Objective The authors report nurse and patient communicate circumstances be short of 30 inexperienced nurses in paediatrics of pediatrics,answer ability accident when they encounter clamant circumstances.Letter press be dead against be short of bring forward measure,acquire approve of effect. Methods Accept ways of give lessons,selective examination,assess and extend invalid questionnaire,strengthen nurse knows in nurse and patient communicate importance and dispute correlation concept,advance ethics level,answer skill and handle skill,accordance relation of nurse and patient. Results After nurse act norm,approve of patients have advanced,bring a lawsuit against of patient have cut down. Conclusion Cut down nurse dispute depend on look up cause of dispute,betimes build up flaw.

Objective To compare the results of emergency clinical training for medical students and to put forward some suggestions.Methods Toatlly 207 medical students of Grade 4 studied in the first people' s hospital of Shanghai Jiaotong university from 2009 to 2011 were divided into the traditional group (n =90 ) and the experimental group (n =117 ).The students in the experimental group participated in emergency clinical training in summer vacation while those in the traditional group did not.Questionnaires about their self-learning ability,clinical communicating ability and critical thinking ability after training the were conducted and the data were analyzed by descriptive statistical analysis.Results One hundred and five effective questionnaires were recovered from the experimental group,with the recovery rate 89.7％ and 62 effective questionnaires were recovered from the traditional group,with the recovery rate 68.9％.The scores about clinical communicating ability and critical thinking ability of the experimental group were significantly highcr than those of the traditional group [ (79.45 ± 9.354)vs.(75.87 ± 9.926),(263.38 ± 30.925 ) vs.(251.36 ± 23.679),P ＜ 0.05 ].However,there was no significant difference in scores about self-learning ability between the two groups [ ( 153.97 ± 23.725 ) vs.( 149.83 ± 13.891 ),P ＞ 0.05].Conclusion Emergency clinical training is helpful to improve medical students' clinical communicating ability and critical thinking ability.It is worth popularizing.

ObjectiveTo analyze the results of implementing the tutorial system for medical interns, and to put forward some suggestions. MethodsThe medical interns and the doetors selected as tutors were asked to do questionnaires to study the tutorial system's feasibility and effectiveness. Simultaneously, we adopted the Objective Structured Clinical Examination ( OSCE ) to assess its process and resuits. Results74.3％ of the students and 75.5％ of the doctors think that they need the tutorial system,73.2％of the students think that this system can train better clinical skills,67.9％ of the doetors think that they can review the knowledge learned through teaching. Implemented after one year, students' OSCE scores are improved. ConclusionTutorial system for medical interns has achieved preliminary success, and the preparatory work and related-system building need to be further improved.

[Objective] To evaluate the influence of dexmedetomidine on median effective target effect-site concentration(EC50)of sufentanil-inhibiting urethroscope insertion response in patients undergoing transurethral resection of prostate(TURP).[Methods] Forty patients with ASA grading Ⅰ-Ⅱ who accepted selective TURP were divided by random digits table method into two groups with 20 cases each.The patients in dexmedetomidine group were treated with 0.6 μ g/kg dexmedetomidine intravenous infusion for more than 10 min,while control group were treated with equivalent capacity of 0.9％ sodium chloride.At 5 min after stopping injection,target-controlled infusion of propofol was started and the plasma target concentration was 3.0 μ g/ml.At 10 min after infusion,target-controlled infusion of sufentanil began and the plasma target concentration was 0.20 ng/ml.The target concentration of sufentanil of the next patient accorded to the patient with or without the urethroscope insertion response and the adjacent rate of the target concentration was 1.1.The EC50 and 95％ confidence interval(CI)of sufentanil were calculated.[Results] There were 20 cases in dexmedetomidine group ultimately selected and 19 cases in control group.There was no statistical significance in absolute value of ST segment of intraoperative electrocardiogram,systolic blood pressure,heart rate,pulse oxygen saturation and bispecual index between two groups(P＞0.05).EC5o of sufentanil-inhibiting urethroscope insertion response in dexmedetomidine group was 0.1148 ng/ml(95％ CI 0.1055-0.1249 ng/ml),which was significantly lower than that in control group[0.1454 ng/ml(95％ CI 0.1339-0.1580 ng/ml)](P＜0.05).[Conclusions] 0.6 μg/kg dexmedetomidine intravenous infusion before operation can reduce the EC50 of sufentanil-inhibiting urethroscope insertion response in patients undergoing TURP.

