The purpose of the medical moral education is to make medical undergraduates form stable feature and tendency of the medical moral psychology.In order to improve the development of the medical moral psychology as well as ensure the result of medical moral education,we should continuously make the medical moral education suit to the rule of the formation and development of medical moral psychology.

[Objective]To explore the vascularization within spherical porous ?-TCP scaffolds in vivo.[Method]Thirty adult rabbits were selected and divided into 5 groups randomly.Spherical porous ?-TCP scaffolds(the diameter was 2 cm,the pore size was 500～600?m,the interconnection size was 110～120 ?m) were harvested at 1,2,4,8 and 12 weeks after embedded into muscle-fascia lumbodorsalis pouches in each rabbit separately,in order to observe the vascularization by means of morphological and quantificational analysis.[Result]No vessel was detected at one week after surgery,and only a few immature vascular buds could be seen at the 2nd week.The first vascularization peak could be observed at 4 weeks,characterized by the growth of quantity of new blood vessels(P0.05).[Conclusion]The process of vascularization comprises two phases,the quantity increasing in the early stage and the quality enhancing in the later stage.The special architecture and biodegradation characters of scaffolds could influence the vascularization.

Purpose:To evaluate radiotherapy after operation of esophageal carcinoma. Methods:A comparative study was done between the group of 80 patients treated by postoperative radiotherapy and the group of 80 patients by operation only from January 1989 to June 1994. The radiation dose was 40—50 Gy. Results:The 1 ,3 ,and 5 year survival rates of operative group were 76.3%, 37.5%, 22.5%, and those of postoperative radiotherapy were 77.5 %,56.3 %,32.5 %. There was significant difference between the 3 year survival rates of the two groups ( P

The authors first describe the current situation of cooperative medical care in China, pointing out that due to low levels of guarantee, difficulties in fundraising and insufficient government reimbursement, cooperative medical care in rural areas have come across many hardships. It is, therefore, imperative to set up as soon as possible a health security system for people in rural areas. Firstly, it is necessary to break up the dual social security structure of urban and rural areas and set up a model with transitional goals based on the actual situation of the country. Secondly, it is suggested that security taxes begin to be collected, bringing the health security for people in rural areas into line with the social security framework so as to promote the health security for people in rural areas without lowering the level of social security in urban areas.

Objective The aim of the study is to investigate whether the progressive incremental exercise can induce the change in bone maximum force.Methods One hundred and seventy healthy SD rats,aged 3 months,were used as samples after adaptive exercise for one week,and then they were divided to a basic control group(C_0),8 control groups and 8 exercise groups according to the training duration(2W,4W,6W,8W,9W,11W,13W and 15W).Based on Bedford and our pre-study.the longest training duration of the rats was 15 weeks.The maximum force(F) of femoral bone and the 2nd lumbar vertebrae(L_2)were tested by three-point bending test and compressive test separately.Results It was shown that there was no pronounced difference in F of femoral bone between con trol groups and exercise groups.But significant differences in F of L_2 were found between the control groups and exercise groups(P<0.001).Conclusions Changes in different degree were found in the F of femoral bone and L_2 during the process of growth.The differential effects of incremental exercise on F were caused by the difference in training intensities and in the bone types.

Objective To explore the imaging features and its correlation with pathological findings of giant cell tumor of the ten-don sheath (GCTTS).Methods The clinical data,radiographic images and pathological characteristics of sixteen cases of GCTTS confirmed by pathology were retrospectively reviewed.Plain CT,pre and post-contrast MR were performed in all patients.HE stai-ning was used to investigate the histological characteristics of GCTTS,and immunohistochemistry was employed to detect the ex-pression of CD68.Results There were nine cases of local type GCTTS and seven cases of diffuse type GCTTS in our present study. Nine cases were located in the knee joint,four cases in the foot,and three cases in the hand.Compared with normal skeletal muscle signals,lesions showed isointensity or low intensity on T1 WI and inhomogeneous low intensity on T2 WI.Three cases caused adja-cent bone destruction,one case lead to adjacent bone absorption,and no abnormality was found in other twelve cases.Six cases were injected Gd-DTPA for enhanced scan,in which four cases showed significantly heterogeneous enhancement,one case mild heteroge-neous enhancement,and one case no heterogeneous enhancement.Pathology examination results revealed that GCTTS parenchyma cells were mainly formed by histocyte-like monocytes,and scattered multinuclear giant cells.GCTTS mesenchyme was rich in gelat-inous fiber and hemosiderin pigmentation.Conclusion MR has a significant advantage in detecting specific hemosiderin pigmentation and determining lesions area of GCTTS.Combination of MR with pathology results may improve the diagnosis accuracy.

