This article discussed the importance and current dilemmas of the cultivation of medical students′consciousness of responsibility based on the special relationship between professionality and responsibility. The di-lemmas mainly included the followings:the motivation to select the Medicine specialty was impure, the humanistic quality was lacking, and the workplace showed reverse guidance. In addition, it expounded the methods to strengthen the cultivation of medical students′ responsibility consciousness from three aspects, which included the cultivation of social responsibility, the practical training teaching of humanities quality and the clinical teaching practice.

Objective To study the correlation between hand, foot and mouth disease (HFMD) in lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, and syndrome of stirring wind due to toxic-heat with IL-6, PCT, CRP, CD3+, CD4+, CD8+ and NK cells.Methods Ninety patients with HFMD were randomly selected, dividing into lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, and syndrome of stirring wind due to toxic-heat, 30 cases for each syndrome. IL-6, PCT, CRP, CD3+, CD4+, CD8+ and NK cells were detected, and the distribution of above indicators in the three syndromes were analyzed.Results Levels of IL-6, PCT and CRP in syndrome of stirring wind due to toxic-heat were significantly higher than those in lung-spleen damp-heat syndrome and syndrome of stagnation and steaming due to damp-heat, with statistical significance (P<0.01); There was statistical significance in absolute value counting of CD3+, CD4+, CD8+ and NK cells among the three syndromes (P<0.01); There was statistical significance in the percentage of CD3+ cells in syndrome of stirring wind due to toxic-heat and lung-spleen damp-heat syndrome (P<0.01) and syndrome of stagnation and steaming due to damp-heat (P<0.05); There was statistical significance in the percentage of CD4+ cells syndrome of stirring wind due to toxic-heat and lung-spleen damp-heat syndrome (P<0.05) and syndrome of stagnation and steaming due to damp-heat (P<0.01); There was statistical significance in the percentages of CD8+ and NK cells in the three syndromes (P<0.01).Conclusion Proinflammatory cytokines, proinflammatory markers, and T cell sub-group related to HFMD in lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, syndrome of stirring wind due to toxic-heat are not only correlative with morbidity, but also with the severity of diseases and prognosis, which can relatively effectively evaluate the state of diseases and judge prognosis.

Objective To evaluate the quality of life in children with primary nephrotic syndrome and analyze the influencing factors of the quality of life of the population.Methods The quality of life in children with primary nephrotic syndrome was assessed with Inventory of Subjective Life Quality for Children and Adolescent(ISLQ) edited by CHENG Zao-huo and compared to 55 normal children.The influencing factors were analyzed with multi-linear Logistic regression analysis.Results The total degree of satisfaction,recognition and emotion satisfaction of life of quality in patient children were significantly lower than those in healthy children.The data in each satisfaction degree in patient children were lower than those in healthy children,thereinto,the degree of satisfaction in score of home life,school life,depression practice and anxiety practice,self-cognition in patient children were significantly lower than those in healthy children.Conclusions The quality of life in patient children were significantly lower than that in healthy children,they should accept the comprehensive treatment intervention.

Objective To investigate the clinical effect of regulating Spleen Yangwei Decoction combined with rabeprazole in the treatment of rheumatoid gastritis with hot and humid obstruction.MethodsFrom April 2013 to February 2015, 88 patients with reflux gastritis caused by cholecystectomy in our hospital were selected as the subjects.TCM syndrome differentiation was hot and humid type, and random number table was divided into observation Group and control group of 44 cases, the control group given rabeprazole, citrate xylapril tablets and other Western medicine treatment, observation group on the basis of this plus self-adjusting spleen and stomach soup, are treated for 3 months, (TNF-α) and interleukin-8 (IL-8) levels were measured by enzyme-linked immunosorbent assay (ELISA) in the two groups before and after treatment, and the quality of life scale was used to evaluate the levels of tumor necrosis factor-α (TNF-α) (QOL) and digital pain score (NRS) were compared between the two groups to improve the quality of life and pain, and to observe the recurrence of bile reflux and adverse reactions.ResultsThe effective rate was 93.18% in the observation group and 77.27% higher than that in the control group (P<0.05).The QOL score (121.29±1.88) in the observation group was higher than that in the control group(P<0.05).The results of bile test showed that the levels of pg/mL, IL-8 (8.58±1.64) pg/mL and NRS (2.10±0.71) were lower than those in the control group (P<0.05).There was no significant difference between the observation group (11.36%) and the control group (4.54%).The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P< 0.05).ConclusionModified Spleen Yangwei Decoction combined with rabeprazole can effectively treat rheumatoid reflux gastritis, reduce bile reflux, improve the level of inflammatory factors, quality of life and pain, and mild adverse reactions, it is worth in the clinical promotion application.

