Professional competence is the inevitable requirement of medical students toward jobs.At present, the cultivation of professional competence of clinical internship has many problems and this requires higher medical colleges and universities should take the the cultivation of professional competence of clinical internship as an im-portant task.Cultivate goodness and moral self-discipline ability, demonstration and practice of medical knowl-edge ability and colleagues cooperation and doctor-patient communication ability.To this end, should optimize the path of the cultivation of professional competence:perfect the education contents and courses of professional compe-tency;organize professional competence training and simulation contest;encourage clinical interns to learning and self-improvement;build the assessment mechanism of professional competence of clinical internship.

Discussion on the construction of medical dispute prevention and control mechanism from the per -spective of crisis management and the ethical thinking are conducive to the effective prevention , control and solution of medical disputes .This can promote the healthy development of the doctor -patient relationship and has the im-portant value of ethics .At present , should strengthen the crisis management from the aspect of ethics to control medical disputes in the following aspects: establishing the medical dispute crisis -prevention mechanism by strengthening the training of medical staff′s medical ethics and medical skill;establishing the medical dispute crisis-resolution mechanism under the principle of respect for life and the patient first;establishing the medical dispute crisis assessment and post -processing mechanism around the idea of love , gratitude , and excellence development .

Through expounding the connotation of clinical physicians'humanistic medicine practice ability,this paper pointed out that building the evaluation index system should abide by the four principles of systematicness,scientificity,guidance and feasibility.Constructing the evaluation index system of clinical physicians' humanistic medicine practice ability included 4 first-level indicators,13 second-level indicators and 47 third-level indicators,which is beneficial to promoting the physicians' humanistic medicine practice ability and is conducive to improve the human resource evaluation and management of hospitals.

Objective:This study is to investigate the job satisfaction of nursing staff in public hospital and ana-lyze the influential factors, thus to provide evidence for improving the performance of human resource management in the hospitals. Methods:A sample of 100 nurses in the affiliated hospital of Weifang Medical University was se-lected to participate in this study with cluster sampling method. Job satisfaction was investigated using self-de-signed questionnaire, and data analysis was conducted with SPSS software. Results:The total score of job satisfac-tion is(92. 52 ± 18. 17). The highest is about their working group with 3. 89 ± 0. 58, while the lowest is about their labor return with(2. 19 ± 0. 89). Authorized strength, education, working years and monthly salary all impact the job satisfaction of nurses. Conclusions:At present, nurses′job satisfaction is at a media level. The managers of public hospitals should build a scientific compensation system and humanized duty system and so on, which can meet the different needs of nursing staff and improve their job satisfaction.

Objective To analyze 137 cases of clinical invasive fungal infection (IFI), and to sum up clinical experiences in the treatment of early anti-fungal. Methods 137 patients with 91 males and 46 females, who suffered from invasive fungal infection in ICU from January 1, 2000 to June 30, 2006, were enrolled in this study. The age ranged from 17 to 82 years. Among 137 patients with IFI, the respective incidence of infection of Candida albicans, Candida glabirate, Candida tropicalis and Candida parapsilosis was 47.4%, 26.3%, 20.4% and 3.6%. The sputum, urine, blood and other excreta were collected for examination three days after admission and then every three days. Results Out of the 137 patients, 42 patients were complicated with hemorrhage (30.7%), 53 patients developed candida rash in the chest, abdomen and extremity (38.7%), and 49 patients developed organ dysfunction (35.8%). The chest films revealed that infiltration caused by IFI mainly occurred in the apex of lung in some patients. 137 patients were treated with fluconazole at first, and among them, 64 patients were cured. The cure rate was 46.7%. 39 patients out of 61 patients treated with Amphotericin B(AmB) or lipid AmB were cured. The cure rate was 63.9%. 11 patients were treated with voriconazole and 6 patients were cured. The cure rate was 54.5%. 28 patients failed to respond to the above therapy and died.The mortality was 20.4%. Conclusion The clinical symptons of IFI included hemorrhage, candida rash, organ dysfunction, and infiltration in apex of lung. Fluconazole and amphotericin B(AmB) or lipid AmB still have a good curative effect on invasive fungal infection.

