Objective The aim of this study is to discuss the clinical teachers' behavior choices in the aspects of medical care,education and research,and explore the related factors by making an investigation.Methods This study adopts the method of Literature Review,interview and questionnaire investigation.Results 57.6％ of clinical teachers obviously felt enormous pressure,83.28％ of clinical teachers support the saying busy and time pressing is one of the most important facts; in view of the time allocation,the majority of the clinical teachers' arrangement is medical care ＞ research ＞ education or medical care ＞ education ＞ research.Conclusions Time and energy became the scarce resources for clinical teachers.On the other hand,the conflict relationship among medical care,education and research makes clinical teachers stand at the crossroads.The understanding of the relationship among medical care,education and research,and the policy environment are important factors when a clinical teacher was making a stand.

Objective:to study the relationship between YSR and CBCL in adolescents.Method:466 adolescents were collected from 3 middle or high schools by striated random sampling. YSR (youth self report) and CBCL (child behavior checklist) were applied to the adolescents,and their parents .Result:there were 103 questions same in both YSR and CBCL, the Kappa=0.001-0.218 (P=0.975～0.000). In male, the result of YSR was correlated with only one syndrome in CBCL, in female, it correlated with 7 syndromes, introversion/extroversion, and the total score of CBCL. In middle school students, the result of YSR correlated with all subscores of CBCL. In adolescents of core family, in good relationship with parents, with father had higher educational level (high school), the result of YSR correlated with most of the subscores of CBCL.Conclusion:in the population of male, high school students, of non-core family, or in poor relationship with parents, results of YSR and CBCL are not consistent.

Objective: To investigate the related factors to depression in middle and high school students Method: The BDI (Beck depression inventory), EMBU (Egna Minnen av Barndoms Uppufostran, own memories of parental rearing practices in childhood) and a self-designed psychosocial factor inventory were administrated to 1382 students in middle or high schools Result:The BDI score was positively correlated to some factors in EMBU, they were firm control and punishment, over-interference, rejection and deny, and over-protection Compared with those with low BDI score, the group with higher BDI score had more experiences of fosterage, being maltreated by family members, reared in inharmonious family, unhappy childhood and with more family history of suicide or violent behavior More of them were still in abnormal families, with poor parent-child relationship Their parents had less expectancy on them, they had poor academic achievement, even failed in go up to next grade; they were more bullied and inclined to bully peers, had no good friend, taking less sports or other entertainment, had less opportunity to be assumed class or school service jobs More of them were just before graduation Conclusion:Poor family background, poor school performance and academic stress are risk factors for depression of middle or high school students

Objective:To study the associated factors with suicide ideas in middle school students.Method:Multiple random sample method was used in the study. 1421 middle school students in Chengdu urban area were sampled and 1393 gave effective feedback. Self-made questionnaire (including age, sex, family circumstance, experience in childhood, substance abuse, question about suicide ideas, etc.), Beck Depression Inventory (BDI), Adolescent Self-Rating Life Events Check List (ASLEC) were applied to the students.Results:328 (23.5%) of the 1393 have suicide ideas. The risk factors of suicide ideas included: 1) family factors: parents' divorce, father/mother's passing away, remarried family, experienced abuse in childhood, violence or suicide behavior of family member. 2) school factors: bullying or being bullied. 3) substance abuse: smoking, drinking and addictive drugs abuse. 4) high score of BDI. 5) high score in inter-person relation factor and being punished factor of ASLEC. 6) sex factor: female. Protecting Factors of suicide ideas included better achievement in school, singleton in family and harmony of family member.Conclusion:Suicide ideas were not rare in middle school students. Clinicians and teachers should discover and try to prevent possible suicide as early as possible.

