Clinical communication skills are the one of seven lowest requirements of global medical education.This review emphasizes the importance of cultivating communication skills in general medical,indicates the defections of curriculum installation and discusses the training mode and examination mechanism.

Animals ; Genes, T-Cell Receptor ; genetics ; Humans ; Hypoxanthine Phosphoribosyltransferase ; genetics ; Mice ; Mutation

Objective To understand the work tasks of rural doctors in our country and to provide bases for the reforms of clini‐cal medical education of junior colleges .Methods A self‐made questionnaire was performed in 1 245 rural doctors from 86 rural grassroots health institutions in 7 provinces/municipalies of our country .Results The academic levels of rural doctors were low (65 .54% )and the rates of their medical certification holding were low in western district(7 .79% ) .The work load including basic medical care and basic public health services they committed were approximately matching .The top 5 items of basic medical care were ,in proper sequence ,diagnoses and treatments of common diseases ,common symptoms ,chronic disease management ,communi‐ty rehabilitation ,community first aid .The top 5 items of basic public health services were establishment of residents′health files , maternal and child health ,health care of the aged ,immunization ,health education .Conclusion The technological levels of diagnosis and treatment and theoretical knowledge of rural doctors should be further improved .The clinical medical education of junior medi‐cal colleges must strengthen the training and cultivation of the students′abilities of basic public health services ,besides consolida‐ting the training of the abilities of practical diagnosis and treatment .

Objective To learn the professional ability of rural doctors in our country ,to provide scientific reference for educa-tional reform of junior-college clinical medicine .Methods A self-made questionnaire was performed in 1 245 rural doctors from 86 rural grassroots health institutions in 7 provinces(municipalities) of our country .Results The rural doctors were familiar with working environment ,coordinated and communicated well with colleagues ,basic competence at work .But their clinical diagnosis-treatment technology and operational capability of medical equipments were not strong .The doctor-patient relationship was not so good .Conclusion Not the proper use of medical equipment and treatment technology of weak seriously affected the quality of serv-ice .Not ideal doctor-patient relationship influenced the service effect .It was suggested that college of clinical medical professional education should enhance the cultivation of students′clinical diagnosis technology ,basic operational skills and communication skills between doctors and patients .

Objective To assess the relationship between auditory evoked potential (AAI) index and plasma concentration of propofol administered by target-controlled infusion (TCI) in Chinese.Methods Ten ASA Ⅰ～Ⅱ tumor patients (5 males,5 females) scheduled for elective abdominal surgery under general anesthesia was enrolled in this study.Age ranged from 34 to 61 years,body weight from 52 to 79 kg and height from 155 to 178 cm.Radial artery was cannulated for blood sampling.The patients were premeditated with intravenous injection Midazolam 0.06 mg/L.Anesthesia was induced by fentanyl 2μg/kg,vecuronium 0.1 mg/kg and TCI of propofol which the target plasm concentration was set at 3 mg/L.After intubation,the target plasma concentration of propofol was adjusted at 1.7～2.5 mg/L.Vecuronium was continuous infusions at 2～3mg/h.Anesthesia was maintained with fentanyl-TCI of propofol-vecuronium and inhalation of 0.5 MAC isoflurane.The TCI system was composed of Base Primea company orchestra infusion pump using,the schnider pharmacokinetics model.ECG,Bp,HR,PETCO2,SpO2 and TETISO were monitored during anesthesia.Danmeter company A-line depth of anesthesia monitor recorded AAI index.Blood samples were taken at induction of anesthesia (To baseline),1,3,5,10,15,30,60 min (T1-7) and after cessation of infusion 10 and 20 min (T9-10).Plasma propofol concentration were determinated by fluorescence photometry.Results Compared with target concentrations,the measured concentrations of propofol were significantly lower during TCI(P＜0.05).There was negative correlation between AAI and plasma propofol concentrations(r=-0.818,P＜0.01).Conclusion On base of the Schnider pharmacokinetics model,the target propofol concentrations are not paralleled to plasma propofol concentrations which is descending with time prolongation.From negative correlation between AAI index and plasma propofol concentrations,AAI index will reflect indirectly plasma propofol concentrations.

