We often have to choosea between amputation and salvage after severe injuries in lower limbs of children.We have established the score scale and discriminatory equation in judging the severity of low limb injury in children.Through medical ethical analysis,the author makes a conclusion that the score scale and the discriminatory equation is valuable in determining severity of lower limbs injury in children.

Medical science is the science which closely combines scientific knowledge with humanistic spirit. Becausemodern science and technology have been more and more applied in medical research and practice, the medical sciencehas been developed rapidly. But medical science calls us to concern more about medical humanistic spirit, so how wecombine medical scientific knowledge with humanistic spirit is a very important topic in our medical university education.[

BACKGROUND:Analgesia in different ways can be selected for the elderly in hip and knee arthroplasty. Considering the actual situation of the elderly patients, choice of anesthesia should be reasonable in order to achieve fast acting, long lasting time and good analgesic effect. OBJECTIVE:To explore the analgesic effect of ropivacaine of lumbar epidural anesthesia on elderly knee arthroplasty. METHODS:A total of 78 elderly patients aged 80-96 years, who were treated with hip and knee arthroplasty in the Shenyang Orthopaedic Hospital from September 2011 to September 2014, were enrol ed in this study. They were equal y and randomly assigned to control group and observation group, and separately administered continuous epidural anesthesia and lumbar epidural anesthesia with ropivacaine. The excel ent and good rate, onset time, anesthetic induction, frequency of use of Duffing mixture, and adverse reactions were compared between the two groups. RESULTS AND CONCLUSION:The excel ent and good rate of analgesic effect was higher in the observation group (97%) than in the control group (87%) (P<0.05). Onset time was significantly shorter, the dose of anesthetic was significantly less, frequency of use of Duffing mixture was significantly less in the observation group than in the control group (P<0.05). The difference was not significant in adverse reactions between the two groups (P>0.05). Above results indicated that lumbar epidural anesthesia of ropivacaine obtained good analgesic effects during elderly knee arthroplasty.

The scenario simulation teaching method created a novel teaching mode for medical ethics and explored the new methods to enhance the teaching level.Through 6-year practice teaching,the authors made a comprehensive summary,refined the process,and resolved the existing problems.Several experiences gained in the process.The form of scenario simulation is novel,which is loved by the students.It is helpful to achieve the teaching goal that class should be led by students,cultivate medical students' humanistic quality,and make teaching benefits teachers as well as students.

Indirect fluorescent antibody test (IFAT) using frozen sections of Brugia malayi adult worms as antigen was employed in the diagnosis and epidemiological investigation of human filariasis. Sera were collected from 704 cases with bancroftian or malayan microfilaremia. the positive rate was 92.8-99.1%. Of 150 healthy people from non-endemic areas, only one showed a positive reaction (false positive rate 0.7%) (Table 1). This technique proved to be highly sensitive and specific for the diagnosis of filariasis and the antigen is easy to prepare. It might be used in sero-epidemiological investigation for the assessment of filariasis control.

Chinese Physician Declaration and Medical Professionalism in the New Millennium-Physician De-claration in the United States and European countries are two significant documents that promote and cultivate phy-sicians′professionalism. Researches showed that the two declarations were basically the same in the background and guiding ideology. However, influenced by the historical tradition, cultural characteristics, medical and health system, medical science technological development, and social psychological factors, there exists difference in terms of perceive and practice. The differences manifest in the comprehension and grasping, ethnical theory basis, the nature and the degree of standard abilityand practice guarantee of physicians′professionalism. Therefore, study on the differences between the two declarations is beneficial to the construction of physicians′professionalism in our country.

