation was undertaken on one patient with splenenctomy result of spleen rupture during first aortic aneurysms repair.All patients were follow-up,ranging from 18 to 84 months postoperatively,all 20 survivors were alive and had good functional status.One patient was reoperated with aortic valve replacement because of massive valve insufficiency after two years.Neo- intercostal arteries were clogged in 3 patients within follow-up,and two of those patients with Marfan syndrome underwent pseudoaneurysm after intercostal arteries reconstruction.Conclusion Single-stage repair of extensive aortic aneurysms with total or subtotal aortic replacement is safely and effectively.It is feasible with acceptable surgical risks and satisfactory results.It can eliminate the risk of remnant aortic aneurysm rupture in staged total aortic replacement and has satisfactory mid-term results.