Because of the specificity and complexity,of obstetrics and gynecology,interns often meet doctor-patient communication problems during the internship.This study explores these problems to enhance interns' doctor-patient communication and to cultivate interns' technical proficiency.We have also made them grasp the methods and skills of doctor-patient communication,and enable them to successfully communicate with patients on internship.

Objective To investigate the effect of alternative decompression body pad in the intraopera-tive pressure sore prevention.Methods Using random sampling methods,100 cases of patients were collect-ed and divided into the experimental group and the control group with 50 cases in each group,the experimental group adopted self-designed alternative decompression body pad and the control group used common body pad.The skin red,and hurt situation in the main parts of compression were observed,the average pressure of the main parts of compression,such as forehead,chest, anterior superior iliac spine was measured by means of stress-based software DZX29 figure measuring instrument, the above data underwent comparison.Results Statistical differences existed in skin red,skin damage and the average pressure between the two groups.Conclusions The alternative decompression body pad can effectively reduce the partial pressure of the vertical principal stress,and having an active role in the prevention of intraoperative pressure sores.But the prevention of pressure sores will still need to take comprehensive nursing measures.

As an effective method of studying soluble protein-protein interactions, yeast display system is now widely used for affinity maturation of single-chain antibodies.Due to the strong homology recombination machinery of yeast and the high-throughput nature of FACS detection, a rapid scan for interaction between antigen-antibody pairs could be easily achieved.Based on this system, a novel and reliable method for determining conformational epitopes was developed.Different fragments of macrophage migration inhibitory factor(MIF) and several point mutations of MIF were displayed on yeast cell surface using homologous recombination technology.Three MIF monoclonal antibodies, 10C3, 2A12 and 4E10, were screened for their binding affinity to each displayed peptide.Utilizing this technology, the key amino acids of MIF that bind to the MIF monoclonal antibodies were easily identified.

Objective To study the relationship of apoptosis-related gene survivin with bcl-2, bax protein in endometriosis. Methods The expressions of survivin, bcl-2 and bax protein were detected by immunohistochemical method (SP) in ectopic endometrium from 40 cases, and compared with that in eutopic endometrium from 25 cases without endometriosis. Results The expression rate of survivin protein in endometriotic cells was much higher than that in normal endometrial cells. The survivin was not correlated with the phase of menstrual cycle , but positively correlated to bcl-2, negatively to bax. Conclusion Survivin may play an important role in pathogenesis of endometriosis. With survivin gene, apoptosis-related gene bcl-2 may have a synergic role and bax have an antagonistic role in the formation and progression of endometriosis.

Cardiovascular fibrosis is the common pathological manifestation of many heart diseases.Relaxin inhibits fibrosis through several mechanisms as follows relaxin inhibits fibroblast function,collagen synthesis/secretion and the influence of several profibrotic factors.Relaxin stimulates MMP expression.Relaxin rapidly inhibits cardiovascular fibrosis and has no effect on normal tissue.It is a potential and selective antifibrotic target of cardiovascular diseases.

Objective To explore causes and solutions of false estimates of elevated serum creatinine in patients with Walden‐strom′s macroglobulinemia throug wet chemical enzymatic method .Methods 5 cases of patients hospitalized in the Bethune Inter‐national Peace Hospital were enrolled as subjects from 2010 to 2012 .The large molecular proteins were removal from serum sam‐ples collected from patients with Waldenstrom′s macroglobulinemia by using centrifugal ultrafiltration tube .The serum creatinine levels were detected through using the wet chemical enzymatic method ,wet chemical picric acid method and dry chemical enzymatic method before and after ultrafiltration ,and data were compared .Results Before ultrafiltration ,the levels of serum creatinine of 2 cases of patients with Waldenstrom′s macroglobulinemia detected by using wet chemical enzymatic method differed with those de‐tected by using wet chemical picric acid method and dry chemical enzymatic method .While there were no obvious differences be‐tween levels of serum creatinine detected by wet chemical picric acid method and dry chemical enzymatic method .While ,after ultra‐filtration ,no obvious differences were founded in levels of serum creatinine detected by the thress methods .Conclusion The large molecular proteins should be eliminated when using the wet chemical enzymatic method in the detection of serum creatinine levels , in order to avoid abnormal increase .And the wet chemical picric acid method and dry chemical enzymatic method could also be uti‐lized to determine the accuracy ,and provide reliable determination results .

