From the status quo of doctor—patient relationship and medical students' communication competence and in combination with the need of transformation of modern medicine,the article discussed stressing the training of the clinical medical students' ability to deal with doctor—patient relationship so as to cultivate their communication competence.

Objective:The patients undergoing operation for the fracture of hip or/and pelvis are at risks for venous thromboembolic complication.We measured the level of tumor necrosis factor-alpha(TNF-?) and intercellular adhesion molecule-1(ICAM-1) to evaluate the relation between cytokine and deep venous thromboses(DVT).Methods:28 patients of fracture of hip or/and pelvis were divided into two groups according to venography.The levels of ICAM-1 were tested with enzyme-linked immunosorbent assay(ELISA),while TNF-? were tested with radioimmunoassay at the first day after injury,and 1st,3rd,7th,12th day of postoperative period.Results:We found a marked increase of TNF-? and ICAM-1 in all the patients,and there was significant difference between the patients and normal controls (P

Forty patients with hip disease who underwent first total hip arthroplasty (THA) in Department of Orthopedics, Second Hospital of Chongqing Medical University from January 1999 to January 2002 were selected. They were treated with cemented (n =16) and cementless THA (n =24). The time to leave bed of cemented-THA group was obviously shortened compared with cementless THA group (P

Objective To explore the clavicular hook plate in the treatment of distal clavicle fracture dislocation acromioclavicular joint clinical effects.Methods Twenty-three cases of Neer Ⅱ type distal clavicle fracture and 28 cases of Allman Ⅲ acromioclavicular joint dislocation line with open reduction and clavicular hook plate fixation.Results Fifty-one patients in this group have received 6-24 months of follow-up,an average of 18 months.2-3 weeks after the activities returned to normal off the shoulder,clavicle fractures were 3-12 months after bone healing and no-dislocation of acromioclavicular joint occur.According to Karlsson evaluation criteria:excellent in 40 cases,good in 9 cases and poor in 2 cases,excellent rate of 96.1％.Conclusion The clavicular hook plate fixation strength in the design and in line with the anatomical acromioclavicular joint physiological characteristics,surgical trauma,and has a fixed precise,allows early functional exercise.It is the ideal way to lock joint dislocation.

Fourty - seven cases were treated with this remedy, a~ mong them, 26 cases were markedly effective, 12 cases abated, 4 cases ineffective, the total effective rate being 91. 5%. The results were apparently superior to the blank control group. The mechanism of such effectiveness lies in the improvement of evacuation of gastric content and gastrointestinal movements.

ObjectiveTo introduce a new procedure of penile lengthening which yields satisfactory outcomes and avoids persistent postoperative hydrophallus with the results of fresh body researches.MethodsIndirect intralymphatic injection and routine H-E staining were used to investigate the ramification of lymphatics of penis on fresh bodies.We found that the lymphatic return of penis was primarily mediated by dorsal and bilateral superficial lymph vessels,which converged dorsally at the root of penis and then ramified into the superior region of pubic symphysis and bilateral inguinal grooves.However,most previous incisions were done at the converging region of lymph vessels at the dorsal root of penis.It blocked most lymphatic return.Our modified method avoided interruption of lymph vessels in the converging region.Based on the results of the above investigations,the operative incision at the root of penis was shifted upward by 1.5 cm,and then the lengthened cavernous body of penis was covered by scrotal flap.ResultsEighty patients who accepted the new method achieved satisfactory outcomes.Postoperative hydrophallous decreased gradually from the 3rd day and vanished basically on the 6-7 day.ConclusionsOur modified procedure of penile lengthening reduces the damage of these vessels.Consequently,postoperative hydrophallus resolves fast and the new procedure yields high success rates,sound appearance and sensation of penis.Therefore,the new procedure is an ideal option for surgenons in clinical practice.

