Nowadays the education of medical professional ethics has been obviously weakened.We can see that from some mainly expressions: There are many prejudices about medical ethics and the medical ethics education seems not very effective.But the medical professional ethics education is an important part of medical education,which directly affects the healthy development of medical and hygienic enterprise.And we must correct it,enhance it.We should inherit the good quarters of traditional medical ethics,reestablish the humanism medicine,promote virtue of medical personnel increasing,and establish the professional ethics of medical students before they become doctors.

Objective To study the method, advantage and shortcoming of mini-laparoscopic treatment for indirect inguinal hemia in children. Methods 136 cases with indirect inguinal hernia(right:75cases,left:44 cases,bilateral:17 cases) had been treated by high ligation with mini-laparoscopy. Results The mean operation time was 10 mmin for unilateral hernia and 23 mmin for bilateral hernia. Among 119 cases with unilateral hernia,38 cases had been found with contralateral latent hernia. The mean of postoperative inhospital stay were about 1 ～ 2 day(s). All patients had been followed-up for 3 ～ 12 months,there were only 2 cases recurrence found but no complications was detected.Conclusion Mini-laparoscopic high ligation for indirect inguinal hernia in children is a single, safe, satisfactory, effective,and minimally invasive surgical method.

Objective The aim of this paper was to develop the Mobile Nutrition Order System based on the technology of hospital information system to adapt the nutrition and food security management model in the new situation, so that the unified informa-tization management of diet for patients could be implemented by the Department of Nutrition. Methods The Mobile Nutrition Order System, with the functions of information entry, nutrition recipe, order making and data transmission, could be constructed by the com-bination of technologies between informatization and digital order. Results The automation of nutrition order in hospital was a-chieved, and the nutrition recipe and nutritional therapy could be realized in hospital, the effect was very obvious. Conclusion Since the application of Mobile Nutrition Order System, the labor intensity of servers has been reduced, saving working hours effective-ly.Meanwhile, the management of nutritional therapy was improved and the quality of logistics services in hospital and nutritional ther-apy ascend to a new high.

Objective To explore the application of mini-laparoscopy in the diagnosis and management of nonpalpable undescended testis in children.Methods 38 cases of impalpabal testes(46 testicular) had been operated by mini-laparoscopy in children with cryptorchidism.Results 38 children with nonpalpable undescended testis (46 testicular) had been operated by mini-laparoscope.Results After laparoscopic exploration,inguinal probe and postoperative pathology,it had been confirmed that 2 testicular were absent,34 testicular were found in high inguinal location,10 testicular were located in intraperitoneal cavity.In addition to the absent testicular,the rest had been performed with mini-laparoscope:one period descent fixation 41 testes,Fowler-Stephens (F-S) installment orchiopexy three testes.Follow-up with side testicular atrophy 2,including one period orchiopexy a testis,F-S installment fixation a testicular; Testicular rebound 1,who had been operated with one phase of testicular descent fixtion.Conclusion For inguinal failed to find the testicular,children with cryptorchidism should be done by laparoscopy because of its positioning accuracy,and most children can do a period drop fixed,but for those really intraperitoneal more exalted person,stage surgery should be needed.Its overall treatment effect is satisfactory and is worth popularizing.

A comparison is made on the healthcare systems,economy,informationization environment,developers,investment and compensation mechanisms in nine countries featuring early startup,rich experiences,and relatively higher ratio of success in their development projects.This lead to a discussion focusing on the construction steps and development strategies for regional health informationization,and an analysis of the present regional health informationization overseas,common measures taken,and key factors for successful regional health informationization.Based on these,recommendations were made on development of regional health informationization compliant to China's circumstances.

