Objective To investigate meclical ethits level of first-year mecdical stuclents in Guangzhou medical college,which contributes to provide guidance of medical ethics education for interns. Methods To investigate 183 cases of first-year medical students. They were asked to deal with a case of 'a vagrant needed emergency treatment'. The statistics datum were classified according to 'norms of medical ethics and ways of implementation made by the Ministry of Health for medical staff'.Results 99.45% of them thought they should immediately save patients' live;but less than 28.96%thought of using cheap and fine medicines;only 38.80% mentioned the patients' mood. And there was no significant difference between boys and girls(P>0.05). Conclusion Medical students have already established a 'life-saving' awareness when they are freshman, but they also need to learn how to put ethics into practice.

Objective To observe the clinical effect of benzene sulfonic amlodipine combined with traditional Chinese medicine (TCM) Yangxueqingnao granules for treatment of patients with hypertensive urgencies (HU) with acute headache, and its effect on serum brain derived neurotrophic factor (BDNF) level.Methods A prospective study was conducted, 186 HU patients with acute headache admitted to the Department of Cardiology in the Affiliated Hospital of Southwest University from January 2014 to December 2016 were enrolled, and they were divided into a control group (90 cases) and an observation group (96 cases) by random number table method. The patients in control group received benzene sulfonic amlodipine (10 mg, once a day) and the patients in observation group were additionally given Yangxueqingnao granules (4 g, 3 times a day for consecutive 7 days) on the basis of treatment in control group. The mean arterial pressure (MAP), the nature and location of headache and the levels of serum BNDF were examined before and after treatment and compared between them in the two groups, the degree of headache was evaluated by visual analogue scale (VAS), and the clinical therapeutic effects in the two groups were observed.Results There were no statistical significant differences in MAP (mmHg, 1 mmHg = 0.133 kPa) between the two groups before treatment and at 2 hours, on 1, 3, 7 days after treatment (control group: 99.7±9.5, 94.2±9.1, 88.6±7.6, 81.8±9.3, 75.6±5.3 respectively, the observation group: 95.4±13.5, 91.2±8.1. 88.9±8.7, 83.2±8.6, 77.2±4.8 respectively, allP > 0.05). Compared with the control group, after treatment for 1, 3, 7 days, the nature of acute headache (dull pain, distending pain) was relieved more significantly, the number of patients with whole head headache was decreased more obviously in observation group [dull pain (cases): 16, 8, 3 vs. 28, 24, 18, distending pain (cases): 11, 6, 2 vs. 22, 16, 10, whole head pain (cases): 12, 5, 3 vs. 26, 20, 16, allP < 0.05]. With the prolongation of treatment, the VAS scores in the two groups were gradually decreased, on 7 days after treatment they reached to the lowest levels, and the degree of descent in the observation group was more significant than that in the control group (0.5±0.4 vs. 1.4±0.9,P < 0.05); thelevels of serum BNDF in the two groups were gradually increased after the 1st day of treatment, reached to the highest level on 7 days after treatment,and the degree of increase in observation group was more obvious than that in the control group (ng/L: 24.8±2.3 vs. 17.8±2.2). The therapeutic effective rate of the observation group was significantly higher than that of the control group [70.8% (68/96) vs. 53.3% (48/90),P < 0.05].Conclusion The combination of benzene sulfonic amlodipine and Yangxueqingnao granules can effectively relieve the acute headache in HU patients, and its mechanism is related to the increase in expression of BDNF.

Objective To discuss the effect of group social skills training on improving psychiatric symptoms and disability and the family relationship in patients with schizophrenia.Methods 101 followup patients of rehabilitation with schizophrenia in mental health center of a top three hospital and in a community were chosen from June 2011 to August 2012.Based on the principle of voluntary,45 and 56 patients were grouped into the control group and the intervention group,respectively.The scores of psychiatric symptoms,mental disability and family relationship were compared between two groups by independent sample test.Results At the end of six months,the score of positive and negative symptoms and mental disability were lower in the intervention group,and there was significant difference in different measuring time,the interaction existed between the intervention and the measuring time.Meanwhile,the total score of family concern in the intervention group was higher than that in the control group,and there was significant difference in different measuring time,no interaction existed between the intervention and the measuring time.Conclusions Group training of social skills could improve psychiatric symptoms and the family relationship of patients with schizophrenia,reduce mental disability and promote recovery of patients.

