Objective to get the message of the state of refreser doctor patient communication and put forward the solution.Method 200 patients were investigated who were hospitalized in the department of gynaecology and obstetrics of the seconed affiliated hospital of Chongqing Medical University,and the state of the doctor patient communication as well as the affecting factor were questionnaired.Results 182 questionnaire was reclaimed,the ratio of reclaim was 91%.50.3% patient considered the advanced study doctor communation was satisfactory,41.2% patient considered the communicatin is common,8.5% patient considered the communicatin is dissatisfing.65.3% patient considered the service attitude affected the communication,42.3% patient considered the speech of the doctor effect the communication,41.2% patient considered the behavior of the doctor effected the communication.Conclusion the refresher doctor was deficient in the doctor patient communication,and the training was required in the service attitude,speech and behavior arts.

Objective To compare the effect of electroacupuncture at head points and body points on glucose metabolism of the cerebral motor function regions in normal subjects.Methods To observe the change of glucose metabolism of cerebral motor area in normal subjects between before and after acupuncture during the movement by PET.Talairach coordinates(Atlas of brain) and statistical parametric mapping(SPM) software were used to deal with the acquired imaging data.Results ① Acupuncture at Baihui(GV20) and left Qubin(GB7) could increase metabolism of glucose in bilateral Lps and precuneus,the activation of left area in the brain being more significant.②Acupuncture at right Quchi(LI11) and Zusanli(ST36) change metabolism of glucose in left gyrus precentralis,right loblus paracentralis,right gyrus frontalis medialis,both cerebellums and both putarnens.Conclusion All acupoints can change glucose metabolism in cerebral structures related to motor function in the bilateral cerebral hemispheres,different acupoints active different motor areas.The function of acupuncture is a kind of comprehensive regulative process.

Lung ultrasound has been proven to have high sensitivity and specificity in the application of lung diseases, and significantly reduces the radiation exposure of children, especially in newborns, which makes it widely used in diagnosis, treatment and prognosis of childhood disease.In emergency and intensive care units, lung ultrasound can even replace chest radiographs as a routine examination method for chest lesions.However, the research of children′s lung ultrasound still falls behind the development of adult ultrasound, and there is a lack of standard procedures and specifications for children′s lung ultrasound.Therefore, this study mainly reviewed the research status of children′s lung ultrasound.

Aim: To investigate the effect of endogenous nociceptin/orphanin FQ(N/OFQ) on arrhythmias induced by myocardial ischemia/reperfusion (I/R) in rats and the role of microRNA-1 (miR-1) in it. Methods: Twenty-four Sprague-Dawley rats were randomly divided into sham-operation group (Sham group), ischemia/reperfusion group (I/R group) and the pretreatment of N/OFQ receptor antagonist (UFP-101) group(U + I/R group). The model of myocardial ischemia/reperfusion was prepared by ligating the left anterior descending branch of the coronary artery of rats. The incidence and arrhythmogenic scores during reperfusion in rats were recorded and analysed. The myocardium at the risk of ischemia was collected at 120 min after reperfusion. MiR-1, GJA1 and KCNJ2 levels were detected by qRT-PCR and Cx43 and kir2. 1 protein levels were detected by Western blot. Results: Antagonism of endogenous N/OFQ could significantly reduce reperfusion arrhythmias and arrhythmogenic scores, compared with I/R group (P < 0. 01). The qRT-PCR and Western blot results suggested that compared with sham group, miR-1 expression significantly increased in I/R group(P < 0. 01), while the expression of Cx43, Cx43 mRNA and kir2. 1 decreased(P< 0. 05); compared with I/R group, pretreatment with UFP-101 led to reduction of miR-1 (P<0. 05) and rise of Cx43 and kir2. 1 (P < 0. 05). Conclusions: Endogenous N/OFQ up-regulates miR-1 and inhibits the expression of Cx43 and kir2. 1 proteins, leading to reperfusion arrhythmias in rats.

