This article emphasizes the importance of medical communication and expounds how to strenthen medical communication by some principles and methods,like paying attention to and lov-ing patients,listenning carefully,explaining patiently and confidently,learning modestly and so on.

Humans ; Malocclusion, Angle Class I ; therapy ; Orthodontic Appliance Design

Objective To Know the present situation of diabetes′ self-management ,explore its influencing factors and provide theoretical evidences for conducting diabetic health education and improving patients′ level of self-management .Methods Using random sampling method ,we took 483 cases of diabetic patients concluded inpatient and outpatient from a first class hospital and two community hospitals who meet the inclusion criteria from March 2011 to April 2013 in Chongqing city .All patient were investi-gated with diabetes self-management questionnaire scale .Results 500 questionnaires ,received 483 valid questionnaires ,and the ef-fective rate of recovery is 96 .6% .Among 483 cases of diabetic patients in the investigation ,78 .7% of patients understood diabetes knowledge from medical staffs .In the aspect of following the treatment plan :drug plan had the best executive power with 59% ;the average score of diabetes knowledge was (41 .747 ± 10 .23) ,score index was 51 .5% ;82 .2% of patients did ,not understand their value of glycated hemoglobin ,44 .5% of patients did not understand the two-hour postprandial blood glucose ;The average score of diabetes′self-care behaviors was(3 .59 ± 1 .249) ,score index was 51 .29% ,different score index accompany with different self-man-agement levels .Educational level ,retirees ,diet control ,blood glucose monitoring ,the understanding of diabetes knowledge were pro-tective factors for receiving health education .Conclusion Patients grasp diabetic knowledge are poorly in average ,the present situa-tion of patients′self-management is not optimistic ,it is better to increase the health education of diabetes′ self-management ,and make great efforts to improve diabetes′self-management skills .

Objective: To analyze the association between the concentration of metalloestrogens ( MEs ) in seminal plasma and sperm quality in infertile patients, so as to provide the basis for the study of MEs on human sperm quality. Methods: The spermatozoa concentration, progressive rate ( PR ), normal morphology rate ( NMR ) and DNA fragmentation index ( DFI ) were determined in the infertile male patients from Zhejiang Provincial People's Hospital from March to April, 2020. The contents of As, Cd, Co, Cr, Cu, Hg and Ni in seminal plasma were determined by inductively coupled plasma mass spectrometry ( ICP-MS ). The distribution of MEs in seminal plasma and the sperm quality in different concentration of MEs ( grouped by quartiles ) were analyzed. Results: Among 105 cases recruited, 28 cases were normal in sperm parameters and 77 cases were abnormal, including 22 cases of oligospermia, 47 cases of asthenospermia, 54 cases of dysspermia and 30 cases of abnormal DFI. As, Cr, Cu, Hg and Ni were detected in all samples, the detection rates of Cd and Co were 78.57%-90.91%. Compared with the normal group, the concentration of As in oligospermia group was higher [( 18.96±12.56 ) µg/L vs. (13.67±4.19) µg/L, P<0.05],the concentration of Cr was higher in asthenospermia, dysspermia and abnormal DFI in Q3 and Q4 groups groups [( 386.62±81.92 ), ( 378.02±81.46 ), ( 393.88±77.03 ) µg/L vs. ( 343.12±55.08 ) µg/L,P<0.05]. The PRs in Q3 and Q4 groups of Cr were lower than that in Q2 group [( 32.95±18.22 )%, ( 27.74±22.77 )% vs. ( 54.18±24.64 )%, P<0.05], the DFI in Q3 and Q4 groups was higher than that in Q2 group [( 26.91±14.77 )%, ( 29.91±16.93 )% vs. ( 9.87±10.93 )%, P<0.05], and the NMR in Q4 group was lower than that in Q2 group [( 1.62±1.72 )% vs. ( 3.36±1.97 )%, P<0.05]. The concentration of sperm in Q3 group of Cu was higher than that in Q2 group [( 115.87±88.22 )×106/mL vs. (61.91±66.16)×106/mL, P<0.05]. Conclusion As and Cu in seminal plasma are associated with abnormal sperm concentration, and Cr is associated with NMR, PR and DFI.

Objective To study the effects of Liensinine on apoptosis of 5637 cells, and its mechanism thereof. Meth?ods CCK-8 method and the colony formation test were used to detect cell viabilities, and then inhibition rates were calcu?lated. Flow cytometry was used to detect the effects of Liensinine on apoptosis of 5637 cells. Western blot assay was used to detect Caspase-7 protein expression. Results CCK-8 assay and colony formation test indicated that Liensinine inhibited the cell proliferation significantly. Results of flow cytometry indicated that Liensinine induced early apoptosis of 5637 cells. Western blot assay showed that Liensinine improved the expression of Caspase-7 and enhanced the activation of Caspase-7 in 5637 cells. Conclusion Liensinine could inhibit the proliferation of 5637 cells, induce early apoptosis, which may be re?lated with the enhanced expression of Caspase-7 and its activation.

