Objective To investigate the professional situation and talent drain of pediatric residents,and explore the coping strategies. Methods One hundred and twenty pediatric residents and 6 administrative personnels were selected from three hospitals featured in pediatrics.Questionaires were administered to pediatric residents,and interviews were conducted with administrative personnels. Results Only 28.85% pediatric residents were satisfied with present professional situation.The talent drain of pediatric residents was severe,and the major causes were hard work,low incomes and unfavourable career development prospects. Conclusion A considerate number of pediatric residents are not satisfied with the professional situation,and the talent drain is a common occurrence.Government should attach great importance to pediatric medical education and increase health care investment.Besides,the view of value of pediatric residents should be improved and a harmonious medical environment should be established.

Shanghai Medical Center for Children, jointly set up by the municipal government and the World Health Foundation of America, possesses advanced intelligence hospital buildings and medical facilities. The authors gave a detailed account of the centers practice in implementing reform with modern ideas of hospital management. Specific ways include: ①improving the overall quality by training all workers and staff of the management contingent; ②strengthening medical quality control via orienting medical service towards the needs of patients; ③conducting widespread international exchanges and cooperation with specialty development serving as the link; ④enriching hospital culture by strengthening the building of a spiritual civilization with special characteristics; ⑤setting up the centers development department so as to raise social charity funds for the advancement of the hospital; ⑥outsourcing logistic service so as to improve operating efficiency.

The General Rules of the Civil Law of the People′s Republic of China(hereinafter the General Rules)shall officially come into effect as of July 1 of 2017.In this consideration,the paper probed into the legal attributes of the doctor-patient relationship in China in view of the relationship management in line with the General Rules.Also analyzed are the basic principles to be observed by both parties as regulated by the General Rules and patient rights protection.These efforts aim at elevating China′s medical service,protecting legitimate rights of both parties,and encourage a healthy and harmonious doctor-patient relationship.

OBJECTIVE:To study the characteristics of adverse drug reactions(ADR) induced by gatifloxacin.METHODS:A total of 866 ADR cases induced by gatifloxacin collected in Zhejiang ADR Monitoring Center between Oct.30,2003 and Oct.30,2006 were analyzed with Excel.RESULTS:The common ADR induced by gatifloxacin were lesions of skin and appendages,gastro-intestinal system,systemic and nervous system.Most of the cases were slight in symptoms,but gatifloxacin could also induce severe ADR such as dysglycemia etc that resulting in potential risks to vital human organs.CONCLUSION:ADR monitoring should be emphasized when using gatifloxacin so as to decrease or avoid the occurrence of ADR.

Objective To analyse the possible risk factors associated with the progression of vitiligo.Methods A questionnaire survey was carried out to collect the clinical data on 1088 patients with vitiligo.The relationship between possible inducements to the progression of vitiligo and lesion area was statistically analyzed in patients with the same clinical course of vitiligo. Paired t test was performed to compare the mean area index of involvement between patients with inducements and those without Results A significant difference was observed in the mean area index of involvement between patients with isomorphic response and those without (t = 6.770, P ＜ 0.01 ) as well as between patients negatively affected by psychiatric factors and those unaffected (t = 6.704, P ＜ 0.01 ), but not between patients with family history and those without (t = 1.499,P ＞ 0.05). Conclusion A rapid progression of vitiligo is more likely to be observed in patients negatively affected by psychiatric factors and patients with isomorphic response.

Objective To determine the clinical features of childhood vitiligo in Han nationality.Methods A standardized questionnaire was used to clinically investigate 396 cases of vitiligo in patients aged less than 12 years;825 adult patients with vitiligo served as controls.Data analysis was done by SPSS 10.0.Results In child patients with vitiligo,46.2% were males,and 53.8%females;there was no statistically significant difference in gender ratio between the childhood and adult groups(P＜0.05).The incidence of segmental vitiligo was 33.3%in children,significantly higher than that in adult patients(13.5%).On the contrary,the incidence of generalized vitiligo was significantly lower in children han in adult patients(4.3%vs 11.6%).A family history of vitiligo was observed in 12.4%of children,and in 12.7% of adults,withoutsignificant difference between the two groups.For both childhood and adult vitiligo patients,the incidence of vitiligo was significantly higher in firSt-degree relatives than in second-degree relatives.The most common precipitating factor of childhood vitiligo was trauma.The incidence of halo nevi was higher in patients with childhood vitiligo compared to patients with adult vitiligo,while thyroid disease was seen more frequently in adult patients.Conclusion There are some differences in clinical characteristics of vitiligo between children and adults.