OBJECTIVE To explore the method for sterilizing hands which is effective,convenient and without stimulation for medical personnel.METHODS A total of 150 nurses on duty were divided into three groups randomly.In the test groups 1and 2,towels with 0.2% peracetic acid and BANENG disinfectant fluid were used separately,but in the control group only soap with flowing water was used for hands sterilization.RESULTS The rate of bacterial removal was 98.82%,72.63% and 68.64%,respectively,among the 3 groups.The efficacy of BANENG disinfectant fluid was similar to 0.2% peracetic acid.Both of them showed significant differences compared with control group.CONCLUSIONS Both 0.2% Peracetic acid and BANENG disinfectant fluid have better disinfection efficacy,and BANENG disinfectant fluid is more easier in use.

OBJECTIVETo observe the effect of xuebijing Injection (XI) on perioperative coagulation and inflammatory reaction in senile patients receiving total hip arthroplasty (THA).

METHODSTotally eighty patients receiving THA at Luoyang Orthopedics Hospital, 65 to 85 years old, were randomly assigned to the control group (40 cases) and the treatment group (40 cases). All patients received routine perioperative therapies. Those in the treatment group received XI (adding 50 mL XI in 100 mL normal saline, 30 min each time). XI was continually injected after THA, twice daily for 3 successive days. Blood samples were harvested on the morning of the 2nd admission day (TO), immediately after operation (T1), on the morning of the 3rd day after operation (T3), and on the morning of the 5th day after operation (T4) to detect prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), levels of FIB and D-dimer (D-D), changes of white blood cell (WBC), neutrophils (N), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and IL-6. Complications of surgery were compared between the two groups.

RESULTSThere was no statistical difference in operation time, intraoperative blood loss, and blood transfusion between the two groups (P >0.05). Compared with TO in the same group, WBC, N, CRP, ESR, IL-6, PT, TT, and D-D all increased in the control group at T1-T4 (P < 0.05); APTT increased at T1-T2 (P <0.05); FIB increased at T1-T3 (P <0.05). WBC, N, IL-6, PT, and D-D all increased in the treatment group at T1-T3 (P <0.05); CRP and ESR increased at T1-T4 (P < 0.05); TT increased at T1-T2 (P <0.05); APTT and FIB increased at T1 (P <0.05). Compared with the control group at the same time period, WBC, N, CRP, and IL-6 all decreased in the treatment group at T1-T4 (P <0.05), ESR decreased at T3-T4 (P <0.05); PT and TT decreased at T1-T3 (P <0.05); FIB and D-D decreased at T2-T4 (P<0.05). The occurrence of each complication was significantly lower in the treatment groups than in the control group.

CONCLUSIONXI could improve the perioperative high coagulation state of senile THA patients, inhibit inflammatory reactions, and reduce complications.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Blood Coagulation ; drug effects ; C-Reactive Protein ; Dementia ; Drugs, Chinese Herbal ; therapeutic use ; Fibrin Fibrinogen Degradation Products ; Humans ; Hydrocarbons, Chlorinated ; Inflammation ; Injections ; Interleukin-6 ; Partial Thromboplastin Time

