A total of 120 medical students were surveyed to investigate the current status of communication between medical students and old patients and the awareness of medical laws. The questionnaire shows many students don't have enough knowledge of communication skills and medical laws. Furthermore, the most important reason of the medical disputes is the lack of communication between doctors and patients so the cultivation of communication skills and legal knowledge should be strengthened.

Objective To study the optimum preparation process of gastrodin liposome, characterization its structure.Methods Perpared gastrodin liposome with film-ultrasonic method.The entrapment efficiency as index, quality between lecithin and cholesterol ratio, oil-water phase volume ratio and ultrasonic time as factors by L9 (34 ) orthogonal test to optimize the preparation process.Observed the liposome morphology, particle size and distribution under the microscope, and determined the entrapment efficiency and stability.Results Regression equation was Y=239.75 +0.0207X(n=5), R2 =0.9996, 0.002 to 0.010 mg/mL had a good linear relationship.The optimum of preparation process: lecithin and cholesterol quality ratio was 4:1, water and oil phase volume ratio of 3:1, ultrasonic time control for 60 min;Liposomes showed spherical or oval shape, regular shape, uniform size.The average entrapment efficiency was 60.65%, the average particle size distribution at 327 nm, and it had good stability.Conclusion The preparation of gastrodine liposome has advantages of simple, higher entrapment efficiency and even particle size.The method can be used for embedded water-soluble medicine.

Ten to twenty ?l of 20-50% horseradish peroxidase (HRP) in normal saline solution was injected into the myocardium of the anterior wall of left and right ventricles in 11 rabbits. The areas containing sino-atria as well as atrio-ventricular nodes and the dorsal wall of the atria were removed separately. Frozen or cryostate sections of these tissues 25-40?m thick, were incubated according to the HRP (tetramethylbenzidine "TMB" method)-AChE combined method. The blue granules produced by the HRP with TMB were observed in the perikarya of a few AChE intensely positive ganglion cells which were located in the epicardium of the dorsal wall of the atria. This indicated the processes of the HRP-AChE double labeled cells distributed to the myocardium of the anterior wall of the ventriculum. It is generally believed that the nerve cells of strong AChE activity can be referred as cholinergic neurons. For this reason, the present study may give further identification to assert the parasympathetic innervation of the ventricular myocardium. The parasympathetic postganglionic neurons innervated the anterior wall of left and right ventriculi are situated primarily in the epicardium of the posterior wall of the atria.

Objective To investigate the relationship between serum vitamin B12 level and arsenic methylation and the risk of arsenic poisoning in the arsenic exposed population.Methods Three villages in Midu County,Dali City,Yunnan Province were investigated.Cross-sectional study was used to select 103 subjects.The population was divided into three groups according to drinking water arsenic exposure situation and whether arsenic poisoning patients:28 cases of control group (not exposed to high arsenic),30 cases of arsenic patient group and 45 cases of non patient group.Instant peripheral blood samples and urine samples were collected.The content of arsenic in urine was determined by hydride generation cold trap and atomic absorption spectrophotometry.The levels of vitamin B12 in serum were determined by chemiluminescence immunoassay.The urine arsenic and serum vitamin B12 contents in different groups were compared,the arsenic poisoning prevalence rate in people with different levels of serum vitamin B12 was investigated,and the correlation between serum vitamin B12 level and the metabolism of arsenic methylation was analyzed.Results The level of urinary inorganic arsenic (iAs),monomethylated arsenic (MMA) and dimethylated arsenic (DMA),total arsenic (tAs) were significantly different between groups (F =13.032,20.778,21.978,22.155,all P ＜ 0.05).The levels of urine arsenic in patients with arsenic exposure [(94.56 ± 107.62),(75.76 ± 54.31),(270.19 ± 185.10),(444.02 ± 323.28) μg/g Cr] and non patient with arsenic exposure [(40.05 ± 47.47),(45.11 ± 46.06),(183.91± 151.45),(270.84 ± 231.45) μg/g Cr] were significantly higher than those in control group [(7.58 ± 4.82),(4.27 ± 2.01),(26.89 ± 11.45),(38.91 ± 13.34) μg/g Cr,all P ＜ 0.05].The serum levels of vitamin B12 were significantly different between groups (F =6.650,P ＜ 0.05),patients exposed to arsenic [(366.05 ± 120.03) ng/L] was significantly lower than the control group [(533.70 ± 180.12) ng/L,P ＜ 0.05].There were significant differences in the detection rate of arsenic poisoning among different levels of serum vitamin B12 (x2=8.13,P ＜ 0.05),the lower dose of vitamin B12,the more serious the incidence of arsenic poisoning.The content of vitamin B12 was negatively correlated with MMA％ (r =-0.21,P ＜ 0.05),and positively correlated with SMR (r =0.21,P ＜ 0.05).Conclusion Low levels of vitamin B12 in serum may increase the risk of arsenic poisoning.