In order to identify the chemical constituents of Yushu tablets comprehensively, we studied the chemical constituents of CHCl3 extract from Yushu tablets by the ultra performance liquid chromatography-electrospray ionization-ion trap-time of flight mass spectrometry (UPLC-ESI-IT-TOF/MS). It showed that there were more than 100 compounds separated, and forty-nine peaks among these were identified on the basis of high resolution mass spectrometry data and literature data reported. Determination of twelve peaks was further confirmed by standard substances. These components assigned to the different plant sources mainly included phenylpropanoids, triterpenoids, quinones and m-trihydroxybenzene compounds. By analyzing the chemical components of CHCl3 extract from compound Chinese medicine Yushu tablets comprehensively, this study provided the foundation for studying chemical components, pharmacodynamic substance and quality control of Yushu tablets.
Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Drugs, Chinese Herbal ; analysis ; Spectrometry, Mass, Electrospray Ionization ; Tablets ; Tandem Mass Spectrometry

OBJECTIVETo investigate the effects of RCCS on cell seeding onto 3-D scaffold and cell-scaffold composite culture in vitro.

METHODSRabbit skin fibroblasts of passage 2 were seeded at 2 x 10(6) cell per cm(3) onto/into polyglycolic acid (PGA) foams by static seeding (dropping a cell suspension onto foams) or dynamic seeding (rotating PGA foams and a cell suspension in RCCS). Attachment of cells in foams was observed by cell-counting after trypsin digestion. The effects of culture condition were next studied by culturing cell-PGA complexes in RCCS versus static culture condition. Distribution and proliferation of cells in foams were investigated with MTT, stereomicroscope and scan electron microscope.

RESULTSNumbers of cells adhering to polymers increased gradually during an initial period of 24 hours. Eight, 12 and 24 hours after seeding, the rates of adhering cells were significantly higher in the dynamic seeding group than in the static seeding group (46.70% + 2.16% vs. 31.50% +/- 3.54%; 56.36% +/- 3.18% vs. 34.28% +/- 3.16%; 66.32% +/- 4.60% vs. 37.38% +/- 4.66%; P < 0.01). The dynamic culture method as compared to the static method resulted in new tissues with a higher cellularity and more uniform cell distribution during a 3 period of weeks.

CONCLUSIONSRCCS has advantages of promoting cell attachment, uniform migration and proliferation in polymer scaffolds and can be used for construction of 3-D cell-polymer tissues in vitro.

Animals ; Cell Adhesion ; Cell Culture Techniques ; methods ; Cell Division ; Cell Movement ; Fibroblasts ; cytology ; Polyglycolic Acid ; pharmacology ; Rabbits ; Time Factors

Objective To investigate the mechanisms of phagocytosis of virulent Leptospira by peritoneal macrophages of guinea pigs,andevaluatetheroleof innateimmuneinthepathogenesisof leptospirosis. Methods Peritoneal macrophages of guinea pigs were extracted. Three specific inhibitors ( microfilament inhibitor cytochalasin D,microtube inhibitor colchicine and PI3K signalling pathway inhibitor LY294002) were added respectively to the macrophages 1 h before the infection of virulent Leptospira interrogans serovar Lai type strain Lai in vitro.Meanwhile, control group without inhibitor was established.Phagocytosis was observed by laser scanning confocal microscopy and phagocytic rates were evaluated by flow cytometry 3 h after infection.ResultsThe phagocytic rates of control group, cytochalasin D group, colchicine group and LY294002 group were (38.98 ± 0.91)%,(23. 99 ± 1. 40) % ,(40.81±0.91)% and (39.64 ±3.56) %, respectively.The phagocytic rate of cytochalasin D group was significantly lower than that of control group (P < 0. 05), while those of colchicine group and LY294002 group were not significantly different from that of control group (P >0.05). ConclusionMicrofilaments play an important role in the phagocytosis of strain Lai by peritoneal macrophages,but the process is independent on PI3K signalling pathway,and microtubes play little part during the phagocytosis.

