Objective:To evaluate communication ability of medical students and try to construct communica-tion education mode of medical students .Methods:Scale and questionnaire are used to survey 1389 medical students , a radar map is used to evaluate the communication and interviewing related personnal , domestic and over-seas pertinent literature data were browsed and analyzed .Results:Medical students′communication ability level is general , lack of communication of knowledge; The need to build on the basis of doctor -patient communication training mode diversification .Conclusions:Medical schools should attach importance to training the students′com-munication ability and try to construct all -sided education mode and improve medical students′ability of doctor-patient communication .

Objective By comparing the prevalence of mental disorders and social demographic characteristics, to analyze the influencing factors of mental disorders in Xiamen city residents. Method Using multi-stage stratified cluster random sampling, 12 071 subjects aged 18 years and older were identified in Xiamen city. Eventually 10 764 subjects completed the survey, including 4 957 males, 5 807 females, 8 588 urban population and 2 176 rural population. The subjects were screened with the expanded version of GHQ-12, the Structured Clinical Interview for DSM-Ⅳ-TR as a diagnostic tool, and made a determination whether they had mental disorder and specific diagnosis. Result The overall prevalence of mental disorders in Xiamen city was lower than that in other provinces and cities; it was only 3.46%(Shandong province 19.48%, Zhejiang province 17.27%, Qinghai province 18.04%, Hebei province 16.24%, Tianshui city 17.90%, Chengde city 17.71%, Baoding city 13.62%). The one of most common mental disorders was the alcohol use disorders in various provinces and cities, except in Xiamen city. The constituent ratio of Xiamen residents surveyed was 79.78%for urban, higher than those of other provinces and cities (Shandong province 24.91%,χ2=6 624.955,P<0.001;Zhejiang province 32.95%,χ2=3 601.752, P<0.001;Qinghai province 23.55%,χ2=4 991.289,P<0.001;Hebei province 15.95%,χ2=11 547.016,P<0.001;Tianshui city 16.05%,χ2=6 484.483,P<0.001;Chengde city 15.60%,χ2=2 930.811,P<0.001;Baoding city 11.80%,χ2=6 973.770,P<0.001). Most residents of Xiamen enjoyed at least one kind of health insurance (83.06%), higher than those of other provinces and cities (Zhejiang province 23.30%,χ2=8 868.617,P<0.001;Hebei province 8.68%,χ2=17 434.576,P<0.001;Tianshui city 11.20%,χ2=10 862.305, P<0.001;Chengde city 8.69%,χ2=5 884.478,P<0.001;Baoding city 9.54%,χ2=10 728.632,P<0.001). Conclusion The overall current prevalence of mental disorders in Xiamen city residents was lower than those of other provinces and cities. The reasons may be that there was higher degree of urbanization, better health care, no heavy drinking habits and other factors. There might be other protective factors which need to be further studied.

ObjectiveTo evaluate the long-term survival rate of precancerous lesions and early esophageal cancer after endoscopic mucosal resection (EMR).MethodsThe follow-up endoscopy was performed in 154 patients with early esophageal cancer and precancerous lesions who underwent EMR.The examinations were carried out at 1 month,6 months and every 1 year after the procedure,respectively,and argon plasma coagulation (APC) was applied if a recurrent lesion was suspected.The follow-up rate was 100%.ResultsAfter EMR,reecurence occurred in 6 cases (3.9%) in 5 years,of which 4 received esophagectmy,1 underwent APC,and the other one died from matastasis.The 5-year survival rate was 97.4% (150/154),with 1 died from matastasis and 3 from noncancerous diseases.The 5-year survival rate of 125 patients with high grade dysplasia,carcinoma in situ and intramucosal carcinoma was 97.6%( 122/ 125),with 1 died from noncancerous disease and 1 from metastasis.The 5-year survival rate of 29 patients with low grade dysplasia was 96.6% ( 28/29 ) with 1 patient died from noncancerous disease.ConclusionEMR,as a minimally invasive procedure,is suitable for precancerous lesions and early esophageal cancer,especially for high grade dysplasia,carcinoma in situ and intramueosal carcinoma,with little sequela and long-term survival.

Objective To evaluate the treatment outcome of endoscopic esophageal mucosal resection (EMR) and alleviate or prevent the complication of EMR. Methods We explore a strategy of endoscopic esophageal mucosal resection to treat early esophageal cancer and severe dysplasia . Endoscopic esophageal mucosal resection was performed with transparent-cap technique, resdiual lesions were treated by Argon Plasma Cocagulation( APC). All patients have been followed up by endoscopic examinations at one month, 4 months, and 12 months after therapy. Results Seventy one cases (88 lesions) were treated by endoscopic esophageal mucosal resection with transparent-cap method. Average doses of saline-epinephrine 18 ml is injected submucosally to each lesion. The resected specimens were on average(21.8 ?1.0)mm ? (18.2?1. 0)mm in size. Five cases have bleeding after mucosectomy, bleeding were managed and controlled by compression , local injection of saline-epinephrin, and APC. Perforation never occurred. Four cases have stenosis after mucosal resection, in three of them the resected area was more than 3/4 esophageal circumference, then it was dilated with water ballon dilater at one month, two months and three months after mucosal resection, all cases were cured. Conclusions Endoscopic esophageal mucosal resection is a safe, simple, minimally invasive and effective procedure with few complication in treating early esophageal cancer and precan-cerous lesion.

