Objective:To evaluate communication ability of medical students and try to construct communica-tion education mode of medical students .Methods:Scale and questionnaire are used to survey 1389 medical students , a radar map is used to evaluate the communication and interviewing related personnal , domestic and over-seas pertinent literature data were browsed and analyzed .Results:Medical students′communication ability level is general , lack of communication of knowledge; The need to build on the basis of doctor -patient communication training mode diversification .Conclusions:Medical schools should attach importance to training the students′com-munication ability and try to construct all -sided education mode and improve medical students′ability of doctor-patient communication .

ObjectiveTo evaluate the long-term survival rate of precancerous lesions and early esophageal cancer after endoscopic mucosal resection (EMR).MethodsThe follow-up endoscopy was performed in 154 patients with early esophageal cancer and precancerous lesions who underwent EMR.The examinations were carried out at 1 month,6 months and every 1 year after the procedure,respectively,and argon plasma coagulation (APC) was applied if a recurrent lesion was suspected.The follow-up rate was 100%.ResultsAfter EMR,reecurence occurred in 6 cases (3.9%) in 5 years,of which 4 received esophagectmy,1 underwent APC,and the other one died from matastasis.The 5-year survival rate was 97.4% (150/154),with 1 died from matastasis and 3 from noncancerous diseases.The 5-year survival rate of 125 patients with high grade dysplasia,carcinoma in situ and intramucosal carcinoma was 97.6%( 122/ 125),with 1 died from noncancerous disease and 1 from metastasis.The 5-year survival rate of 29 patients with low grade dysplasia was 96.6% ( 28/29 ) with 1 patient died from noncancerous disease.ConclusionEMR,as a minimally invasive procedure,is suitable for precancerous lesions and early esophageal cancer,especially for high grade dysplasia,carcinoma in situ and intramueosal carcinoma,with little sequela and long-term survival.

Objective To evaluate the treatment outcome of endoscopic esophageal mucosal resection (EMR) and alleviate or prevent the complication of EMR. Methods We explore a strategy of endoscopic esophageal mucosal resection to treat early esophageal cancer and severe dysplasia . Endoscopic esophageal mucosal resection was performed with transparent-cap technique, resdiual lesions were treated by Argon Plasma Cocagulation( APC). All patients have been followed up by endoscopic examinations at one month, 4 months, and 12 months after therapy. Results Seventy one cases (88 lesions) were treated by endoscopic esophageal mucosal resection with transparent-cap method. Average doses of saline-epinephrine 18 ml is injected submucosally to each lesion. The resected specimens were on average(21.8 ?1.0)mm ? (18.2?1. 0)mm in size. Five cases have bleeding after mucosectomy, bleeding were managed and controlled by compression , local injection of saline-epinephrin, and APC. Perforation never occurred. Four cases have stenosis after mucosal resection, in three of them the resected area was more than 3/4 esophageal circumference, then it was dilated with water ballon dilater at one month, two months and three months after mucosal resection, all cases were cured. Conclusions Endoscopic esophageal mucosal resection is a safe, simple, minimally invasive and effective procedure with few complication in treating early esophageal cancer and precan-cerous lesion.

Objective To assess volume state precisely and rapidly by ultrasonography of internal jugular vein (IJV) in healthy blood donor.Methods The values of the sonographic IJV collapse index and corrected IJV longitudinal length (cIJVLL) of 46 healthy blood donors were compared before and after blood donation.The correlations between IJV collapse index and cIJV LL were analyzed.Results The value of cIJV LLs before and after blood donation were significantly difference (6.56 ± 0.32 vs.6.11 ± 0.41,P ＜ 0.01).IJV collapse index before blood donation was not differently significant after blood donation (33.12 ± 2.21 vs.39.01 ± 3.83,P＞ 0.05).There was correlation between the value of cIJV LLs before and after blood donation (r =0.81).The value of IJV collapse index before and after blood donation,as well as cIJVLL was not well correlated (r =0.24,r =0.13,respectively).Conclusion The IJV collapse index is not a useful parameter for evaluation of hypovolemia,cIJV LL is more valuable marker for the detection of blood loss in emergency.

Objective To study the value of adrenal venous sampling (AVS) in the differential diagnosis of primary aldosteronism (PA).Methods Fourteen patients (11 adenoma and 3 adrenal hyperplasia) clinically diagnosed as PA were examined with AVS for measurement of plasma aldosterone and cortisol levels.Selectivity of AVS was assessed by the aldosterone level in each adrenal vein and in the infrarenal inferior vena cava plasma.The data were compared with CT and postoperative pathologic result.Results The diagnosis of adenoma by AVS in 9 (9/11) cases was in accordance with the postoperative pathologic findings.The diagnosis of hyperplasia by AVS in all 3 cases was in accordance with CT scanning result.Conclusion AVS should be selected to distinguish the PA without overt occupational lesion in CT scanning.

