Through discussing the traditional medical ethics culture and medical ethics,this paper pointed out the main problems in the teaching practice of medical ethics:it did not well handle the relationship between the inheritance of traditional culture and the absorption of foreign culture;it emphasized too much on the learning of analysis methods and tools of ethical problems but ignored the cultivation of personality and morality;the teaching curriculum of medical ethics is unreasonable.This paper discussed the similarities and differences between medical ethics and traditional ethics culture,gasped the common essence of ethics,and put forward to better improve the teaching of medical ethics through the construction of basic theory system,the settings and perfection of curriculum system,the construction and improvement of the curriculum evaluation system,and the inheritance of traditional medical ethics cultural.

Objective:To observe the clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia.
Methods:A total of 154 cases with post-stroke insomnia were randomly divided into a control group and an observation group by the random digital table, 77 cases in each group. The control group was treated by auricular acupoint sticking, while the observation group was treated by auricular acupoint sticking plus music therapy, to compare the clinical effects at the end of the treatment and three months after the treatment between the two groups.
Results:At the end of treatment, the total effective rate was 98.7% in the observation group, remarkably higher than 89.6% in the control group, with a statistically significant difference between the two groups (P<0.05). Three months after the end of the treatment, the total effective rate was 90.9% in the observation group, remarkably higher than 80.5% in the control group, with a statistically significant difference between the two groups (P<0.05).
Conclusion:Auricular acupoint sticking plus music therapy was affirmative in the clinical effects for post-stroke insomnia, providing a new idea to design a best nursing and rehabilitative plan for the patients with post-stroke insomnia.

The progress and application of teletriage,which is one of emerging telemedicine technologies, is introduced with highlighting its advantages and characteristics. Advices are also given on how to explore this technology in China by learning the experience abroad. Teletriage will be one of the most useful e-health technologies for meeting the great need of medical resources in the innovation process of Chinese medical system.

BACKGROUND: Microwave had been widely used in medical field, which can lead to local coagulation necrosis and repair the necrosis with fibrous tissue. However, whether microwave coagulation can be used in stomatology is poorly understood.OBJECTIVE: To observe the functional and volumetric changes of skeletal muscles following microwave coagulation, and to explore the possibility of microwave coagulation for volumetric reduction of skeletal muscle.METHODS: Both sides of tibialis anterior muscle of 20 New Zealand rabbits were exposed; one side was coagulated by 2 450 MHz microwave therapeutic instrument at 70 W for 20 seconds. No treatment was performed at the other side. Rabbits were sacrificed at hours 24, 48, weeks 1 and 8 after microwave coagulation. The volumetric changes of the ablated tibialis anterior muscle were measured, and electricitic physiology observations were conducted on the ablated muscle at 8 weeks after microwave coagulation before being sacrificed.RESULTS AND CONCLUSION: The volume of ablated muscle increased at hours 24 and 48, which was (5.82±0.93) and (6.04±0.47) mL, especially greater at hour 48 after microwave coagulation. After 1 week, the muscle volume began to decrease to (4.90±0.80) mL, reduced to (4.27±0.67) mL at week 8, which was 23.6% volumetric loss. However, the electrophysiologic observation showed that the latent periods were (1.765+0.393) and (1.760±0.394) ms, and the wave width was (6.273±0.808)and (6.259±0.773) ms of the control group and experimental group, respectively, without apparent differences (P ＞ 0.05). The volume of the skeleton muscle increased at hour 48 after microwave coagulation, and then decreased, but the muscle function of the skeleton muscle can be preserved.

Objective:To observe the morphological changes in skeletal muscles after therapeutic. Methods:Tibialis anterior muscles of 25 New Zealand rabbits were exposed and coagulated with 70 W for 20 s. The rabbits were sacrificed at 1 hour?24 hours?48 hours?1 week and 2 months after MCT. The specimens of coagulated areas were prepared for histological observation. Results:Obvious rims could be found bet ween coagulated and normal tissues .The ablated site showed tissue fixation in the inner zone and coagulative necrosis in found the outer zone.these were four zones can be seen under high powered magnification:the application zone,the central zone,the transition zone and the reference zone. Demarcation zone of necrosis appeared 24h after MCT. Tibrosis encapsulation occurred after 7 days.Replacement with fine cicatrix was demonstrated after 2 months. Conclusion:Tissue destroyed by coagulation can be replaced with a fine cicatrix gradually.

