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.

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.

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.

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.

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 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.

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 investigate the role of atherosclerotic monocytes Siglec-1 in stimulating CD4 + and CD8 + T lymphocytes proliferation and activation.Methods Experimental research.Cluster of differentiation antigen 14 (CD14) positive monocytes of 18 acute coronary syndrome (ACS),41 stable angina (SA) and 32 healthy volunteers were separated by magnetic-activated cell sorting.Different concentration of interferon-α (IFN-α,0,2,5,10 ng/ml) were used to up-regulate Siglec-1 and small interfering RNA (siRNA) or blocking antibody were used to down-regulate Siglec-1.Then monocytes were cocultured with CD4 + T/CD8 + T cells from a third healthy volunteer for 5 days.The experiment was designed for 11 groups (n=10 for each group),that was (1) normal CD14,(2) normal CD14 + IFN-α 5 ng/ml,(3) normal CD14 + IFN-α 5 ng/ml + anti-Siglec-1 2 μg/ml,(4) ACS CD14,(5) ACS CD14 + control siRNA group (Mock),(6) ACS CD14 + siRNA 679 40 nmol/L,(7) ACS CD14 + anti-Siglec-1 2 μg/ml,(8) SA CD14,(9) SA CD14 + Mock,(10) SA CD14 + siRNA 679 40 nmol/L and (11) SA CD14 + antiSiglec-1 2 μg/ml.Cell Counting Kit-8 (CCK-8) was used to determine T cells proliferation and ELISA was used to detect Interleukin-2 (IL-2),IL-10,IL-12 and IFN-γ of culture supematant.Data of cytokines detection were expressed as medium (quartiles) and analyzed by nonparametric rank sum test.Results By the blockage of Siglec-1 (group 6),the proliferation of CD4 and CD8 were decreased.Secretion of IL-2,IL-12 and IFN-γ by CD4 cells [67.00(62.50-87.30),0.86(0-1.63),and 47.82(37.60-56.67) pg/ml,respectively] were decreased and IL-10 [56.00(46.25-67.40) pg/ml] was increased compared with those in control group [group 4,213.70 (187.50-275.30),6.87 (4.90-8.93),114.90 (89.50-167.40),and 21.08 (15.70-33.20) pg/ml,respectively,with U =8.50,17.00,8.50,and 87.50,respectively.all P ＜ 0.05].When monocytes Siglec-1 from control group was up-regulated by IFN-α (group 2),secretion of IL-2,IL-12 and IFN-γ [220.44(174.30-312.30),7.90(6.540-10.40) and 143.75(78.20-210.00) pg/ml,respectively] were increased and IL-10 [21.95 (16.30-25.00) pg/ml] was decreased (compared with group 1,with U =89.50,98.00,100.00,and 0,respectively.all P ＜ 0.05).Regulation of Siglec-1 had no role in cytokines production in cocultured CD8 + T cells (all P ＞ 0.05).Conclusions IFN-α can upregulate monocytes Siglec-1.Siglec-1 may participate in the pathogenesis of AS via promoting proliferation of CD4 +/CD8 + T cells and Thl cytokines secretion of CD4 + T cells.

Objective To study the efficacy of trimctazidine combined with atorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 160 patients of pri-mary hypertension with paroxysmal auricular fibrillation were randomly divided into 4 groups. Forty patients were treated with amiodarone (control group),600 mg/d for the first week,400 mg/d for the second week and 200 mg/d later;40 patients were treated with atorvastatin (20 mg/d,3 times per day) in addition to amiodarone (the atorvasat-in group);40 patients were treated with trimetazidine (20 mg/d,3 times per day) in addition to armiodarone (the trimetazidine group);40 patients were treated with combination of trimetazidine and atorvastatin in addition to amiod-atone (the combination group),and the dose was the same as the above groups. The treatment was started within 24 hours of recovering from paroxysmal auricular fibrillation and lasted for 1 year. Results After 1 year there was 1 pa-the control group,and 62.5% (25/40) for the atorvasatin group,64.1% (25/39) for the trimetazidine group,and 84.6% (33/39) for the combination group. Compared to the control group,the effective rate of the 3 treatment groups were all significantly higher (X2=4.56、5.13、17.55,P<0.05). The effective rate of the combination group was significantly higher than that of the atorvasatin group and the trimetazidine group (X2=4.95、4.30,P<0.05),and there was no significant difference of effective rate between the atorvasatin group and the trimetazidine group(X2= >0.05). After treatment LAD was (40.96+1.81) mm in the control group,(38.65±1.90) mm in the atorvasatin group,(39.15±1.85)mm in the trimetazidine group,and (37.22±1.74) mm in the combination group. LAD of the 3 treatment groups were all significantly different from the control group(F=3.42,P<0.05). LAD of the combina-tion group was significantly smaller than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no significant difference of the LAD between the atorvasatin group and the trimetazidine group(P>0.05). There was no significant difference between the 4 groups on CRP before treatment (F=0.96,P>0.05). After treat-ment CRP was (8.85±1.45) mg/L in the control group,(5.96±1.26) mg/L in the atorvasatin group,(6.81± 1.37) mg/L in the trimetazidine group,and (3.75±1.15) mg/L in the combination group. CRP of the 3 treatment groups were all significantly different from the control group (F=3.63,P<0.05). CRP of the combination group was significantly lower than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no signif-icant difference of CRP between the atorvasatin group and the trimetazidine group (P>0.05). Conclusion The treatment with trmetazidine combined with atorvastatin could prevent recurrence of paroxysmal auricular fibrillation though anti-inflammatory and inhibiting the remodeling of left atrial.