Objective:To investigate the effect of ultrasound-guided transverse abdominal plane block combined with dexmedetomidine on cesarean section.Methods:Eighty pregnant women undergoing elective cesarean section under general anesthesia in Binzhou Central Hospital from October 2017 to October 2019 were included in this study. They were randomly assigned to undergo either cesarean section under general anesthesia followed by patient- controlled intravenous analgesia (control group, n = 40) or ultrasound-guided transverse abdominal plane block combined with intravenous dexmedetomidine administration (observation group, n = 40). Analgesic efficacy and the analgesic effect on puerperas and their newborns were compared between the observation and control groups. Results:At 2, 4 and 12 hours after surgery, the Visual Analogue Scale score in the observation group was (2.1 ± 0.9) points, (2.2 ± 0.7) points, (3.0 ± 0.6) points, respectively, which was significantly lower than (4.4 ± 1.3) points, (4.9 ± 1.2) points, (3.9 ± 0.8) points in the control group, respectively ( t = 8.946, 7.854, 6.246, all P < 0.05). At 2, 4 and 12 hours after surgery, the comfort score in the observation group was (3.4 ± 0.8) points, (3.2 ± 0.7) points, (3.3 ± 0.7) points, respectively, which was significantly higher than (2.1 ± 0.7) points, (2.2 ± 0.9) points and (2.5 ± 0.8) points respectively in the control group ( t = 7.235, 6.130, 5.953, all P < 0.05). After surgery, the number of times the demand button of the anesthesia pump in the observation group was pressed was (8.4 ± 2.9), with the rate of patient satisfaction of 97.50% (39/40), which was significantly higher than that in the control group [13.1 ± 3.7, 77.50% (31/40), t = 7.036, χ2 = 9.347, both P < 0.05). At 1 and 2 days after surgery, the cumulative amount of anesthetics used for patient-controlled intravenous analgesia was (52.1 ± 1.9) mL and (121.7 ± 4.1) mL respectively, which were less than (63.6 ± 2.4) mL and (146.5 ± 5.3) mL in the control group, respectively ( t = 6.240 and 8.842, both P < 0.05). The score of extubation quality in the observation group was significantly lower than that in the control group [(1.3 ± 0.3) points vs. (3.2 ± 0.5) points, t = 6.664, P < 0.05]. There was statistically significant difference in cortisol content between the two groups at 10 minutes after extubation and at the time points of fetus removal, skin incision and intubation (all P < 0.05). In the observation group, the partial pressure of carbon dioxide in the umbilical cord blood was significantly reduced, the partial pressure of oxygen and the oxygenation index in the umbilical cord blood were significantly increased, and Apgar score at 1 minute after birth was significantly increased (all P < 0.05). Conclusion:Ultrasound-guided transverse abdominal plane block combined with dexmedetomidine can enhance the anesthetic effect on cesarean section, prolong analgesic time, reduce the amount of analgesics, improve the operation effect, reduce maternal stress responses, and improve maternal and infant health.