Objective To explore the effect of arthroscope assisted percutaneous plate fixation combined with early postoperative rehabilitation training in the treatment of 27 cases tibial plateau fractures. Method From 2012 July to 2014 December, we treated 50 patients who got tibial plateau fractures. Random grouping is used in this experiment. 27 cases as experimental group were treated with arthroscopic surgery, after surgery all the patients were treated with early comprehensive rehabilitation therapy; 23 cases as control group were treated with traditional open surgery and rehabilitation therapy. Using the hospital for special surgery knee score ( HSS ) after operation respectively in 3, 6, 12 months to assess limb knee joint function. Results Postoperative patients incisions were healed, patients were followed up for 3 ~ 12 months, average 12 months. According to the HSS score, the excellent rate of knee function in the experimental group was 55.6 %, 70.3 % and 85.2 % respectively. The excellent rate of the control group was 47.8 %, 60.8 % and 73.9 %, respectively. Conclusion For the treatment of fracture of tibial plateau. There is a good effect in recovering the function of the patients’ knees by using arthroscope assisted combined with minimally invasive technique and postoperative early rehabilitation exercise.

Objective A systematic review of implementation outcomes of the essential medicine system in China to identify scientific evidences for a better system.Methods A systematic review is made to extract data from the research papers on outcomes of the essential medicine system,followed by an analysis and description of such data.Results Of the 87 papers included,most of them focused on primary care institutions,while four of them on residents or patients,and one of them on pharmaceutical enterprises.The study found the medical institutions with rising availability of essential drugs,lowered medicine costs,rising or dropping business volume,and apparent drop of out-of-pocket expenses for patients.These have encouraged rational drug use.Evidences in hand indicate expected outcomes from the essential medicine system.Conclusion Current researches on the system focus on primary care institutions in developed areas in China,lacking rigorous design.Studies of broader scale,further depth and more rigorous designs of the implementations of the system are recommended for evaluation of the impacts and outcomes of the system on various stakeholders of the policy.

Objective To study the state of doctors' psychological capital in public hospitals,and to analyze the characteristics of such capital,so as to better leverage the capital as a hospital management tool.Methods A quantitative and qualitative research was made on the state of doctors＇ psychological capital.Results The doctors' task-oriented psychological capital scored 4.25,and guanxi-oriented psychological capital 4.41; “modesty and prudence”scored the highest in all dimensions of the doctors' psychological capital,“optimism and hope”lowest; the doctors with different genders,ages,seniority,and monthly average income have a difference in psychological capital.However,no significant difference was found with varying titles,hospital levels,and employment models.Conclusion The doctors were found with a strong psychological capital to cope with stress.Better psychological capital will raise quality of care in practice.

ObjectiveTo analyze the association between single nucleotide polymorphisms (SNPs) in DISC1 gene.MethodsThe studied sample consisted of 528 patients with schizophrenia (264 males and 264 females) and 528 healthy controls (264 males and 264 females).Two function SNPs were selected and gcnotyped by Illumina Golden Gate assay.Genotype and allele frequencies were compared between patients and controls to assess the association to schizophrenia.The clinical features of the hospital first patients were further examined with the Positive and Negative Syndrome Scale (PANSS) before trcatment with antipsychotics.ResultsTwo SNPs were genotyped in subjects.A significant association was found between rs3737597 and schizophrenia in genotype (387:133:8,350:164:14) and allele frequencies (907:149,864:192,P＜0.05 ).Moreover,the haplotypes,A-A constructed from two SNPs showed significant differences between cases and controls ( P＜ 0.05).For rs821616,there were significant difference in positive syndrome score,delusions and poor rapport between patients with genotypes AA or not.ConclusionThis study describes a positive association between DISC(1) and schizophrenia in the Han Chinese population and DISC1 is the susceptible gene in schiz ophrenia.

Objective To investigate the effect of epinephrine combined with methoxamedrine on rate of successful cardiopulmonary resuscitation (CPR) in rabbit model of sudden cardiac arrest by the method of clamping the trachea to asphyxia.Methods Twenty-seven rabbits were randomly (random number)divided into methoxamedrine group,epinephrine group and epinephrine combined with methoxamedrine group.After the modeling,rabbits in the three groups were treated methoxamedrine,epinephrine,and epinephrine combined with methoxamedrine respectively by intravenous injection during CPR.The change of heart rate (HR),mean arterial pressure (MAP) and electrocardiogram (ECG),restoration of spontaneous circulation (ROSC) and mortality within 2 hours of each experimental group were recorded before suffocation and 15 min,30 min,60 min,120 min after the success of the resuscitation.The pathological changes of myocardium were observed under optical and electronic microscope.Results The number of ROSC rabbits in methoxamedrine group,epinephrine group and epinephrine combined with methoxamedrine group were 1,6,5 respectively.The heart rate and mean arterial pressure of the rabbits after ROSC were lowered compared with those before suffocation significantly (P ＜0.05).The levels of mean arterial pressure at 15 minutes and 30 minutes after ROSC in combined treatment group were higher than those of epinephrine group significantly (P ＜ 0.05).The myocardial structure of rabbits after ROSC observed by optical and electronic microscope showed an acute injury,however,the damage degree of myocardium in combined treatment group was slighter.Conclusions Epinephrine combined with methoxamedrine has no apparently additional effect on ROSC during CPR compare with epinephrine used alone,but this combination of two agents can be benefit for stabilizing hemodynamic at early post-ROSC stage,and methoxamedrine can reduce the damage of myocardium during CPR.