Based on the foreign experience of communication skills training for medical students and the present situation of communication skill training in China, this paper analyses the aim and model of communication skills training for medical students, and provides some advice on the reform of medical education and cultivation of medical talents.

Objective To investigate the influence factors of left ventricular hypertrophy ( LVH) in incipient systemic lupus erythe-matosus (SLE) patients with lupus nephritis (LN).Methods A total of 210 LN patients in the authors′centre were enrolled in this cross-section study .General information , laboratory measurements , examinations of left ventricular hypertrophy by ultrasonography were col -lected.Patients were divided into two groups according to left ventricular mass index (LVMI):left ventricle thickening (LVT) group (n=89) and left ventricle normal group (n=121).General information and laboratory results of two groups were statistically analyzed .In-fluence factors of the patients were analyzed with Spearman rank correlation and multiple linear regression .Results Serum uric acid and hyper-sensitive C-reactive protein (hs-CRP) were higher in left ventricular thickening (LVT)group, as compared with those in left ventricle normal group .Hemoglobin and estimated glomerular filtration rate ( eGFR) in LVT group were significantly lower than those in left ventricle normal group (P<0.05).Spearman rank correction indicated that LVH was positively correlated with serum uric acid and hs-CRP (r=0.283、0.327, all P<0.05).LVH was negatively correlated with hemoglobin and eGFR (r=-0.232, -0.186, all P<0.05).Multiple linear regression showed hs -CRP and hemoglobin correlated with LVH (β=0.235、-0.206, all P<0.05).Conclu-sion Inflammatory state and anemia were risk factors of LVH in LN patients .

OBJECTIVE: To provide reference for effective and safe application of anticancer drugs in the clinic. METHODS: Combined with the practice and experience in PIVAS for 5 years, the evaluation approach of anticancer drugs were analyzed and summarized comprehensively. RESULTS & CONCLUSIONS: The anticancer drugs prescription was evaluated in respect of reasonable dosage, rational solvent, appropriate drug usage, special usage and the reasonability of drug combination, which guarantee the quality of anticancer drug and rational use of drug in the clinic.

Objective To evaluate the common causes of chronic cough and the diagnostic value of clinical symptoms,and provide evidences for empirical treatment.Methods The causes of patients with chronic cough were evaluated by a validated systematic diagnostic protocol.The characteristics of the cough timing,characters,incentives and associated manifestations of chronic cough with different causes were compared.Results A total of 160 patients with at least 8 weeks of chronic cough and normal chest radiographswere recruited from the Department of respiratory diseases of Yichang Central Hospital between Jan.to Dec.2009.The most common causes of chronic cough were cough variant asthma (CVA,n =72,45％ ),upper airway cough syndrome ( UACS,n =54,33.75％ ),eosinophilic bronchitis ( EB,n =14,8.75％ ),gastroesophageal reflux-related chronic cough ( GERC,n =9,5.63％ ),other etiologies ( n =11,6.87％ ).Significant differences were observed in different etiological subtypes.The incidence of nocturnal cough in CVA was 52.8％ ( 38/72 ),significantly higher than others types ; URCS patients manifested more day coughs,with 70.2％ postnasal drip syndrome and significantly more cases had the history of nasal diseases compared with other types.The specificity of cough associated with meals in GERC were 66.7％,and the regurgitation associated symptom in GERC were77.8％,significantly higher than other types.However no special syndromes were observed in EB patients.Conclusion All kinds of chronic coughs have specific symptoms.The spectrum of causes and clinical features of chronic cough are important in the diagnostic procedure of chronic cough.

Using the micromethod of Farmer and Abt, plasma vitamin C content of 9S boys and girls in a middle school was determined throughout the year 1954 to 1955. A dietary survey was also carried out every month of the year, for calculating the vitamin intake. The results of the present study are as follow:1. When the diet contains ample amount of fresh leafy vegetables in season, a satisfactory plasma vitamin C level can be maintained. When the diet is limited in fresh vegetables, plasma vitamin C readily decreases in those seasons.2. There is a significant seasonal variation of plasma vitamin C content Highest values are obtained in winter, the maximal content occurring in December. The minimal value is observed in June. This corresponds to the variation in the. level of vitamin C intake in different seasons. There is no significant difference between Autumn and Winter.3. No definite correlation between plasma vitamin C content and the condition of the gums was observed in the present study.4. The plasma vitamin C content of Chinese and English school children observed by some other authors was lower than that obtained in the present investigation. It is believed that the increase plasma vitamin C of the subjects in this study is mainly due to improvement of the living condition of the population and widespread education of the people in the fundamentals of nutritional science in recent years.

