Coincidence exists in the value selection,main form of human communication and imbalance between teacher-student relationship and doctor-patient relationship.Therefore,teacher-student relationship today will directhy have an impact on the future of doctor-patient relationship.Teachers should cultivate medical students'equality consciousness and communicating ability between doctors and patients by establishing equal relationship and good communication between teachers and stdents.

Objective To clone and express the extracellular portion of mouse Fcγreceptor Ⅱ-b ( FcγRⅡb) and to analyze the functions of the expressed proteins in a mouse model of systemic lupus ery-thematosus ( SLE) .Methods The gene fragment encoding FcγRⅡb was amplified by PCR, and then in-serted into the prokaryotic expression vector pET-32a(+) to construct the recombinant expression plasmid pET-FcγRⅡb.The expression plasmid was identified with restriction enzymes and then sent to the Shanghai Bio-Engineering Co.LTD for further sequencing analysis.The transformed Escherichia coli ( E.coli) BL21 ( DE3) strains carrying the recombinant expression plasmid pET-FcγRⅡb were induced by isopropylβ-D-1-thiogalactoside ( IPTG) .The expressed fusion proteins were analyzed by Western blot assay and purified with purification kits.The immune complex ( IC)-binding ability of FcγRⅡb was measured by ELISA.MRL/lpr mice with SLE in both the prevention (12 weeks old, n=40) and the treatment groups (19 weeks old, n=40) were randomly divided into four groups including 60 μl (4.8 μg) treatment group, 120 μl (9.6 μg) treatment group, 180μl (14.4μg) treatment group and PBS treatment group with 10 mouse in each group. The MRL/lpr mice with SLE were injected with the fusion protein through tail vein once a week for four con-secutive weeks.Serum samples were collected from each mouse after one week of observation.The levels of FcγRⅡb in soluble form in mice form both the prevention and treatment groups as well as the levels of anti-double stranded DNA antibodies were detected by ELISA.Results The gene encoding FcγRⅡb was ampli-fied and the recombinant expression plasmid pET-FcγRⅡb was successfully constructed.The recombinant proteins were expressed in the prokaryotic expression system, and then successfully purified.The recombi-nant proteins could bind to IC.Compared with the corresponding PBS control group, the levels of FcγRⅡb in soluble form were increased in mice from both prevention and treatment groups after treating with various concentrations of the recombinant protein (P<0.05).Significant differences in the levels of FcγRⅡb were found among mice of the same age after treating with different concentrations of the recombinant protein ( P<0.05).Compared with the corresponding PBS control group, the levels of anti-double stranded DNA anti-bodies were decreased in mice from both prevention and treatment groups after treating with various concen-trations of the recombinant protein (P<0.05).The levels of anti-double stranded DNA antibodies were grad-ually decreased along with the increasing dosage of protein (P<0.05).Conclusion The extracellular por-tion of murine FcγRⅡb in soluble form was successfully expressed.The recombinant proteins played a cer-tain role in the prevention and treatment of SLE in a mouse model.

12)is good after nonoperative treatment above 2 years.

Objective To investigate the effect of carvedilol combined with spironolactone in the treatment of elderly patients with chronic heart failure clinical efficacy and to provide reference for clinical treatment of formulation. Methods 104 elderly patients with chronic heart failure were randomly divided into observation group and control group,52 cases were randomly divided into observation group and control group.Control group intervention in accord-ance with the conventional treatment of chronic heart failure program,the observation group in the conventional scheme based on,combined with oral carvedilol and spironolactone therapy.6 months after treatment,clinical efficacy was compared between the two groups.The results of echocardiography before and after treatment in two groups were compared.The adverse reactions in the treatment process were compared.Results The effective rate in the observation group was 59.62%,the total effective rate was 96.15%,which were significantly higher than those of the control group (χ2 =4.10,9.82,all P <0.05);After treatment,LVEDD and LVESD of the two groups were significantly lower than those before treatment[(51.89 ±7.06)mm,(41.39 ±6.85)mm,(60.71 ±7.43)mm,(51.02 ±7.95)mm], LVEF[(52.31 ±9.02)% and (41.64 ±7.73)]were significantly higher than that before treatment,there were statistifically significant differences between the two groups(t =4.92,5.10,5.45,2.87,2.98,3.03,all P <0.05);After treatment,LVEDD[(51.89 ±7.06 )mm],LVESD [(41.39 ±6.85 )mm]of the observation group were significantly lower than those of the control group,and LVEF(52.31 ±9.02)% were significantly higher than that of the control group,there were statistifically significant differences between the two groups (t =3.02,2.98,2.97,all P <0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P >0.05).Conclusion Carvedilol combined with spironolactone can significantly improve the clinical effect of the treatment of elderly patients with chronic heart failure,effectively improve the left ventricular remodeling in patients with,improve myocardial contractility in patients and has good security.