Workers with high quality, high job satisfaction levels and high stability are indispensable to the sustainable development of community health services. The present research aimed to find out about the scope of job satisfaction and stability of community health workers by means of designing relevant questionnaires and sample survey and to identify the major factors affecting the scope of job satisfaction and stability. The research found that among the community health workers, those engaged in preventive healthcare were a group with the lowest job satisfaction level and there were six factors affecting the scope of job satisfaction, including working conditions, the effect of the implementation of rules and regulations, respect from and care by leaders and so on. It also found that 45.1% of the workers once had the thought of leaving their community health centers or stations and there were 5 factors affecting job stability, including environment for medical practice, doctor-patient relationship, scope for bringing one's ability into play and so forth.

0.05).[Conclusion]The technique of double-tunnel with double-bundle of TE for reconstruction of anterior cruciate ligament(ACL) can improve the knee stability at the different flexion degree(0?～90?) and is more efficiently than the technique of single-tunnel with single-bundle.

Objective To compare the consistency and accuracy of determination of peripheral blood lymphocyte(PBL)interleukin-2(IL-2)with ELISA and evaluation of the expression of PBL IL-2 mRNA with real time PCR(RT-PCR).Methods In 20 kidney recipients,the PBL IL-2 level was determined with ELISA and the mRNA expression in PBL IL-2 was evaluated by real time fluorescence quantitative PCR(RT-FQ-PCR)before operation and C0/C2 time on the 7th day after operation.The same detection and evaluation were also done in 15 chronic allograft nephropathy(CAN)patients and 5 non CAN patients.Results IL-2 and IL-2 mRNA expression showed positive correlation before operation and 1 year later after operation,R2=0.58 and 0.4 respectively,both P0.05.On the 7th day after operation,IL-2 and the inhibition rate of IL-2 mRNA expression were(16.31?9.59)% and(69.92?7.10)%,respectively.A positive correlation existed between C2 IL-2 concentration and the inhibition rate of IL-2 mRNA expression,R2=0.56,P0.05.Also,IL-2 inhibition and PBL IL-2 mRNA inhibition showed no linear correlation.Conclusions The technique of determining PBL IL-2 by ELISA can be used for evaluating immunity status and immunosuppressive tolerance in patients with renal transplantation before the operation and at stable stage after operation.However,it should not be used for assessing perioperative immunity status and evaluating effect of cyclosporine.

Objective To explore the efficacy of transurethral nephroscopic pneumatic lithotripsy combined with ultrasound lithotripsy for bladder calculus.MethodsBy using transurethral F20.8 nephroscope and EMS LithoCaster,we performed transurethral nephroscopic pneumatic lithotripsy and ultrasound lithotripsy on 69 patients with bladder calculus(63 men and 6 women)between October 2005 and May 2008.The diameter of the calculi was ranged from 1.5 to 6.0 cm.Among the patients,42 had one stone in the bladder,while 27 had multiple calculi.Fifty-five patients were complicated with BPH,14 had neurogenic bladder,and 4 showed bladder diverticulum with stones in situ.Pneumatic frequency was set at 8-12 Hz,and ultrasonic energy was 50%-60%.For the patients with BPH electrovaporization ablation was plused.ResultsAmong the 69 patients,68 were cured in one session.The mean operation time was 25 minutes(15 to 40 minutes).One patient was converted to open surgery because of rupture of the bladder during the procedure.No patient had urethral stricture,infection,or massive hemorrhage during the operation.Follow-up was available in 68 patients for 6 to 10 months(mean,9 months).During the period,no recurrent calculi was found by ultrasonography and X-ray.ConclusionTransurethral nephroscopic pneumatic lithotripsy combined with ultrasound lithotripsy is effective for bladder calculus.

objective To analyse the traditional Chinese medicine syndromes of lung cancer by the way of variable cluster analysis. Methods 176 cases of lung cancer were collected and their symptoms were recorded. Then these patients’ clinical data were analyzed by variable cluster analysis. Results The Chinese medicine syndromes of these patients could be divided into 5 types, and the variable proportion is 50.94%. Conclusion TCM syndromes of metaphase and advanced lung cancer patients include both deficiency and excessive syndrome, mainly deficiency syndrome with. And, the way of variable cluster analysis could help TCM syndrome differentiation of lung cancer patients.

Objective To analyze the correlation between the principal components of TCM symptoms and the quality of life of the middle-advanced stages lung cancer patients. Methods 176 lung cancer patients of the middle and advanced stages were collected, and their principal components of TCM symptoms were abstracted, and then the representative correlation analyses between the principal components and the quality of lives was made. Results There were two kinds of principal components of TCM syndromes. One was Qi and blood deficiency, phlegm and blood stasis, and water stasis;the other was Qi and blood deficiency. There was significantly negative correlationship between Qi and blood deficiency and GH, MH, RE, BP. Conclusion The principal components of TCM syndromes were consistent with the TCM thesis. And there was a significantly negative correlationship between the principal components of TCM syndrome and patients’ quality of life.