Communication and integration of medicine andphilosophy,medicine and legal science must be strengthened,and the education of philosophical qualities of medical students must be strengthened to make them adapt to the society and enterprising.

The medical jurisprudence culture is an important aspect of in the culture construction of medical universities.Education of medical jurisprudence culture is instrumental,fundamental and humanistic.In the new era,on the one hand the principle of independence must be adhered to.On the other hand,we also need international cooperation and participate actively in the globalization.We should adhere to the national entity in the construction of medical jurisprudence culture,make full use of the value of traditional Chinese culture,absorb and draw lessons from the outstanding achievement of mankind culture development,and construct an ecological and harmonious medical jurisprudence culture.

Objective To explore the correlations between quantitative parameters of dynamic contrast-enhanced MRI ( DCE-MRI) and nasopharyngeal carcinoma ( NPC) clinical stage.Methods 69 patients with NPC were selected from Oct 2013 to Oct 2015 in Shaoxing People's Hospital,39 men and 30 women,aged 39-76 years old,average 50.6 ±10.5 years old.All patients underwent clinical staging,DCE-MRI and histopathological examina-tion before treatment.Clinical stages were determined based on Chinese 2008 staging system.Value of the volume transfer constant ( Ktrans) and the extravascular extracellular space volume per unit volume of tissue ( Ve) was detec-ted by bi-compartmental pharmacokinetic model.The correlations between quantitative parameters and clinical stage were analyzed by Pearson correlation analysis.Results Mean Ktrans and Ve for NPC were (0.532 ±0.156) mL/min/100cm3 and (0.982 ±0.356),respectively.Ktrans of NPC showed negative correlation with clinical stage (r=-0.506,P=0.001),T stage (r=-0.326,P=0.014),N stage (r=-0.296,P=0.017) and M stage (r=-0.312,P=0.015),while Ve showed positive correlation with clinical stage (r=0.415,P=0.002),T stage (r=0.478,P=0.001),N stage (r=0.318,P=0.015) and M stage (r=0.346,P=0.011).Conclusion DCE-MRI quantitative parameters are significantly related to clinical stage of NPC,which has important values for clinical treat-ment and prognostic assessment.

Objective To study the protective effect of paeonol against hypoxic-ischemic brain damage of neonatal rats. Methods 36 neonatal SD rats were randomly divided into normal control group, sham group, HIBD group, and HIBD plus Pae group. The expression of cleaved caspase -3 in the damaged cortex of rats was examined by the immunohistochemical staining and the number of necrotic neurons was counted after hematoxylin-eosin staining. Results The number of the cleaved caspase - 3 positive cells in the damaged cortex of rats in the HIBD plus Pae group was significantly lower than that in the HIBD group( P < 0.05 ). The percentage of necrotic neurons was decreased in the HIBD plus Pae group in comparison with HIBD group( P <0.01). Conclusions Paeonol may take protective effect against hypoxic-ischemic brain damage.

Background Different depthes or distances are prompted with many visual cues on the flat screen.Which kind of depth cues plays a major role in the accommodation of human eyes,in addition,whether this effect exists in the different distance are still below understood.Objective This study was to research the effect of the monocular space depth perception on accommodative response at different distances,and to analyze the effect of linear perspective and size-constancy perceptual depth cues on the level and amplitude of accommodative fluctation.Methods Four groups of visual targets were designed by FLASH software and placed at the front of eyes with the distance of 50 cm or 33.3 cm,representing static change from far to near and dynamic change from far to near,from near to far respectively.Twenty-six healthy volunteers aged 22-26 years were included in this study,with the spherical power of (-4.06± 1.99) D and cylindrical power of (-0.38±0.41) D under the informed consent.The accommodative response and accommodative fluctuations during monocularly watching the targets were recorded at 5 times/second by Grand Seiko WAM 5500 automatic infrared refractor.This study was approved by Ethic Committee of Wenzhou Medical University,and written informed consent was obtained from each subject before entering the study group.Results At the distance of 50 cm,the accommodative response caused by the depth perception of near was (1.52±0.46) D,the one of distance was (1.37±0.46) D,with a significant difference of 0.15 D under the combined effect of linear perspective and size-constancy (P =0.016).The accommodative response caused by the depth perception of big car was (1.43 ± 0.35) D,and the one of small car was (1.43 ± 0.36) D,without statistically significant difference under the effect of size-constancy alone (P =0.467).At the distance of 33.3 cm,the accommodative response caused by the depth perception of near was (2.40±0.53)D,and the one of distance was (2.35 ±0.51) D,without significant difference under the combined effect of linear perspective and size-constancy (P=0.379).The accommodative response caused by the depth perception of big car was (2.38±0.48)D,the one of small car was (2.39±0.52)D,without statistically significant difference under the effect of size-constancy alone (P =0.820).In addition,the total curve of accommodative microfluctuation showed apparent fluctuation periodically caused by the distance perception involving linear perspective only.Conclusions Monocular space depth perception has some impacts on the accommodative response at certain distance.Linear perspective,which is one of the depth cues of space perception,plays a major role in the accommodative response.Compared with the size-constancy,linear perspective can provide depth perception at higher level.The size-constancy has a little or contrast impact to the accommodation,because it depends on the assistance from other depth cues like linear perspective.

