The paper discussed the working platform for medical ethics education,for the purpose of making such education regular,normalized and popular among the staff.Such means as better organization,innovative media,reinforced implementation and repeated examination will encourage hospital staff to develop better medical ethics for better quality of care and elevation of hospital culture and social satisfaction.

[Objective]To explore the clinic results of bi-posterolateral fusion combined with coralline hydroxyapatite interbody fusion,a three point stable spine fusion technique in the treatment of degenerative vertebra disc disorder.[Method]Bi-posterolateral fusion combined with posterior interbody fusion were performed to treat 41 cases of degenerative vertebra disc disorder from August 1998 to August 2006.The patients included 18 men and 23 women;their average age was 48 years.The slippage and grade of spondylolisthesis before and after spine fusion were investigated.The severity and slippage of radiographic measurements were also recorded,along with the average follow up of 19.1 month(range 12-48 months).The three point spine fusion applied autologous bone chips for bi-posterolateral fusion and one cubic block of coralline hydroxyapatite for anterior inter body fusion which achieved by PLIF technique.[Result]In the 41 patients who had underwent three point spine fusion surgery,only 1/41 patients experienced nerve root pain after surgery,and in most cases clinical symptoms were improved greatly.In 21/41 patients who had severe lower back pain completely disappeared after surgery,and in 9/41 cases these symptoms were minimal.The clinical evaluation according to the symptoms before the operation was excellent 2.4%(1/41),good 19.5%(8/41),fair 21.9%(9/41),bad 56.1%(23/41);after operation excellent 68.3%(28/41),good 29.2%(12/41),fair 2.4%(1/41),bad 0.0%(0/41).A radiographic measurements showed the anterior disc height was 8.05?2.35mm before operation and 11.44?3.38mm after operation(P

Adolescent ; Blood Glucose ; analysis ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; etiology ; Child ; China ; epidemiology ; Diabetes Mellitus ; etiology ; Humans ; Metabolic Syndrome ; diagnosis ; epidemiology ; etiology ; prevention & control ; Obesity ; complications ; Practice Guidelines as Topic ; Risk Factors ; Waist-Hip Ratio

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

AlM: To observe the influence on the incidence of diffuse lamellar keratitis ( DLK ) after laser in situ keratomileusis ( LASlK ) whether or not wearing sterile gloves with talc during operation, and to confirm the role of residual talc in the occurrence of DLK.
METHODS: Totally 563 patients ( 1 126 eyes ) accepted operation with the method of surgical hand antisepsis only were set as the experimental group, while 592 patients ( 1 184 eyes ) with the method of surgical hand antisepsis and sterile gloves as the control group. Each patient was rechecked to observe the occurrence of DLK on the first day and the seventh day after the operation. Then the data of DLK were statistically analyzed byχ2 test and rank sum test.
RESULTS:On the first postoperative day, the incidence of DLK was 7. 4% (83 eyes) in experimental group and 12. 2% (144 eyes) in control group. ln the former group, stage Ⅰ of DLK accounted for 4. 6% (52 eyes) and stageⅡ for 2. 8% (31 eyes);while in the latter, stage l did for 7. 7% (91 eyes) and stageⅡfor 4. 5% (53 eyes). On the seventh day, all DLK were cured. The other 2 cases ( 3 eyes) occurred in stage Ⅳ DLK ( the first time recheck was on the eighth day after operation and fluorometholone ophthalmic solution was not used on time ) . The incidence and the severity were both significant lower in the experimental group than in the control (both P<0. 01).
CONCLUSlON: Talc is one of the most important factors resulting in DLK after LASlK. The method of surgical hand antisepsis without wearing gloves could avoid the stimulation of talc and reduce the incidence of DLK obviously.

Objective: To investigate the secondary metabolites from Chinese marine Sponge Cinachyrella australiensis. Methods: Column chromatography techniques including HPLC were used for the separation and purification of the compounds, and extensive spectral analyses including various 2D NMR spectra were employed for structure elucidation. Results: Nineteen compounds were obtained ,including 2 methyoxy 6,12,15 trien 8 yne octadecanoic acid(1), 2 benzenedicarboxylic acid dibutyl ester(2), 1,2 benzenedicarboxylic acid bis(2 ethylhexyl)ester(3), ( ) (3S) 1,2,3,4 tetrahydro ? carboline 3 carboxylic acid(4), L Tryptophan (5), p hydroxylbenzaldehyde (6), p hydroxyl benzylethanol(7), p hydroxyl benzyl propanol(8), cholesta 4 en 3 ol(9), 2 methyl 6 amino 9 (2 deoxy ? D ribofuranosyl purine(10), 2' Deoxyadenosine (11), 6 amino 9 ? D ribofuranosyl 9H purine (12),uracil(13), thymine(14), thymidine(15), 1 (2 deoxy ? D Ribofuranosyl)uracil(16), 1 ethyl ? (2 deoxy) ? D ribofuranos(17),isolumichrome(18),and zarzissine(19).Conclusion:Compounds 1 and 18 are new natural products,and compounds 2 to 17 as well as 19 are isolated from this species for the first time.

