A probe into the management of outpatient medical records written by rural doctors:Such a record is indispensible for technical appraisal of medical accidents; yet writing of such a record might involve illegal medical practice or go beyond the scope of practice.It is recommended to normalize the behavior of rural doctors in their writing of outpatient medical records,stipulating that the Basic Regulations on Medical Records do not apply to rural doctors at present.It is also recommended that separate regulations for rural doctors be formulated,along with a promotional period before these regulations are in practice.An alternative would be clarifying that Article 28 of the Regulations of Medical Malpractice Settlement do not apply to rural doctors.

Secretome includes all the gene products secreted by a cell. The development of proteomicbased approaches and genome-based computational prediction technology have gradually revealed secretome plays an important role in pathogen infection recently. Secretome facilitates pathogen to proliferate and invade the host by inhibiting the host's immune system, resisting acidic PH conditions, snatching nutrition and so on.Identification of pathogenic secretome helps discovering new drug targets and biomarkers, and supporting the diagnosis and treatment.

BACKGROUND:Mechanotransduction is an issue of concern in the study on the relationship between stress and growth. Mechano-growth factor (MGF) holds stress sensitivity, and exerts similar effect with stress in bone metabolism regulation. OBJECTIVE: To explore the mechanotransduction during bone remodeling, and investigate the relationship between stress and growth at molecular level. METHODS: The governing equations about the relationship between MGF and mechanical stimulation, regulation of MGF on osteoblasts and osteoclasts, regulation of MGF on RANK-RANKL-OPG signaling axis were established, and then the MGF-mediated bone reconstruction model was established to simulate the bone remodeling process under mechanical stimulation. RESULTS AND CONCLUSION:Under the condition of disuse, there was a decrease in osteoblasts/osteoclasts ratio, bone mass and bone volume fraction, and bone resorption was more than bone formation. Under the condition of overload, there was an increase in osteoblasts/osteoclasts ratio, bone mass and bone volume fraction, and bone formation was more than bone resorption. The simulation results were in accordance with Frost mechanostat theory. These findings show that the mechanobiological model of bone remodeling based on MGF can simulate the bone remodeling process under mechanical stimuli, and achieve mechanotransduction.

0.05), but were highly significant at doses of 100 ?mol/L or above (P

AIM To set up the model of stom- effects of its treatment drugs. METHODS To ap-ach smooth muscle cells contraction and assess the ply the culture of isolated stomach fundus smooth muscle cells in rats in vitro and to obtain the mixture of stomach smooth muscle cells. The cells were examined with the Trypan blue dilution technology under microscope and the length of cells and the contraction rate of muscle cells were adopted to the evaluation index of effects. The change of cells in different time was observed and calculating the survival rate and time of cells. The selected neuro-medium and its antagonist, such as acetyl-choline chloride (ACh) and atropine, 5-HT and domperidone(Domp) , histamine( His) and diphen-hydramine(Diph) were added to the mixture cells so as to provoke irritant reaction observe the effects of drugs. RESULTS Obtaining cells in stomach fundus smooth muscle was more than 1 X 106 in each rat by this way, and the survival rate and time of cells was 95% and 2. 5 h. The contraction of cells was observed after adding ACh 5-HT or His ,and the effects of these agents were antag- onized by antagonist atropine, Domp and Diph respectively. The effects of maximum contraction of ACh in concentration 1?10-8 mol ? L-1 was 38%, and in 5-HT may exist two receptors, and the maximum rate was 20. 7% and 10. 5% respectively. The effective dose of contraction was 1 X 10-13 -1?10-10 mol ? L-1 induced by His, the contraction effects was significantly weakened in high of 1 ?10-10 mol ? L-1 and antagonized by Diph. CONCLUSION The smooth muscle cells by digesting stomach fundus smooth muscle of rats would be more than 95% survivors and survival time was more than 2. 5 h. ACh,5-HT and His could induce the contraction of smooth muscle cells, and the effects of contraction were antagonized by atropine, Domp and Diph respectively.

Objective To discuss the effect and feasibility of BiPAP in refractory asthma patients. Methods A total of 15 coses of refractory bronchial asthma admitted by our hospital during Feb 2003 to May 2006 were treated by BiPAP in addition to medical therapy。 The symptoms、signs and the arterial blood gases were observed and analyzed。Results Among 15 patients,2 gave up treatment,13 patients were successfully treated with the BiPAP therapy。There were significant improvement of PaCO2、PaO2、pH and respiratory rate ,heart rate after 2h BiPAP。Conclusions Ventilation in BiPAP is an effective method for refractory asthma ,which can save the patients life and decrease the complications.

