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.

Arsenic ; urine ; Chromatography, High Pressure Liquid ; methods ; Formamides ; analysis ; Humans ; Urinalysis ; methods

AIM: To analyze and summarize the effect of glaucoma trabeculectomy in the department of ophthalmology in basic hospital.
METHODS: Postoperative intraocular pressure ( IOP ) , filtering bleb and complications of 316 cases (405 eyes) of patients with glaucoma after trabeculectomy were analyzed.
RESULTS: After follow- up 12mo, 76. 5% IOP was controlled in normal level. 42. 5% was filtration bleb typeⅠ, 33. 1% typeII, 14. 6% in typeⅢand 9. 9% in typeⅣ. Intraoperative complication rate was 2. 5%, that was 31.4% at postoperative early stage ( before discharge ) , and 6. 7% at postoperative long - term ( 6mo after discharge) .
CONCLUSION:Trabeculectomy for glaucoma can better solve the problem of high IOP. It is more mature in primary hospitals, but there are still a variety of intraoperative and postoperative complications.

AlM:To discuss the clinical effect and safety of the combined surgeries of phacoemulsification and goniosynechialysis for patients with primary angle -closure glaucoma ( PACG) .METHODS:Eighty-three eyes of 83 patients with PACG and cataract were ranomized into two groups. Group A:39 patients with 39 eyes of angle-closure <180.;Group B:44 patients with 44 eyes angle - closure ≥180.. The changes of visual acuity, anterior chamber depth ( ACD) , anterior chamber angle and lOP after operation were measured. The follow-up period was for 1a.RESULTS: The visual acuity was improved significantly in both group after operation. No significantly difference in ACD, anterior chamber angle after operation in two groups (P>0. 05). The lOP in group A was lower than that in group B 3mo after operation, there was statistical significance (P<0. 05).CONCLUSlON:Phacoemulsification and goniosynechialysis can deepen ACD significantly. This method make the anterior chamber angle open, can reduce lOP and improve the patients’ visual acuity, especially in patients with PACG. lt is a safe and effective approach to patients with PACG and cataract.

Objective To discuss the clinical significance of fetal encephalic accumulated fluid revealed by prenatal ultrasonography.Methods Prenatal ultrasonography was performed on 8426 women at more than 20 weeks' gestation.Totally 150 women with fetal encephalic accumulated fluid more than 5 mm were included in this study.The changes of fetal encephalie accumulated fluid and the associated anomalies were observed regularly every 2 weeks until delivery.The live infants were followed up regularly.Results The incidence of fetal encephalic fluid was 1.8%,including 72 cases with fluid in the fetal anterior or posterior cornu of unilateral ventricle,46 cases with accumulated fluid in fetal posterior fossa,32 cases with fluid in more than 2 sites.Generally,the accumulated fluid in fetal encephalus was first diagnosed at 17-40 gestational weeks,with a median of(26?5)weeks.Most of them were found between 29-32 gestational weeks(63 cases,42.0%),and the maximum amount of accumulated fluid was also found between 29-32 weeks(70 cases,46.7%).Spontaneous regression of intracranial fluid could be seen in 111 fetuses (74.0%).The period of fluid regression ranged from 29 to 40 weeks of gestation,of which the average gestational week was(36?2)weeks.Additionally,the most frequent period of regression was in the first two thirds of the three trimesters of pregnancy.The incidence of defected infants was 3.8%,10.2% and 67.4%,respectively,when the amount of accumulated fluid was less than 10mm,10-14 mm and more than 15 mm.And the accumulated fluid in more than 2 sites was also a risk factor of defected fetuses,with an incidence of 60.0%.Conclusions Most cases could be diagnosed between 29-32 gestational weeks, and the maximum amount of accumulated fluid is also observed in this period.The more fluid in fetal encephalus,the more sites the fluid distributed in,the more defected fetuses or infants would be observed.So in cases of more than 15 mm of fluid,or accumulated fluid in more than 2 sites,anomalies should be observed extremely carefully.

Objective:To study the in vitro and in vivo transdermal enhancement of one kind of arginine oligomer-chitosan ( CS-R9). Methods: In vitro mouse skin as the barrier, Franz diffusion cells were used to study the transdermal property of tinidazole ( TNZ) solution in vitro enhanced by CS-R9 using TNZ solution as the negative control and TNZ solution with Azone as the positive control. The rats were randomly divided into three groups, TNZ solution group ( the negative group) , TNZ solution with Azone group (the positive group) and TNZ solution with CS-R9 group. At the predetermined time intervals, 0. 5 ml blood was withdrawn from the rats and TNZ concentration was detected by HPLC to evaluate the enhancement of CS-R9 on TNZ in vivo. Results:Compared with the negative group, CS-R9 had significant enhancement on TNZ trandermal penetration in vitro(P <0.05), and showed no significant difference with Azone (P>0. 05). The in vivo results showed CS-R9 exhibited similar transdermal enhancement on TNZ as Azone at the same concentration (P>0. 05), and CS-R9 had sustalned-release property. Conclusion: CS-R9 has promising transdermal en-hancement on TNZ, which is valuable to be studied further.