Objective: To explore value of exercise stress test guiding aerobic exercise rehabilitation in patients with myocardial infarction.Methods: A total of 102 patients with myocardial infarction in recovery were selected.According to random number table, they were randomly and equally divided into routine rehabilitation group (received routine rehabilitation guidance) and aerobic exercise rehabilitation group (received aerobic rehabilitation exercise in guidance of exercise stress test).Amount of exercise, hemodynamic parameters and psychological state were compared between two groups.Results: After treatment, amount of exercise: compared with routine rehabilitation group, there were significant rise in amount of exercise[(6.79±0.58)METs vs.(7.42±0.69)METs], maximum heart rate[(126.27±5.26) beats/min vs.(138.18±5.81) beats/min], heart rate blood pressure product[(221.87±21.46) vs.(244.85±23.09)]and exercise duration[(10.36±1.36) min vs.(11.18±1.45) min]in aerobic rehabilitation group, P<0.05 or <0.01;hemodynamic parameters: compared with routine rehabilitation group, there were significant rise in cardiac output[(5.36±0.57) L/min vs.(5.72±0.68) L/min], cardiac index[(2.96±0.53) L min-1 m-2 vs.(3.25±0.52) L min-1 m-2], stroke volume[(73.16±8.47) ml vs.(78.12±9.14) ml]in aerobic exercise rehabilitation group, P<0.05 all;psychological state: compared with routine rehabilitation group, there were significant reductions in scores of Hamilton rating scale for anxiety[HAMA, (9.74±3.26) scores vs.(6.35±1.18) scores]and Hamilton rating scale for depression[HAMD, (14.83±4.58) scores vs.(10.56±3.27) scores]in aerobic exercise rehabilitation group, P<0.05 both.Conclusion: Exercise stress test guiding aerobic exercise rehabilitation can help to improve exercise function and hemodynamic indexes, alleviate the negative mood, then promote patients recover.

Objective To observe the clinical efficacy of bloodletting and cupping at Fengchi (GB 20) plus acupuncture in treating peripheral facial paralysis in acute stage.Method Sixty patients with peripheral facial paralysis in acute stage (disease duration ≤7 d) were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by bloodletting and cupping at Fengchi (GB 20) plus acupuncture, while the control group was treated with ordinary acupuncture. The two groups were treated once a day, 5 times a week, 2 weeks as a treatment course and 3 treatment courses in total. The House-Brackmann (H-B) facial nerve grading system was observed before and after the intervention, and the clinical efficacies in the two groups were compared. Result The total effective rate was 96.7% in the treatment group versus 93.3% in the control group, and the difference was not statistically significant (P>0.05). There were statistically significant differences in the H-B score between the two groups respectively after 2 and 3 treatment courses (P<0.05).Conclusion Bloodletting and cupping at Fengchi (GB 20) plus acupuncture is an effective approach in treating peripheral facial paralysis in acute stage.

Objective To evaluate the significance of cystatin C (CysC) in the diagnosis for early kidney injury of diabetes and hypertension by testing serum CysC and serum creatinine concentration and urinary albumin excretion (UAE) in patients with type 2 diabetes and primary hypertension.Methods Sixty-six patients with type 2 diabetes were selected,among whom the total 38 patients whose UAE were 30-300 mg/24 h were classified into early diabetic nephropathy (DN) group,and 28 patients whose UAE were ＜ 30 mg/24 h were classified into non diabetic nephropathy (NDN) group.Fifty-two patients with primary hypertension were selected,among whom the total 25 patients whose UAE were ≥ 30 mg/24 h were classified into hypertension with kidney injury group,and 27 patients whose UAE were ＜ 30 mg/24 h were classified into hypertension without kidney injury group.Sixty health people were selected as control group.The UAE,CysC and creatinine levels were detected.Results The CysC in early DN group was significantly higher than that in control group and NDN group [(1.84 ± 0.83)mg/L vs.(0.41 ± 0.62) and (0.66 ± 0.59) mg/L],and there was statistical difference (P ＜ 0.05).There was no statistical difference in CysC between NDN group and control group (P ＞ 0.05).There were no statistical differences in creatinine and UAE among the DN group,NDN group and control group (P ＞ 0.05).The CysC in hypertension with kidney injury group was significantly higher than that in control group and hypertension without kidney injury group [(0.93 ± 1.04) mg/L vs.(0.41 ± 0.62) and (0.69 ± 0.57) mg/L],and there was statistical difference (P ＜ 0.05).There was no statistical difference in CysC between hypertension without kidney injury group and control group (P ＞ 0.05).There were statistical differences in creatinine and UAE among hypertension with kidney injury group,hypertension without kidney injury group and control group (P ＞ 0.05).Conclusion CysC can be regarded as the value to judge early kidney injury,and it is very important inunderstanding patient's condition,by which appropriate treatment can be carried out to prevent or decrease the occurrence of chronic renal failure.

Objective To generate an human interleukin-17 receptor-like molecule (IL-17RLM) recombinant plasmid with 6?myc tag and detect its specific expression in eukaryotic cells. Methods Design two specific primers(including the enzyme sites of EcoRⅠand XhoⅠ), reextract hIL-17RLM-L DNA fragment after PCR and insert it into the 6?myc tagged pcDNA3.0 vector, then detect its expression by Western blot after transfecting COS7 cells. Results The 6?myc tagged recombinant plasmid pcDNA3.0- 6?myc /hIL-17RLM-L was generated successfully and its expression can be detected by Western blot in eukaryotic cells. Conclusion The eukaryotic expressing plasmid pcDNA3.0-6?myc /hIL-17RLM-L was generated successfully and its specific expression was realized, which may provide the basis for further research of its biological function.