AIM:To study the effects of FK506 binding protein 12.6(FKBP12.6) overexpression on the performance of sarcoplasmic reticulum(SR) in ventricular myocytes of rats with heart failure.METHODS:The adenovirus(Ad)-mediated gene transfer was used to overexpress FKBP12.6 in ventricular myocytes of rats with heart failure.Western blotting and reverse transcriptase-polymerase chain reaction(RT-PCR) analysis were used to reveale specific overexpression of FKBP12.6.X-rhod-1-AM was used as the Ca2+ indicator,and cells were viewed under a confocal microscope.RESULTS:Adenovirus mediated overexpression of FKBP12.6 resulted in a 5-fold increase in relative FKBP12.6 mRNA levels and a 4-fold increase in relative FKBP12.6 protein levels at 48 h after transfection compared with control.The amplitude of the fluorescence [Ca2+]i transient was significantly increased in Ad-FKBP12.6-GFP cardiomyocytes compared with Ad-GFP myocytes(peak F/F0,3.16?0.42 vs 1.43?0.38,P

Objective To learn the academic level and scientific impact of the Chinese Journal of Dermatology by using bihliometric methods. Methods Citation frequencies, first authors and their affiliation, citing journals of cited articles published in the Chinese Journal of Dermatology from 2002 to 2007 were statistically analyzed according to the database of Chinese Medical Citation Index (CMCI) by using bibliometric methods. Results From 2002 to 2007, a total of 2259 original papers were published in the Chinese Journal of Dermatology. Of them, 1224 were cited with a total citation frequency of 3963, citation rate of 54.1%, average citation frequency per paper of 3.2 and top citation frequency of 204. The number of first authors of cited papers amounted to 893, and 61 (6.63%) authors published 3 or more cited papers during this period. These authors were distributed in 30 provinces, municipalities, autonomous regions and 1 foreign country; Jiangsu, Beijing, Zhejiang, Guangdong, Shanghai and Shandong ranked in the top 6 regions with high total citation frequencies. There were 517 journals citing articles published in the Chinese Journal of Dermatology from 2002 to 2007;the top citing frequencies were observed in the Chinese Journal of Dermatology, China Journal of Leprosy and Skin Diseases, The Chinese Journal of Dermatovenereology, Journal of Clinical Dermatology and Southern China Journal of Dermato-Venereology, etc. Conclusions The articles in the Chinese Journal of Dermatology have a high academic quality and citation frequency. Chinese Journal of Dermatology is an important publication in the dermato- venereology field as well as a core periodical in medical field of China.

Objective To investigate the optimal regimen of narrow-band ultraviolet B (NB-UVB) phototherapy in the treatment of chronic actinic dermatitis (CAD),and to analyze factors influencing treatment compliance.Methods Demographic data,results of photobiological tests,treatment parameters and clinical responses were collected from CAD patients who received NB-UVB phototherapy in Huashan Hospital affiliated to Fudan University from January 2008 to June 2015,and were reviewed retrospectively.Statistical analysis was done by using two independent samples t-test and chi-square test with SAS9.3 software to compare the clinical data between patients who completed and did not complete the NB-UVB phototherapy.Results A total of 79 CAD patients with Fitzpatrick skin type Ⅳ received NB-UVB phototherapy.Of these patients,61 (77％) completed the whole treatment,while 18 (23％) dropped out because of intolerance to the NB-UVB radiation.Among the 61 patients who completed the treatment,the average initial,final and cumulative radiation doses of NB-UVB were (0.08 ± 0.01) J/cm2,(0.32 ± 0.08) J/cm2and (5.9 ± 2.5) J respectively,and patients received (28 ± 8) times of treatment in average.When the radiation dose went up to 0.30 J/cm2,most skin lesions were cleared in 52 (85％) patients.A total of 19patients received phototesting again after the end of phototherapy.Among 16 patients sensitive to ultraviolet A (UVA) before the treatment,6 had normal minimal erythema dose to UVA (UVA-MED),and another 6 had improved UVA-MED after the treatment.Among 16 patients sensitive to UVB before the treatment,11 got normal UVB-MED and another 3 had improved UVB-MED after the treatment.Univariate analysis showed no significant differences in gender,age,duration of the disease,sensitivity to UVA and UVB radiation,results of photopatch test and patch test between the patients who completed and did not complete the treatment (all P ＞ 0.05).Conclusions The appropriate NB-UVB phototherapy for CAD patients should start at an initial radiation dose of 0.08 J/cm2 in spring and end at a final radiation dose of 0.30 J/cm2 for about 28 sessions,which can effectively reduce the photosensitivity to both UVA and UVB in CAD patients.Additionally,NB-UVB phototherapy can be applied in CAD patients of different gender,age,disease duration and photosensitive condition.

Objective To investigate the therapeutic effect of ambroxol in bleomycin-induced pulmonary fibrosis of rats.Methods Sixty Wistar rats were divided into three groups:The normal control group(group N),the model group treated with bleomycinA5(group B)and the group treated with ambroxol(group A).Pulmonary fibrosis was induced by intratracheal instillation of bleomycin.Then the rats received daily ambroxol 35mg/kg(group A),or normal saline(group B).Five rats in each group were killed on 3.7.14 and 28 days after intratracheal instillation.Histological changes of the lungs were evaluated by HE stain and Masson's trichrome stain.The levels of tumor necrosis factor-?(TNF-?)in lung homogenates were measured by radioimmunoassay.Results Pulmonary fibrosis of Group A was significantly improved as compared with that of Group B(P