Objective:To explore the influencing factors of physicians' professionalism,to understand the cognitive status and changes of professional responsibility and put forward the corresponding strategy.Methods:The satisfaction and cognitive status of physicians'professionalism were investigated using the self-designed questionnaire that adapted to medical staff,and the data was analyzed using statistical software SPSS19.0.Results:It showed that the satisfaction with the job itself was quite high.But they thought that the work risk was high,their own value was difficult to realized,and the professionalism was lack of cultivation.Conclusions:It suggests to put forward measures and suggestions from the perspective of system reform,vocational education,hospital culture,social atmosphere,decision-making of doctors and patients together.

The article briefly reviewed the different perspectives on the definition of medical professionalism and summarized the current status of medical professionalism studies in China and foreign country represented by the United States.In terms of medical moral values , conflict of interest , autonomy and the professionalism training , based on the status quo of physician professionalism in China , some ideas to improve and build medical profession-alism in China are proposed .

Acute respiratory distress syndrome (ARDS) patients experiencing protective mechanical ventilation, is associated with a marked mortality reduction. However, the incidence of acute cor pulmonale (ACP) in ARDS patients has recently been reported to range between 22% and 25%, as well as a trend for higher mortality. Therefore, the mechanical ventilation strategy is proposed, not only based on the protection of the lung, but also focused on the impact on the right ventricle function. Currently, point-of-care ultrasound has been widely practiced in a variety of clinical setting, which plays more and more important role in the early detection and management of ARDS and its complications. A retrospective study concerning the incidence, pathophysiology and risk factors for ACP patients in ARDS was done to analysis the application of lung ultrasound and echocardiography combined with lung ultrasound in clinical hemodynamics monitoring, and so as to optimize the ventilation setting to protect the function of lung and right ventricle. Further exploration of effective improvement of the pulmonary vascular and right ventricle function the goal-directed ultrasound approach, and the diagnosis and treatment flow is expected.

Adult ; Amyloidosis ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Muscular Diseases ; pathology ; surgery ; Neck Muscles ; pathology ; surgery

Objective To investigate the safety and effectiveness of percutaneous balloon pulmonary valvuloplasty (PBPV) in the treatment of pulmonary stenosis (PS). Methods The subjects were 52 patients with PS from 2007 to 2012, including 24 male and 28 female. Their age ranged from 1 year old to 56 year old and mean age was 9.2±7.6 years old. Their body weight ranged from 10 kg to 60 kg and mean weight was 17.3±8.9 kg. All patients were assessed with electrocardiogram (ECG), chest X-ray, right heart catheterization and right ventricular angiagraphy before the procedure. Results All 52 patients received PBPV successfully. Comparing the transvalvular pressure gradient before and after the operation, it decreased from 86.3±27.6 mmHg (1 mmHg=0.133 kPa) to13.8±7.7 mmHg, and statistically difference (P<0.01). Among these patients, one patient occurred ventricular fibrillation and Aspen syndrome (hypoxie-ischemic encephalopathy), one patient occurred respiratory and cardiac arrest, 24 patients occurred transient arrhythmia, one patient had hypotension, one patient had bradycardia and one patient showed desaturation. All these symptoms resolved after appropriate treatment during the PBPV. Two patients had hematoma in the puncture point and 2 patients had reactive infundibular stenosis after PBPV. Conclusions Performing the percutaneous balloon pulmonary valvoplasty on the patients with pulmonary stenosis is safe and effective. PBPV causes less pain and can be used as the preferred treatment for pulmonary stenosis.

Objective To establish a rapid method having great capability for enrichment and anti-interference, higher sensitivity and good precision for determination of trace silver in drinking water. Methods The conditions of determination such as the definition of peak potentials, the selection of auxiliary electrolytes, the selection of kind and amount of oxidants and anti-interference test were carried out by MP-1 potentiometer using glass-carbon electrode. Results The lowest detection limit, average recorery rate and average relative standard deviation were 0.004 ug/ml, 100.3% and 2.73% respectively. Conclusion This method was suitable for determination of trace silver in drinking water.

