Based on the analysis on the present status and importance of medical humanity education for inter-national medical students during the clinical internship, this paper discussed the importance of strengthening medi-cal students′humanistic education during the clinical internship and proposed ways to promote the humanity educa-tion:optimizing the setting of humanity education curriculum and adhering to the humanity education throughout the whole process of clinical internship;improving the clinical supervisors′humanity quality and ensuring the quality of humanity education;holding the orientation of evaluation and adding the humanity quality as one of the evaluation indicators; establishing hospital atmosphere with humanity spirit and highlighting environmental education effect;building theuniversity-intern hospital two-grade platform of humanity education and standardizing the relevant systems.

Objective:To explore the effects of quality control circle(QCC) on the complaint management and patient satisfaction in the medical insurance center.Methods:We set up QCC,defined the subject,identified the problems and made the cause analysis,made the countermeasures and implemented them.Results:Mter QCC ac-tivities,patients'major unsatisfactory factors such as long waiting time and poor staff coordination ability were signif-icantly improved.In addition,patient complaints decreased significantly (P ＜ 0.01).Conclusion:The application of QCC management on patient complaints can not only increase patient satisfaction,but also provide an importantway for the hospital to build up the brand.

Objective To investigate the clinical features,diagnosis and treatment of medullary thyroid microcarcinoma (MTMC).Methods The clinical data of 14 patients with MTMC from Mar.2012 to Sep.2016 were retrospectively reviewed.All cases were treated with surgery and pathologically proved to be MTMC.Results All patients were sporadic MTMC.Calcitonin and CEA levels were measured before surgery in 11 patients.The median values were 81.61 (3.36-1187) pg/ml and 7.42 (0.81-90.75) ug/ml,respectively.All patients were followed up postoperatively.During a median follow-up of 24 months (8-63 months),no death happened.Regional lymph node metastasis occurred in 8 patients (57.14％),and lateral lymph node metastasis in 5 cases (35.71％).The rate of postoperative calcitonin abnormal was significantly higher in patients with lateral lymph node metastasis (P＜0.01).6 cases (42.86％) had abnormal postoperative calcitonin,among whom 5 cases had preoperative baseline calcitonin level higher than 100 pg/ml.Patients having abnormal postoperative calcitonin suffered from higher calcitonin and CEA baseline (P＜0.05).The tumor size was similar in two groups (P＞0.05).Conclusions For patients with thyroid nodules,preoperative screen of calcitonin can effectively detect MTC.Patients with elevated CEA also need to exclude the possibility of MTC.Compared with tumor size,calcitonin baseline is more important to surgical options and postoperative outcomes.Lateral lymph node metastasis,baseline calcitonin ＞100 pg/ml indicates abnormal postoperative calcitonin.

Objective To study the quality control methods for dragon's blood spraying film agent. Methods The pH value and viscosity of dragon's blood spraying film agent were detected. Drug dispersed homogeneous degree and particle sizes were determined with Nano Particle Size Analyzer and microscope. Content of Loureirin B was measured by Ultra Performance Liquid-Chromtography (UPLC). UPLC was performed on Waters C18 column (2. 1 mm×100 mm,1. 7 μm), the wavelength was 280 nm, the column temperature was 40 ℃ , and the mobile phase was 0. 1% formic acid aqueous solution and acetonitrile, and the flow rate was 0. 8 mL·min-1 . Results The pH value and viscosity of dragon's blood spraying film agent were stable, drug dispersion was homogeneous, and particle size of the drug was tiny. The concentration of Loureirin B had a good linear relationship in the range of 15. 51-77. 54 μg. Conclusion This method can be accurately controlled, has good stability and repeatability, and can fully control quality of dragon's blood spraying film agent.

Objective To evaluate the role of cabon nanoparticles for dissecting lymph nodes and preserving parathyroid glans in patients with differentiated thyroid carcinoma undergoing total thyroidectomy plus bilateral central neck dissection.Metheds From Sep.2015 to Feb.2016,100 patients in Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine with thyroid carcinoma undergoing primarily total thyroidectomy plus bilateral central neck dissection were randomly divided into carbon nonoparticle group and the contol group.The numbers of total dissected lymph nodes,the lymph node posterior to fight recurrent laryngeal nerve,metastasized lymph nodes,inadvertent parathyroidectomy,the parathyroid hormone and serum total calcium were measured.Results The average counts of lymph nodes in carbon nonoparticle group (10.96±5.43)were more than those in the control group at (8.22±4.40)lymph nodes,(t＝2.78,P＝0.01).The average counts of lymph node posterior to fight recurrent laryngeal nerve in carbon nonoparticle group (1.62±1.95)were more than those in the control group at (0.76±1.21)lymph nodes,(t＝2.66,P＝0.01).The numbers of metastasized lymph nodes was 2.02±2.40 in carbon nonoparticle group and 1.84±2.61 in the control group.The difference had no statistical significance(t＝0.36,P＞0.05).The amount of PTH and the decrease of PTH discrepancy one day after surgery between the two groups had no statistical difference (t＝0.23,P＞0.05),(t＝l.04,P＞0.05).The carbon nonoparticle group had 2％(1/50)mistakenly parathyroid gland removed incidence,on contrary,the control group had 6％(3/50)mistakenly removed incidence.The difference had no statistical significance(x2＝0.26,P＞0.05).Conclusion Carbon nonoparticle can improve the central lymph node detection rate,but the protection of the parathyroid glands is more likey to depend on the experience of the operator and the vascular protection.