Objective:To explore and compare the value of radiomic features based on 18F-fluorodeoxyglucose (FDG) PET and CT in distinguishing epidermal growth factor receptor (EGFR) mutation status in patients with lung adenocarcinoma. Methods:Pretreatment 18F-FDG PET/CT images and EGFR gene status of 114 patients (64 males and 50 females, aged range: 35-84 (average age: 61) years) with primary lung adenocarcinoma between January 2017 and December 2017 were retrospectively collected. The volume of interest was drawn manually slice by slice, then the features were extracted by the LIFEx software. The parameters were screened by least absolute shrinkage and selection operator (LASSO) method for 200 times, and ten-fold cross-validation was used to select the best tuning parameter λ. Three models, namely M PET, M CT, M PET+ CT, were constructed by binary logistic stepwise regression. The receiver operating characteristic (ROC) curve was generated and the corresponding area under the curve (AUC), sensitivity, specificity and accuracy were calculated. The AUCs of three models were compared by Delong test. Results:Totally, 53.51%(61/114) patients were with wild type EGFR and 46.49%(53/114) patients had EGFR mutation. There were 3, 3, 7 parameters selected to form M PET, M CT, M PET+ CT, respectively. The AUCs for M PET, M CT, M PET+ CT were 0.730, 0.752 and 0.866 respectively. When the cut-off values were 0.427, 0.522, 0.378 for M PET, M CT and M PET+ CT, the Youden index were up to the maximum as 0.420, 0.405, 0.630, with sensitivities of 83.0%(44/53), 58.5%(31/53), 92.5%(49/53), specificities of 59.0%(36/61), 82.0%(50/61), 70.5%(43/61) and accuracies of 70.2%(80/114), 71.1%(81/114), 80.7%(92/114), respectively. There was no significant difference between AUC of M PET and M CT ( z=-0.320, P>0.05). The differences of AUCs between M PET+ CT and M PET, M PET+ CT and M CT were statistically significant ( z values: 2.963, 2.523, both P<0.05). Conclusions:PET, CT and PET+ CT radiomic features are all associated with EGFR gene expression in lung adenocarcinoma. M PET+ CT has the highest predictive efficiency.

ObjectiveTo evaluate the short-term effect and side effects of ICE regimen treating the patients with relapsed and refractory non-Hodgkin's lymphoma(NHL). MethodsTwenty-five patients with relapsed and refractory NHL were treated with ICE regimen. Treatment was repeated every 3 weeks. ResultsThe total effective rate was 76.0％ for 25 patients,The response rate(PR) was 60.0％. The main side effects were marrow suppression including of leucopenia and thrombocytopenia,no patients dead for toxic reactions of chemotherapy. ConclusionICE regimen was a safe and effective salvage regimen for the patients with relapsed and refractory NHL.