OBJECTIVE:To systematically review the efficacy and safety of Elemene injection combined with chemotherapy in the treatment of gastric carcinoma,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CBM, CJFD,VIP Database,Wanfang Database,Medline,EMBase,Cochrane Library and American Medical Association Database,ran-domized clinical trials(RCT)about Elemene injection combined with chemotherapy in the treatment of gastric carcinoma were col-lected,Meta-analysis was performed by using Rev Man 5.3 software after data extracting and quality evaluating by Cochrane 5.1.0. RESULTS:Totally 7 RCTs were enrolled,involving 434 patients. Results of Meta-analysis showed recent efficacy [RR=1.38,95%CI(1.14,1.67),P=0.001] and improvement rate of life quality [RR=1.36,95% CI(1.15,1.60),P<0.001] of Elemene injection combined with chemotherapy in the treatment of gastric carcinoma were significantly higher than only chemotherapy. The incidence of Ⅲ-Ⅳ leukemia inhibition [RR=0.58,95%CI(0.37,0.91),P=0.02],incidence of Ⅰ-Ⅳ hemoglobin inhibition [RR=0.76,95%CI(0.60,0.95),P=0.02],incidence of Ⅰ-Ⅳ platelet inhibition [RR=0.69,95%CI(0.52,0.91),P<0.001] and Ⅲ-Ⅳ[RR=0.53, 95%CI(0.30,0.93),P=0.03] and incidence of Ⅰ-Ⅳ neurotoxicity[RR=0.69,95%CI(0.52,0.93),P=0.01] in test group were sig-nificantly lower than control group,the differences were statistically significant. CONCLUSIONS:Both efficacy and safety of El-emene injection combined with chemotherapy in the treatment of gastric carcinoma are good.

AIM:To investigate the influence of F10 on the activities of transcription factor NF-?B and AP1 in A549 cells.METHODS:The luciferase report plasmids of NF-?B-Luc,AP1-Luc and F10 gene were introduced into A549 cells and the luciferase activity was detected.The DNA binding activities of AP1 and NF-?B in the cells were measured by the electrophoretic mobility shift assay(EMSA).RESULTS:The luciferase activity in F10+ transfection group decreased 30% and increased 2-fold respectively 48 h after transfected with the luciferase report plasmid of NF-?B-Luc and AP1-Luc in A549 cells.The DNA binding activity decreased 49% and increased 23%,respectively.CONCLUSION:F10 gene up-regulates the transcription activity of AP1 and down-regulates the NF-?B in A549 cells.

Objective To evaluate the influence of preoperative quitting time on coronary artery bypass grafting (CABG) patients with postoperative hypoxemia incidence.Methods 151 patients with coronary bypass surgery and preoperative history of smoking who preparation of CABG in hospital were recruited from September 2011 to September 2013.According to the preoperative smoking cessation time patients were divided into five groups:0 days,1-30 days,31-60 days,61-90 days,more than 90 days.Single factor regression and Logistic analysis were used to analyse the influence of preoperative quitting time on CABG patients with postoperative hypoxemia incidence.Results Age,weight,smoking habit,quitting time,hypertension,diabetes mellitus were risk factors of hypoxemia after coronary artery bypass grafting.Logistic regression analysis showed that age,body weight,smoking habit,smoking time were independent risk factors of hypoxemia after coronary artery bypass grafting.The incidences of hypoxemia of the five groups 0 days,1-30 days,31-60 days,61-90 days and more than 90 days were 55.56％ (15/27),59.26％ (16/27),27.58％ (8/29),22.73％ (5/22),15.63％ (5/32).The incidence of hypoxemia had significant difference (x2=19.212,P ＜ 0.05).Conclusions Age,weight,smoking habit,quitting time were independent risk factors of hypoxemia after CABG.With the quitting time increase,hypoxemia after CABG overall downward trend.Difference quitting time before the operation,the hypoxemia occurred difference rate influence,On the preoperative smoking CABG patients were smoking cessation intervention timely helps to reduce the occurrence of postoperative hypoxemia.