Lower limb ischemia is common and refractory diseases,in severe cases,it can impact on life quality even threat life.The traditional treatment contain medical and surgical,but cannot obtain satisfactory results.And therapeutic angiogenesis has achieve satisfactory results in animal experimnents and clinical study as its put forward.In recent years,Cell Therapy as one of the research hotspot,the micle aims to introduce the research of progress about therapeutic angiogenesis in detail.

Objective:To explore the feasibility of pharmacy trusteeship in Shanghai medical institutions to provide useful informa-tion for the reform of medicine without added profit and pharmacy transition to clinical pharmacy. Methods: On-site investigation of seven hospitals and one famous drug retail company in Shanghai was performed combined with the communication with relative person-nel and non-random sampling questionnaire survey on the staff of pharmacy. Statwing software was used in the statistical analysis of the data. Results: A total of 93 valid questionnaires in the study were taken back. Although one hospital has achieved great progress in pharmacy trusteeship, most of respondents had negative attitudes and the common thought was that pharmacy trusteeship did more harm than good to the development of clinical pharmacy at present. Conclusion: As a consequence of drug zero interest policy and clinical pharmacy development, pharmacy trusteeship should be explored and attempted. The duties and responsibilities of all parts in pharma-cy trusteeship should be definite in law in order to standardize drug retail market and protect the interests of patient.

Cullinl is a member of the cullin genome.The cullin1 assembly complex has typical ubiquitin ligase activity,and mediates cell cycle proteins,especially cancer-associated protein degradation process,an then effectively regulates the cell cycle progression.Cullin1 play an important role in the genesis and development of malignant tumors.

Objectives To evaluate methods to diagnose Budd-Chiari syndrome with inferior vena cava (IVC) thrombosis.Methods 31 cases underwent phlebography, 28 cases received color Doppler sonography preoperatively. Radical thrombectomy was carried out in 28 cases. Results IVC thrombi was found by phlebography in 24 cases, and by color Doppler sonograhy in 25 cases. There was no intraoperative death, nor acute pulmonary embolism.All patients were discharged uneventfully. Follow-up of 6 to 80 months found recurrence in 3 cases.Conclusions Large or lateral thrombi can be easily diagnosed by phlebography. Fresh or floating thrombi often missed by phlebography could be rushed out by blood stream at the time IVC was incised.The thrombi adhered to the IVC wall could be taken out with large balloon catheter or manually.

0.05) . There was no significant difference in Q-T interval and Q-Tc before and after intravenous droperidol in the three groups. Conclusion It is safe to give low dose droperidol before operation to prevent postoperative nausea and vomiting.

Objectives To investigate the etiological factors,clinical features and treatment of pediatric primary spontaneous pneumothorax (PSP). Methods The clinical data of 84 PSP patients under the age of 18 from Departments of Emergency,Respiratory Diseases and Thoracic Surgery of our hospital from June 1999 to June 2009 were collected. There were 72 males (85.7%) and 12 females (15.3%) with a ratio of 6 to 1. Their age ranged from 14 to 18 (mean 17.06). Patients with pneumothorax following trauma,pneumonia,iatrogenic and other underlying causes were excluded. Therapeutic methods included oxygen therapy for 4.8% patients,closed drainage of pleural cavity for 57.1% patients,and surgery for 38.1% patients,But there were 31 patients receiving surgical treatment after closed drainage was failed. The period of follow-up ranged from 1 to 123 months (mean 25.73 months) through telephone or outpatient. Results Eighty-four patients were included,of whom 96.4% had chest pain,7.1% had chest tightness,66.7% had dyspnea,8.3% had shortness of breath and 14.3% had cough. There were 96.4% patients having decreased breathing sound and 3.6% having absent breathing sound. Bullae or blebs occurred mostly in apex and upper lobe. Twenty-one patients suffered from recurrent pneumothorax. Smokers (66.7%,n=9) had higher recurrent rate than non-smokers (22.0%,n=75). Conclusion PSP should be considered when symptoms such as chest pain and dyspnea appear in teenagers. Closed drainage of pleural cavity combined with surgical procedure is recommended for treatment. PSP patient with a history of smoking has higher recurrent rate of PSP.