Objective To investigate the effects of rosiglitazone on the proliferation,connective tissue growth factor and Smad expression in cultured cardiac fibroblasts induced by advanced glycosylation end-products (AGEs).Methods After being treated with various amounts of rosiglitazone,the cultured neonatal rat cardiac fibroblasts were incubated with AGEs.The status of cardiac fibroblasts proliferation and cell cycle were detected by 3-(4,5-dimethyhhiazol-2-yl) -2,5-diphenyl tetrazolium bromide (MTI) assay and flow cytometry.Furthermore,ELISA technique was applied to identify the level of TGF-β1.The protein expressions of CTGF and Smad in cardiac fibroblasts of neonatal SD rats were detected with Western blotting.Results The exposure of cardiac fibroblasts to AGEs at doses of 0-200 mg/L induced a dose-dependent increase in cell proliferation.At the concentration of rosiglitazooe (0.1,1,and 10 μmol/L),the cell proliferation was reduced compared with 200 mg/L AGEs group by O.823±0.072,0.785±0.060,0.601±0.081 vs 0.981±0.049,respectively (P < 0.05).The increased levels of TGF-β1 in supematants of cultured cardiac fibroblasts stimulated by AGEs were inhibited by rosiglitazone at the concentrations of 0.1,1,10μmol/L by 257.77±9.09,230.29±6.56,200.84±10.26 vs 300.68±8.56,respectively (vs 200 mg/L AGEs,P<0.01).Western blot indicated that pretreatment with rosiglitazone (0.1,1,and 10 μmol/L) inhibited CTGF protein production in a dose-dependent by 0.769±0.108,0.590±0.095,0.534±0.115 vs 1.021±0.113,respectively (vs 200 mg/L AGEs,P<0.01).It was also demonstrated that pretreatment with rosiglitazone (1 and 10 μmol/L) inhibited Smad2 protein production by 0.424±0.059,0.396±O.080 vs 0.572±0.073,respectively (vs 200 mg/L AGEs,P < 0.05 or P < 0.01).Meanwhile pretreatment with rosiglitazone (1 and 10 μmol/L) inhibited Smad4 protein production by 0.580±0.063,0.556±0.051 vs 0.672±0.059,respectively (vs 200 mg/L AGEs,P < 0.05 or P < 0.01).Conclusions The findings suggest that AGEs promote the proliferation of cardiac fibroblasts and stimulate the protein production of Smad and CTGF of cardiac fibroblasts.Rosiglitazone inhibits the above reaction.These results indicate that CTGF/Smad pathway may play an important role in the protective effect of rosiglitazone on myocardial fibrosis.

Waldenstrom macroglobulinemia (WM) is a malignant B-cell lymphoproliferative disorder, which still remains incurable. Reports on the latest research progress of WM were presented in the 58th American Society of Hematology (ASH) Annual Meeting, covering the theoretical and clinical researches of this disease. In basic research, mechanism of ibrutinib resistance has been further explored. The application of modern technologies, such as next-generation sequencing, has promoted the pathogenesis and prognosis of WM. In clinical research, retrospective analyses of traditional treatment provide new theoretical foundation in the choice of regimen, while clinical trials on new drugs including BGB-3111 and oprozomib may improve the therapy. The research advances in WM will be summarized in this paper.

Despite different opinions on its definition and classification in the past,a consensus has gradually been reached regarding the na-ming,classification,and clinical diagnosis of liver failure.The classification of liver failure is described,and the definition and natural his-tory of severe exacerbation of hepatitis B are summarized.Antiviral treatment and artificial liver support in the early stage are beneficial for clinical outcomes and prognosis.

Objective To evaluate the influence of the preparation-to-colonoscopy interval, diet control and excise on bowel preparation quality in the split-dose method for colonoscopy. Methods Observational study, prospective cohort study design, three bowel preparation methods were set up in different departments for A, B, C 3 groups, each group of 110 cases. In group A, no movement was required. Diet preparation was 3 days earlier than the examination, and take all the medicine in once at 20:00 the day before examination, group B, 1 L medicine required for 20 minutes movement, diet preparation was 1 day earlier than the examination, and take the medicine in twice the day before examination at 14:00, group C, keep walking during taking the medicine, diet preparation was 1 day earlier than the examination, and took all the medicine in once the day before examination at 20:00. The Boston Bowel Preparation Scale was used to evaluate the bowel cleansing quality. A questionnaire was administered to investigate patients′tolerability and safety. Results A total of 330 consecutive patients undergoing colonoscopy. There was no significance among three groups on bowel cleansing quality(P>0.05). However, the number ofexcellently cleanedwas higher in group B than the others, in group A,B and C respectively 30, 46, 29 cases, the difference was significant (χ2=7.627, P=0.022). Group B was superior to the others in terms of comfort, sleep quality, hunger, and discomfort, the difference was significant (χ2=19.425, 6.687 and 8.130, P < 0.01 or 0.05). Group B was also superior to the others in terms of the compliance of completing the preparation under the doctors′advice (χ2=14.756, P=0.001) and exercises (χ2=11.848, P=0.001). Conclusions The new method shortened the time of the diet control and set the exercises time to 20 minutes. So it was found to have a higher level of safety, bowel preparation quality and tolerability.