Background and purpose:In 2013, the ofifcial journal of European Society of Radiotherapy &Oncology (ESTRO) -Radiotherapy & Oncology published the updated version of Consensus Guidelines of Delineation of the neck node levels for head and neck tumors, which contributed to the standardization of description of neck nodal metastasis, as well as reduction of treatment variations from various institutions. This study applied this updated guidelines to analyze the patterns of lymph node metastasis of nasopharyngeal carcinoma and explore the prognostic value of the radiologic characteristics of nodes, in order to provide evidence for future revision of N staging system. Methods:A total of 656 patients from Jan. 2009 to Dec. 2010 were retrospectively recruited to analysis. All were pathologically diagnosed as non-metastatic nasopharyngeal carcinoma, treated with intensity-modulated radiotherapy. All patients received a pretreatment MRI scan. We retrospectively reviewed the MRI imaging of 656 patients and mapped the lymph node metastasis using the 2013 International Consensus Guidelines.Results:Median follow-up was 46.9 months. Four-year local recurrence-free survival, nodal recurrence-free survival, distant metastasis-free survival, disease-free survival and overall survival was 91.3%, 95.1%, 87.7%, 78.5% and 92.8%, respectively. The most common metastatic node levels were levelⅡ (76.2%) and levelⅦa (65.1%), followed by levelⅢ (50.4%),Ⅴa(17.5%) andⅣa (11.7%). There was a very low incidence of node skipping (1.0%). Cervical nodal necrosis was observed in 46.4%of patients with positive nodes and extracapsular spread was noted in 74.4% of them. Univariate analysis showed that bilateral nodal involvement, greatest dimension of positive nodes (≥6 cm), central nodal necrosis, T stage and N stage were prognostic factors for disease-free survival and distant metastasis-free survival (P<0.05). Extracapsular spread showed a trend to correlate with poor distant metastasis-free survival (P=0.060). The involvement of lower neck levels (below the caudal border of cricoid cartilage) did not have a signiifcant impact on disease-free survival and distant metastasis-free survival. In multivariate analysis, T stage and greatest dimension of nodes (≥6 cm) were independent prognostic factors for distant metastasis-free survival (P<0.05). T stage, greatest dimension of nodes (≥6 cm) and central nodal necrosis were independent prognostic factors of disease-free survival (P<0.05).Conclusion:This study demonstrates the patterns of lymph node metastasis of nasopharyngeal carcinoma based on 2013 International Consensus Guidelines. Bilateral nodal involvement, greatest dimension of positive nodes and central nodal necrosis had prognostic values on disease-free survival and distant metastasis-free survival. In our study, the involvement of lower neck levels was not proved to be a prognostic factor for disease-free survival and distant metastasis-free survival.

Objective To investigate the effect of down-regulated Blimp1 gene expression on differenetiation of bone marrow cells into dendritic cells (DCs).Methods Blimp1-shRNA was constructed and then loaded into lentivirus vector as lenti-blimp1-shRNA.Bone marrow cells from Balb/c mice were induced differentiation to DCs in an 8-day cell culture system with GM-CSF/IL-4 incubation and LPS stimulation at day 7.The cells were divided into groups as empty control (no treatment),lenti-control (transfected by lentivirus empty vector at day 1),and lenti-Blimp (transfected by lenti-blimp1-shRNA at day 1).The transfection efficiency was evaluated by GFP fluorescence for one week.The morphology and growth curve were analyzed.Real-time PT-PCR and Western blotting were used to evaluate mRNA and protein expression of Blimp1.At day 8,CD11 c and CD86/MHC-Ⅱ were quatitified using flow cytometry.Results GFP fluorescence emerged 3 days after transfection and was continuously expressed.Classic DC morphology was shown in no treatment cells,while damaged morphology presented in the cells with lentivirus transfection.The empty control cells proliferated from day 3,peaked as (2.45 ± 0.26) 106/well at day 4,and kept at (2.27 ± 0.19) 106/ well at day 8,The cells receiving lentivirus presented (1.69 ± 0.39) 106/well.The expression of Blimp1 mRNA and protein in the lenti-Blimp1 group was 76％/1％ and 1.0％/74.0％ of the empty control group.At day 8,CD11c,CD86 and MHC-Ⅱ expression in the empty control group was (69.2 ±5.0)％,(51.1± 4.9) ％ and (56.3 ± 7.3) ％,while (68.6±5.9)％,(49.5±4.3)％ and (69.4±4.5)％ in the lenti-control group,and (72.8 ± 5.5)％,(50.2 ± 6.0)％ and (46.5 ± 5.7)％ in the lenti Blimp1 group.Conclusion Lentivirus-mediated Blimp1-shRNA gene therapy modulates blimp1 expression of DC precursors.Down-regulation of Blimp1 fails to interrupt the differentiation of DCs but inhibits the maturation.