Objective To introduce the preliminary experience of using rigid neuroendoscope in repair of spinal meningocele or myelomeningocele. Methods 3 infantile patients aging between 13 months and 22 months underwent the resection and repair of spinal meningocele or myelomeningocele in May, 2013. The operations were performed under the direct visualization of the rigid neuroendoscope in the aid of the intraoperative electrophysiological monitoring. All the surgical manipulations were accomplished outside the sheath of the endoscope. Results The surgical procedures were smooth. All the patients recovered satisfactorily. There was no postoperative complication. At the one-year follow-up, they were developing normally. Conclusions The rigid neuroendoscope is useful to the resection and repair of spinal meningocele and myelomeningocele. It could simplify the surgical procedures.

Carcinoma ; Humans ; Parathyroid Neoplasms

Objective To explore the relationship of expression and the effect of preoperative radiotherapy of endothelin-1 (ET-1) and pyruvate kinase M-2 (PKM2) in rectal carcinoma.Methods Immunohistochemical method was used to detect the expression of ET-1 and PKM2 proteins of rectal cancer tissues in 96 cases.The expressions of ET-1 and PKM2 were analyzed with the effect of preoperative radiotherapy in rectal cancer tissue.Results The high expression of ET-1 protein was 59 cases (61.46％).The high expression of PKM2 proteins was 54 cases (56.25％).The high expressions of ET-1 and PKM2 protein were worsen the effect of tumor regressive grade (TRG) than lower expressions of those after preoperative radiotherapy of rectal cancer tissue (P ＜ 0.05).The protein expression of ET-1 and PKM2 were positively correlated (P =0.006).Conclusions The high expressed ET-1 and PKM2 proteins in rectal cancer are closely related to preoperative radiotherapy resistance.ET-1 and PKM2 proteins are expected to become new targets of radiotherapy sensitivity and radiotherapy sensitization of rectal cancer.

Objective To investigate the expression of 14-3-3ε protein in the bladder urothelial carcinoma (BUC) and to explore its association with the clinicopathologic features.Methods The bladder urothelial carcinoma samples were divided into three groups:normal control group of 10 cases,low-grade malignant BUC group of 25cases (includes 5 cases of papilloma,10 cases of PUNLMP and 10 cases of low grade non-invasive papillary urothelial carcinoma),high-grade malignant BUC group of 21 cases (includes 11 cases of high-grade non invasive papillary urothelial carcinoma and 10cases of infiltrating carcinoma).The expression and location of 14-3-3ε in three groups were detected by immunohistochemical EnVision and the relationship with clinicopathologic parameters was analyzed.Results 14-3-3ε expression was observed in the cytoplasm of the cell.The expression of 14-3-3ε in normal control group was 90 ％ (9/10),low-grade malignant BUC group was 72.0 ％ (18/25),high grade malignant BUC group was 14.3 ％ (3/21).It correlated with histological grading but had not showed correlation with other clinicopathologic parameters.There was significant difference in 14-3-3ε expression between the high grade malignant BUC group and the low-grade malignant BUC group,the high grade malignant BUC group and norml control group (all P ＜ 0.05).Conclusions 14-3-3ε plays an important role in carcinogenesis of BUC.It may be a biomarker for early diagnosis and classification of BUC and shows promise for clinic application.

Objective To study the film￣forming property of film￣forming materials in dragon blood ethanol solution, and provide the reference for screening of film￣forming materials for dragon blood plastics. Methods PVA124,PVA1788, PVP￣K30, EC, MC, PVB were chosen to study the film￣forming property of film￣forming materials based on solubility, formation time, and adhesion. Results PVA1788 and PVP￣K30 mixed in dragon blood ethanol solution in proportion of 4:1 showed good film￣forming property, and the membrane was smooth, uniform and easy to tear off.However, PVA124 and PVP￣K30 mixed in proportion of 4:1 precipitated in dragon blood ethanol solution.EC, MC and PVB were not easy to tear off the membrane. Conclusion PVA1788 and PVP￣K30 mixed in proportion of 4:1 and added with propylene glycol is the optimal choice of film￣forming material for dragon blood spray film.