At present, oncology medical student in our country has many communication problems, such as communication awareness is not strong,the lack of communication,communication is not enough self-confidence and other issues.To improve the communication ability between doctors and patients for the oncology professional medical students:it is the necessary premise for correct implementation of diagnosis and treatment, an effective way to reduce medical disputes, adapt to the demand of the development of higher medical education.And pointed out the effective ways to improve the ability of doctor-patient communication:to set up the doctor-patient communi-cation and tumor department before the internship training course;establishlisten with your heart and professional guidancemode;with teacher actively guiding; learn to empathymode; adhere to the concept of taking pa-tients as the center.

The role of serotonergic system in vasovagal syncope (VVS) has been more concerned.Serotonin is a kind of neurotransmitter which is widely distributed in central nervous system.There are kinds of serotonergic receptors on postsynaptic membrane,among which 5-HT1A receptors participate in the mechanism of central blood pressure depression and promote the release of hormones such as prolactin and adrenocorticotrophic hormone.Acute administration of selective serotonin reuptake inhibitors (SSRIs) during head-up tilt test (HUT) blocks the reuptake of serotonin in the synapse space and thus increases stimulation of the serotonin receptors,which induces syncope episode.Long-term administration of SSRIs downregulates the postsynaptic serotonergic receptors,thus it weakens the reaction to the rapid change of serotonin concentration, which results in rapid depression of sympathic nerves and prevention of syncope episode.These demonstrate that central serotonergic system may participate in the pathogenesis of VVS and SSRIs are important for the diagnosis and treatment of VVS.

Carcinoma, Hepatocellular ; pathology ; Drug Resistance, Multiple ; Humans ; Liver Neoplasms ; pathology

Animals ; Body Water ; Brain ; anatomy & histology ; Male ; Organ Size ; Rats ; Rats, Wistar ; Specific Gravity

Objective To investigate the resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides and its resistance genes.Methods The minimal inhibitory concentrations (MICs) of seven antimicrobials (gentamicin, amikacin, tobramycine, netilmicin, neomycin, streptomycin and kanamycin) against 20 strains of multi-drug resistant Acinetobacter baumannii were detected by agar dilution method. Meanwhile, two resistance genes of aminoglycoside nucleotidyltransferase were amplified by PCR and vertified by DNA sequencer.Results It was found that MIC50 and MIC90 of gentamicin, amikacin, streptomycin and kanamycin in 20 strains of Acinetobacter baumannii were all above 1 024 mg/L, and their resistant rates were 95%, 95%, 100% and 90% respectively, while the resistant rates of tobramycin, netilmicin and neomycin were 85%, 90% and 40% respectively. Two aminoglycoside-modification genes ant(2″)-Ⅰ and ant(3″)-Ⅰ were detected in 20 strains, with 55% and 80% of positive rate respectively. The double positive rate of two resistance genes was 50%.Conclusion The resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides was closely associated with ant(2″)-Ⅰ and ant(3″)-Ⅰ genes.

Objective To summarize and evaluate the technique and clinical outcome of limited tarsal sinus incision plus locking plate internal fixation for minimally invasive treatment of intra-articular calcaneal fractures. Methods Between February 2010 and February 2011,16 cases of intra-articular calcaneal fractures were treated in a minimally invasive manner in our department. All cases were evaluated carefully with routine X-rays and CT scans preoperatively to define the type of fracture and the involvement of articular surface.Open reduction and locking plate internal fixation with percutaneous screws were performed via a limited tarsal sinus approach 3 to 6 days after injury (average,4 days).Regular X-ray follow-ups were conducted to measure the Bohler's and Gissane angles.Overall functional evaluation was carried out according to Visual Analogue Scale (VAS),the Hind-foot Score by American Orthopaedic Foot and Ankle Society (AOFAS) and Short Form 36 Health Survey Questionnaire (SF-36).Complications were recorded as well.Results The 13 cases were followed up for a mean duration of 18 months (from 12 to 24 months).There were no wound infection,skin and flap necrosis or implant failure.Bone union was achieved at an average of 10 weeks (from 8 to 12 weeks) post-operatively.The average Bohler's angle was improved significantly from 13.4° ± 3.4° (from 8° to 19°) pre-operatively to 26.5° ± 4.5° ( from 21° to 38°) post-operatively ( t =9.781,P ＜ 0.001 ).The average Gissane angle was improved significantly from 88.1° ± 7.6° (from 77° to 100°)pre-operatively to 116.2°±7.5° (from 100°to 124°) post-operatively (t =12.934,P ＜0.001).On average,the VAS score was 1.5 ± 1.7,the AOFAS score was 84.2 ± 5.9 and the SF-36 score was 79.5 ± 8.1 at the final follow-up.The follow-ups revealed no post-traumatic arthritis. Conclusion Open reduction and locking plate fixation with percutaneous screws via a limited tarsal sinus incision is a safe and reliable treatment for intra-articular calcaneal fractures,because it has the advantages of direct reduction of the articular surface,solid fixation,and limited soft tissue complications.