Objective To investigate the effects of eritoran on the expressions of the inflammatory cytokines interleukin-1β (IL-1β),tumor necrosis factor-α (TNF-α) and interferon-[ (IFN-β) mRNA in the basilar artery after subarachnoid hemorrhage (SAH) in rabbits.Methods Atotal of 36 healthy adult male New Zealand white rabbits were randomly allocated into three groups:SAH (n =12),normal saline (n =12) and eritoran (n =12) groups.A SAH model was induced by injection of autologous arterial blood into cisterna magnatwice.An equal amount of cerebrospinal fluid was displaced with the saline in the normal saline group.An equal amount of autologous non-heparinized arterial blood was injected immediate after the replacementof cerebrospinal fluid in the SAH group.Eritoran 1.5 mg/kg was injected intravenously immediately after the blood injection via the cisterna magna each time in the eritoran group.The food intake and neurological deficit were assessed.The expressions of IL-1β,TNF-α and IFN-β mRNA in the basilar artery were detected by real-time fluorescence quantitative polymerase chain reaction.Results The food intake scores (1.20 ± 0.41 vs.2.20 ±0.61; t =53.073,P =0.002),the neurological deficit scores (1.46 ± 0.32 vs.2.6 ± 0.08; t =306.431,P =0.001),the expressions of IL-1β (1.22 ±0.48 vs.2.38 ±0.06,P =0.000),TNF-α (1.39 ±0.07 vs.3.32 ±0.21,P =0.000) and IFN-β (1.51 ±0.08 vs.2.18 ±0.05,P =0.000) in Eritoran group were all significantly lower than those in the SAH group.Conclusions Eritoran may downregnlate the expressions of inflammatory cytokines IL-1β,TNF-α and IFN-β mRNA in the basilar artery after SAH in rabbits,increasing food intake,and improving neurological deficits.

Objective To develop a sheet to assess infection risks in children with malignant tumors after chemotherapies.Methods A risk assessing sheet (to consult) was designed and used to consult 24 experts from 9 hospitals located in 6 provinces.After 3 rounds of expert consultation,a sheet (to try) was developed and tried by nurses in the clinic.And then a sheet (to use) was developed.Results The authority coefficient of experts was 0.79,the positive coefficient of experts was 1.00 and 0.96.The sheet (to try) developed after 3 rounds of expert consultation consisted of 30 items and was divided into 2 parts,one was about static items and the other was about dynamic items.Depending on the trying of the sheet (to try),the sheet (to use) was constituted by 8 fundamental immune state assessing items and 16 infection risk screening items.Conclusions Experts consulted in the study were quite reliable,representative and positive.The sheet (to use) seemed to have good pertinence and practicability.Further studies should be done to verify whether the sheet (to use) may help nurses to prevent children with malignant tumors from infections after chemotherapies.

Background and purpose: The effects of tumor after radiotherapy and chemotherapy with tumor cell apoptosis have positive correlation. Survivin is an apoptosis suppressor gene, which is overexpressed in lung cancer. The reduction of its expression can increase lung cancer cell apoptosis. RNA interference can speciifcally and effectively blocked the expression of this gene. After accepting a dose of radiation, tumor tissues can raise the rate of gene transduction. The purpose of this study was to investigate the effects of the expression of Survivin gene suppressed by intratumor injection siRNA and radiation in lung cancer. Methods:Mouse subcutaneous transplanted with tumors were randomly divided into four groups:untreated group (group A), group with intratumor injection siRNA (group B), group with radiation (group C), group 4 Gy pre-irradiation combination with intratumor injection siRNA (group D). Two days later, mouse with different treatments were executed by cervical dislocation and stripped the subcutaneous tumors. mRNA and protein levels of Survivin gene were detected by quantitative real-time PCR (qRT-PCR) and Western blot; Cell cycle and cell apoptosis were assayed by lfow cytometry (FCM). Results:The expression of Survivin gene in mRNA and protein levels in group B, C, and D were signiifcantly reduced compared with group A. The differences of Survivin expression in mRNA level between group A and group D were statistically signiifcant. Compared with the other 3 groups, the expression of Survivin gene in group D was signiifcantly reduced, the differences were statistically signiifcant (P=0.036);The proportion of cells in S-phase of group D was (2.70±0.34)%, compared with group B [(8.93±0.75)%] and group C [(6.71±0.51)%], that was significantly reduced. The differences of the proportion of S-phase cells in group A and group D were statistically signiifcant (P=0.034);The rate of cell apoptosis in group D was (25.67 ± 0.65)%, which was signiifcantly increased compared with the rate of cell apoptosis in the other 3 groups, the differences were statistically signiifcant (F=78.82, P<0.05). Conclusion:Pre-irradiation can enhance the transduction rate of siRNA, reduce the expression of Survivin gene in lung cancer, promote cell apoptosis, and increase the sensitivity of the radiotherapy.