Clinical tutors' personality manifesting during the process of clinical practice and daily communication with medical interns has a series of influences on medical ethics formation of medical interns,including influences of direction,demonstration,contraction,and halo effect.Thus,clinical tutors should pay attention to cultivating a decent moral personality,and hospitals should value the proper combination of moral evaluation and supervision for medical staff in order to achieve the unity of heteronomous morality and self discipline,and effectively promote the formation of decent morality and personality of clinical tutors.

Objective To observe the effect of nerve growth factor(NGF) on Caspase-3 expression in hippocampus of epileptic rats induced by kainic acid(KA) and explore the protective effect and mechanisms of NGF on the epileptic neurocytes.Methods Sixty healthy rats aged 21 to 30 days were randomly divided into 3 groups,each of which included 20 rats.Rats in group A were treated with 9 g?L-1 sodium,rats in group B were treated with KA,rats in group C were treated with KA and NGF.Concentration of KA was 2 g?L-1 diluted by 9 g?L-1 sodium;KA was injected into rats in group B and group C,intraperitoneally.Then state of seizure was recorded,and EEG and pathological section were performed.Five rats in each group were sacrificed by perfusion with paraform respectively at 6 hour,on the 1st day,on the 3rd day after injection of KA.Specimen was sampled and made into frozen section.Expression of Caspase-3 in hippocampus of epileptic rats was analyzed by immunohistochemistry.And microscope image measuring and analysis instrument was used to analyze image of expression.Results Symptoms of seizure appeared 30 min after injection of KA.Seizure was proved by detection of EEG and pathological section.Expressions of Caspase-3 detected by immunohistochemistry in group C decreased at every time spot were higher than those in group B,and the defferences between 2 groups had statistically significant(Pa

Objective To detect serum bone specific alkaline phosphatase(BAP) and osteocalcin(OC) in children with idiopathic short stature(ISS),and explore the status of osteoblast.Methods Thirty-six cases of ISS in this study were divided into two groups(preaddescence group and adolescence group),50 healthy children as control group.The height,weight and body mass index in every group were measured.Left hand and wrist were measured with CHN way for bone age.Serum BAP and OC were measured by enzyme linked immunosorbent assay(ELISA).Results BAP and OC in ISS group of preadolescence were(79.90?25.96) U/L,(60.96?18.46)?g/L,and(152.17?35.36)U/L,(76.16?28.03)?g/L in normal children.In the ISS group of adolescence BAP and OC were(108.33?35.20)U/L,(63.82?24.81)?g/L,and(156.30?35.29)U/L,(104.92?28.26)?g/L in normal group.There was significant difference between ISS and control group in both age in the levels of BAP and OC(Pa

Objective To evaluate the effect of arsenic trioxide (As2 O3 ) on the proliferation of human renal carcinoma cell line 786-O ,and to explore the changes of the PI3K-Akt signaling pathway .Methods Human renal cancer cells 786-O was cultured in 96-well plates ,and divided into the control group (n= 45 holes) and the experimental group (n= 45 holes) .After stimulation by 1 μM As2 O3 and saline ,the cells in 15 holes were collected at 0 ,12 ,and 24 h .BrdU assay was performed to quantify DNA synthesis to evaluate the cells proliferation ,the quantitative PCR was used to measure PI3K and Akt relative mRNA expression ,and Western blot was used to quantify the relative expression levels of of intracellular PI 3K and Akt .Results After 12 ,24 h of As2 O3 stimula-tion ,the amount of DNA synthesis in the observation group was gradually lower than that of the DNA synthesis at 0 h(P<0 .05) and significantly lower than that of the control group at 12 h and 24 h(P<0 .05) .At 0 ,12 ,24 h ,the relative expression level of in-tracellular PI3K and Akt mRNA and protein in the observation group had no significant difference (P>0 .05) ,and the relative ex-pression levels of PI3K and Akt mRNA and protein in the control group were increased as the proliferation was gradually increased . Conclusion As2 O3 inhibits human renal carcinoma cell line 786-O proliferation through inhibiting the PI3K-Akt transduction path-way ,and has potential clinical value for the treatment of kidney cancer .

Objective To evaluate the expression of MMP-2 and MMP-9 and their relation with tumor invasion and metastasis in transitional cell carcinoma of bladder (TCCB). Methods Immunohistochemistry of EliVision were respectively used to determine the MMP-2 and MMP-9 expression in tumor tissues of 46 patients with TCCB and 14 cases of control group which were screened quantitatively (3-5 cm of surrounding tumor) between August 2006 and August 2008. Results Expression of MMP-2 and MMP-9 in TCCB are obviously higher than the normal control group (P <0.01), expressions of MMP-2 and MMP-9 in level Ⅱ,Ⅲ are obviously higher than in level Ⅰ (P <0.01), but there was no significant relationship between high stage or level Ⅲ and low stage or level Ⅱ (P >0.05). Conclusion The positive expressions of MMP-2 and MMP-9 in tumor tissues correlated with the malignant degree, invasion and metastasis of TCCB, MMP-2, MMP-9 could be useful indicators for the assessment of prognosis of TCCB.

