Arrhythmias, Cardiac ; etiology ; Birth Weight ; Electrocardiography ; Female ; Humans ; Hypocalcemia ; complications ; Infant, Newborn ; Male

Differences are existed in two textbooks of doctor-patient communication between China and foreign countries concerning perspectives of doctor-patient communication,teaching goals and applicable scope based on the consensus on importance of doctor-patient communication and education training.Contents in textbooks of china emphasize the logic of discipline while that of foreign countries pay attention to the logic of clinical treatment.The advantages of textbooks of China are having strong theoretical basis and ample contents while those of foreign text books are practicability and effectiveness.Some suggestions which to benefit the textbook development of Chinese doctor-patient communication has been offered:textbooks of doctor-patient communication in our country should be separated from those of nursing communication; advantages and experiences of foreign textbooks should be drew from; in-depth development of doctor-patient communication theory research and education reform should be conducted; diversification of teaching materials of doctor-patient communication should be gradually perfected ; teaching quality of doctor-patient communication should be improved.

OBJECTIVE:To investigate the bacteriological characteristics of nasal secretions of chronic rhinosinusitis(CRS)in our hospital,and conduct drug sensitivity test in order to provide theoretic reference for clinical treatment. METHODS:87 CRS patients underwent nasal endoscopic surgery were selected and the nasal secretions of patients were taken for bacterial culture. Automatic microbial analyzer was used to identify the bacteriological characteristics,and disk diffusion test was adopted for drug sensitivity test. RESULTS:Of 87 patients,bacterial strains were detected from 77 cases of nasal secretions,with positive rate of 88.5%. 112 strains were detected,including 81 strains of aerobic bacterium and 31 strains of anaerobic bacterium,and the most common bacterium were Staphylococcus aureus (20.54%). Antibiotics with the highest sensitivity was moxifloxacin (89.29%), followed by ciprofloxacin(87.50%),vancomycin(87.50%). CONCLUSIONS:The bacterial in nasal secretions of CRS patients has high positive detection rate and mainly are aerobic bacterium. Antibiotics should be used rationally according to the results of drug sensitivity test.

The cultivation of medical talents is the main goal of medical postgraduate training. Zunyi Medical University innovates many aspects of postgraduate education, including student sources, spirit of scientific research, curriculum setting, assessment mechanism and quality control, etc. It fo-cuses on cultivating students' practical and innovative abilities through developing professional-typed education, constructing excellent courses, and boosting students' core competitiveness.

Objective To discuss the changes of serum Th1/Th2 cytokine levels of allergic rhinitis patients and the intervention effect of montelukast.Methods 40 cases of allergic rhinitis patients were selected as treatment group,who were given montelukast tablets (10mg) through the mouth one time daily for 8 weeks.The changes of interferon-γ (IFN-γ) and interleukin-4 (IL-4) in peripheral blood (PB) before and after medical treatment were observed,as well as the clinical curative effect and security.Accordingly 30 cases of healthy people were also selected as the control group.Results The IFN-γlevel in culture supernatant of patients in the treatment group [(8.74 ± 1.37) ng/mL] was lower than that in the control group before the medical treatment [(15.13 ± 3.16)ng/mL],while the IL-4 level of patients in the treatment group [(1.64 ± 0.47) ng/mL] was higher than that in the control group [(0.72 ± 0.21) ng/mL] (t =2..93,3.52,all P ＜ 0.01).After 8 weeks' medical treatment,the IFN-γ level in culture supernatant of patients [(12.36 ± 2.56) ng/mL] increased obviously than that of before [(8.74 ± 1.37) ng/mL],while the IL-4 level [(1.21 ± 0.28) ng/mL] declined obviously than that of before [(1.64 ± 0.47) ng/mL] (t =2.36,2.31,all P ＜ 0.05).The total clinical efficiency of patients in the treatment group was 92.5 ％ (37/40).No serious drug adverse reaction (DAR) appeared during the medical treatment.Conclusion The Th1/Th2 cytokine unbalances in peripheral blood (PB) of allergic rhinitis patients.Montelukast has reliable curative effect with high security,whose mechanism of action has close effect on lowering the IL-4 in peripheral blood (PB),increasing the IFN-γ level in peripheral blood (PB),correcting the balance disorders of Th1/Th2 cytokine,and the transformation of immunity reaction from Th2 to Th1.

