The paper discussed the working platform for medical ethics education,for the purpose of making such education regular,normalized and popular among the staff.Such means as better organization,innovative media,reinforced implementation and repeated examination will encourage hospital staff to develop better medical ethics for better quality of care and elevation of hospital culture and social satisfaction.

[Objective]To explore the clinic results of bi-posterolateral fusion combined with coralline hydroxyapatite interbody fusion,a three point stable spine fusion technique in the treatment of degenerative vertebra disc disorder.[Method]Bi-posterolateral fusion combined with posterior interbody fusion were performed to treat 41 cases of degenerative vertebra disc disorder from August 1998 to August 2006.The patients included 18 men and 23 women;their average age was 48 years.The slippage and grade of spondylolisthesis before and after spine fusion were investigated.The severity and slippage of radiographic measurements were also recorded,along with the average follow up of 19.1 month(range 12-48 months).The three point spine fusion applied autologous bone chips for bi-posterolateral fusion and one cubic block of coralline hydroxyapatite for anterior inter body fusion which achieved by PLIF technique.[Result]In the 41 patients who had underwent three point spine fusion surgery,only 1/41 patients experienced nerve root pain after surgery,and in most cases clinical symptoms were improved greatly.In 21/41 patients who had severe lower back pain completely disappeared after surgery,and in 9/41 cases these symptoms were minimal.The clinical evaluation according to the symptoms before the operation was excellent 2.4%(1/41),good 19.5%(8/41),fair 21.9%(9/41),bad 56.1%(23/41);after operation excellent 68.3%(28/41),good 29.2%(12/41),fair 2.4%(1/41),bad 0.0%(0/41).A radiographic measurements showed the anterior disc height was 8.05?2.35mm before operation and 11.44?3.38mm after operation(P

Adolescent ; Blood Glucose ; analysis ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; etiology ; Child ; China ; epidemiology ; Diabetes Mellitus ; etiology ; Humans ; Metabolic Syndrome ; diagnosis ; epidemiology ; etiology ; prevention & control ; Obesity ; complications ; Practice Guidelines as Topic ; Risk Factors ; Waist-Hip Ratio

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

AlM: To observe the influence on the incidence of diffuse lamellar keratitis ( DLK ) after laser in situ keratomileusis ( LASlK ) whether or not wearing sterile gloves with talc during operation, and to confirm the role of residual talc in the occurrence of DLK.
METHODS: Totally 563 patients ( 1 126 eyes ) accepted operation with the method of surgical hand antisepsis only were set as the experimental group, while 592 patients ( 1 184 eyes ) with the method of surgical hand antisepsis and sterile gloves as the control group. Each patient was rechecked to observe the occurrence of DLK on the first day and the seventh day after the operation. Then the data of DLK were statistically analyzed byχ2 test and rank sum test.
RESULTS:On the first postoperative day, the incidence of DLK was 7. 4% (83 eyes) in experimental group and 12. 2% (144 eyes) in control group. ln the former group, stage Ⅰ of DLK accounted for 4. 6% (52 eyes) and stageⅡ for 2. 8% (31 eyes);while in the latter, stage l did for 7. 7% (91 eyes) and stageⅡfor 4. 5% (53 eyes). On the seventh day, all DLK were cured. The other 2 cases ( 3 eyes) occurred in stage Ⅳ DLK ( the first time recheck was on the eighth day after operation and fluorometholone ophthalmic solution was not used on time ) . The incidence and the severity were both significant lower in the experimental group than in the control (both P<0. 01).
CONCLUSlON: Talc is one of the most important factors resulting in DLK after LASlK. The method of surgical hand antisepsis without wearing gloves could avoid the stimulation of talc and reduce the incidence of DLK obviously.