Humans ; Male ; Middle Aged ; Polycythemia ; etiology ; Sleep Apnea, Obstructive ; complications

Cyclosporine ; pharmacokinetics ; therapeutic use ; Humans ; Treatment Outcome

Objective To compare the effects of general anesthesia versus combined epidural?general anesthesia on postoperative complications in the patients undergoing thoracic surgery. Methods Two hundred twenty?one patients of both sexes, aged 18-80 yr, weighing 36-100 kg, of American Society of Anesthesiologists physical status Ⅰ?Ⅲ, scheduled for elective thoracic surgery, were randomly divided into either combined epidural?general anesthesia group ( group GE, n=112) or general anesthesia group ( group GA, n=109) . The patients were further allocated to high?risk population and low?risk population. Anesthesia was induced with target?controlled infusion of remifentanil and iv injection of propofol, sufentanil and rocuronium. A double?lumen endotracheal tube was placed, and the patients were mechanically ventilated. Partial pressure of end?tidal CO2 was maintained at 30-40 mmHg. Anesthesia was maintained with inhalation of 1% sevoflurane, target?controlled infusion of remifentanil, iv infusion of propofol, and intermittent iv boluses of sufentanil. 2% lidocaine 4 ml∕h was infused epidurally in group GE, and normal saline 4 ml∕h was given in group GA. Bispectral index value was maintained at 40-60 during surgery. Patient?controlled epidural analgesia ( PCEA ) was performed after surgery. PCEA solution contained
0.125% ropivacaine and sufentanil 0.5μg∕ml ( in 250 ml of normal saline) . The PCEA pump was set up to deliver a 2 ml bolus dose with a 20?min lockout interval and background infusion at 4 ml∕h, and visual analogue scale ( VAS) score was maintained less than 4. When VAS score ≥ 5, sufentanil 5 μg was injected intravenously as the rescue analgesic. The requirement for rescue analgesics after surgery, length of hospital stay after surgery, complications during postsurgical hospital stay ( cardiovascular events, cardiac insufficiency, acute coronary syndrome, pulmonary infection, stroke, transient cerebral ischemic attack) , and death within 30 days after surgery were recorded. Results Compared with group GE, the incidence of postsurgical cardiovascular events and atrial fibrillation was significantly decreased in group GA ( P<0.05) . In the high?risk population, compared with group GE, the length of hospital stay after surgery was significantly shortened, and the incidence of postsurgical atrial fibrillation was decreased in group GA ( P<0.05) . In the low?risk population, compared with group GE, the length of hospital stay after surgery was significantly shortened (P<0.05), and no significant change was found in the incidence of postsurgical complications, requirement for rescue analgesics after surgery, and fatality rate in group GA (P>0.05). Conclusion Compared with combined epidural?general anesthesia, general anesthesia alone provides lower occurrence of postsurgical complications for the patients undergoing thoracic surgery, and offers advantage for the high?risk patients having underlying diseases before surgery.

Objective To observe influence of salmeterol xinafoate and fluticasone propionate powder applied in asthmatic exacerbated period on relieving efficacy of a fast-acting beta2-agonist.Methods Eighty-nine children with asthma in exacerbated period were randomly assigned into two groups.Thirty-nine cases in treatment group inhaled salmeterol xinafoate and fluticasone propionate powder, compared with 50 cases in control group treated with budesonide aerosol. Two groups were all given Bricanyl aerolised inhalation in same way at meanwhile.Results The improvement of peak expinatory flow in two groups was evident. The disappearing time of main symptoms and signs, the duration of staying in hospital of two groups were no difference (all P

Objective To explore the clinical significance of dynamic determination of serum procalcitonin(PCT)levels in judgment of infection and prognosis in patients with severe craniocerebral injury.Methods A total of 80 patients with severe craniocerebral injury were selected and they were divided into infection group and non-infection group.Infection group was divided into improved group and non-improved group.Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score and Glasgow coma scale(GCS)score was compared between infection group and non-infection group.The level of serum PCT,white blood cell count(WBC),C-reactive protein(CRP)and interleukin(IL)-6 was compared on the first,third,fifth day of admission in intensive care unit among these groups.Results Infection group in 48 patients,and non-infection group in 32 patients.There was no significant difference in age,sex and GCS score between two groups(P ＞0.05).APACHE Ⅱ score in infection group was higher than that in non-infection group [(21.71 ± 7.13)scores vs.(15.32 ± 6.17)scores],and there was significant difference (P＜ 0.05).The level of serum PCT on the first day of admission in intensive care unit in infection group was higher than that in non-infection group[(2.15 ± 1.79)ng/L vs.(0.56 ± 0.47)ng/L],and there was significant difference(P＜ 0.05).There was no significant difference in WBC,CRP and IL-6 between two groups(P＞0.05).The level of serum PCT,WBC,CRP,IL-6 on the third day of admission in intensive care unit in infection group was higher than that in non-infection group,and there was significant difference(P＜ 0.05).The level of serum PCT on the fifth day of admission in intensive care unit in infection group was higher than that in non-infection group [(3.09 ± 1.98)ng/L vs.(1.06 ± 0.63)ng/L],and there was significant difference (P＜0.05).WBC,CRP,IL-6 on the fifth day of admission in intensive care unit was(15.13 ±6.32)×109/L,(103.56 ±40.62)mg/L,(230.41 ± 121.83)ng/L in improved group(38 cases),and (18.62 ±8.89)× 109/L,(134.38 ± 34.16)mg/L,(268.73 ± 138.12)ng/L in non-improved group(10 cases),and there were significant differences between two groups(P ＜ 0.05).The level of serum PCT on the first,third,fifth day of admission in intensive care unit in improved group was lower than that in non-improved group,and there was significant difference(P ＜ 0.05).Conclusion The alteration of serum PCT level may be used as one of the effective predictors for infection in patients with severe craniocerebral injury and for their prognosis.