Improving medical students' legal quality is not only the requirements of modern education and their self-improvement,but also the needs of reform on medical system in the new era and establishment of a harmonious relationship between doctors and patients.Medical universities should carefully integrate the existing law education resources and establish three staged teaching model (stages of basis law education,health law education and stage of comprehensive improvement) when being fronted with the education model which is unilateral,sporadic and lack of cohesion in order to improve the law quality of medical students.

Metabolic syndrome (MS)is a clinical syndrome featured by glucose and lipid metabolic disorders,hyper- tension and obesity etc.,whose key links are insulin resistance and abdominal obesity.MS is closely related with cor- onary atherosclerosis,every link of MS can lead to occurrence and development of atherosclerosis.The present arti- cle mainly stated research progress of the correlation between MS and coronary atherosclerosis in recent years.

Objective To compare the effects of hypothermic arrest circulation ( HAC) with moderate or deep hypothermic antegrade selective cerebral perfusion ( ASCP) technique in patients with DeBake type Ⅰ aortic dissection or aortic arch aneurysm undergoing total aortic arch replacement. Methods Between Feb. 2007 and Aug. 2009, 60 patients who underwent aortic arch replacement using HAC + SCP technique. Patients were divided into two groups according to the lowest nasopharyngeal temperature: moderate hypothermia (18 - 20℃) (group MH, n = 28), and deep hypothermia (23 -25 ℃) (group DH,n=32). The clinical and neurological outcomes were observed. Results The overall in-hospital mortality was 3. 33% (2/60) ; In-hospital mortality was 3. 6% in the MH group, while3.1% in the DH group. There were no significant differences regarding to preoperative the patients' character parameters in both groups. At the beginning of ASCP, the nasopharyngeal and rectal temperatures were significantly higher in group MH[MH group (23.8 ± 1. 9 ) ℃ ( 26. 6 ± 2. 4 ) ℃ vs. DH group group (29.4 ±9.3) min vs. DH group(32.9 ± 13.4) min]. The rewarming time and CPB time were significantly shorter in MH group[(65.0±13.9) min vs. (90.3 ±27.2) min; (142.8 ±34.2) min vs. (194.1 ±42.0) min, P <0. 05]. Temporary neurologic deficits occurred in four patients (6. 67% ) without significant differences between two groups ( MH group 7.14% vs. DH group 6. 25% ). No patient suffered from permanent neurologic dysfunction. There were no significant differences between two groups in other parameters including intubation time, kidney insufficiency, the stay times in ICU and hospital. Conclusion Our results demonstrate that moderate HCA + ASCP technique is a safe strategy for the treatment of patients who require conventional total arch replacement with individual arch-vessel reconstruction. Shorter CPB time in patients with moderate HCA + ASCP did not increase any other postoperative adverse effects.

Objective To study the expression of E-cadherin protein and Snail protein in the labial glands of patients with primary Sj(o)gren's syndrome(pSS) and to analyze their roles in the pathogenesis of pSS.Methods The expression of E-cadherin protein and Snail protein were detected by immunohistochemical method.The labial glands were obtained from 50 patients with pSS and 30 healthy controls.The data was analyzed by Chi-Square test,Fisher's exact probability and Spearman's rank correlation analysis.Results The expression rate of E-cadherin in the labials gland of the patients with pSS were lower than that in normal salivary tissues (x2=14.651,P＜0.01).The positive rates of Snail in the labial glands of the patients with PSS were 40％ and it's expression rates were significantly higher than those in normal salivary tissues (x2=28.800,P＜0.01).There was a negative correlation between lymphocyte focus score and the expression of E-cadherin (P＜0.01) and a positive correlation between lymphocyte focus score and the expression of Snail in pSS group (P＜0.01).There was a negative correlation between the expression of E-cadherin and Snail (rs=-0.484,P＜0.01).Conclusion The interaction of E-cadherin and Snail may have played an important role in the pathogenesis of PSS.