Objective Study the fecal flora diversity of the tree shrew , to provide a basis data of fecal bacteria of feeding the tree shrew .Methods Ten tree shrews were used in this study .The Stools of the animals were respectively cultured with oxygen and without oxygen to isolate the bacterial .Then the PCR-amplified 16S rRNA of the bacterial was sequenced and analyzed .Results 25 bacterial strains belonging to ten bacterial species were isolated by anaerobic incubation , and 25 bacterial strains belonging to twelve bacterial species were isolated by aerobic incubation .Proteus vulgaris, Enterococcus faecalis, Escherichia fergusonii, Enterococcus faecium, Shigella flexneri, Shigella sonnei, Staphylococcus aureus , Aeromonas salmonicida subsp .masoucida , Rahnella aquatilis , Exiguobacterium aquaticum , Raoultella terrigena , and Escherichia coli were identified in this study .Conclusions There is a fecal flora diversity of the tree shrew, and the Proteus vulgaris , Escherichia fergusonii and Enterococcus faecium may be the major parasitic flora .

Objective To explore the prognostic value of APACHE Ⅱscore in patients with Severe acute organophosphorus poi-soning .Methods 42 patients with Severe acute organophosphorus poisoning ,in which 34 cases survived ,8 cases dead ,were select-ed .The APACHE Ⅱscores of patients in first 24 h of admission were collected ,and receiver operating characteristic curves (ROC curve) were drawn .Results APACHE Ⅱ score of the 42 patients with Severe acute organophosphorus poisoning was 18 ~30 (20 .11 ± 6 .32) ,in which the survival group was(16 .10 ± 3 .12) ,the dead group was(28 .01 ± 4 .46) (P<0 .01) .With the increase of APACHE Ⅱ score ,the fatality rate gradually increased .The total area under the ROC curves of APACHE Ⅱ score for death judgment was 0 .922 ,APACHE Ⅱ score of 21 .2 was the best diagnostic point ,the sensitivity was 95% ,and specificity was 89% . Conclusion The APACHE Ⅱscore could predict severity of patients with Severe acute organophosphorus poisoning ,and APACHEⅡscore ≥21 .2 could be used as the prognosis for death of the patients .

On August 2-4,2023,the"Third Summit Forum on'Building a Community of Shared Future for Doctors and Patients'"was jointly organized by institutions such as the Chinese Medical Ethics,the Hospital Humanities Management and Talent Training Special Committee of the China Population and Culture Promotion Association,Center for Ethical Studies of Renmin University of China,the Newspaper for China's Physicians,the China Health Law Society,the China Anti-Cancer Association,and the China Association For Ethical Studies in Harbin.The conference arranged a sub-forum for the"Seminar on the Construction of Chinese Medical Humanities",with domestic medical humanities scholars attending the conference.After heated discussions at the seminar,the Scholars'Consensus on the Construction and Development of Chinese Medical Humanities was formed.It was proposed that in the new era,it is urgent to build the medical humanities discipline,as well as lead the academic integration and development of medical humanities under the core socialist values.At the same time,for the construction of the medical humanities discipline,it is necessary to optimize the organizational mechanism,prosper and develop the overall framework of the medical humanities discipline,accelerate the construction of a professional teaching team for the medical humanities discipline,promote the establishment of a new carrier medical humanities education and teaching in cultivating morality and nurturing talents,as well as focus on solving problems related to the cultivation of medical humanities graduate students.

Objective To study the effect of plaque eccentricity on stent performance and stress distributions of artery and plaque during stent implantation in stenotic vessels. Methods The stent and idealized stenotic vessels were constructed, and 4 different eccentricities (0%, 20%, 40%, 60%) were attributed to the plaque. Then the stent recoil, stent foreshortening, and stress distributions of artery and plaque when the stent was expanded to the target displacement were analyzed by the finite element method. Results Along with the increase of plaque eccentricity, both stent recoil and stent foreshortening gradually grew. At the same time, the stress of artery and plaque also showed an increasing tread, and high-stress areas gradually approached the narrow side. The maximum von Mises stress of the plaque was much greater than that of the artery. Conclusions Plaque eccentricity had a certain effect on performance of the stent and stress distributions of stenotic vessels. In stent design, the geometry of the plaque should be considered to improve clinical effect of the stent in interventional treatment.