Objective To studiy the surgical outcomes of children with congenital aortic stenosis (AS),and summarized the experience of surgical procedures.Methods From February 2006 to November 2011,a total of 49 consecutive children with AS underwent surgical treatments.Twenty-nine patients were male and 20 patients were female.The median age was 17 months (1 month to 14 years),and median weight was 15.6 kg (3.2-47.0 kg).Peak AS gradients was (74.9 ±20.4)mmHg (45-123 mm Hg) before surgery.Fourteen patients had isolated congenital AS,4 had combined moderate-to-severe aortic insufficiency (AI).Thirty-Three patients had associated cardiac anomalies,including ventricular septal defect,atrial septal defect,patent ductus ateriosus,coarctation of aorta,subaortic stenosis,and supravalvular mitral stenosis.Thirty-one patients underwent aortic valvotomy,9 valvuloplasty,2 Aortic valve replacement (AVR),1 Ross procedure,2 Ross-Konno procedure,and 4 Konno/AVR.Median follow-up was 20 months (2-55 months).Clinical and echocardiographic follow-up data were analyzed.Results There was 1 postoperative death who died of heart failure due to severe mitral valve insuffciency.Latest follow-up data showed that the survivals performed in satisfactory cardiac function.Left ventricular ejection fraction (LVEF)was 0.69 ±0.10,and fraction shortening (FS) was 0.38 ±0.09.Peak AS gradients decreased significantly after surgery to (38.6 ± 15.8) mm Hg (20-73 mm Hg),P ＜ 0.001.One patient needed reintervention because of severe recurrence of adhesion in the commissure 3 months after the previous surgery.Totally 31 patients underwent simple valvotomy procedure.Postoperative AI was none or trace in 5,mild in 20,and moderate in 6.Two surgical techniques were used to repair the aortic valve according to the anatomy of the valve and the cause of insufficiency,including commissuroplasty in 6 and pericarial casp extension in 3.Nine patients underwent valvuloplasty procedure,post-operative AI was none or trace in 3,mild in 5,and moderate in 1.We put more attention to the 7 patients who had moderate AI valvotomy or valvuloplasty,and the latest follow-up showed that these patients were in good condition and there was no deterioration the degree of AI.Conclusion Long-term outcomes show that aortic valvotomy and valvuloplasty are reliable and effective approaches for congenital AS in children.When moderate-to-severe AI exists,other procedures such as Ross,Ross-Konno,AVR,or Konno/AVR are preferred.

Objective A retrospective review of the use of delayed sterna closure (DSC) after pediatric cardiac operations.The purpose of this study is to access the morbidity of DSC and to analyze the risk factors that may predict the need for DSC.Methods Between January 2008 and December 2011,5 546 infants (2 843 males,2 703 females) underwent cardiac operations through midterm sternotomy in Shanghai Children' s Medical Center.Median age was 5 months(1 day to 11 months) and mean weight was 6.1 kg(2.0-12.5 kg).The pathologies included transposition of great artery(TGA),corctation of aorta (CoA),interruption of aortic arch (IAA),pulmonary atresia (PA),truncus arteriosus (Truncus),complete atrioventricular septal defect(CAVSD),total anormalous pulmonary vein connection (TAPVC),double outlet of right ventricle(DORV),tetralogy of Fallot(TOF),and ventricular septal defect(VSD),et al.All hospital records were reviewed and clinical data were studied and analyzed.Results A total of 313 patients had DSC (5.6％).There were 191 males and 122 females.The reasons for DSC are hemodynamic instability in 296,bleeding in 11,and ECMO(or VAD) in 6 patients.Two hundred and fiftyone (80.2％) patients were less than 5 kg,84 (26.8 ％) patients were neonates,and 125 (39.9％) patients aged between one and three months old.The incidences of DSC for these patients were 13.9％,34.4％,and 18.4％ respectively.The diagnosis of complex congenital heart defects had a high risk of DSC.The incidences of DSC for TGA,CoA,IAA,PA,Truncus,CAVSD,TAPVC,and DORV were 28.8％,17.8％,43.1％,9.0％,30.4％,6.5％,and 10.8％ respectively.The DSC patients had longer duration of CPB time(147 min versus 72 min) and clamping time(81 min versus 40 min).In 282 patients the sternums were closed 1-11 days after the initial operation.In 3 cases the trial of closure failed for the first time and succeeded a second time until several days later.Fouty-six patients died ultimately including 15 patients died after the closure of sternum with a total mortality of 14.7 ％.Surgical site infection occurred in 17 patients (5.4％),and surgical intervention were needed in 4 severe cases(1.3％).Conclusion Neonates,an age less than 3 months,weight less than 5 kg,long CPB time and clamping time,and the diagnosis of complex congenital heart defects were risk factors of the need for delayed sterna closure after pediatric cardiac operations.