Objective To explore the effect of non-directed musical therapy on the automatic thoughts and therapeutic effect of depression.Methods 60 people outpatient and inpatient who with depression disorder participated in this research.According to the medical order,we choose the people who with Cardinality order as the group of the musical therapy (study group) and the people with the even order as the group of drug therapy (control group).all the patients was test with the Hamilton's Depression Scale (HAMD-24) and Automatic Thoughts Questionnaire (ATQ) before and after 2,4,8 weeks treatment,and comparison of these questionnaires scores of the two groups.Results After the 2,4,8 weeks treatment,the HAMD scores of the study group was (15.70±2.63),(10.03±2.28),(6.00± 1.98) and the scores of control group was (17.43±2.62),(12.47±2.75),(7.50±2.03).The result of HAMD scores had significant difference(F=11.754,P=0.001).ATQ scores of the study group was (73.27± 17.60),(58.33± 13.66),(47.43± 11.94) and the scores of control group was(84.20±22.30),(72.53±20.86),(58.90± 18.61).The result of ATQ scores had significant difference(F=4.136,P=0.047).Conclusion Non-directive musical imagery could be an effective way to improve the automatic thoughts of people who with depression disorder and improve the effect of treatment.

Objective To assess the efficacy of ropivacaine in combination with different doses of sufentanil for epidural anesthesia in patients undergoing hysterectomy. Methods Eighty ASA Ⅰ or Ⅱ patients aged 30-55 yrs weighing 40-70 kg undergoing elective hysterectomy were randomly divided into 4 groups ( n = 20 each) : ropivacaine group (R) and 3 ropivacaine-sufentanil groups (R-S1-3). The patients were unpremedicated. ECG, BP, HR and SpO2 were monitored during ansthesia. Each patient received an epidural catheter placed at L2,3 interspace. After correct placement of epidural catheter was confirmed 0.75% ropivacaine 13 ml and normal saline (NS) 2 ml were given through epidural catheter in group R whereas in the 3 R-S groups 0.75% ropivacaine 13 ml and sufentanil 10 (R-S1), 20 (R-S2) or 30 (R-S3) ?g in NS 2 ml were injected into epidural space. BP, HR and SpO2 were recorded every 3 min. The onset time, upper spread and duration of sensory block; onset and duration of motor block (Bromage scale); degree of abdominal muscle relaxation; level of sedation (OAA/S scale); anesthetic efficacy and side-effects were recorded. The dose-response curve constructed by probit regression analysis was established to calculate ED50 and ED95. Results The onset time, the time needed to reach the highest sensory level were significantly shorter and the duration of sensory block was significantly longer in the 3 R-S groups than in R group ( P

We used SDS-polyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting of monoclonal antibody (McAb) J28 and peanutagglutinin (PNA) for detecting fetoacinar pancreatic protein (FAP) in extracts of 20 cases of fetal pancreas, 5 of pancreatic cancer and 4 of normal pancreas. The result showed that fetal pancreas and pancreatic cancer had a same level band about 110000 in Commassie blue stain, but absent in normal pancreas. The band could react with both McAb J28 and PNA PNA also could react with smaller glycoprotein in pencreatic cancer. It is suggested that McAb J28 and PNA combine with different sites of FAP.

Objective To compare the effectiveness and safety of Foley catheter(FC)and vaginal prostaglandin E2 suppository(PGE2,Propess)for cervical ripening and labor induction in fullterm pregnant women with unfavorable cervix.Methods A prospective randomized controlled trial was conducted.Women with a term or post-term,live,singleton fetus in cephalic presentation,intact membranes,Bishop score＜6,not in labor,medically indicated for labor induction from June 2009 to December 2009 in Drum Tower Hospital of Nanjing University Medical School were randomly divided into two groups:FC group(n=64)and Propess group(n=62).In FC group,a 16-F Foley catheter was inserted into patient's cervical canal; once past the internal os,the balloon was inflated with 80 ml saline.Intravenous oxytocin was initiated after the balloon was spontaneously extruded from the cervix or after 24 hours.In Propess group,vaginal Propess was used.x2 or Fisher's exact test and t test were used to compare the outcomes,delivery mode and induction success rate between the two groups.Results There were no significant differences in gestational weeks,Bishop score,indication of induction,improvement of Bishop score,success rate of induction,rate of vaginal delivery,total duration of labor and volume of postpartum hemorrhage between the two groups(P ＞ 0.05,respectively).Propess group had a higher rate of vaginal birth within 24 hours[56.5％(35/62)vs 28.1％(18/64),t=10.37,P＜0.05],a higher risk for excessively frequent and hard uterine contraction[17.7％(11/62)vs 0.0％(0/64),P＜0.05]and lower incidence of oxytocin induction/augmentation during labor[21.0％(13/62)vs 87.5％(56/64),x2 =56.27,P＜0.05]than those of FC group.There were no differences in neonatal Apgar score,meconium staining and neonatal birth weight between the two groups.Puerperal infection occured in neither group.Conclusions Under strict control of indication and aseptic manipulation,Foley catheter was as effective and safe as Propess for cervical ripening with lower risk of excessive uterine activity.It is suggested that Foley catheter could be used for cervical ripening,especially in patients with economic difficulty.