Objective: To investigate the mechanism of improvement effect of electro-acupuncture at acupoint Neiguan (PC 6) on acute myocardial ischemia (AMI). Methods: Ninety-six rats were randomly divided into sham-operation group, myocardial ischemia model group and myocardial ischemia model plus electro-acupuncture group, the rat model of AMI was established by occlusion of the anterior descending branch of the left coronary artery, then electro-acupuncture therapy was performed at bilateral acupoint Neiguan (PC 6). The myocardial enzyme activities in plasma was detected with biochemical method, and the myocardial c-fos gene expression was detected with reverse transcription polymerase chain reaction(RT-PCR) method. Results: The myocardial enzyme activities in plasma and the myocardial c-fos gene expression in myocardial ischemia model group were obviously higher than those in sham group(P＜ 0.05), after electro-acupuncture treatment, the myocardial enzyme activities in plasma and the myocardial c-fos gene expression were decreased,there was a significant difference (P＜ 0.05). Conclusion: The mechanism of improvement effect of electro-acupuncture at acupoint Neiguan (PC 6) on AMI is related to down-regulation of the myocardial c-fos mRNA expression.

ObjectiveTo study the effects of small-dose glucocorticoid (GC) on glucocorticoid receptor (GR) and cellular immune function in critical patients.MethodsForty ICU critical patients admitted in Shanghai Changzheng Hospital from March 2007 to March 2009 were enrolled in the study and were divided into GC group and non-GC group according to the use or absence of GC.Blood samples were collected at days 1,7 and 10 after GC treatment to detect GR binding affinity of mononuclear leukocytes (MNLs) and polymorphonuclear leukocytes (PMLs) in the peripheral blood and the CD4/CD8 ratio in the T lymphocytes.The method of GC use was that the hydrocortisone was given intravenously at a dose of 100 mg every eight hours.ResultsGR binding capacity of MNLs at day 1 and 7 showed no statistical difference between the GC and non-GC groups.GR binding capacity of MNLs in the GC group was lower at day 1 and was much lower at day 7 (P ＜ 0.05 ).However,in the non-GC group,it was lower at day 1,but showed significant improvement at day 7 ( P ＜ 0.05 ).The change of GR binding capacity of PMLs was similar to that of MNLs.There was no significant difference of CD4/CD8 ratio between the GC and non-GC group at day 1.The ratio of CD4/CD8 in the non-GC group was significantly higher than that in the GC group at day 10 (P ＜0.05).CD4/CD8 ratio in the GC group showed a slight reduction at day 10,with no significant difference from that at day 1.While,the non-GC group showed a significant increase of CD4/CD8 ratio at day 10 as compared with that at day 1 (P ＜ 0.05 ).ConclusionLow-dose GC plays some role in the negative feedback regulation of GR binding capacity of peripheral blood leukocytes and in the inhibition of cellular immune function.

Objective In order to increase the operation coverage of high-frequency (HF) RFID reader without increasing the power output, a novel RFID antenna for multi-drawer intelligent medicine-chest are proposed. Using this antenna, the RFID tags on medicine can be read effectively. Methods Several small antenna coils can be combined in series or parallel connection to make a more efficient RFID reader antenna. The use of small coil will be helpful to eliminate the blind spot of RFID reader with large coil antenna. Results The medicine-chest's size is 58 cm?50 cm?62 cm3, which includes two or three layers. We design four combined small antenna coils to cover the drawer. The test result shows that the antenna read region is about 54 cm?48 cm?30 cm, all RFID tags in the medicine-chest drawer bottom and most RFID tags in the drawer top can be read. Conclusion The multi-drawer coil antenna designed can effectively recognize the RFID tags in medicine-chest. It has a wide application prospect.