Objective To evaluate the clinical significance and prognosis of tetus with lateral ventriculomegaly.Methods We retrospectively analyzed 92 singleton pregnant women who were antenatally diagnosed with fetal ventriculomegaly by ultrasound in genetic conselling clinics,Department of Gynaecology and Obstetrics,Nanfang Hospital,Southern Medical University between August 2007 and August 2010.All participants were divided into three groups according to the width of the lateral ventricles:group A (10.0-12.0 mm,n＝50),group B (12.1-14.9 mm,n=38) and severe ventriculomegaly group (≥15.0 mm,n=4).All fetuses were followed up.Chi-square test(or Fisher's exact test),Bonfferoni method,Mann Whitney or Kruskal-Wallis test were used for statistics.Results In group A,B and severe ventriculomegaly group,18％ (9/50),65.8％(25/38)and 3/4 of fetuses were complicated with structural malformation,respectively (x2 =22.934,P =0.000),and statistical significance were found only between group A and B (x2 =20.798,P=0.000).The incidences of fetal chromosomal aberration were 4.0％ (2/50),7.9％ (3/38)and 0/4 in the three groups,respectively (x2＝0.878,P ＝ 0.645).Eventually,all four cases with severe cerebral ventriculomegaly were terminated.Among cases of mild ventriculomegaly,63 women continued the pregnancy (48 in group A and 15 in group B).The intrauterine improvement of group B was poorerthan that of group A (Z=-3.317,P =0.001).Respectively,three,ten and two cases of ventriculomegaly deteriorated,stabilized and regressed in group B,and the corresponding figures were 3,15 and 30 in group A.In group A,the prognosis of fetus with non-isolated ventriculomegaly was poorer than that of fetus with isolated ventriculomegaly (Z=-2.631,P=0.009).For neonates 14 days after birth (n=62),the rates of normal neonatal behavioral neurological assessment (NBNA) scoring were respectively 93.8％ (45/48) and 71.4％ (10/14) for groups A and B with statistical difference (Fisher's exact test,P =0.040).Bayley scales of infant development (BSID) used to evaluate infants at 12-month-old revealed that the psychomotor developmental index (PDI) between group A and group B had statistical difference (8,26 and 1 case of good,moderate and poor development in group A; one,seven and three cases in group B; Z=-2.203,P=0.043).However,the mental developmental index (MDI) between group A and B had no statistical difference.Twenty babies among the survived ones received magnetic resonance imaging (MRI) examination.The results showed that lateral ventricle width regressed in nine babies (45.0％) and progressed in one baby (5.0％).Ten cases (50.0％) did not change.The change of ventriculomegaly after birth was related to BSID evaluation.Better prognosis of fetuses were found in those with regressed ventriculomegaly (P=0.033).Conclusions Fetuses with mild ventriculomegaly (10.0 12.0 mm) have a favorable outcome.Further investigations,such as fetal development,chromosomal examination,intrauterine infection screening and MRI if necessary,are suggested for fetus with ventriculomegaly.Moreover,intensive intrauterine and postnatal follow-up is recommended.

Objective To construct lentiviral vectors containing small interfering RNA (siRNA) sequence of Siglec-1 and to screen the effective vector.Methods Three fragments of Siglec-1 siRNA were designed and cloned into pGCSIL-GFP lentiviral plasmid.And then the plasmid was cotransfected into 293T cells with pHelper 1.0 and pHelper 2.0 plasmids.Forty-eight hours later,culture supernatant with virus particles was collected and concentrated.Virus titer was determined by 10-fold serial dilution method and virus was transduced into primary cultured mouse bone marrow-derived macrophages (BMM).Flow cytometry and QRT-PCR were used to screen effective vector with inhibition ability.Results Three vshRNA lentiviral plasmids and a control plasmid were constructed successfully and verified by DNA sequencing.Virus titer was between 1×10s TU/ml and 1×109 TU/ml,which was suitable for in vitro and in vivo experiments.The Lv-1 could inhibit Siglec-1 expression effectively in vitro transduction of BMM.Conclusion Lentiviral vectors containing siRNA sequence of Siglec-1 were constructed successfully and an effective vector was screened,which may lay the foundation for using the vector in gene knockdown experiment in vivo.