Objective To investigate the dynamic expression from gene and protein levels of hypoxia inducible factor-1α(HIF-1α) during the development of hypoxic pulmonary hypertension (HPH) in neonatal rats.Methods A neonatal rat model of HPH was established,normal neonatal rats were enrolled as the control group.At the 3th 、7th、10th and 14th days,we measured the mRVSP through catheterization of right ventricule,collected hearts to figure out the right ventricular hypertrophy index(RVHI),evaluated vascular remodeling by the percentage of medial thickness to outer diameter of the small pulmonary arteries (MT％) and the percentage of medial cross section on area to the total cross section area of the pulmonary small arteries (MA％),observed the expression of HIF-1α by immunochemistry,and measured the expression of HIF-1α in mRNA and protein by RT-PCR and Western blot respectively.Results The mRVSP increased at the 3th day,and sustained until the 14th day (P ＜ 0.01).RVHI MT％ and MA％ increased at the 7th day,and sustained until the 14th day (P ＜0.01).HIF-1α mainly expressed in endothelium and smooth muscle cells in the CHPH group and the HIF-1αmRNA increased significantly on the 3th and 7th days (P ＜ 0.05),and the HIF-1α protein increased significantly on the 7th、10th and 14th days in the CHPH group compared with the control group(P ＜ 0.01).Conclusion The mRVSP increased at the early stage after hypoxic exposure in neonatal rats,followed by vascular remodeling and right ventricular hypertrophy.Both mRNA and protein levels of HIF-1α sustained higher than control group during the vascular remodeling stage,indicating that HIF-1α might be a important factor contributing to the vascular remodeling.

Objective To evaluate the efficiency and safety of hair removal with Lightsheer 800 nm diode laser. Methods Lightsheer, 800 nm diode laser, was used to remove hairs from different areas, including hairlines, lips, whiskers, armpit, chest, back, limbs and bikinis area, in 432 patients. Results At least twice treatments, the maximum 29 times, were needed to achieve satisfactory results. Total effective rate increased with the treatment times but depended on the different area:63.4 % of hairlines, 67.7 % of lips, 71.9 % of whiskers, 100 % of armpit, 100 % of chest, 100 %of back, 82.6 % of limbs and 100 % of bikinis area, respectively. The adverse effect was observed with temporal hypopigmentation in 4 patients and hyperpigmentation in 9 patients, without any scar formation. Conclusions Lightsheer 800 nm diode laser is a safe and efficient method of laser hair removal.

Objective To analyze related perioperative risk factors of acute respiratory distress syndrome (ARDS) early after orthotopic liver transplantation (OLT).Methods The cases from the recipients having undergoing OLT,aged from 15 to 65 years and having no chronic respiratory diseases and hyoxemia were collected.The exclusive criteria were as follows:(1) the patients dead or automatic discharging at the day after the OLT or during the OLT; (2) the patients suffered from severe surgical technic complications; (3) initial poor graft function occurred; (4) marginal donor; (5) pulmonary wedge pressure (PAWP)＞ 2.394kPa.251 patients were enrolled in this analysis,who were grouped according to whether they developed ARDS (group B) or not (group A) in the first postoperative day.The analyzed factors were as follows:(1) the sex,age and weight of the recipients; (2) preoperative variables of recipients:Child-Pugh and Model for end-stage liver disease (MELD) score,left vent ricular ejection fractions,oxygenation index,the serum levels of creatinine,BUN,TB,albumin,prealbumin,fibrinogen and hemoglobin,white blood cells (WBC),platelet count and international normalized ratio (INR) ; (3) the variables of donator:age,the time of warm and cold ischemia; (4) the intraoperative variables:operative time,anhepatic phase,the volumes of hemorrhage and blood-transfusion (red cell suspension and plasma),transfusion volume; (5) postoperative variables of recipients:the serum levels of creatinine,blood urea nitrogen (BUN),total bilirubin (TB),albumin,alanine aminotransferase (ALT),sodium and potassium,fibrinogen and hemoglobin,WBC,platelet count and INR.Results The mild ARDS incidence early after OLT was 25.5 ％ (65/251) and the moderate or severe was 4.8％ (12/265).Single factor analysis showed that the factors having significant difference between group A and group B were as follows:the age of the recipients,preoperative variables (Child-Pugh and MELD score,the preoperative serum levels of BUN,TB,prealbumin,fibrinogen and hemoglobin,WBC,platelet count and INR),the intraoperative variables (the volumes of hemorrhage and blood-transfusion including red cell suspension and plasma) and the postoperative variables (the serum levels of BUN,TB,sodium,fibrinogen and hemoglobin,WBC,platelet count and INR).The significant factors were put to the analysis of LOGISTIC regression,and the results showed that the age of recipients,preoperative Child-Pugh score,BUN and INR,intraoperative hemorrhage volume,postoperative serum level of sodium were the independent risks contributing to ARDS.Conclusion The mild ARDS incidence early after OLT was high but the the moderate or severe incidence was low.The age of recipients,preoperative Child-Pugh score,BUN and INR,intraoperative hemorrhage volume and postoperative serum level of sodium may be the main risk factors to lung injury after OLT.