Nanoscale biomaterials,due to their excellent mechanical,chemical and biological properties,are now being applied in regenerative medicine.Nanoscale materials incorporation into 3D synthetic organ scaffolds has had a breakthrough in tissue engineering.This review provides an update report on the use of nanomaterials in 3D scaffolds of tissue engineering,including fabrication methods of 3D scaffolds of nanomaterials and their physicochemical properties,biocompatibility and degradability.

Converting two poorly water-soluble crystalline drugs to co-amorphous drug systems by ball milling, quench-cooling, or cryo-milling method can improve stability of the drug, enhance dissolution rates, and reduce adverse reactions of the single drug. Co-amorphous system has been used to solve problems of co-administration of medicines. Formation and intermolecular interactions of co-amorphous drug systems may be verified by differential scanning calorimetry (DSC), X-ray powder diffraction (XRPD), Raman spectroscopy (RS) and Fourier transform infrared spectroscopy (FT-IR). Stability of co-amorphous drug systems is influenced by their glass transition temperature (Tg) and intermolecular interactions. The theoretical Tg values and the interaction parameter x are calculated by Gordon-Taylor equation and the Flory-Huggins equation, respectively. Thus, co-amorphous drug systems are analyzed theoretically at molecular level. Co-amorphous drug systems provide a new sight for the co-administration of medicines.

Objective To analysis the progress in prevention and control of iodine deficiency disorders (IDD) in Dalian and to provide a scientific basis for further prevention and control of the disease.Methods From 2006 to 2010,5 or 9 townships were randomly sampled from each county in Dalian,4 villages were sampled from each selected townships and 15 or 8 households were sampled from each selected villages for collecting salt samples and salt iodine level was determined by direct titration method.Sixty daytime urine samples from pregnant women,breast feeding women,infants and young children were collected,respectively,every year to detect urinary iodine level.From 2007 to 2009,2 to 11 counties were sampled and from each selected county one school was sampled to collect 100 daytime urine samples of children aged 8-10 and iodine content was determined.From 2006 to 2009,2 to 5 counties were sampled,from each selected county 2 to 5 schools were sampled and 100 children aged 8 to 10 in each selected school were sampled to detect intelligence quotient level and the thyroid volume.Results From 2006 to 2010,16 012 copies of households' edible salt samples were monitored; the average iodine content was ranged 29.68-31.51 mg/kg,the rate of qualified iodized salt in household ranged from 97.24％ to 98.42％.A total of 1398 copies of urine samples of pregnant women,486 breast feeding women,473 infants and 502 young children were monitored,and the median value of urinary iodine was 129.3-189.6,114.6-190.6,148.5-298.5 and 144.4-187.3 μg/L,respectively.A total of 1657 urine samples were monitored,1264 intelligence quotient level and 1197 thyroid volume of school-age children were determined,the median urinary iodine,thyroid goiter rate and intelligence quotient level was 217.9-266.7 μg/L,0-3.29％ and 110.4-117.2 μg/L,respectively.Conclusions From 2006 to 2010,the city's households qualified iodized salt coverage rate has reached the national standard for elimination of iodine deficiency disorders.The iodine nutrition of key population and school-age children has reached adequate level,the thyroid goiter rate is less than 5％,and the level of intelligence quotient has increased every year.But the iodine nutrition of breast feeding women in 2009 and 2010,pregnant women in 2010 is inadequate,so iodine nutrition surveillance and health education in pregnant and breast feeding women need to be strengthened in the future.

The reform for medical insurance payment was the important method for standardizing medical service provider behavior,controlling costs and improving efficiency,which was also the important measurement for further improve and implement the reform of drug and health system.Since the new medical reform in 2009,the central and local government had paid more attention on the role of medical insurance payment reform.Local medical departments of different places implemented reform pilots.Through summarizing the foreign and domestic researches around capitation,bundle payment and global payment,the experiences and effectiveness of these pilots were evaluated so as to provide corresponding policy implications.