Hospital medical ethics is the basis of survival,and an important part of management in modern hospitals.Through the implementation of humanistic services,regulated medical behaviors,expeditious communication channels,and satisfying service for patients with all efforts,can modern hospitals establish a good image for themselves and gain fine reputation from patients.

Objective To examine the application effect of intelligent simulator(SimMan) in comprehensive skill training among doctors and nurses.Methods Totally 168 doctors and nurses were chosen as the training object,6 people (4 doctors and 2 nurses) formed a work team.Comprehensive training course was in accordance with 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science.Real clinical situation was designed by using the third generation SimMan of Norway laerdal company.Trainees were administered two tests before and after training,in which there were two parts containing specialized operation ability and non-technical ability.Overall qualification rate,average mark and treatment time of qualified teams were compared before and after the training.SPSS 16.0 software was used to analyze the data and P ＜0.05 signifies statistically significance.Results Overall qualification rate,average mark and treatment time of qualified teams were 71.43％,(84.70 ± 3.15),and (449.25 ± 77.0) s respectively before training while 100％,(93.55 ± 3.86) and (323.71 ± 42.26) s after training.There were significant differences in results of two groups before and after training (P =0.002,0.000,0.000).Conclusions Application of the third generation intelligent simulator (SimMan) in comprehensive training will obviously improve training effectiveness and cultivate the non-technical ability.

Objective To assess the effects of medicated permeation with traditional Chinese medicine Shujin-Zhitong liquid combined with ion tophoresis on osteoarthritis(OA) of rabbit knee joint in vivo.Methods The modified Hulth OA model was prepared with rabbits by anterior cruciate ligament desmotomy plus medial meniscus resection.Twenty-four model rabbits were randomly divided into three groups: Chinese medicine group: treated with Chinese medicine Shujin-Zhitong liquid by ion tophoresis for 20 minutes per day;positive control group: glucosamine hydrochloride was administered orally per day;blank control group: no treatment was administered to the model rabbits.Serum nitrogen monoxidum(NO) concentration was determined at the time points of prior model making,prior treatment,and 4 and 8 weeks of treatment.At 4 and 8 weeks of treatment,the apoptotic rate of chondrocytes was determined by flow cytometry,and the gene expressions of collagen Ⅱand aggrecan were determined by reverse transcription polymerase chain reaction(RT-PCR).Results The contents of serum NO in Chinese medicine group and positive control group were lower than that in blank control group at 4 weeks after treatment,and the content of serum NO in Chinese medicine group was lower than those in positive control group and blank control group at 8 weeks after treatment.The apoptotic rates in Chinese medicine group and positive control group were lower than that in blank control group at 4 and 8 weeks after treatment.Gene expression levels of collagen Ⅱ and aggrecan in Chinese medicine group and positive control group were higher than that in blank control group at 4 weeks after treatment,while the gene expression level in Chinese medicine group was higher than those in positive and blank control groups at 8 weeks after treatment.Conclusions The treatment of medicated permeation with traditional Chinese medicine Shujin-Zhitong liquid combined with ion tophoresis has shown good therapeutic effect on osteoarthritis(OA) of rabbit knee joint,the mechanism might be the inhibition of chondrocytes apoptosis and reduced secretion of inflammatory factors,and the improvement of cartilage repair by up-regulating related gene expression of chondrocyte.

Objective:To investigate the existence condition of hepatitis B surface antigen(HBsAg) termina-tion codon bias.Methods: A total of 174 reference sequences of all kinds of Hepatitis B virus(HBV) genotypes were chosen from GenBank,and compared by BioEdit.Then secondary structure of RNA was constructed and analyzed together.Results:(1) There were two types of HBsAg termination codon: TAA and TGA in 174 reference sequences.TAA was in 124 cases(71.26%);and TGA in 50 cases(28.74%).(2) There was codon bias selection in HBsAg termination codon,and it could affect the secondary structure of RNA and amino acid sequence encoding protein.Conclusion: HBsAg termination codon bias exists and may be related to RNA structure and the conservatiom of protein function in the evolutionary progress.

Objective To analyze the relation between lamivudine-resistant mutation types and HBV genotypes.Methods 95 cases with YMDD mutation were selected from out-patient clinic and sickroom in our hospital.Restriction endonuclease MboⅠand EarⅠwere used to identify HBV genotypes of PCR product, farther a phylogenesis tree was applied to check it.Results We could divide 95 cases into two parts, 75 cases(78.95%) were HBV C genotype and 20 cases(21.05%) were B genotype, these were verified by phylogenesis tree.With regard to the types of YVDD mutation、YIDD mutation and YMDD+YVDD+YIDD mutation, there were 11 cases, 5 cases, 4 cases in genotype B, respectively, but 35 cases, 27 cases, 13 cases in genotype C.We made the cha-test to check genotypes and types of YMDD mutation, ?2= 0.856, P=0.710. There were no significant differences.Conclusions Using MboⅠand EarⅠcan genotype HBV PCR product easily and reliably. It is no statistical significance between HBV B or C genotype and the types of YMDD mutation.