OBJECTIVE:To discuss our experience of switching use of immunosuppressive agents for patients after renal transplantation.METHODS:23 patients with chronic allograft dysfunction(CAD) were treated with tacrolimus + mycophenolate mofetil instead of cyclosporine A+ azathioprine.The change of renal function and the adverse effects were observed.RESULTS:The serum creatinine(Scr) level before and after therapy conversion were 167～478 ?mol?mL-1 with a mean value of(268?78) ?mol?mL-1 and 112～346 ?mol?mL-1 with a mean value of(174?65) ?mol?mL-1,respectively,showing significant difference in the t test(P

Hepatocellular carcinoma(HCC)is a major cause of cancer mortality worldwide,and liver transplantation (LT)has the potential to improve the survival for patients with HCC.However,tumor recurrence after LT remains the main obstacles for long-term survival.Selection of the ideal recipients based on Milan criteria or Shanghai Fudan criteria is a key point to reduce the incidence of recurrence.C,enomics and proteomics combined with tumor specific tumor markers detection are helpful to screen out the recipients.The norms of rumor-free operation should be strictly followed intraoperatively.Preventive chemotherapy and evaluation of immune function should be considered postoperatively to reduce the risks of tumor recurrence and metastasis.

Objective To evaluate the feasibility and therapeutic effect of kyphoplasty in treating severe osteoporotic vertebral compressive fractures. Methods Thirty-five patients (48 vertebral bodies) with severe osteoporotic compressive fractures were included. There were 33 females and 2 males with the mean age of 74.2 years. The average compressive rate of the affected vertebral bodies was 77.0%. The thoracolumbar vertebrae were treated with kyphoplasties. Percutaneous puncture direction was adjusted according to compressive rate and shape of the vertebral bodies. The inflatable bone tamp was inserted into the fractured vertebral body. The balloon was inflated with low pressure and dilate-relieve-dilate method was applied. The balloon was deflated and withdrawn, leaving a cavity within the vertebral body, which then fulfilled with visualized bone cement. Preoperative and postoperative symptom level, complications and radiographic findings were recorded. Results All 35 patients tolerated procedure well. The mean heights of the anterior, mid and posterior vertebral body had improved from (0.8±0.1) cm, (0.8±0.2) cm, (2.1 ±0.8) cm preoperatively to (1.2±0.3) cm, (1.3±0.2) cm, (2.3±1.0) cm respectively after operation (P ＜0.05). There was significance difference between preoperative and postoperative heights of the anterior and mid vertebral body. The mean kyphosis was improved from 28.2°±5.2° before operation to 19.1°±4.9° after operation. Conclusion Kyphoplasty is feasible and effective for severe osteoporotic vertebral compressive fractures.

Objective To compare the clinical outcome of external fixation device with Kirschner wire or fragment fixation pin with mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture dislocation. Methods From October 2002 to March 2008, 106 patients with metacarpal and phalangeal articular fracture dislocation were randomly divided into A and B group. The 53 patients in A group were treated with external fixation device with Kirschner wire or fragment fixation pin. There were thumb injury in 24 cases, fracture-dislocation of proximal interphalangeal joint(PIP) in 36 cases, fracture-dislocation of metacarpophalangeal joint (MP) in 17 cases. The 53 patients in B group were treated with mini plate and screw fixation. There were thumb injury in 22 cases, fracture-dislocation of PIP in 30 cases, fracture-dislocation of MP in 23 cases. Duncan rating criteria were used to compare finger range of motion. Results The mean follow-up of 16.8 and 17.5 months in A group and B group. According to Duncan rating criteria, there were excellent in 33 cases, good in 16, fair in 3, and poor in 1 case. The excellent and good rate was 92.5% in A group. There were excellent in 30 cases, good in 17, fair in 5, and poor in 1 case. The excellent and good rate was 88.7% in B group. In A group, 1 case of wound infection was found. The average arc of motion of thumb joint was 134°±21° while the average arc of motion of other fingers was 248°±19°. In B group, no wound infection occurred. The average arc of motion of thumb joint was 122°±18° while the average arc of motion of other fingers was 225°±17°. Conclusion External fixation device with Kirschner wire or fragment fixation pin was better than the application of mini plate and screw fixation in treatment of metacarpal and phalangeal articular fracture-dislocation.