Air ; analysis ; Chromatography, Gas ; methods ; Ketones ; analysis ; Workplace

Acute Disease ; Female ; Humans ; Intubation, Intratracheal ; Male ; Organophosphate Poisoning ; Pesticides ; poisoning ; Respiration, Artificial ; Tracheotomy ; methods

Purpose To investigate clinicopathologic fea-tures of sacral cellular schwanoma and the difference from sacral conventional schwanoma.Methods Eight cases of sacral cellular schwanoma were collected.Microscopic examination and immunohistochemistry were performed for studying the clinical feature,radiologic appearance,pathologic characteristic,immunophenotyping,differential diagnosis and postoperative prognosis.Results There were 5 females and 3 males,whose mean age was 46.4 years.The majority of patients complained of pain in sacrococcygeal region.Radiographically,there was an endosacral or endosacral and presacal mass.Histologically,cellular schwannoma was composed of spindle cells,arranged in interlacing fascicles without nuclear palisading and Verocay bodies.Antoni A and Antoni B were not seen overtly.The destruction of bone was found.Immunohistochemically,tumor cells were diffusely and strongly positive for S-100 protein and vimentin.The mean of Ki-67 index was 6％.Tumor recurrence of 4 cases occurred several years after initial surgical resection.The mean interval to recurrence was 6.5 years.Conclusion Sacral cellular schwanoma is a rare tumor.Compared with sacral conventional schwanoma,it shows different growth pattern and pathologic features.So pathological diagnosis of the tumor should be noted for clinical follow-up and treatment.

Objective To evaluate the efficacy of percutaneous vertebroplasty for treating the vertebral compression fractures and vertebral metastatic neoplasms, and to assess its clinical curative effects Methods Among 81 cases (47 men and 34 women; ages 35～84, mean age 61 2 years), 110 vertebrae with metastatic neoplasms (61 cases) or vertebral osteoporosis (20 cases) were infused with methacrylate guided by DSA Effect of the operations was observed closely after the procedures Results The procedures were successful in all the involved patients and no significant complications were noted clinically Among the 61 patients treated for malignancies, 58 showed marked pain relief and 3 moderate pain relief 20 patients with vertebral osteoporosis demonstrated complete pain relief The cement leakage observed on radiographs included slight leakage to the adjacent disc (6 of 110, 5 5%), the epidural fat (8 of 110, 7 3%), the perivertebral venous plexus (2 of 110, 1 8%), and the paravertebral soft tissues (2 of 110, 1 8%) Conclusion Percutaneous vertebroplasty can significantly relieve the pain in patients with osteoporotic fractures caused by the malignancies and the vertebral osteoporosis We suggest that slight PMM leaks, when not symptomatic, should not be considered as complications

Objeetlve To avoid inserting the tip of the central venous catheter into internal jugular vein (IJV) through subclavian vein under ultrasound guidance.Methods sixty breast cancel patients aged 28-63 yr weighing 41-70 kg who needed long-term intravenous infusion and chemotherapy through central venous catheter were randomly divided into 2 groups (n=30 each):control group (group C) and ultrasound group (group U).In group C the insertion of central venous catheter through subclavian vein was guided by pulsatile injection of ice-cold saline.In group U ultrasound detector (type HFL 38/13-6 MH,Sonosite Co,USA) was used to guide the insertion of tbe central vesons catheter.The position of the catheter tip was verified by X-ray radiography.The rate of successful placement at 1st attempt was calculated.Results The tip of the central venous catheter was correctly placed in the vena cava and right atrium in all patients in group U (success rate 100%),while in group C the tip was misplaced in IJV in 6 patients (success rate 80%) and had to be replaced.Conclusion Ultrasound guidance is effective for correct placement of the tip of central venous catheter in the vema cava and right atrium through subclavian vein.