We Injecte(?) 12-16 ?l 20—40% HRP in normal sanne into the myocardium orthe anterior wall of the left ventricle in six rats and 10 ?l choleragenoid-horsera-dish peroxidase conjugate(CB-HRP)in three rats.The Th1-3 DRG and the nodoseganglia of both side were removed.The sections of these ganglia were proceeded bythe TMB chromogentic reaction for HRP and immunohistochemical reaction(the firstantibody is the substance P antiserum).There are three types of labeled cells——theHRP labeled cells.Sp-IR cells,and HRP-Sp-IR double labeled cells were observedin the Th1-3 DRG and nodose ganglia of both side.The parts of Sp-IR nerve fib-ers in the heart wall originate from the DRG and nodose ganglia and these neuronsprojecting the HRP-Sp-IR nerve fiber contained substanse P.Their functions may berelated to the pain(nociceptive)sensation of the heart.This study may also be aevidence of the main function of the cardiac sympathetic afferent fiber is the con-duction of the pain sensation.A few of HRP-Sp-IR double labeled cells in thenodose ganglion observed suggest that the cardiac parasympathetic afferent fibermay participate in conduction of the pain sensation.This question requires furtherstudy.

Objective To evaluate the relationship between obesity and serum soluble intercellular adhesion molectde-1 (sICAM-1) in adolescents. Methods Totally, 158 adolescents aged 13-15 years were divided into three groups based on their body mass index (BMI) , 80 in control group, 44 in overweight group and 34 in obesity group. Height, weight, waist circumference (WC) and blood pressure were measured for all of them and sICAM-1 was assayed from fasting venous blood collected. Results BMI, WC and systolic blood pressure were significantly higher in overweight group than those in control group (P < 0. 01). BMI, WC, systolic blood pressure and diastolic blood pressure were significantly higher in obesity group than those in overweight group (P<0. 05). Level of sICAM-1 was significantly higher in obesity group than that in control group (P <0.05). Their sICAM-1 showed positive correlation with BMI (r = 0.168, P=0.035) and WC (r=0. 179, P =0.025). Multiple linear regression analysis using sICAM-1 as a dependent variable showed that WC (β= 0.009, 95% CI 0. 001-0.018, P=0.025) was an independent predictors for sICAM-1 adjusted for age, sex, BMI and blood pressure. Conclusions Results mentioned above suggest that endothelial dysfunction associates with obesity, particularly with abdominal obesity. sICAM-1 can be used as an early marker of atherosclerosis in adolescents.

accumulation and endothelial dysfunction are associated with insulin resistance.

Objective To review the research of self-management intervention in patients with hematopoietic stem cell transplantation,clarify the intervention elements,so as to provide references for clinical practice and future related research.Methods According to the scoping review framework,a literature search was performed in the PubMed,Embase,CINAHL,Web of Science,Cochrane Library,CNKI,Wan fang Database,VIP,CBMdisc for all the studies on self-management intervention of patients with hematopoietic stem cell transplantation.The retrieval time was from the establishment of the database to December,2022.There were 2 researchers who extracted and analyzed the data of the included literature.Results A total of 12 articles were included,including 3 randomized controlled trials,8 quasi-experimental studies,and 1 mixed study.6 studies were conducted with interventions based on the theoretical basis or nursing model such as self-management oriented 5A nursing model,continuous nursing model,problem-based learning theory.The intervention methods of 12 studies included nurse-led self-management guidance,mobile applications,multidisciplinary collaboration,and graphic cards.The intervention time was mostly 1～3 months.The outcome indicators included feasibility evaluation indicators such as operability,ease of use,and user satisfaction of the application,and effect evaluation indicators such as self-management ability,quality of life,and medication compliance of patients.The results showed that self-management interventions could improve patient self-management ability,quality of life,medication compliance,and improve their psychological and nutritional status.Conclusion The research on self-management intervention in patients with hematopoietic stem cell transplantation is still in the development stage,and its positive effect has been preliminarily verified.Medical staff should strengthen the self-management evaluation of patients with hematopoietic stem cell transplantation,play the role of multidisciplinary team,use electronic health intervention methods,and formulate multi-level,scientific and effective self-management intervention programs.