ObjectiveTo find out the effect of improving cooking stove to reduce fluoride in burning coal fluorosis areas in Ankang city Shaanxi province,and to provide a basis for continuing the consolidation of control measures and the elimination of the hazards of burning coal fluorosis.Methods According to the results of a census of 2001 in Ankang city on burning coal fluorosis,cluster sampling method was used in 2009,and 10％ of the diseased villages were included in the study according to the state of the disease(mild,moderate and severe) in seven counties.In each selected village 10 households were selected,and the quality of improved stoves was checked door to door,maintenance and satisfaction of the stoves were asked on the spot,and health education questionnaire was carried out among housewives.Thirty village primary schools were investigated,dental fluorosis of children aged 8 to 12 was checked by Dean method,urinary fluoride was tested by ion selective electrode,health education and knowledge questionnaire survey was curried out.Results A total of 1000 households were investigated in the seven diseased counties,and the completion rate of improved stoves was 90.00％ (900/1000);the rate of improved stoves in good condition was 87.14％ (630/723); overall use of improved stoves was 80.33％(723/900); proper use of improved stoves was 79.39％ (574/723),satisfaction rate of improved stoves was 86.89％(782/900),and self-maintenance of improved stoves was 8.00％(72/900).Total detection rate of dental fluorosis of children aged 8 to 12 was 23.74％(509/2144),dental fluorosis index was 0.50.Awareness of prevention knowledge among housewives and students was 65.20％ (2608/4000) and 83.36％(4518/5420),respectively.A total of 358 urine samples of children aged 8 to 12 were tested,urine fluoride ranged 0.16 - 6.35 mg/L,and geometric mean 0.79 mg/L.Conclusions The implementation of defluoridation project by improving cooking stove has achieved the goal of prevention and treatment of fluoride poisoning in burning coal fluorosis areas of Ankang city.Local residents are satisfied with the improved stoves,and most of the improved stoves are used constantly.The detection rate of dental fluorosis is less than 30％ of the control line.Some furnace are damaged,correct usage rate is not high.There is a need to further strengthen the management of the project and strengthen health education interventions to improve stove maintenance outlets,and make sustained control of the disease.

Objective: To observe blood levels of cystetine C (Cys C) and superoxide dismutase (SOD) in patients with obstructive sleep apnea syndromes (OSAS) related hypertension (HP). Methods: A total of 102 HP patients received polysomgography (PSG) in our hospital from 2013-01 to 2013-12 were studied. According to apnea hypopnea index (AHI), the patients were divided into 2 groups: OSAS with HP (OH) group, n=55 patients with AHI≥5 and HP group,n=47 patients with AHI<5; in addition, there was a Control group,n=45 normal subjects with PSG examination at the same period. The general conditions, biochemical and sleep parameters were studied, the differences among 3 groups were analyzed by SPSS 17.0 software. Results: In OH group, HP group and Control group, blood levels of Cys C were (1.06 ± 0.27) mg/L, (0.91 ± 0.19) mg/L and (0.79 ± 0.32) mg/L respectively; SOD were (127.63 ± 63.19) U/mL, (149.14 ± 60.12) U/mL and (181.54 ± 59.37) U/mL respectively, allP<0.05. Based on clinical conditions, OH group was further divided into Mild, Moderate and Severe sub-groups, blood levels of Cys C and SOD were similar among different sub-groups,P>0.05. Conclusion: Blood levels of Cys C in OH and HP groups were higher than Control group, Cys C in OH group was higher than HP group; SOD levels in OH and HP groups were lower than Control group, SOD in OH group was lower than HP group. The relationships between Cys C, SOD and OH severity were unclear.