Our previous work has indicated that enzymatic resolution of glycidyl butyrate are strongly affected by many factors, including concentration of substrate, amount of lipase, the temperature, pH, shaking speed and reaction time. In this study, Plackett-Burman design was undertaken to evaluate the effects of the six factors. By regression analysis, concentration of substrate, amount of lipase and the temperature were found to be important for enzymatic resolution of glycidyl butyrate. In the second phase of the optimization process, a response surfacemethodology (RSM) was used to optimize the above critical factors, and to find out the optimal concentration levels and the relationships between these factors. By solving the quadratic regression model equation using appropriate statistic methods, the optimal parameter of the variables were determined as: 0.499 mol/L glycidyl butyrate, 30.23 mg/g lipase and 29.68 degrees C. In the optimum condition, the value of enantiomeric excess(ee%) was 93.28%. Compared to 84.65% which was the maximum ee% under the non-optimized condition, this study has a significant advancement. The experimental data under various conditions have validated the theoretical values.
Butyrates ; chemistry ; Catalysis ; Enzyme Activation ; Epoxy Compounds ; chemistry ; Lipase ; metabolism ; Molecular Conformation ; Propanols ; chemistry ; Regression Analysis ; Stereoisomerism ; Substrate Specificity ; Temperature

Objective To compare the normal thickness of the esophageal wall measured by contrast?enhanced three?dimensional ( 3DCT ) , four?dimensional ( 4DCT ) , and cone beam computed tomography ( CBCT) ,and to provide a basis for target volume delineation in esophageal cancer. Methods From 2009 to 2016,thoracic contrast?enhanced 3DCT and 4DCT simulations were performed in 50 patients with lung cancer or metastatic lung cancer. Contrast?enhanced CBCT scans were acquired during the first three?dimensional conformal radiotherapy. The normal esophageal wall was contoured on 3DCT images, the end?exhalation phase of 4DCT images ( 4DCT50 ) , the maximum intensity projection of 4DCT images (4DCTMIP),and CBCT images. The wall thickness was measured on each segment and the average thickness of esophageal wall was obtained. Comparison of the thickness of a fixed segment of esophageal wall between different CT images was made by paired t test. Comparison of thickness on the same type of CT images between different segments of esophageal wall was made by one?way analysis of variance. Results For the thoracic and intra?abdominal segments,there was no significant difference in the thickness of esophageal wall between 3DCT and 4DCT50 images ( P= 0?056?0?550 );however, the thickness of esophageal wall was significantly smaller on 3DCT images than on 4DCTMIP or CBCT images (P=0?000?0?004).For the upper and middle thoracic segments,the thickness of esophageal wall was significantly larger on CBCT images than on 4DCTMIP images ( P= 0?008, P= 0?001 ) . On 3DCT, 4DCT50 , and 4DCTMIP images, the thickness of esophageal wall was significantly larger in the lower thoracic segment than in the upper or middle thoracic segments ( P=0.008~0?041);the intra?abdominal segment had a significantly larger thickness of esophageal wall than the thoracic segments ( all P=0?000 ) . There was no significant difference in wall thickness on CBCT images between three thoracic segments ( P=0.088~0?945) . Conclusions A uniform criterion can be adopted to judge the normal thickness of esophageal wall in gross tumor volume ( GTV ) delineation on 3DCT and 4DCT50 images for thoracic esophageal cancer. However,caution should be taken when 5 mm is used as a criterion for normal thickness of esophageal wall in GTV delineation on 4DCTMIP and CBCT images.

