In order to improve the quality of medical record written by pediatric interns, the defects of 535 medical records written by pediatric interns were analyzed. The main reasons affecting the quality of medical record written by pediatric interns were found: writing defects among history of present illness,physical examination and personal history. At present, many factors have caused the deficiencies of medical record writing, such as the factor of low-level teachers, the lag of the teaching management, the particularity of pediatric practice, and students' lack of training in school. So some countermeasures have been suggested:firstly, importance should be attached to the construction of the teaching staff. Measures should be taken to inspire the teachers to work more actively with a serious and responsible attitude. With a solid clinic and teaching skills, teachers can use a variety of methods properly. The management of teaching should be enforced. A variety of means can be used to improve the interns' clinical thinking and language expression ability , to establish and improve the medical quality control system of the interns constantly, to make use of pre job training and education reason-ably, to strengthen the intern's legal ideas, to straight their internship attitude, and to help them to adapt to the pediatric practice environment as soon as possible. At last, measures should be taken to cultivate interns' interrogation, physical examination and patient communication skills actively and reform the school education to meet the needs of clinical development as well.

According to the characteristics of Chinese medicine profession,the author explores the theory and practice of developing personnel training program and formulate compre-hensive,scientific,practical clinical skills for medical students to improve and dialectical thinking program. Through practice study,students'basic medical knowledge and clinical medicine are more closely combined to adapt to clinical study and clinical practice and their clinical basic skills have generally been consolidated and developed.

OBJECTIVE:To review the recent advances in analgesics study and summarize the drugs for central sensitization and analgesia model by relating to the latest means and methods of research.DATA SOURCES:The literature on analgesics was retrieved in NCBI database for the related papers published between January 1996 and December 2001, with the key words of "analgesia", "analgesic", and "pain"and language restricted to English. At the same time, papers published in the past two years were retrieved in http:∥www.wanfangdata.com.cn, with the key words of "analgesia", "analgesic" and "ganglioplegic" in Chinese and the language restricted to Chinese.STUDY SELECTION:Totally more than 50 000 research references repeated contents.DATA EXTRACTION: Altogether 100 basic research articles were collected. We selected 15 articles relevant to the research development in analgesic drugs, and excluded 82 review papers with repeated content.expressed by proto-oncogene c-Fos located in the nucleus is a kind of DNA conjugated protein. It can regulate the expression of some pain-related genes. Some studies found that substance P synthesis is likely to play a research: Developing the central sensitization drugs is the orientation of sal root ganglion neurons and model of swallowing response were established.CONCLUSION:By investigating the effects of various new research methods and models on pain, we intended to look for more new drugs, to further study neurotransmitters and the clone of transmitter receptor at the cellular and molecular level so as to find the new effect target of the drugs, and to have a better understanding of the integrity of chronic pain in humans and achieve more breakthroughs in the development of neuroscience research.

Objective To investigate the changes of apoptosis and expression of related apoptosis regulatory factors in neointima after canine coronary angioplasty Methods Stents were implanted in the left circumflex coronary artery in 15 canines Arteries were harvested at 1, 4, and 12 weeks after stenting Uninjured arteries were used as controls Apoptosis was demonstrated by the terminal uridine nick end labeling (TUNEL) method and transmission electron microscopy Proliferating cells were identified by immunostaining for proliferating cell nuclear antigen (PCNA) Expressions of Bcl xl proteins were detected by immunohistochemical method and Western blot Results Stents implantment induced intimal hyperplasia Apoptosis was not detected in control vessels Apoptotic cells and PCNA positive cells were identified at 1, 4, and 12 weeks with a peak at 1 week Profiles of apoptosis and cell proliferation after stenting were accordant in neointima, but cell proliferation rates were higher than cell apoptosis rates at all time points Expressions of Bcl-xl proteins were detected at 1 week, peaked at 4 weeks, and lasted till 12 weeks after stenting Conclusion Apoptosis may be an important determinant of in stent restenosis Bcl xl appears to play a critical role in regulating cell apoptosis

Objective To assess the incidence and management of nocturnal acid breakthrough (NAB). Methods Forty patients with duodenal ulcer confirmed by gastroscopy were randomly divided into five groups, eight patients in each group. Patients were treated by the following strategies for a course of 5 days: group A (omeprazole 20 mg per day orally in the morning), group B (omeprazole 20 mg twice a day orally in the morning and at 4 p.m), group C (intravenous injection of omeprazole 40 mg twice a day in the morning and at 4 p.m), group D (omeprazole 20 mg per day orally in the morning plus ranitidine 150 mg at bed time) and group E (omeprazole 20 mg twice a day orally in the morming and at 4 p.m plus ranitidine 150 mg at bed time) respectively. Intragastric pH over 24 hours was recorded on the morning of the fifth day for each patient. Results In comparison with that in group A, intragastric pH was higher in the other four groups. The mean intragastric pH and mean nocturnal pH each in group B (6.2?0.7, 6.4?1.1), group C (6.9?0.7, 6.8?0.9), group D (6.0?0.7, 5.9?0.7) and group E (5.8?0.5, 6.1?0.5) were significantly higher than those in group A (4.8?0.7, 4.7?0.8, P

Objective To evaluate the effectiveness of A type behavior in the development of essential hypertension.Methods The questionnaire of A type behavior were used to investigate 230 patients,divided into hypertension group (147) and no hypertension group (66). There are 89 patients and 14 patients of A type behavior in each group. 17 patients were eliminated. In some patients including A type (24 cases) and B type (26 cases), the level of norepinephrine (NE), renin (Ren) , angiotensin Ⅱ (AngⅡ), aldosterone (Ald) was tested. Results There were more A type behavior in hypertension group than no hypertension group, P 0.05).Conclusions The result confirmed that A type behavior has some influence on the development of essential hypetension and has some adverse effect on prognosis of patients.