Objective To investigate the cause,prevention methods and curative effect on two different drainage methods of subcutaneous effusion after breast cancer surgery.Methods The clinical data of 68 cases subcutaneous effusion among 2 100 cases underwent breast cancer modified radical surgery in our hospitial were analyzed retrospectively from January 2010 to December 2016.The vacuum sealing drainage was performed in 1 032 cases and wound high negative pressure drainage system was performed in 1068 casess.Both the elastic bandage compresstion dressing didn't used.Results In 2 100 cases,68 cases of subcutaneous effusion occured (3.2％),including longitudinal incision 48 cases and transverse incision 20 cases.Among 1 068 cases of high negative pressure drainagesystem,subcutaneous effusion occured in 36 cases including 28 cases of incisional infection and 8 cases of skin flap necrosis.The extuhation time was 8-36 days,average 12 days.Among 1 032 cases of vacuum sealing drainage,subcutaneous effusion occured in 32 cases including 22 cases of incisional infection,10 cases of skin flap necrosis.The extubation time was 6-12 days,average 8 days.All cases were followed up for 3 months,no subcutaneous effusion and axillary effusion occurred.Conclusions Adequate drainage is the key to prevent subcutaneous effusion.Both vacuum sealing drainage and wound high negative pressure drainage can effectively reduce the occurrence of subcutaneous effusion,however,vacuum sealing drainage is more suitable for wounds with more exudation,larger lacuna and deeper incisions,especially the infected wound and abscess.

Objective To explore the clinical value of serum procalcitonin (PCT)-based antibiotic therapy in the second-classedexacerbations of chronic obstructive pulmonary disease (AECOPD). Methods 240 patients diagnosised as AECOPD were randomized to the PCT group and the control group. Serum PCT levels of patients from the PCT group were measured 1 h after hospitalized and the third, fifth, eighth day respectively. When PCT < 0.1 μg / L, patients will stop taking antibiotics and initiated while PCT≥0.1 μg / L. Antibiotic treatment in the control group was based on guidelines of COPD diagnosis and treatment. Results Duration of antibiotic therapy and hospitalization were respectively 5.6 ± 1.4 and 8.2 ± 1.1 days in the PCT group, 9.2 ± 2.2 and 11.4 ± 2.5 days in the control group (both P < 0.05). Mean costs of hospitalization expensesand antibiotic therapy were 5700 ± 201 and 1650 ± 189) yuan in the PCT group, 6210 ± 220 and 2350 ± 210 yuan in the control group (both P < 0.05). The clinical effective rate, times of exacerbation, one-year ΔFEV1, the 1-year hospitalization rate and time to next exacerbation all showed no significant differences between the two groups. Conclusion PCT-guided antibiotic treatment reduces antibiotic use inthe second-classed acute exacerbations patients.

Objective:To research the clinical effect of Yi-yuan moxibustion on the bladder dysfunction after incomplete spinal cord injury Method:Forty patients with urinary retention were randomized into treatment group and control group,20 cases in each group.The two groups were treated by rehabilitation training,and the treatment group received Yi-yuan moxibustion,once a day,5d a week,8 weeks in total.Bladder volume and residual urine were tested by B-scan ultrasonography.After 8 week treatment,the curative effect was assessed.Result:One week after all treatments,the results of B-scan ultrasonography showed that bladder volume and residual urine volume of both groups are were improved than before.The curative effect after 6 weeks treatment suggests that the effective rate in control group was 55％ and the treatment group was e 90％.The difference was statistically significant (P＜0.05).Conclusion:Yi-yuan moxibustion is a kind of good therapy to ameliorate urinary retention caused by spinal cord injury.

Objective To summarize the experience ofmultidisciplinary team (MDT) in diagnosis and treatment of complicated and refractory thyroid tumors.Methods A retrospective review was performed on clinical data of 46 cases with complicated and refractory large thyroid tumors admitted to our hospital from Jan.2010 to Dec.2016.There were 23 cases in MDT group and 23 cases in the control group,respectively.The MDT group received diagnosis and treatment provided by multidisciplinary team during perioperative period whereas the control group received conventional surgery.Results Short-term complications such as trouble breathing and thyroid crisis were not observed in 46 patients after surgery.In the control group,the mean durations were (52±11.5)minutes for anesthesia,(159±38.1) minutes for surgery and (11 ±3.5) days for hospital stay,respectively.After surgery,bleeding occurred in 5 cases,hoarseness in 5 cases,irritating cough when drinking in 7 cases,transient hypocalcemia in 8 cases,permanent hypocalcemia in 6 cases,and neck tracheotomy due to tracheomalacia during surgery in 2 cases.In MDT group,the mean durations were (37±8.5) minutes for anesthesia,(134±28.5) minutes for surgery and (7±1.5) days,respectively.After surgery,bleeding occurred in 0 case,hoarseness in 0 case,irritating cough when drinking in 1 case,transient hypocalcemia in 2 cases,permanent hypocalcemia in 0 case,and neck tracheotomy due to tracheomalacia during surgery in 4 cases.Conclusion Application of multidisciplinary team in diagnosis and treatment of complicated and refractory thyroid tumors can reduce duration of preoperative endotracheal anesthesia as well as surgery,decrease postoperative complications,shorten duration of hospitalization and improve life quality after surgery.