This study was aimed to explore the resource diversity and microbial inhibition activity of endophytic fungi from medicinal plant Plantago asiatica L. The endophytic fungi were isolated from the root, stem and leaf of the host by tissue inoculation culture and five plant pathogenic fungi and four bacteria strains used as indicating microbes to test microbial inhibition activity by agar plate antagonistic action and modified agar gel diffusion methods. The results indicated that thirteen fungal endophytic strains were isolated from the host. Most of them came from stem, then leaf, and root as the least in number. The isolated strains attribute to five genera, two fam-ilies, and two orders based on morphological characteristics. For the isolated strains, eleven of them were found to have some microbial inhibition activities against one or more indicating fungi, making up 84.6% of the total iso-lates. Six isolated strains had some antimicrobial activities against one or more indicating bacteria, amounting to 46.2% of the total isolates. Three isolated active strains, which are PAEFS001, PAEFS007 and PAEFS008, ex-hibited evident inhibition activities against five kinds of pathogenic fungi used in the trials respectively. The strain of PAEFS001 ascribed to Ozonium sp. Both strains of PAEFS007 and PAEFS008 ascribed to Aspergillus sp. One active strain of PAEFS003 showed evident antibacterial activities to Bacillus subtilis and Staphyloccus aureus, which belonged to Fusidium sp. The endophytic fungi from medicinal plant Plantago asiatica L. have evident an-timicrobial activities. Their inhibition activities against pathogenic fungi have relatively broad spectrum. And their inhibition activities to both Bacillus subtilis and Staphyloccus aureus as G+ are evident and have certain selectivi-ty. It is feasible to find new bioactive compounds associated with endophytic fungi from Plantago asiatica L. Fur-ther research and development of the endophyic fungi will be important for the integrated utilization of the host.

OBJECTIVE To understand the epidemiological and clinical features of enteritis caused by Norwalk virus in the hospital and observe the effectiveness of prevention and control system in order to provide the basis for the control of outbreaks.METHODS By adopting field epidemiological and clinical data study,investigation and analysis were conducted on eight cases of suspected patients with enteritis caused by Norwalk virus in the hospital.Control on gastrointestinal infections and droplet infection was implemented.RESULTS Bacterial test on feces was conducted on eight cases of suspected gastroenteritis caused by Norwalk virus.Results were negative,thus diagnosed as viral infection;among them,virology test on feces was conducted on two cases which were diagnosed as enteritis caused by Norwalk virus.All patients were recovered after proper treatment and no new cases were found after timely disinfection.CONCLUSIONS The epidemic outbreak of enteritis caused by Norwalk virus has been timely and effectively controlled in the hospital;because communication channel on infection control management is open,contingency plans are effective and the prevention and control taskforce functions well.

Objective To investigate the effect of insulin-like growth factor-1(IGF-1) and basic fibroblast growth factor (bFGF) on the differentiation of human dental pulp stem cells in vitro. Methods Mono-cell suspension was separated from the human adult dental pulp with collagenase Ⅰ and dispase digestion. Colony-forming efficiency of cells was calculated. Cells were observed under an invert microscope. Dentin sialoprotein (DSP), dentin matrix protein 1 (DMP-1) and dentin sialophosphoprotein (DSPP) mRNA of the 3rd passage cells induced with IGF-1 and bFGF in vitro were detected by immunohistochemistry and RT-PCR. Results Clonogenic cells were obtained from dental pulp and colony-forming efficiency of cells was 2.6-3.5 colonies/10 4 cells. Human specific DSP, DMP-1 protein and DSPP mRNA expressed in colony-forming cells after 7 d of induction with IGF-1 and bFGF in vitro. Conclusion Adult stem cells might exist in human dental pulp. Dental pulp stem cells could differentiate into odontoblast under the induction of IGF-1 and bFGF.

Background Researches showed that the content of nitric oxide (NO) and nitric oxide synthetase (NOS) increases in blood,aqueous humor and tear of cataract patient.But the function of NO and NOS in cataract formation is still elusive.Objective The aim of this study was to explore the prevention and treatment effect of NOS inhibitor,1-nitro-arginine methyl ester (L-NAME),on galactose cataract.Methods Sixty clean three-week-old Wistar rats were equally and randomly divided into 3 groups.0.9％ Normal saline solution (30 ml/kg) was subcutaneously injected every day for 30 days in the rats of the control group,and 50％ of D-galactose solution (30 ml/kg) was used in the rats of the model and L-NAME group at the same way.L-NAME eye drops was simultaneously administered in the L-NAME group 3 times per day for 30 days.The eyes of the rats were examined under the slit lamp in 10,20 and 30 days,and the degree of lens opacification was scored.Lenses of the rats were obtained at the end of this experiment for the detect of NO,NOS contents.Flow cytometry was used to assay the caspase-3 level of rat lens.Repeated measurement two factor analysis of variance was used to analyze the difference of lens opacification scores in different groups and different time points,and one-way ANOVA was used to analyze the differences of NO,NOS and caspase-3 contents in lens among the groups.Results Lens opacification appeared in 10 days after injection of 50％ D-galactose solution in the rats of the model group and L-NAME group.Lens opacification score was higher among the different groups and different time points (Ftime =435.251,P =0.000 ;Fgroup =395.120,P=0.000).NO content in the lens was (0.45±0.15) μmol/g,(2.67 ± 0.47) μmol/g and (1.68±0.34) μmol/g in the control group,model group and L-NAME group,showing a significant difference (F=58.872,P=0.000).The NOS contents in the lens was (0.0160±0.0020) U/ml,(0.0370±0.0040) U/ml and (0.0270±0.0010) U/ml in the control group,model group and L-NAME group,showing a significant difference (F =66.174,P=0.000).Caspase-3 contents in the lens was (339.4 ± 37.9),(697.7 ± 46.5) and (650.7 ± 53.1),Showing a significant difference among them (F =100.005,P =0.000).Conclusions The increase of NO,NOS and caspase3 levels are associated with lens opacification.Topical administration of L-NAME eye drops can down-regulate NOS content in lens,reduce the NO formation and inhibit the apoptosis of lens epithelial cells.