To perfect the medical ethics archives,we should stress the filling system of medical ethics evaluation,the detailed check and registration of medical staff's medical ethics condition.It could form the right think leading and normative professional criterion of medical staff,developing their work potential and decrease the conflict between doctors and patients.The main purpose and significance to establish and perfect the medical ethics archives is that it could bring the guidance,self-discipline,awards and punishments and regulation role in the medical ethics construction.

The problems in nursing postgraduate training in China are summarized,which include the ambiguity of subject orientation,absence of unified standard on training objective,imperfection of tutor team,uncertainty of research direction,lack of scientific research funds,etc.The countermeasures are then proposed,and the direction of nursing postgraduate education reform in China is discussed.

China ; Forecasting ; Gaucher Disease ; diagnosis ; therapy ; Humans ; Rare Diseases

The BRAFV600E mutation in papillary thyroid carcinoma is the most common genetic event,which is an invasive tumor clinical phenotype and a poor prognosis indicator.The BRAFV600E mutation detection has an important guiding significance for the differential diagnosis of malignant thyroid nodules on preoperative,guiding the surgical resection range of thyroid cancer,judging the patient(s) prognosis and guiding the subsequent treatment of postoperative.

Autophagy is a dynamic process which subcellular membranes undergo morphological changes that lead to the degradation of cellular cytoplasmic organelles and macromolecules.It is regulated by themammalian target of rapamycin ( mTOR ) -dependent or -independent signaling pathways.It has been demonstrated that autophagy is induced or inhibited in various tumor cells,and it is closely related with cell survival and drug resistance.Because of the complex relationships with cell death,the roles of autophagy in cancer developnent,treatment,and drug-resistance are not the same,and thus controlling autophagy properly may become one of new means of cancer therapy.

BACKGROUND:Attention deficit hyperactivity disorder(ADHD) is treated clinically mainly with medication,psychotherapy and acupuncture,which is seldom treated with simple massage.During working in Swaziland, the writer found a part of children only accept massage for they did not receive remarkable results by medication and also were scared of acupuncture. OBJECTIVE:To probe manipulation and mechanism of massage on ADHD in children. DESIGN:Cases analysis. SETTING:Sino Japan Friendship Hospital. PARTICIPANTS:All the cases were collected from April 2000 to April 2002 while the writer was working in Swaziland. Thirty three children with ADHD were in accordance with the symptomatic diagnostic standards of American DSM IV.No control was selected. INTERVENTIONS:Simple massage manipulation was adopted in treatment of the 33 ADHD children.The common manipulations included head manipulation,chest abdominal manipulation and back manipulation.According to various clinical manifestations,the manipulations were modified based on differentiation of syndromes. MAIN OUTCOME MEASURES:Therapeutic results on patients with massage manipulations. RESULTS:Of the 33 cases of ADHD children treated with massage, 10 were cured,9 were remarkably effective,9 were improved and 5 had no effect. CONCLUSION:The therapeutic results of massage on ADHD in children are satisfactory and safe without side effects.

Objective:Cardiac index(CI) and mixed venous oxygen saturation SvO2 were studied in 85 patients undergoing coronary artery bypass grafting(CABG). Methods: Measurement of CI and SvO2 was carried out with a fiberoptic ballon-tip thermodilation pulmonary artery catheter. Fentanyl-based anesthesia was applied in all patients. Hemodynamic parame-ters were obtained prior to anesthesia induction as the baseline, after endotracheal intubation, after stemotomy, after weaning of cardiopulmonary bypass, at 6 and 24h after operation. Results: CI and SvO2 increased or was not changed at all time intervals, compared with the baselines. The changes of SvO2 correlated well with those of CI. Conclusion: The results suggest that continuous monitoring of SvO2 may be useful to predicting alteration in CI in patients undergoing CABG.

OBJECTIVE To investigate the antibiotic resistant phenotyping of Acinetobacter spp on NC21 panel. METHODS A total of 275 strains were isolated from clinical specimens.Acinetobacter were identified and antimicrobial susceptibility test performed.Phenotyping was according to David Livermore.Resistance phenotyping analysis included 13 antibiotics. RESULTS The susceptible results of 13 antimicrobial agents in 275 strains of Acinetobacter spp showed imipenem,amikacin,ampicillin-sulbactam,ciprofloxacin,tobramycin,ceftazidime,cefepime,gentamicin and trimethoprim had the greatest susceptibility(97.8%,88.4%,86.6%,82.2%,81.9%,9.6%,76.8%,73.8% and 73.6%,respectively).Beta-lactam agent-resistant phenotypes Ⅰto Ⅴ(wild type,penicillinase,cephalosporinase,penicillinase+cephalosporinase,multi-drug resistance mechanism) and nontyping were 67.3%,1.8%,1.8%,19.6%,0.7% and 8.8%,respectively.74.2% of 275 strains were susceptible to gentamicin,amikacin and tobramycin.Aminoglycosides resistant phenotype(gentamicin-resistant,gentamicin-amikacin-resistant,gentamicin-amikacin-tobramycin-resistant) and nontyping were 7.3%,1.1%,10.9% and 6.5%,respectively.8.7% were the penicillinase-cephalosporinase and gentamicin-amikacin-tobramycin-resistant phenotyps,those strains were all susceptible to imipenem and half to ampicillin-sulbactam. CONCLUSIONS Resistance phenotyping system should be useful in epidemiological studies of Acinetobacter and avoiding unnecessary antibiotics treatment,ampicillin-sulbactam as imipenem shows high antibacterial activities,aztreonam has a lower antimicrobial susceptibility than other 12 antibiotics.

OBJECTIVE To apply the clinical pathway in hospital infection control in order to cut down the development of hospital infection.METHODS To take clinical pathway combined with clinic,to establish scientific,effective and standard measures to reduce hospital infection.RESULTS To practice clinical pathway could raise medical quality,rationally utilize the health resources,decrease economy burden of the patient and control hospital infection.CONCLUSIONS It′s of practical importance to promote the hospital infection management through clinical pathway.

Objective To investigate the clinical efficacy and safety of alteplase thrombolysis in the treatment of patients with acute ischemic stroke.Methods 42 patients with acute ischemic stroke were randomly divided into the control group and the study group.1 8 cases in the control group were treated by urokinase thrombolysis, and 24 cases in the study group were treated by alteplase thrombolysis.The clinical efficacy and safety were compared between the two groups.Results The total effective rate of the study group(91 .7%)was higher than that of the con-trol group(77.8%),and the difference was statistically significant(χ2 =9.7,P <0.01 ).Compared with the control group,the total vascular patency rate was higher,the difference was statistically significant(χ2 =97.6,P <0.01 ).The NIHSS score was lower in the two groups after treatment(t =1 0.1 58,1 5.962,all P <0.05),and that in the study group was more lower,the difference between the two groups was statistically significant(t =1 0.564,P <0.05 ). Conclusion Alteplase thrombolysis in the treatment of acute ischemic stroke patients,thrombolytic therapy for patients,in the use of drugs within the time window patients can get good clinical curative effect,no more than drug use the most extensive restrictions rarely cause patients with intracranial hemorrhage,and being suitable for populari-zation and application.