Objective To investigate the epidemiologic features of infant rotavirus (RV) diarrhea in Nanjing area .Methods The detection of group A rotavirus were performed on 7 325 outpatients from intestinal clinic of Nanjing Children′s Hospital by using immune colloidal gold method ,and the epidemiological analysis were did according to the detection results .Results In the 7 325 pa-tients ,2 353 were found rotavirus positive ,the total positive rate was 32 .12% .The positive rate of 1 -2 years old group was the highest(43 .51% ) ,compared with other age groups (P< 0 .05) .In November ,December and January ,the positive rates were 52 .20% ,46 .98% ,46 .59% ,respectively .Compared with the positive rate in other months ,there was statistically significant differ-ence(P<0 .05) .The infection rate of RV in vaccine group and non-vaccine group were 9 .06% and 38 .74% ,respectively .There was significant difference between the two groups .Conclusion Infants of 6 months to less than 3 years old in Nanjing have higher de-tection rate of RV infection ,and the infection peak appears in autumn and winter .

Objective To investigate the influencing factors on the nursing ability of caregivers who provide service for elderly Methods patients with cardiovascular disease in medical and nursing combination institutions. A total of 276 caregivers who provide service for elderly patients with cardiovascular disease in medical and nursing combination institutions in Beijing urban area were selected as research subjects using the judgment sampling method. The Chinese Caregiver Task Inventory, eHealth Results Literacy (eHL) Scale and Sense of Coherence (SOC) Scale were used to investigate the nursing ability, eHL and SOC. The scores of nursing ability, eHL and SOC of the caregivers were (28.3±6.1), (17.0±5.9) and (69.0±9.4), respectively. The results of multiple linear regression analysis showed that caregivers who regarded the occupation as a career, had general or good subjective income, cared for disabled subjects, had a good basic knowledge of cardiovascular disease and qualified eHL had P P Conclusion relatively high nursing ability (all <0.01). The higher the SOC score, the higher the nursing ability ( <0.01). Occupational recognition, subjective income, master the basic knowledge of cardiovascular diseases, disability of nursing patients, eHL and SOC were factors affecting the nursing ability of caregivers who provide service for elderly patients with cardiovascular diseases in urban medical and nursing combination institutions.

A 39-year-old female with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by lung lesions. The diagnosis of IgG4-related disease was confirmed by laboratory and pathological results. It should be alert to consider the possibility of IgG4-related disease in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as lung disease.

Enhanced expression of adhesion molecules on human endothelial cells of synovial tissue has been demonstrated in patients with dialysis related amyloidosis(DRA).The study was conducted to elucidate the mechanism by which the expression of adhesion molecules on human endothelial cells was up regulated. Human endothelial cells derived from umbilical veins(HUVEC) were coincubated in vitro with native human serum albumin(HSA) or HSA modified with advanced glycation end products(AGE HSA).The expression of adhesion molecule intercellular adhesion molecule 1(ICAM 1),vascular cell adhesion molecule 1(VCAM 1) and E selectin was determined respectively by immunofluorescence staining and flow cytometer analysis.The results showed that ICAM 1 and VCAM 1, but not E selectin,were constitutively expressed on HUVEC. AGE HSA enhanced the expression of ICAM 1, VCAM 1 and E selectin on HUVEC in a time and dose dependent manner. HSA had no effect on the expression of adhesion molecules. The results led to the conclusion that AGE HSA up regulated the expression of adhesion molecules on human endothelial cells and therefore promoted the infiltration of monocytes/macrophages around ? 2 microglobulin amyloid.

0 05),BP decreased significantly,which was lower in group B than in group A (P

Objective To study the relationship between T~(-786)→C mutation in the 5′-flanking region of the endothelial nitric oxide synthase gene and type 2 diabetes(T2DM) with coronary heart disease(CHD). Methods One hundred and eighty-six T2DM were selected,and of them,65 had CHD.Meanwhile,63 healthy individuals were selected as control.PCR/ASO(allele-specific oligonucleotide probe) technique was used to determine the T~(-786)→C mutation.Results Compared with control,the T/C genotype and C allele prevalences were significantly higher in T2DM with CHD(P