Objective To study whether the correlation exists between 6 kinds of autoimmune antibodies and female infertility . Methods The protein microarray technique was adopted to detect serum antibodies of anti-sperm antibodies(ASAb) ,anti-endome-trial(AEmAb) ,anti-zona pellucida(AZpAb) ,anti-ovarian(AVoAb) ,anti-hCG(AhCG Ab) and anti-trophoblastic(ATAb) in 140 ca-ses of female infertility and the correlation between these 6 kinds of antibody with female infertility was evaluated .Results Com-pared with the control group ,except AvoAb ,the positive rates of other 5 kinds of antibody had statistically significant differences (P<0 .05) .In the infertility group ,the positive rate of the combined detection of these 6 kinds of autoimmune antibody had statisti-cal difference compared with that of single item detection (P<0 .05) .The positive rate of these 6 kinds of autoimmune antibody in the primary infertility group and the secondary infertility group had statistical difference compared with the control group ;the posi-tive rate of these 6 kinds of autoimmune antibody in the secondary infertility caused by different etiologies had no statistical differ-ence (P>0 .05) .The positive rate of ANA had no statistical difference between the infertility group and the control group (P>0 .05) ,but the titers of ANA in the experimenter were ≥1∶100(6/7) and most of karyotypes were nuclear coarse (5/7) ,which was differed from the low positive titer in the control group .The positive rate of ANA had statistical difference between the infertility related antibody positive and the infertility related antibody negative in the infertility patients .Conclusion ASAb ,AZpAb AEmAb , AhCGAb and ATAb are related with female sterility .The combined detection of these 6 kinds of antibody can significantly increase the detection sensitivity .

Objective To evaluate ECG-aided tip localization of peripherally inserted central catheter(PICC),and to explore the predictive value of in vitro measurement length to optimal length.Methods Convenience sampling method was used to recruit 743 patients from 18 tertiary hospitals in 11 provinces.Patients received ECG-aided tip localization during PICC placement.After PICC was inserted,orthophoria chest radiograph (OCR) was conducted to check whether the tip position of PICC was appropriate.Results Totally 624 valid questionnaires were collected.OCR showed that all tips of PICCs were located in the optimal position.The optimal length was positively correlated with in vitro measurement length (r=0.920,P＜0.01).Linear regression showed regression equation was Y(the optimal length inserted through left basilic vein)=4.290+0.897X(in vitro measurement length)(R2=0.834,F=942.459,P＜0.001),and Y(the optimal length inserted through right basilic vein)=3.097+0.922X(in vitro measurement length)(R2=0.855,F=2055,P＜0.001).Conclusion Change of P-wave can be used to guide PICC placement and predict tip location.ECG-aided tip localization of PICC is accurate,and can be used as an alternative way.Besides,regression equation can be used to predict the optimal length of PICC.

Objective To study the relationship between serum salusin-α and lipoprotein associated phospholipase A2(Lp-PLA2) in carotid unstable plaque with cerebral infarction. Methods One hundred patients with carotid unstable plaque confirmed by carotid ultrasound, divided into two groups as follows:cerebral infarction group (CI group, n = 50) or without cerebral infarction (plaque group, n = 50). We took 50 health subjects in the same period as control. The levels of serum salusin-α, Lp-PLA2 were detected by ELISA. Results Serum salusin-αlevel was significantly lower in the CI group than in the control group (P<0.01), and was also significantly lower in the CI group than in the plaque group (P < 0.01); Serum Lp-PLA2 level was obviously higher in CI group than in control group (P<0.05), and was also significantly higher in CI group than in plaque group (P < 0.05); The correlation between serum salusin-α level(OR = 0.140, 95% CI: 0.054-0.368, P<0.01) and cerebral infarction was significant in patients with unstable plaque. Conclusions The decrease of serum salusin-α level is significantly in patients with unstable plaque; the increase of Lp-PLA2 is significantly in patients with unstable plaque. The serum salusin-αlevel is a possible risk factor for cerebral infarction.

Objective To investigate the correlation between apolipoprotein E (ApoE)polymorphisms and cerebral infarction in Dali Bai populations in Yunnan province.Methods A total of 40 Dali Bai patients with cerebral infarction (female.23,male 17) and 43 Dali Bai normal controls (female 18,male 25) were included in the study.Polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP) analysis was used to detect APoE genotype,meanwhile the lipid levels were detected,and finally,ApoE gene sequencing was conducted.The correlation between the APoE gene polymorphism and the types of cerebral infarction were further studied.Results The frequencies of genotype ε3/ε4 (22.5% vs.4.7%,P ＜0.05) and ε4 (12.5% vs.3.5%,P ＜0.05) in the Dali Bai cerebral infarction group were significantly higher than those in Dali Bai normal control group,and the frequencies of genotype