Objective: To investigate the secondary metabolites from Chinese marine Sponge Cinachyrella australiensis. Methods: Column chromatography techniques including HPLC were used for the separation and purification of the compounds, and extensive spectral analyses including various 2D NMR spectra were employed for structure elucidation. Results: Nineteen compounds were obtained ,including 2 methyoxy 6,12,15 trien 8 yne octadecanoic acid(1), 2 benzenedicarboxylic acid dibutyl ester(2), 1,2 benzenedicarboxylic acid bis(2 ethylhexyl)ester(3), ( ) (3S) 1,2,3,4 tetrahydro ? carboline 3 carboxylic acid(4), L Tryptophan (5), p hydroxylbenzaldehyde (6), p hydroxyl benzylethanol(7), p hydroxyl benzyl propanol(8), cholesta 4 en 3 ol(9), 2 methyl 6 amino 9 (2 deoxy ? D ribofuranosyl purine(10), 2' Deoxyadenosine (11), 6 amino 9 ? D ribofuranosyl 9H purine (12),uracil(13), thymine(14), thymidine(15), 1 (2 deoxy ? D Ribofuranosyl)uracil(16), 1 ethyl ? (2 deoxy) ? D ribofuranos(17),isolumichrome(18),and zarzissine(19).Conclusion:Compounds 1 and 18 are new natural products,and compounds 2 to 17 as well as 19 are isolated from this species for the first time.

Atrioventricular Block ; complications ; Child ; Electromyography ; instrumentation ; methods ; Female ; Histiocytic Necrotizing Lymphadenitis ; complications ; Humans ; Research Report ; Thrombocytopenia ; complications

Objective To investigate the dynamic expression from gene and protein levels of hypoxia inducible factor-1α(HIF-1α) during the development of hypoxic pulmonary hypertension (HPH) in neonatal rats.Methods A neonatal rat model of HPH was established,normal neonatal rats were enrolled as the control group.At the 3th 、7th、10th and 14th days,we measured the mRVSP through catheterization of right ventricule,collected hearts to figure out the right ventricular hypertrophy index(RVHI),evaluated vascular remodeling by the percentage of medial thickness to outer diameter of the small pulmonary arteries (MT％) and the percentage of medial cross section on area to the total cross section area of the pulmonary small arteries (MA％),observed the expression of HIF-1α by immunochemistry,and measured the expression of HIF-1α in mRNA and protein by RT-PCR and Western blot respectively.Results The mRVSP increased at the 3th day,and sustained until the 14th day (P ＜ 0.01).RVHI MT％ and MA％ increased at the 7th day,and sustained until the 14th day (P ＜0.01).HIF-1α mainly expressed in endothelium and smooth muscle cells in the CHPH group and the HIF-1αmRNA increased significantly on the 3th and 7th days (P ＜ 0.05),and the HIF-1α protein increased significantly on the 7th、10th and 14th days in the CHPH group compared with the control group(P ＜ 0.01).Conclusion The mRVSP increased at the early stage after hypoxic exposure in neonatal rats,followed by vascular remodeling and right ventricular hypertrophy.Both mRNA and protein levels of HIF-1α sustained higher than control group during the vascular remodeling stage,indicating that HIF-1α might be a important factor contributing to the vascular remodeling.

Objective:To study the influence of r-tPA and urokinase in curative effect and thrombolysis time on patients with acute and severe pulmonary embolism after interventional thrombectomy .Methods:After reviewing and analyzing the clinical data of 19 acute and severe pulmonary embolism patients , we classified them into two groups in accordance with the application of r-tPA and urokinase to compare the changes of their heart rate , blood pressure , pulmonary arterial pressure , arterial partial pressure of oxygen and hemachrome before and after thrombolysis , as well as the thrombolysis effect time the two groups took.Results: The heart rate, blood pressure, pulmonary arterial pressure , arterial partial pressure of oxygen of the patients in both groups gained remarkable improvement after operation ( P<0 .05 );the pulmonary arterial pressure of the r-tPA patient group dropped but not significantly compared with that before operation ( P>0.05); the pulmonary arterial pressure of the urokinase patient group dropped significantly compared with that study before operation ( P<0.05 ); the hemachrome of both patient groups did not significantly drop after operation ( P>0 .05 );the thrombolysis effect time by adop-ting r-tPA was remarkably shorter than that caused in thrombolysis by adopting urokinase ( P<0 .05 ) . Conclusion: Both r-tPA and urokinase are effective in interventional thrombolysis for acute and severe pulmonary embolism .However , r-tPA could significantly shorten the time caused in thrombolysis without increasing any bleeding risk.