This article discusses the causes and base of clinical teaching theory and practice of Medical Ethics,and how to play it into practice and the effect.As proved by practice,clinical teaching plays an active role in fostering medical students' ethical awareness will,improving ethical determinating ability and bringing up medical moral emotion.Clinical teaching theory and practice of Medical Ethics,both in teaching design and teaching notion,adapts to the transformation of medical model,and emphasizes on the teaching thought of "teachers as center,students as main body".

Objective To explore the effect of modified electroconvulsive therapy (MECT) on working memory in schizophrenia patients.Methods 2-back test paradigm was set to measure the performances of working memory.A total of 30 cases of schizophrenia were recruited and measured with accurate rate and reaction time on this tasks before and after treatment with MECT.Differences were analyzed between patients through MECT treatment and 30 patients through drug treatment.Results Repeated measure ment analysis of variance on the accurate rate ((66.70±9.82) ％,(67.61±6.83) ％,(80.72± 12.08) ％) and reaction time((1415.69± 258.51) ms,(1328.65±236.08) ms,(1094.45± 259.44) ms) of 2-back test were significant among three times of MECT (F=19.163,P＜0.001 ; F=13.084,P＜0.001).Schizophrenia patient's performance of error rate and reaction time of 2-back test were higher at the end of 2 weeks after treatment((80.72± 12.08)％;(1094.45± 259.44)ms) than before MECT treatment ((66.70±9.82) ％ ; (1415.69±258.51) ms).The difference between them were significant(t =-4.369,P＜0.001 ; t=5.596,P＜0.001).Schizophrenia patients performance of error rate and reaction time of 2-back test were higher at the end of 2 weeks after treatment((80.72± 12.08)％;(1094.45±259.44) ms) than at the end of 1 day after treatment((67.61±6.83)％;(1328.65±236.08) ms).The difference between them were significant(t=-5.416,P＜0.000; t=3.824,P=0.001).Schizophrenia patients performance of error rate of 2-back test were higher at the end of 2 weeks after treatment than drug treatment group ((73.67±10.41) ％),and the difference between them were significant(t=2.424,P=0.018).Conclusion Working memory functions in schizophrenia patients may be improved in varying degrees with MECT.

Objective To investigate the correlation between the inflammatory-nutritional index (INI) and recurrence and prognosis in patients with gastric cancer. Methods A total of 78 cases patients of gastric cancer with recurrence and 64 cases without recurrence were enrolled. INI was calculated by the ratio of serum albumin and C-reactive protein. The value of INI predicting recurrence was analyzed using receiver operating characteristic curve (ROC). According to this value, the Kaplan-Meier curves and Cox regression analysis were used to evaluate the effect of INI on prognosis. Results Compared with the control group, the recurrence group showed smaller INI, larger tumors, lower degree of differentiation, deeper invasion and higher TNM stage, the differences were statistically significant (all P < 0.01); The INI significantly predicted the recurrence of gastric cancer, with a sensitivity of 62.5%, specificity of 79.5% and critical value of 0.36 (P < 0.01); Additionally, The pathological features were worse in the low INI group than the high INI group , the differences were statistically significant (P < 0.01); The INI significantly predicted the prognosis of gastric cancer, with a sensitivity of 65.9%, specificity of 66.8% and the critical value of 0.34 (P < 0.01); Obviously, the survival rate was lower in the low INI group than the high INI group (48.8% vs 25.0%, P < 0.01). Furthermore, INI was an independent risk factor for prognosis of gastric cancer (OR = 1.78, 95% CI: 1.34 ~ 2.59, P < 0.01). Conclusion The INI is closely related to the characteristics of gastric cancer, it is an effective marker to predict recurrence and prognosis of gastric cancer.

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disorder of hematopoietic stem cells due to acquisition of somatic mutations.Somatic mutations in phosphatidylinositol glycan class A (PIGA) account for intravascular hemolysis and other PNH manifestations,but the pathophysiology of clonal expansion of PNH cells cannot be elucidated clearly.PNH is closely related to aplastic anemia and myelodysplastic syndromes.Today,the gold standard for PNH is flow cytometry to detect the absence or severe deficiency of glycosylphosphatidylinositol (GPI)-anchored proteins on white and red blood cells.However,PNH diagnosed by phenotype is a group of heterogeneous disease in pathogenesis.Eculizumab,a first-in-class monoclonal antibody that inhibits terminal complement,is highly effective in stopping intravascular hemolysis and improving quality of life.Further research on the pathogenesis of PNH would be helpful to understand the underlying reasons for PNH phenotype cells in different patients,improve differential diagnosis and more targeted and specific therapy.Research progress in recent years will be reviewed in this article.