Aim To select a potential biomarker for early lung cancer diagnosis and targeted therapy by using the cancer specific bounded peptide ZS-6 which had already been obtained from the laboratory.Methods The peptide ZS-6 marked by biotin was used as a probe to pan out the human lung cancer cDNA phage display library,after 4 rounds of subtraction panning,the specific binding clones of ZS-6 were identified.After amplification and purification,then those DNA sequences were identified and analyzed with bioinformatics.Results 18 phage clones were identified to the specific peptide ZS-6 and the DNA sequence showed one of them was an unknown new gene while the others were known tumor related genes.Conclusion A tumor biomarker selected from human lung cancer cDNA library provides a potential tool for early lung cancer diagnosis and therapy.

Objective To investigate the effects of total anthraquinone in rheum on aquaporin 2 and aquaporin 4 expression in rat kidney and explore its diuresis mechanism.Methods Thirty-two SD rats were randomly divided into control group,low dose group,medium dose group and high dose group.Total anthraquinone in rheum was administered to rats at different doses.Urinary volume of 24 h,Na+ concentration and osmolality were detected.Rats were sacrificed 5 days later.Blood samples were taken from the abdominal aorta to detect blood biochemical indicators. Kidneys of rats were removed to detect AQP2, AQP4 expression through immunohistochemistry,Western blot,and RT-PCR. Results Compared with control group,there were significantly increased 24 h urine output of rats in medium and high dose group[(16.21±1.96),(18.16±1.8) ml vs(13.85±1.25)ml,P＜0.05].24 h urine output in low-dose group did not change significantly.AQP2 protein and mRNA expression were significantly decreased in rats'kidneys of medium and high dose group (P＜0.01),The AQP4 protein and mRNA expression was significantly down-regulated in high dose group (P＜0.01).In medium does group,the AQP4 protein expression was down-regulated (P＜0.01),without significant decrease in the mRNA expression.Protein and mRNA expression of AQP2 and AQP4 did not significantly change in low dose group.Conclusion Total anthraquinone in rheum can reduce the expression level of AQP2 and AQP4 in rat kidney,which is probably one mechanism of diuresis caused by rheum.

ObjectiveTo explore the relationship between circulating tumor cells(CTCs) in the peripheral blood of patients with esophageal squamous cell carcinoma(ESCC) and the physiopathological characteristics of esophageal neoplasms.MethodsUsing negative selection system,we depleted red blood cells(RBCs) in red blood cell lysis buffer,depleted white blood cells (WBCs) with Miltenyi magnetic beads and enriched the rare cells from ESCC patients'peripheral blood.Immunofluorence staining (IF) was adopted to identify CTCs.ResultsCirculating tumor cells in the peripheral blood of patients with esophageal squamous cell carcinoma was closely related to cell differentiation grade,the invasion of primary cancer,lymph node status,P-TNM stages,and was rarely related to the sex,age or the location of tumor.ConclusionThe results suggest that circulating tumor cells in the peripheral blood of patients with esophageal squamous cell carcinoma may express the development of esophageal cancer and may be served as a tumor marker to evaluate the biological behavior of esophageal cancer.

Clinical medicine is a comprehensive discipline integrating natural science and hu-manities and social science. Lemology is closely related with basic medicine and medical microbiology and medical immunology are the basis of lemology. Therefore, in the process of cultivating postgradu-ates of lemology, we should not only should attach importance to the cultivation of basic medical knowl-edge and clinical professional quality, but also pay more attention to the development of the intelligence factors and non-intelligence factors. Meanwhile education on humanity, social sciences and relevant laws and regulations should be enhanced to cultivate doctors' professional quality. Reverse thinking and lateral thinking in the clinical diagnosis should be strengthened to achieve the training objectives of cultivating international medical talents.

Objective To evaluate the effect of simulated training on in-service physicians electrocardiogram(ecg) theory and operational learning effect.Methods Sixty resident doctors were randomly divided into experiment group (n=30) and control group(n=30).The experimental group adopted teaching + simulation training mode to implement the theory and operation of ECG in continuing while the control group were taught only by lectures.Training effect of both groups was assessed by electrocardiogram theory and operation examination before and after training respectively,and by questionnaires at the end of the training as well.Data of the examination and questionnaires were analyzed by t test or x2 test.P＜0.05 was considered statistically significant.Results After training,the score of theory examination was (90.87 ± 6.67) points in experiment group and was (85.83 ± 5.5) points in control group,with statistical difference between these two groups(t=3.201,P=0.003).Score of operation examination was(93.40 ± 4.31) points in experiment group and was(77.03 ± 7.96)points in control group,with significant differences(t=10.204,P=0.000).The satisfaction degree of enhancing learning interest,theoretical knowledge and operation skill,and strengthening the concept of humauistic care were significantly better in the experiment group than in the control group (x2=34.737,6.405,42.088,41.713,P=0.000,0.011,0.000,0.000).Conclusions Application of simulated training in the study of electrocardiogram is obviously superior in effect to the traditional teaching model.It can improve the theoretical knowledge and operation skill,which is helpful in elevating the in-service physicians' comprehensive capability.