BACKGROUND: +Gz-induced acute dysencephalia and its protection is one of the significant topics in Aero-medical researches. Its pathological mechanism, however, is still unclear and protective measures should be developed further. OBJECTIVE: To observe the expression of inducible nitricoxide synthase (iNOS) in brain tissue after +Gz exposure and to analyze the protective effects of danshen and basic fibroblast growth factor (bFGF) on repeated +Gz exposure-induced brain injury. DESIGN: Randomized controlled animal study. SETTING: Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA.MATERIALS: The experiment was carried out at the Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA from April to August 2000. A total of 20 healthy SD rats of clean grade were divided into 5 groups according to randomly digital table, including control group, +Gz exposure group, bFGF group, danshen group and saline group with 4 in each group.METHODS: All rats were fixed on rotatory arm of centrifugal apparatus,and their heads were towards core of the apparatus. Except the rats in control group, the value of +Gz exposure was +14 Gz, and the growth rate was 1.5 G/s. The exposure at peak value lasted for 45 s. +Gz exposure was done for three times, and the interval was 30 minutes. Rats in the control group were also treated with the same +Gz exposing procedure, but the G value was +1 Gz. Rats in bFGF group and danshen group were intraperitoneally injected with 100 μg/kg of bFGF and/or 15 g/kg of danshen solution, respectively, at 30 minutes before centrifugation and immediateness after centrifugation; moreover, rats in saline group were injected with the same volume of saline. Six hours after exposure, rats were cut off their heads to obtain the brains which were maintained in liquid nitrogen for RNA extraction. The expression of iNOS mRNA in brain tissues of the rats in each group was detected with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and calculated on the basis of ratio between iNOS and glyceraldehyde-3-phosphate dehydrognase.MAIN OUTCOME MEASURES:Expressed level of iNOS mRNA in brain tissue of rats.RESULTS: Expression of iNOS mRNA in brain tissue was higher in repeated +Gz exposure group than that in control group (0.452 ±0.014,0.065±0.008, P ＜ 0.01); however, that was lower in bFGF group and dan-shen group than that in +Gz exposure group (0.196±0.010, 0.183±0.011,0.452±0.014, P ＜ 0.01).CONCLUSION: Repeated +Gz exposure can increase the expression of iNOS mRNA, this plays an important role in cerebral injury induced by repeated +Gz exposure. Moreover, bFGF and danshen have protective effects on cerebral injury induced by +Gz exposure.

Objective To investigate the clinical characteristics of perianal Crohn's disease (CD) with or without proctitis and compare the treatment effect of surgery combined with biological preparation.Methods The retrospective cohort study was conducted.The clinical data of 52 patients with perianal CD who were admitted to the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from June 2011 to October 2014 were collected.Thirty patients with inflammation involvement of the rectum and 22 patients without inflammation involvement of the rectum were respectively divided into the proctitis group and non-proctitis group.All the 52 patients underwent surgery combined with infliximab therapy.Observation indicators included:(1) clinical characteristics:gender,age,body mass index (BMI),lesion location,disease behavior,type of perianal lesions,history of perianal surgeries,CD activity index (CDAI),perianal disease activity index (PDAI),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),white blood cell (WBC),platelet (PLT) and albumin (Alb),(2) treatment and follow-up.Follow-up using outpatient examination was performed to evaluate the perianal lesions up to December 2015.Measurement data with normal distribution were described as-x ± s and comparison between groups was analyzed by the t test.Count data were described as the percentage,and comparison between groups was analyzed by the chi-square test and Fisher's exact probability.Results (1)Clinical characteristics:number of patients with BMI ＜ 18.5 kg/m2 and with normal BMI were respectively 17,13 in the proctitis group and 6,16 in the non-proctitis group.Lesions located at ileum,colon and ileocolon were respectively detected in 3,9,18 patients in the proctitis group and 9,4,9 patients in the non-proctitis group.CDAI≥ 150 and ＜ 150,CRP≥8 mg/L and ＜ 8 mg/L,ESR ＞ normal level and =normal level,Alb ＜ 35 g/L and between 35 g/L and 50 g/L were respectively detected in 23,7,25,5,24,6,12,18 patients in the proctitis group and 8,14,8,14,8,14,2,20 in the non-proctitis group,with statistically significant differences between the 2 groups (x2 =4.446,6.855,8.563,12.076,10.211,6.163,P ＜ 0.05).(2) Treatment and follow-up:all the 52 patients underwent more than 3 times infliximab therapies and perianal surgeries within 1 week after infliximab therapy.All the patients were followed up for a median time of 28 months (range,8-52 months).Thirty-four patients still underwent maintenance therapy of immunosuppressive agents and 18 didn't undergo maintenance therapy up to the end of follow-up.Twenty-two patients in the proctitis group and 12 patients in the non-proctitis group underwent maintenance therapy,with no statistically significant difference between the 2 groups (x2 =1.979,P ＞ 0.05).The total healed rate,improvement rate and unhealed rate of perianal lesion were 55.8％ (29/52),34.6％ (18/52) and 9.6％ (5/52),respectively.The number of patients with healed,improved and unhealed perianal lesions were 16,11,3 in the proctitis group and 13,7,2 in the non-proctitis group,respectively,showing no significant difference in treatment effects between the 2 groups (x2 =O.173,P ＞ 0.05).Conclusions Patients with perianal CD combined with proctitis have higher activity of intestinal inflammation and worse nutritional status compared with patients without proctitis.However,there is no significant difference in the type and activity of perianal lesion between patients with or without proctitis.Surgery combined with biological preparation could render better clinical outcomes in treatment of perianal CD with proctitis.