OBJECTIVE：To study the repa ir effect and mechanism of Taohong siwu decoction on rotator cuff injury in rabbits. METHODS：New Zealand rabbits were randomly divided into blank control group ，model group ，Taohong siwu decoction low-dose，medium-dose and high-dose groups （2.75，5.5，11 g/kg），and Taohong siwu decoction+LY 294002 group [ 5.5 g/kg Taohong siwu decoction+ 6.4 μg/kg LY294002（pathway inhibitor ）]，with 11 rabbits in each group. Except for blank control group ， other groups underwent right subscapularis muscle detachment to establish rotator cuff injury model. After modeling ，blank control group and model group were given normal saline intragastrically ；Taohong siwu decoction groups were given relevant medicine intragastrically；Taohong siwu decoction+LY 294002 group was given Taohong siwu decoction intragastrically ，and then injected with LY 294002 at the ear edge ，once a day ，for 12 weeks. After last intragastric administration （injection），the pathological changes of tendon-bone interface was observed ；the levels of TNF-α，IL-10 and IL- 6 in serum were detected ；mRNA and protein expressions of PI 3K，Akt and mTOR in tendon-bone interface were detected ；the expression of autophagy related protein （Beclin1， LC3Ⅱ）were detected. RESULTS ：Compared with blank control group ，the tendon-bone interface was uneven and the intima was swollen in model group. Serum levels of TNF-α and IL-6，mRNA and protein expressions of PI 3K，Akt and mTOR in tendon-bone interface were increased significantly （P＜0.05 or P＜0.01），while the level of IL- 10 and protein expression of Beclin 1 and LC 3Ⅱ were decreased significantly （P＜0.01）. Compared with model group ，the tendon-bone interface of rabbits in Taohong siwu decoction low-dose and medium-dose groups still had certain intimal damage ，while the tendon-bone interface of rabbits in high-dose group was smooth and flat without an obvious intimal tear ；the levels of most indexes in serum and tendon-bone interface of rabbits were significantly reversed in each dose group （P＜0.05 or P＜0.01）. Swollen tendon-bone interface and obvious intimal tear were obse rved in Taohong siwu decoction + LY group；compared with model group ，there w as no significant difference in above indexes of serum and tendon-bone interface （P＞0.05）. CONCLUSIONS ：Taohong siwu decoction may repair the rotator cuff injury of rabbits ，the mechanism of which may be associated with inhibiting PI3K/Akt/mTOR signaling pathway，activating autophagy and inhibiting inflammatory response.

OBJECTIVE：To establish the fingerprint of Fritillariae thunbergii formula granules and determine the contents of 3 components. METHODS ：HPLC method was used. Using peiminine as reference ，HPLC fingerprints of 13 batches of F. thunbergii formula granules were drawn with Similarity Evaluation System of TCM Chromatogram Fingerprint （2012 edition）. Similarity evaluation and common peak identification were conducted. The contents of peimisine ，peimine and peiminine in F. thunbergii formula granules were determined by the same HPLC method. The quality difference of samples were compared among different manufacturers. RESULTS ：There were 5 common peaks in 13 batches of F. thunbergii formula granules ，and the similarity was 0.669-0.971. Three common peaks of peimisine ，peimine and peiminine were identified. The linear ranges of peimisine ，peimine and peiminine were 30.00-180.00 μg/mL（r＝0.999 9），79.58-477.50 μg/mL（r＝0.999 6）and 97.33-584.00 μg/mL（r＝0.999 4）， respectively. RSDs of precision ，stability（24 h）and reproducibility tests were all lower than 3％. The average recoveries were 95.82％（RSD＝1.17％，n＝6），99.00％（RSD＝1.96％，n＝6）and 95.39％（RSD＝2.00％，n＝6），respectively. In the 13 batches of samples ，the content of peimisine ，peimine and peiminine were 0.17-1.02 mg/g，0.52-2.26 mg/g，and 0.70-3.50 mg/g， respectively. Their average total content was 3.62 mg/g. The average total content of manufacturer C and A was higher （5.02 mg/g and 4.61 mg/g），followed by manufacturer E and B （3.48 mg/g and 3.02 mg/g）；the lowest was manufacturer D（only 1.87 mg/g）. CONCLUSIONS：Established fingerpri nt and content determination method is simple ，feasible and reproducible ，which can be used for the quality evaluation of F. thunbergii formula granules. There are some differences in content among different manufacturers.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.