Objective　To study the alterations of surfactant protein A (SP-A) and B (SP-B) in rats in the early stage of acute lung injury induced by oleic acid. Methods　An acute lung injury model was established by injecting oleic acid into the superior vena cava of rats and the levels of SP-A and SP-B in branchoalveolar lavage fluid (BALF) were determined with Western Blot and ELISA. Results　The levels of SP-A and SP-B in BALF were significantly decreased in the injured group 1 h after acute lung injury (P<0.01) and remained low in the next 6 h. Conclusion　The levels of SP-A and SP-B were decreased in the early stage of acute lung injury. The methods used for detecting SP-A and SP-B we adopted are specific and sensitive, and might be helpful for other experimental study.

All organisms regulate their life activities through the biological clock, which makes a variety of activities regular.For example, many physiological activities such as sleep-wake cycle, temperature, heart rate, blood pressure, endocrine and metabolic activity of the kidney and liver are subject to the regulation of circadian rhythms, that is to say they are all under the control of circadian pacemaker.Physiological activity of cell cultured in vitro also possess rhythms.This paper conducts a brief overview of biological clock of cell cultured in vitro and analyzes the molecular mechanism of the biological clock of the neurons and peripheral tissue cell as well as the existing problems, which provide reference for comprehensive interpretation of the molecular mechanism of biological clock.

OBJECTIVE: To study the chemical constituents of Scirpus yagara Ohwi. METHODS: Column chromatography techniques were applied to isolate the constituents. The chemical structures of the constituents were elucidated on the basis of physicochemical properties and spectral data. RESULTS: Forteen compounds were isolated and identified as sanleng diphenyllactone (1), β-sitosterol (2), ferulic acid(3), succinic acid(4), azelaic acid(5), docosanoic acid (6), 6, 7, 10-trihydroxy-8-octadecenoic acid(7), 4, 4-dime-thyl-1, 7-pimelic acid(8), vanillic acid(9), 3, 5-dihydroxy-4-methoxy-benzoic acid(10), p-hydroxybenzaldehyde(II), 3, 4-dihydroxy-benzoic acid(12), 2, 7-dihydroxy xanthone(13) and daucosterol(14). CONCLUSION: Compounds 1-10 and 12-14 are obtained from this plant for the first time, and compounds 1 and 13 were obtained from the genus Scirpus for the first time.

Objectives: To evaluate the outcome of mini-PNL and standard PNL in horseshoe kidney. Methods: A total of 14 patients with horseshoe kidney were offered PCNL from January 2007 to December 2010 in our department. The male/female ratio was 2.5(10/4). The mean age was 38 years (range 29-55). All underwent color Doppler sonography, plain x-ray of kidney, ureter, and bladder, intravenous urography and CT. The left-to-right ratio was 1.8(9/5). All 14 patients had multiple stones or complex renal calculi, including 1 with staghorn stones. Mean stone size was 4.2cm(2-6.5cm). 10 patients had a history of failed extracorporeal shock wave lithotripsy. All percutaneous renal surgery was performed in one session under ultrasonography guidance. Among the treatments, 4 were mini-PNL, 10 were standard PNLs. Results: All surgery was successfully performed in one session under ultrasonography guidance by F18 tract or F24 tract. The stone-free rate after one-session operation was 78.6%(11/14). mini-PNL group was 75%(3/4), while PNL group was 80%(8/10). 3 cases received ESWL to remove the residual calculi, no second-session operation. 9 were performed in one tract and 5 in two tracts. 9 in upper calix, 7 in middle and 3 in lower. Mean operative time was 112.5±67.5min, mini-PNL operative time was longer than that of standard PNL (135±45min vs102.5±75min, respectively). Conversely, there was an advantage for miniperc over standard PNL in terms of a significantly reduced hematocrit drop (2.8±0.4g/dl VS 4.2±0.8g/dl, respectively). No mini-PNL patients required blood transfusions, whereas 3 did in the standard PNL group. Postoperative rate of surgery-related infection was 14.4%(2/14). No pleural or abdominal injury occurred. Conclusion: Both treatments have their own advantage. Mini-PNL and standard PNL are both effective and safe for calculi within horseshoe kidneys.