Objective To explore whether the PDA patients in the early stage of Eisenmenger syndrome can accept interventional surgery. Methods Three patients were choose from the “National Multicenter Prospective Registration Study on Pulmonary Artery Hypertension”, Clinical assessment, as well as examinations and registrations associated with PAH, was conducted in accordance with relevant provisions of the registration study within 1 wk prior to surgery. The way of the interventional treatment were right heart catheterization and pulmonary vasodilator testing (a capsule of iloprost solution for inhalation), and measurement of the pulmonary arterial pressure, descending aortic pressure, ratio of pulmonary to systemic blood flow, ratio of pulmonary to systemic blood pressure, pulmonary capillary wedge pressure [mean≤15 mmHg(1 mmHg=0.133 kPa)], before and after testing. After clear the results of pulmonary vasodilator test all patients underwent transcatheter closure testing, if it was positive,the amplatzer was released if her family members’ approved;Conversely, the amplatzer was quickly withdrawn with negative results, and symptomatic treatment was conducted based on the patient’s clinical symptoms. Results The first cases pulmonary vasodilator test was negative, but positive in transcatheter closure testing. Satisfaction immediate effect of surgery, and the occluder was released with her family members’ approval. patients of Example 2 and Example 3 were negative in pulmonary vasodilator testing and transcatheter closure testing, can not released the occluder. Conclusions Some Patents Ductus Arteriosus (PDA) patients in early stage of Eisenmenger syndrome is feasible to accept interventional therapy , try plugging test is may be an important indicator of prognostic assessment.

AIM:To explore the role of sphingosine 1-phosphate (S1P) in the dysfunction of vascular endo-thelial cells exposed to high glucose.METHODS: In human aortic endothelial cells cultured under high-glucose ( 22 mmol/L glucose) medium, nitric oxide ( NO) level, polymorphonuclear neutrophil-endothelial cell adhesion rate, protein level of intercellular adhesion molecule-1 ( ICAM-1) , migration of endothelial cells and Akt/endothelial nitric oxide syn-thase ( eNOS) pathway activation were observed after S1P, sphingosine kinase-1 inhibitor and/or Akt inhibitor treatments. RESULTS:S1P decreased NO level, increased polymorphonuclear neutrophil adhesive rate, enhanced ICAM-1 protein level, and inhibited migration of endothelial cells and activation of Akt/eNOS pathway in endothelial cells cultured under high-glucose condition.Sphingosine kinase-1 inhibitor, which reduced S1P content, significantly improved the above endo-thelial cell function indexes and restored the activation of Akt/eNOS pathway.CONCLUSION: S1P promoted high glu-cose-induced dysfunction of endothelial cells probably by inhibiting the activation of Akt/eNOS signal pathway.Targeting S1P is expected to become one of potential treatment strategies to reduce endothelial cell dysfunction.

Objective To investigate the effects of physical and chemical factors in the environment for dried blood sample (DBS) preparation of neonatal screening assay.Methods A total of 60 normal and 120 positive DBS were prepared under control and 10 different conditions.Another 30 normal and 80 positive DBS were prepared under control and 7 different concentration gradients of formaldehyde.The levels of phenylalanine (Phe),glucose-6-phosphate dehydrogenease (G6PD),thyroid stimulating hormone (TSH) and 17α-hydoxyprogesterone (17α-OHP) were tested by time-resolved fluorescence immunoassay or fluorescence assay.Statistical analysis was performed using SPSS 22.0 software.Results Compared with the control group,the results of Phe were not significantly different (P ＞ 0.05) when the samples were dried under the formaldehyde sensitive threshold (4.62 to 6.95 ppm for 18 hours).G6PD levels were significantly lowered when the samples were dried under all the conditions except for fast cold drying (2 to 8 ℃ overnight and formaldehyde condition,0.30 to 0.38 ppm for 4 hours or 0.21 to 0.24 ppm for 18 hours).TSH and 17α-OHP levels were lowered obviously when the samples were dried under the conditions of humidity,UV and formaldehyde condition (TSH:0.32 to 0.52 ppm for 4 hours,0.38 to 0.45 ppm for 18 hours,17α-OHP:4.37 to 4.62 ppm for 4 hours,0.38 to 0.45 ppm for 18 hours).The results of Phe,G6PD,TSH and 17α-OHP were not statistically different with the control group when the samples were dried under the fast cold drying and 2 to 8 ℃ overnight.Conclusion The physical and chemical factors in the environment of DBS preparation should be related to the accuracy of neonatal disease screening closely.The necessary control factors including formaldehyde,ethanol,glacial acetic acid,ultraviolet irradiation,heat,humidity and decoration pollution may exhibit significant effects on the preparation of DBS.Fast cold drying and overnight at 2 to 8 ℃ could be available for DBS preparation.

Aged ; Coal Mining ; Electrocardiography ; Heart Rate ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; physiopathology ; Tachycardia ; etiology