Sixty-seven students suffering from nightblindness in a middle school in Peking were examined with a new apparatus designed by us for the dark adaptation test before and after the treatment of the disease during April, 1955. This apparatus was equipped with a series of holes with different luminosity. The time needed to see all the holes before and after the treatment with vitamin A, was 118 and 62 seconds respectively. In the following spring, a year after diet improvement program was started, there were no complaint of nightblindness among the students. In May, 1956, 49 students who had sufferred from nightblindness in the previous year, were reexamined with the same apparatus, and the time needed was 45 seconds When this result was compared with that of a vitamin A supplemented group (31 seconds), there was no significant difference.From the above findings, it has been shown that nightblindness can be prevented by improvement of the diet alone, and the above apparatus is suitable for the diagnosis of nightblindness for mass nutritional survey. The description of the apparatus is presented in the text.

OBJECTIVE:To summarize general regularity and characteristics of amiodarone-induced pulmonary toxicity,and to provide reference for rational use of amiodarone and avoiding the occurrence of ADR. METHODS:Retrieved from CNKI,VIP and Wanfang database,individual case report literatures about amiodarone-induced pulmonary toxicity were collected during 1990-2016. The included cases were analyzed statistically. RESULTS:A total of 19 related literatures were collected,involving 20 cases of amiodarone-induced pulmonary toxicity. Among them,the patients older than 60 years old accounted for 75.0% with ratio of male to female 3:1. 75.0% patients had used medicine more than 1 month when pulmonary toxicity occurred. The dose of amiod-arone in 17 patients ranged 200-400 mg/d. Six patients died,accounting for 30.0%. CONCLUSIONS:Pulmonary toxicity induced by amiodarone may be related to patients'gender,age,dose and medication time. The mortality of it is in relative high level. Med-ical staff should pay attention to it,regularly monitor and process it timely.

AIM: To investigate the effect of IL-10 on IL-1?-induced prostaglandin E 2(PGE 2) release and cyclooxygenase-2(COX-2) expression in human mesangial cells and to examine whether IL-10 has effect on the biological function of IL-1?.METHODS: The PGE 2 concentration in supernatants of HMC was measured by radioimmunoassay. The COX-2 mRNA and protein were measured by RT-PCR and Western blot, respectively. RESULTS: PGE 2 and COX-2 were significantly increased after treatment with IL-1?( P0.05 , respectively), while it inhibited IL-1?-elicited PGE 2 production, as well as COX-2 mRNA and protein expression in a concentration-dependent fashion. CONCLUSIONS: These results indicated that IL-10 depressed the IL-1?-induced release of PGE 2 and expression of COX-2. These data suggested that IL-10 could exert anti-inflammatory actions at several levels, not only by inhibiting the production of pro-inflammatory cytokines but also by suppressing their biological function.

Objective To explore the clinical application and the relative factors that effect on the diagnostic accuracy in CT-guided percutaneous puncture biopsy(PPB) of pulmonary masses.Methods PPB in 72 cases with pulmonary masses were performed.The results ofsurgery,pathology, image,and the relative factors that effect on the diagnostic accuracy of PPB were analyzed.Results The punctureaccuracy was 100%,the diagnostic accuracy was 89.6%(61/72),the rate of complication was 11.1%(8/72) in CT-guided percutaneous puncture biopsy of pulmonary masses.The determining factors that effect on the diagnostic accuracy and the rate of complication were age of patients,present of emphysema,size and internal content of pulmonary masses in CT-guided percutaneous puncture biopsy.Conclusion CT-guided percutaneous puncture biopsy was a safe,accurate and simple mean of diagnosis and differential diagnosis for pulmonary masses.To improve the accuracy and reduce complication ,the related factors of patients ,lesion,and the technique should be attended.

Objective To study CT and MR imaging features of pulmonary carcinoma of mediastinal type.Methods CT and MRI data (including anatomic site,size,shape,margin of the tumors and the relationship between tumors and mediastinum) of 15 patients with pulmonary carcinoma of mediastinal type confirmed by surgery and pathology were analyzed retrospectively.All patients underwent plain CT scans,and 11 of them also underwent contrast-enhanced CT scans,and 3 of them underwent plain MR scans and Gd-DTPA enhanced MR scans.Results On CT and MRI,the single mass was located subpleural of mediastinum with wide base.There were 5 cases of small cell lung carcinoma,8 squamous carcinoma,1 adenocarcinoma and 1 adenosquamous carcinoma.The majority of tumors manifested as ellipse.The tumors were lobulated in 12 and spicular margins in nine.8 tumors located in superior mediastinum,5 in medium mediastinum,2 in infra mediastinum and 12 in the borderline between the anterior mediastinum and medinum mediastinum.The tumors and enlarged lymph nodes of hilar and mediastinum connected closely in 7 cases.The bronchus were stenosed or obstructed by the tumors in 9 cases,and metastatic bone destruction of thoracic cage in 4 cases.Conclusion The pulmonary carcinoma of mediastinal type is easy misdiagnosed,CT and MRI findings in combination with clinical data can improve its diagnostic rate.