Objective:To identify the differences in clinical manifestations between Chinese giant cell arteritis (GCA) patients and polymyalgia rheumatica (PMR) patients.Methods:Twelve GCA patients were included during September 2010 to September 2019 in our hospital. Clinical and laboratory data were collected. Twenty-four age and sex-matched pure PMR patients were selected as control. Statistical analysis was performed using Statistical product and service solutions (SPSS) software. The categorical variables were tested by chi square test, and the continuous variables were expressed by mean and standard deviation ( ± s). The comparison between groups was conducted by t-test. P<0.05 was considered statistically significant. Results:In these 12 GCA patients, the onset age was 55-70 (67±7) years old, and male to female ratio was 1∶11. The most common initial symptom of GCA was the same as PMR (7/12, 58%) . Compared with PMR patients, the specific clinical manifestations of GCA patients were scalp pain ( P=0.031), mandibular claudication ( P=0.031) and migraine ( P=0.000). The creatine kinase of GCA (60±27) U/L patients was higher than that in PMR (41±15) patients ( t=1.098, P=0.029). There was no significant difference in other laboratory tests including erythrocyte sedimentation rate, C reactive protein level. Seven of 12 GCA patients were first diagnosed with PMR, then were diagnosed with GCA during follow-up. No obvious differences could be found in clinical manifestations between these 7 patients and 24 pure PMR patients. Through imaging examinations, we found that 9 of the 12 GCA patients had arterial stenosis, 5 had thickened vascular walls, 5 had atherosclerosis, and 2 had rough endometrium. Conclusion:GCA patients and PMR may have similar clinical presentations. The presence of scalp pain, mandibular claudication and migraine during the course of the disease implies that GCA is more likely. Vascular ultrasound, arterial CTA, and positron emission tomograph (PET)/CT play an increasingly important role in the diagnosis of GCA.

OBJECTIVE:To prepare the vinorelbine-tetrandrine liposomes modified with RGD,and study the inhibitory effect on glioma C6 cells. METHODS:Film dispersion method and ammonium sulfate gradient method were used to prepare the vinorel-bine-tetrandrine liposomes modified with RGD,and the morphology and particle size distribution were observed. The vinorelbine content was determined,and sulforhodamine B method was used to respectively determine the inhibitory effects of blank targeting liposomes,normal vinorelbine liposomes and vinorelbine-tetrandrine liposomes modified with RGD on C6 cells. RESULTS:The prepared vinorelbine-tetrandrine liposomes modified with RGD were spherical or almost spherical with smooth surface,and particle size was about 120 nm. The average content of vinorelbine was 28.27 μg/mL(RSD=0.38％,n=3). Blank targeting liposomes had no significant effect on the growth of C6 cells;vinorelbine-tetrandrine liposomes modified with RGD can obviously inhibit the growth of C6 cells,and cell viability after its effect was significantly lower than normal vinorelbine liposomes (P<0.05). CON-CLUSIONS:Vinorelbine-tetrandrine liposomes modified with RGD are successfully prepared,and they show obvious inhibitory ef-fects on the growth of C6 cells.

Objective To investigate the technical feasibility and oncological safety of EPMR for early esophageal cancer and precancerous lesions. Methods Clinicopathological data, procedure quality and complications of 70 patients with early esophageal cancer or precancerous lesions were retrospectively ana?lysed. The technical safety and feasibility were assessed, and the complications were investigated through postoperative surveillance. The results were compared with published data from two high?quality meta?analysis studies on ESD. Results In a total of 70 patients who underwent EPMR, 35?7%( 25/70) were diagnosed as having early esophageal cancer and 64?3%( 45/70) atypical hyperplasia. And tumor size greater than 2 cm was 78?6%(55/70). The mean EPMR time was(28?31±9?49) minutes. The R0 resection rate of EPMR was 88?6%(62/70) and no perforation occurred. The bleeding rate was 21?4%(15/70). The esoph?ageal stricture rate was 1?4%( 1/70) . The recurrence rate was 2?9%( 2/70) . Compared with published ESD data from the two studies, EPMR showed shorter procedure time, lower curative rate and lower rates of stric?ture and perforation, but slightly higher rates of bleeding and recurrence. Conclusion Both EPMR and ESD are feasible and effective for early esophageal cancer and precancerous lesions. The curative results of EPMR are similar to ESD, with shorter procedure time, but higher bleeding and recurrence rates.

Objective To explore how to establish and safeguard the peripherally inserted central catheters(PICC) maintenance network for the management and practical activity of PICC,so as to provide continuous high-quality PICC maintenance for discharged patients with PICC. Methods 40 nurses each year from 10 cities and 100 country hospitals affiliated with Shanxi Quality Control Center to train in the 1st and 2nd affiliated hospital of Xi`an Jiaotong University were choosen as 214 PICC maintainers. These maintainers were taken into the inner-net of 1st affiliated hospital of Xi`an Jiaotong University management system complete the PICC maintenance net of Shanxi province. Results After the establishment of maintenance network, the number of patients with PICC increased (from 610 cases in 2008 to 1 434 cases in 2014);A large number of PICC management had been down by the qualified nurses in primary hospitals; Duration of PICC in patients days was prolonged; The PICC related complications including thrombophlebitis, catheter infection,occlusion or dislodgment and unplanned extubate were significantly decreased (P < 0.05 respectively). Conclusions Establishment of PICC maintenance network can provide patients with standardized and convenient PICC maintenance service,decrease the incidence of catheter which related complications and ensure patient safety. The application of PICC maintenance network should be used more and more.