Objective To explore the etiology of and timing for operation of acalculous biliary acute pancreatitis(ABAP).MethodsWe retrospectively analyzed the etiology study and treatment experience of 38 cases of ABAP.ResultsThirteen cases underwent a surgery, including 6 early operations for complicated biliary tract infection without morbidity and mortality, 5 middle staged patients (5～14 days after onset of ABAP) underwent surgery because of intraabdominal indications with one postoperative death and 2 late operations for severe acute pancreatitis (SAP) resulted in one postoperative death of sepsis. The total postoperative mortality rate was 15%( 2/13). Four SAP cases were managed conservatively with one death of MOF. The remaining 21 cases of acute edematous pancreatitis (AEP) were cured by nonoperative methods.ConclusionWhereas an early exploration is indicated, when complicated by biliary tract infections, it is judicious to try a conservative therapy first for ABAP patients.

Objective To detect a quantitative relation between reaction time of substance P (SP) and histamine release of mast cells (MC) in hypertrophic scar (HS) and discuss the interaction and time-effect of substance P and histamine release in HS. Methods The HS specimens were from the 4 to 7-year-old scalded or burnt patients who underwent operation because of cicatricial contraction. The normal skins were the autograft. HS specimens were cut into 0.5-1 mm 3, then treated with 5?10 -5 mol/L SP for 5, 15, 30, 60 min. The degranulation of MC was detected and the histamine released by mast cells in the supernate after SP treatment was examined by immunofluorescence. Conclusion SP and MC are of a close relationship in HS, and SP can affect histamine release of mast cell in time-dependent manner.

BACKGROUND:Alendronate is a new generation of diphosphate,which is the second generation of osteoporosis drugs.It is widely used to treat diseases related to increase of bone absorption in clinic.OBJECTIVE:To observe the effect of alendronate on the proliferation and the mRNA expression of osteoprotegerin(OPG) and receptor activator of nuclear factor kappa B ligand(RANKL) of human osteoblasts.DESIGN,TIME AND SETTING:A single sample observational experiment was performed at the Basic Research Institute of Chongqing Medical University from November 2007 to March 2008.MATERIALS:Osteoblasts were isolated from cancellous bone in a surgical operation.Alendronate was the product of Merck Sharp & Dohme S.p.A.METHODS:Osteoblasts were cultured with various concentrations of alendronate(1?10-9,1?10-8,1?10-7,1?10-6,1?10-5,1?10-4 mol/L).Osteoblasts cultured without alendronate were assigned as controls.MAIN OUTC0ME MEASURES:①The morphology and growth of osteoblasts were observed.②Effect of alendronate on the proliferation of osteoblasts were detected by MMT method.③The effect of various concentrations of alendronate on the mRNA expression of OPG and RANKL were detected by using RT-PCR.RESULTS:1?10-5 and 1?10-4 mol/L alendronate inhibited the proliferation of osteoblasts.1?10-9-1?10-6 mol/L alendronate promoted the proliferation of osteoblasts,and the 1?10-8 mol/L alendronate had the strongest effect.Alendronate inhibited RANKL mRNA expression in a concentration-dependent manner,1?10-5 mol/L alendronate had a strongest effect at 72 hours after culture(P

Objective:To analyse the evaluation and experience of clinical effect of minimally invasive drainage and craniotomy in the treatment of patient with epidural hematoa.Methods:100 cases of patients who were diagnosed as epidural hematoma from January 2015 to January 2016 were selected and randomly divided into two groups,where the control group were given craniotomy,and the observation group were given minimal invasive drainage.The effect of the surgery and the life qualities before and after treatment of the two groups were compared.Results:The effect of observation group is better than that of control group (P ＜ 0.05);craniocerebral defect and the re-hemorrhage incidence occurrence in the observation group were obviously lower than those in the control group,(0 ％,6 ％ vs 12 ％,20 ％) (P＜0.05).Conclusion:Compared with craniotomy,minimal invasive drainage in clinical treatment of epidural hematoma showed advantage in at smaller trauma,faster recovery,and better effect,thus deserving further promotion of clinic application.