Objective To measure the expression of granulocyte colony-stimulating factor receptor (G-CSFR) in human melanocytes and to evaluate the biologic effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on human melanocytes.Methods Melanocytes were obtained from circumcision specimens of healthy males,and neutrophils were isolated from heparin-andcoagulated peripheral blood of healthy human followed by a primary culture.Then,the melanocytes in third passage were cultured with or without the presence of various concentrations (200,400,600,800 μg/L) of rhG-CSF for 72 hours.The growth and morphology of melanocytes were observed.Flow cytometry was performed to detect the expression of G-CSFR in untreated human melanocytes,neutrophils and erythroleukemia cells (HEL 92.1.7).Western blot and reverse transcription PCR (RT-PCR) were carried out to measure the expression of G-CSFR protein and mRNA respectively in the neutrophils,HEL 92.1.7 cells,treated or untreated human melanocytes.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation,and dopa-oxidation assay to estimate the tyrosinase activity,of treated melanocytes.Results The expression rate of G-CSFR was 76.81％ ± 10.70％ in human melanocytes,significantly higher than that in the HEL 92.1.7 cells (2.53％ ± 1.54％,P ＜ 0.01 ),but lower than that in the neutrophils (85.76％ ± 15.71％,P ＜ 0.05).Both G-CSFR protein and mRNA were expressed in melanocytes,and there was no significant differences in the expression level of G-CSFR protein and mRNA among melanocytes treated with different concentrations of rhG-CSF (both P ＞ 0.05).The expression levels of G-CSFR protein and mRNA in the melanecytes were significantly higher than those in the HEL 92.1.7 cells (both P ＜ 0.01 ),but lower than those in the neutrophils (P ＜ 0.05 or ＜ 0.01 ).rhG-CSF at 200-800 μg/L displayed a significantly promotive effect on the proliferation of melanocytes (P ＜ 0.01 or ＜ 0.05 ),and the effect was in a dose-dependent manner when rhG-CSF ranged from 200 to 600 μg/L (P ＜ 0.01 ).The rhG-CSF at 600 μg/L and 12-O-tetradecanoyl-phorbol-13-acetate (TPA) at 20 μg/L showed an equivalent effect on the proliferation of melanocytes (164.04％ ± 13.0％ vs.165.62％ ± 10.6％,P ＞ 0.05).However,rhG-CSF from 200 to 800 μg/L had no significant impact on the tyrosinase activity of melanocytes (all P ＞ 0.05 ).Conclusions G-CSFR is expressed in human melanocytes. rhG-CSF can promote the proliferation of cultured human melanocytes,but has no obvious influence on the tyrosinase activity of melanocytes.

Objective To explore the value of bedside ultrasound used by ICU doctor in the rapid diagnosis of traumatic abdominal,and to evaluate the advantage of bedside ultrasound in the treatment decision.Methods 60 patients with traumatic abdominal blood in our hospital admitted to the ICU were selected.All patients were checked through bedside ultrasonography by physicians with professional training of ICU,bedside ultrasound and abdominal CT and abdominal flat piece of traumatic hematocelia,and compared the diagnosis of the time of the bedside ultrasound,abdominal CT and abdominal X -ray and ultrasound physician ultrasound examination.Results The difference of abdominal blood detection rate between bedside ultrasonography and abdominal computed tomo-graphy (CT)had no statistical significance (P >0.05);bedside ultrasonography of abdominal blood detection rate was higher than plain film of the abdomen,the difference was statistically significant (χ2 =73.346,P <0.01);bed-side ultrasound received a preliminary diagnosis of time -consuming (4.37 ±2.1)min was significantly lower than that of the examination of ultrasound physicians (13.86 ±5.6)min,abdominal CT (22.13 ±6.9)min and abdominal plain film (28.19 ±7.32)min,the differences were statistically significant (t =3.947,14.607,21.139,26.338,all P <0.01 ).Conclusion By the professional training of ICU physicians for bedside ultrasound traumatic blood abdominal patients can make a more accurate diagnosis,time -shorten,more accord with the requirement of treating critically ill patients in ICU,which has important clinical value for trauma abdominal blood in early rapid diagnosis and treatment.

Objective:To evaluate the acute oral toxicity , skin irritation and skin allergy of Thuja essential oil ( TEO) , and pro-vide experimental basis for the clinical use of TEO .Methods:The acute oral toxicity was measured by Horn ’ s assay .Totally 40 KM mice were divided into four groups and intragastrically administered with TEO at different dose of 21.50, 10.00, 4.64 and 2.15 g · kg-1 .After the 14-day observation, the death number and toxic manifestations were recorded and observed , and LD50 was calculated by checking the Horn's form of LD50 .The skin irritation test was performed on healthy adult white rabbits .Totally 9 rabbits were divid-ed into 3 groups randomly , and TEO at the concentration of 100%, 50%and 25%was painted on the skin of the rabbits .Edible vege-table oil was used as the negative control .The erythema and edema of the treated skin were evaluated and scored .Delayed skin hyper-sensitivity reaction was used to investigate the allergy of TEO .Totally 30 white guinea pigs were randomly divided into 3 groups:TEO group, the negative control (edible vegetable oil) and the positive group (1%2, 4-dinitrochlorobenzene).After the intracutaneous in-duction stage and local induction stage , TEO was used to activate the hypersensitive reaction .The skin response was observed and scored after the 24-hour and 48-hour activation.Results:The mice in 21.50 g · kg-1 TEO treatment group were all dead , while only a part of the mice in 10.00 and 4.64 g · kg-1 TEO treatment groups were dead , and no mice died in 2.15 g · kg-1 TEO treatment group.According to the Horn's form of LD50 , LD50 of TEO was 9.26 g · kg -1 for male mice and 7.94 g · kg -1 for female mice.The results of skin irritation test indicated the strong irritation effects of TEO .However , the irritation of TEO was reduced after the dilution , and 25%TEO showed no irritation to the skin of rabbits .The results of delayed skin hypersensitivity reaction showed obvious erythema and edema induced by 2, 4-dinitrochlorobenzene , while no obvious erythema and edema were found in TEO treated guinea pigs , indi-cating non-allergic effect of TEO .Conclusion:TEO has strong skin irritation in rabbits , while no obvious oral toxicity in mice and skin allergy in guinea pigs .

Effective chemotherapy is the mainstay of malaria control. However it is undergoing the serious threat by resis?tance of falciparum malaria to antimalarial drugs. In recent years with the development of molecular biology technology molec?ular markers have been widely used to monitor antimalarial drug resistance. This paper reviews the researches on the common molecular markers related to Plasmodium falciparum drug resistance.