Objective To evaluate the efficacy and safety of oral erythromycin in the prevention and treatment of feeding intolerance in preterm infants. Methods The Cochrane Library,PubMed,EMBASE,CBMdise,VIP,WartFang and CNKl were searched up to the year of 2008.Randomized controlled trials (RCT) of erythmmycin for feeding intolerance in preterm infants were included.According to the dosage (low-dose,3-15 mg/kg and high dose,>15 mg/kg)and gestational age(≤32 weeks vs>32 weeks),all infants were divided into several subgroups.Meta-analysis was performed with the Cochrane Collaboration's software RevMan. Results Nine RCrs involving 542 premature infants were included.(1)In preventive studies,low-dose erythromycin could significantly decrease the duration of total parenteral nutrition compared with the high-dose erythmmycin (WMD=-2.99,95%CI:-3.99--1.98).(2)Intreatment studies,highdose erythromycin could significantly decrease the duration of total parenteral nutrition (WMD=-7.06.95%CI:-7.91--6.20,P<0.01)and hospital stay (WMD=-8.10,95%CI:-14.02--2.18,P=0.007)compared with the placebo when gestational age≤32 weeks. Erythromydn could decrease the incidence of iaundice(RR=0.36,95%CI:0.21-0.63,P=0.0003)which might be the effect of bigh-dose erytromycin. Conclusions Compared with placebo,oral erythromycin of different dosage might help to achieve full enteral feeding,shorten the duration of parenteral nutrition and hospital stay,and reduce the associated cholestasis jaundice of preterm infants with different gestational age respectively.

Objective To investigate the effects of different doses of dexmedetomidine on cerebral oxygen saturation and pulmonary shunt fraction in patients undergoing one-lung ventilation (OLV). Methods Sixty ASAⅠ-Ⅱpatients, aged 46-71 years, with body mass index (BMI)18-24 kg/m2 and scheduled for thoracotomy were randomly divided into three groups (n=20 each):high dose dexmedetomidine group (group D1), low dose dexmedetomidine group (group D2) and control group (group C). Dexmedetomidine 1μg/kg was infused in group D1 after anesthesia induction, and then a rate of 0.5μg·kg-1·h-1 was continuously infused. Dexmedetomidine 0.5μg/kg was infused in group D2 after anesthesia induction, and then a rate of 0.3μg · kg-1 · h-1 was continuously infused. Group C was received the equal volume of normal saline. Anesthesia was main?tained with propofol-remifentanil and intermittent iv boluses of rocuronium. Arterial and jugular venous blood samples were collected before anesthesia induction (T0), at 15 min after two-lung ventilation (T1), at 5 min (T2) and 30 min (T3) of OLV for blood gas analysis. Value of Qs/Qt was calculated and SctO2 was recorded at the same time. Results Compared with group C and group D2, Qs/Qt was decreased at T2 in group D1 (P<0.05). Qs/Qt was lower at T3 in group D1 and D2 than that of group C, and which was lower in group D1 than that of group D2 (P<0.05). In group C and group D1 a significant de?crease in SctO2 was observed at T2 and T3 compared to that at T0 and T1 (P<0.05). SctO2 was significantly higher at T2 and T3 in group D2 than that in group C and group D1 (P<0.05). Conclusion Dexmedetomidine given during OLV undergoing thoracotomy can improve oxygenation, decrease pulmonary shunt fraction and reduce the occurrence of low SctO2.