Objective To evaluate the role and safety of continuous vano-venous hemofiltration(CVVH) in treating critical patients. Methods We summarized 109 cases of critical patients treated by CVVH in our ICU from 2002 to 2006. Results The therapy time ranged from 18 to 72 hours. Of all patients, there were 13 cases of hypotension, 5 cases of filter occlusion,2 cases of bleeding and 3 cases of local or blood infection. Conclusion CVVH can be appli-Gated in critical patients with good safety and efficiency. High-quality management plays an important role in the carry--out of CVVH.

Objective To evaluate the value of spiral CT in analyzing correlation of growth pattern with pathology and prognosis in gastric stromal tumor(GST).Methods CT findings and pathological data including immunohistochemical staining sections of 43 patients with GST were reviewed and all patients were followed.The correlation between growth pattern,pathology and prognosis was studied.Results Of the 43 GST,there were benign in 9 and malignant in 34.the benign or malignant GST closely correlated with the growth pattern.Of the 17 intra-and extra-luminal growth patients,16 cases were malignant and 5 cases recurred in 3 years.Conclusion The GSTs that appear intra-and extra-luminal gowth hint the poor prognosis.

Medical Ethics Committee founded in medical orgnizations,universities,academic periodicals and hygiene institutes is an international regulation in the filed of medicine.Although we have done a large amount of work to be in line with international standards,there are still some problems such as no systemic roles,function deficiencies etc.Therefore,we should study its establishing background and main function and strengthen its construction.

Objective To investigate the efficiency of chitosan hemostatic dressing combined radial artery hemostasis device in patients after transradial coronary intervention.Method Six hundred consecutive patients after transradial coronary intervention were selected and randomly divided into the experimental group and the control group according to the hospital number,there were 300 cases in each group.Single pneumatic tourniquet was used in the control group,while the chitosan hemostatic dressing combined with pneumatic tourniquet was used in the experimental group.Hemostasis consumption time,incidence of bleeding,ecchymosis and radial arterial occlusion were compared between two groups.Results There was no significant difference in the incidence of skin ecchymosis between two groups,P ＞ 0.05.The hemostasis consumption time and the incidence of bleeding,early radial arterial occlusion and chronic radial arterial occlusion were (127.6± 33.0) min,7.0％(21/300),5.7％(17/300),4.0％(12/300) in the experimental group and (181.6± 32.2) min,20.0％(60/300),11.7％(35/300),9.0％(27/300) in the control group,t or x2 values were 20.258,21.708,6.822,6.170 respectively,and there were significant differences,P＜0.01 or ＜0.05.Conclusion In patients after transradial coronary intervention,the application of chitosan hemostatic dressing combined with pneumatic tourniquet is safer and more effective than using pneumatic tourniquet alone.

Objective To discuss the feasibility of constructing the system of traditional Chinese medicine nursing diagnosis.Methods Based on the theoretical analysis and status quo analysis,the feasibility of constructing the system of TCM nursing diagnosis was discussed,and the achievements and problems waiting for settlement were also narrated.Resuts It has the foundation of constructing the system of TCM nursing diagnosis,but some problems still need to be solved.Conclusions It is feasible for building TCM nursing diagnosis system,and the TCM nursing diagnosis system does not conflict with NANDA-I.

Objective To study the right ventricular function of patients with pulmonary thromboembolism by using color Doppler ultrasound.Methods 31 patients with acute pulmonary thromboembolism,compared with 31 vohnteers,were enrolled in this study.The right ventricular anterior wall movement,right ventricular end diastolic volume,right ventricular ejection fraction,and myocardial performance index were observed by echocardiography.Resuits The right atrium diameter,right ventricles diameter,right ventrieular end diastolic volume and pulmonary artery inner diameter in study group were much larger than that in control group (P<0.01),and the right ventricular anterior wall movement and right ventrieular ejection fraction decreased in study group (P<0.01).Tricuspidal annular E peak velocity tended to be decreased,isovolumie relaxation time and isovolumic contraction time were prolonged and myocardial performance index was increased (P<0.01).Right ventricular myocardial performance index showed significant correlation with right ventrieular ejection fraction (r=0.78,P<0.01),isovolumic relaxation time and isovolumic contraction time(rl=0.88,r2=0.57,P<0.01).Conclusion The right ventricular function in patients with pulmonary thromboembelism is decreased and myocardial performance index is a sensitive index which can be used to reflect right ventricular function in pulmonary thromboembolism.