By means of literature review,the paper made a comparative study of key development projects of healthcare information in China over the last decade,in terms of their project characteristics,economic environment,development entity,investment and compensation practice,development strategy,coverage,experience and promotional values.Setbacks identified include the following:discrepancy in regional development stages of healthcare information; successful pilots are limited to scientific research samples; lack of regional models; systems separation; poor continuity and coordination; waste and insufficiency of resources in the investment and construction among others.The authors recommend a better exchange of experiences in building the regional healthcare information service platforms,greater investment,better compensation mechanism,better top-tier design,and maximized coverage within reach of supervision and technology.

Objective To analyze the prognostic factors and trerapy strategy of lung cancer in the patients aged 80 years and over.Methods Totally 107 patients aged ≥ 80 years with lung cancer were retrospectively reviewed.Patients' clinical characteristics and treatment were analyzed.Results Median survival time of the patients was 6.9 months.92.9％ (13/14) of small cell lung cancer patients and 34.4％ (31/90) of non small cell lung cancer patients were treated.Life cycle of patients who accepted effective treatments and supportive treatments were 16.5 months and 8.7 months,respectively (P=0.008).In the early stage of tumors,survival time of patients undergoing surgery was 36.7 months,15.5 months in patients without surgery (P=0.023),while in the late stage,survival time of patients receiving combined chemotherapy was 13.4 months,4.6 months in patients receiving single agent chemotherapy(P=0.002).In small cell lung cancer,survival time of patients who received radiotherapy was 12.8 months,6.4 months in patients who did not receive radiotherapy (P=0.049).Performance status (PS),clinical stage,early surgery,late chemotherapy and radiotherapy(x2=38.236,18.831,5.187,9.827,4.186,P＜0.05),but not sex and pathology type affected the prognosis.PS score (P=0.003)and clinical stage(P=0.046) were the independent influencing factors.Conclusions Performance status and clinical stage are the independent influencing factors of lung cancer in the patients aged over 80 years.Patients may improve survival if receiving surgery,chemotherapy and/or radiotherapy when they have good PS,otherwise patients may choose best supportive care.

Objective To explore the immunomodulatory mechanism of 2-(-2-benzofuranyl )-2-imidazoline(2-BFI) in rat model of experimental autoimmune encephalomyelitis (EAE).Methods Fifty fe-male Sprague-Dawley(SD) rats were randomly divided into five groups by random digit table , including con-trol group(n=10), EAE model group(n=10), low dose 2-BFI group(1.5 mg/kg, n=10), median dose 2-BFI group (3 mg/kg, n=10) and high dose 2-BFI group (6 mg/kg, n=10).The SD rat model of EAE was induced by immunizing with a guinea pigs′spinal cord homogenate ( GPSCH ) .The severity of EAE was scored according to the signs and symptoms .Pathological changes were observed through Hematoxylin-eosin staining, and then the degrees of inflammatory infiltration were evaluated .The number of activated neuroglia that expressed GFAP and iba 1 in lumbar cords was counted by immunohistochemistry .The expressions of IL-1β, IFN-γ, IL-4 and IL-10 in cervical cords were measured by ELISA .Results Compared with EAE group, rats in the low, median and high dose 2-BFI treatment group had lower incidence of EAE , prolonged latency and decreased CNS inflammation , but only the median dose group showed significant alleviation in clinical symptoms and decrease in CNS inflammatory cell infiltration (P<0.05).Immunohistochemical re-sults showed that the numbers of activated microglia were significantly inhibited ,but the numbers of activated astroglia were increased in the rats treated with median dose of 2-BFI in comparison with the EAE group ( P<0.05).Results of ELISA demonstrated that expressions of IL-1βand IFN-γin 3 mg/kg 2-BFI treated group were significantly decreased compared with that in the EAE group (P<0.05), but expressions of IL-4 and IL-10 were remarkably increased(P<0.05).Conclusion 2-BFI at median dose of 3 mg/kg has a benefi-cial neuroprotective effect on rats with EAE , and its mechanism might be related to immunodulation .