Objective To study the relationship between white blood cell(WBC) count and cardiac events in acute ST-elevation myocardial infarction(STEMI) patients treated with reperfusion in the early stage. Methods Two hundred and thirty-five patients with acute STEMI were divided into two groups:percutaneous coronary intervention group (PCI group, 97 patients) and thrombosis therapy group (138 patients). WBC count and cardiac events of the two groups before and after treatment (3 h and the second day and the third day) were recorded and compared. Results The level of WBC count had no changes in two groups before and after treatment in first 3 h (P>0.05) , while the level of WBC count was significantly decreased, and the level of WBC count was significantly lower in PCI group than that in thrombosis therapy group (P<0.05). The rate of no cardiac events and two cardiac events in two groups has no significant differences (P > 0.05). The rate of one cardiac events in PCI group was significantly higher than that in thrombosis therapy group (P<0.05). The rate of three cardiac events in PCI group was significantly lower than that in thrombosis therapy group (P<0.05). WBC count had a positive correlation with cardiac events rate (r = 0.231, P < 0.05). Conclusions Primary percutaneous coronary intervention decreases WBC count and cardiac events rate. In patients with acute myocardial infarction, level of WBC count has positive relationship with cardiac events.

Disease Notification ; Humans ; Internet ; Occupational Diseases

Through summarization on published literatures on allergic rat model in recent 20 years, domestic current research status and trend were analyzed. Some insights were provided on how to build a standard process for modeling and post-modeling evaluation. “Allergic rhinitis,” “rat model of allergic rhinitis”, or “animal experiment” was used as search terms. Related published articles were searched in the CNKI database from August, 1993 to October, 2013. Documents and data, including modeling method, drug dose, modeling cycle, model assessment described in the articles were extracted, summarized and quantitative analyzed. The results showed that 208 valid articles were included in this study. SD rat was used as animal model. Ovalbumin plus aluminum hydroxide were used as adjuvant sensitizing agents. Intraperitoneal injection plus nasal stimulation were the most commonly used modeling method. Behavioral evaluation scale score was used as the main evaluation index. It was concluded that currently there were many methods for allergic rhinitis animal modeling domestically. The post-modeling evaluation was relatively single. It was urgent and necessary to establish the standard process for modeling and post-modeling evaluation for allergic rhinitis animal model.

Objective To discuss the application of serum hs-CRP and lipids detection and the correlations between them in type 2 diabetes mellitus.Methods The levels of serum hs-CRP,TC,TG, HDL-C,LDL-C,ApoA1,ApoB were all measured in 49 type 2 diabetic patients and 53 normal cases.Results The type 2 diabetic group had significantly higher hs-CRP, TC,TG, LDL-C, ApoB and lower HDL-C than the control group. The concentration of serum hs-CRP correlated positively with TG,ApoB and negatively with HDL-C.Conclusion Serum hs-CRP level is associated with serum lipid level and inflammatory response might play an important role in the pathogenesis of type 2 diabetes mellitus. In type 2 diabetic mellitus there is an increased risk of development of cardiovascular diseases.

Although tyrosine kinase inhibitors (TKI) have profoundly improved prognosis of patients with chronic myeloid leukemia (CML), it still can not cure CML with high relapse rate when TKI is used alone. Except for effective development of TKI and precise application of the existing TKI,the exploitation of new therapy target, research on treatment for leukemia stem cells and cocktail targeted therapies also provide further inspiration for improving treatment and curing CML. This article will introduce the advances of therapy in CML.

95%) was performed in 62 cases, a subtotal resection (76%~95%) was performed in 6 cases, and a partial resection (≤75%), 2 cases. No peri-operative deaths occurred. Transient diabetes insipidus was noted in 24 cases and was cured within 3 weeks after operation. Nasal cerebrospinal fluid leakage was observed in 8 cases, 5 of which spontaneously recovered after 2 weeks of bed rest, and 3 of which were cured by lumbar cistern drainage. Follow-up observations for 3 months ~ 2 years (mean, 7 months) in 48 cases found 2 cases of recurrence. Conclusions Transnasal transseptal transsphenoidal approach adenomectomy is an effective and minimally invasive procedure, with simplicity to performance, short operative time and fewer complications.