Objective To discuss the rehtionship between lipoprotein [Lp (a)],homocysteine (Hcy) and coronary artery disease (CAD) in men.Methods Two hundred and twenty-two male patients admitted for coronary angiography were classified into CAD positive group (111 cases) and CAD negative group (111 cases).The clinical data and plasma Hcy and Lp(a) levels were recorded in both groups.Logistic regression analysis was used to analyze males CAD risk factors.Results Lp (a) ≥0.3 g/L was a risk factor for CAD (OR =5.04,95％ CI 1.88-13.51,P =0.001),whereas Hcy was not related to CAD (OR =1.35,95％ CI 0.63-2.89,P =0.443).However,when both factors were considered together in an interaction model,plasma high Hcy and high Lp (a) levels were risk factors for CAD (OR =11.54,95％ CI 2.62-45.61,P=0.003).Conclusion Plasma Lp (a) and Hcy levels may increase the incidence of male CAD process.

Objective To investigate the mastery of clinical students' doctor-patient communi-cation skills and to assess the teaching effectiveness about the doctor-patient communication, and then propose some improvement ideas. Methods We conducted a study in students of clinical medicine of Nanjing Medical University in Grade 2009, using Objective Structured Clinical Examination (OSCE) after internship, which included graduation assessment of doctor-patient communication skills. Then we analyzed the doctor-patient communication skills and related scores of students trained in different clinical medical programs. Results The average score of doctor-patient communication skills of 549 students was (82.72±4.23), of which, the average score of 329 five-year students of clinical medicine was (81.88±4.23) and the average score of seven-year students was (83.96±3.91) in. The average score of seven-year students of clinical medicine was significantly higher than five-year students (P=0.000). Moreover, there was a significant positive correlation between the total score of OSCE and the score of doctor-patient communication skills in both five-year and seven-year students of clinical medicine (five year program students' score correlation coefficient was 0.520, P=0.000;seven year pro-gram students' score correlation coefficient 0.416, P=0.000). Conclusion The teaching effectiveness of doctor-patient communication has proved to be quite effective, and it is definitely of great significance in improving clinical students' doctor-patient communication skills. The score of the assessment of the doctor-patient communication reflects not only the training effectiveness of the communication skills, but also the comprehensive capacity.

The authors give an account of the changes in both internal and external environments that hospitals confront in the new century, emphasizing that it is imperative for hospital managers to manage their hospitals with new concepts and means so as to meet the needs of the times. The paper is focused on 10 ways of management, namely, knowledge management, human resources management, operational management, efficiency and benefit management, new medical quality content management, fuzzy management, information management, image management, humanistic management, and hospital culture management.

With the development of the times and the constant change of the forms of labor, it is imperative to explore the value of labor and principle of distribution of medical workers. The authors first describe a number of relevant concepts, including instruments of labor, forms of labor, value of labor, and human resources. Then they analyze the value of labor of medical workers and their administrators, including the features and forms of the creation of value by medical workers and their administrators. Finally, they expound the importance of deepening reform in the distribution system of medical institutions. By analyzing the theoretical basis for readjusting the distribution mechanism, they put forward the principles of giving expression to the creation of the value of labor in readjusting the distribution system and taking efficiency, capital and production factors into account in distribution and offer suggestions respectively for the reform of the distribution system in profit and non profit medical institutions.

Firstly the authors expound the management attribute of hospital management ethics, clarifying the connotation of hospital management ethics, the basic issues in the study of hospital management ethics, and the eight functions, tasks and goals of hospital management ethics. Secondly they discuss the relationship between hospital management and hospital management ethics. Thirdly they offer a preliminary account of the application of hospital management ethics in hospital management: ①illustrating via a diagram the application of hospital management ethics in hospital decision-making; ②presenting ways of judging “good” and “evil” activities in the hospital; and ③describing the application of hospital management ethics to the monitoring and assessment of medical programs. Finally they propose some methods for cultivating the capability of the entire staff of the hospital to fulfill the obligations of moral excellence.

Acupoints Xiaguan ( ST 7 ), Jiache ( ST 6 ),Hegu (LI 4 ) and Neiting (ST 44 ) were selected and electroacupuncture, TDP and Tuina were used to treat 60 cases of temporomandibular joint disturbance, all the patients were randomly divided into two groups to compare the therapeutic effect, the results showed the effective rate were 100% and 83% in groups of electroacupuncture, TDP and Tuina, and group of electroacupuncture and Tuina respectively.