Objective To investigate doctor-patient communication skills status and the influencing factors so as to pu forward to develop the proposal.Methods We selected undergraduate students in fourth grade which participated in the 2012 Shanghai Jiaotong University School of Medicine OSCE examinations before practice of clinical medicine by cluster sampling 1 and we selected four western and chinese medicine hospitals randomly sample 2,which are three level of first-class hospitals in Shanghai.We design the questionnaire and observe sampling with the SEGUE framework.Application of SPSS 13.0 data for statistical analysis,descriptive statistics analysis,u test,t test,ANOVA,rank sum test and correlation analysis method.Results The test with SEGUE framework shows that the scores of samplingl were 12.54 points(out of 24),the score rate is low which was 52.25％,and in the score rate of the dimensions,the end of inquiry dimension is 4％ which is the lowest.There are significant statistical differences between different groups of influencing factors such as Medical occupation interest score and so on.There is no statistically significant difference between the SEGUE score of traditional Chinese medicine and western medicine clinical Intern.The communication skills of western medical students are higher.Doctor-patient communication skills related factors such as recognition of the importance of doctor-patient communication skills and other groups are statistically significant,the correlation coefficients are very small which is between 0.1 and 0.3.Conclusion The overall level of doctor-patient communication skills on clinical internship are not high,through the guidance and training on the occupation interest of medical students,we can strengthen the recognition of the importance of doctor-patient communication skills,so that we will improve the doctor-patient communication skills for the medical students.SEGUE framework should be used to routine medical students communication skills evaluation.

Objective To explere the curative effects of L-carnitine on neonates with myocardial injury caused by asphyxia.Methods Ninety-one neonates with myocardial injury caused by asphyxia were randomly divided into L-carnitine treatment group(48 cases) and control group(43 cases).The patients in control group were received routine treatment;the patients in treatment group were given L-carnitine 0.1 g/(kg?d) on the basis of routine treatment for 10 days.Symptoms and physical signs were observed pretreatment and during the time of therapy.Before and after the treatment,serum MB isoenzyme of creatine kinase(CK-MB) and aspartate aminotransferase(AST) were mea-sured with immunosuppression and enzyme rate respectively,and serum albumin and prealbumin were detected with the method of bromcresol green chromatometry and immunoturbidimetry,respectively.Results Clinical effective rate of the treatment group(91.67%)was higher than that of control group(74.42%)(P

The cytolytic effect of perforin is a mechanism of anti-virus,killing microbial-infected cells and tumor cells.Perforin is a very important non-specific immune factors in fish.In order to understand the function of perforin,the cDNA of grass carp perforin C-terminal peptide was amplified from grass carp liver and kidney cDNA library.It contains a protein kinase C conserved region 2(C2).The cDNA was connected with pET32a,and transformed to expression bacteria DE3.PFP-C was expressed by a prokaryotic expression system and then purified by affinity chromatography.It showed a significant haemolytic activity when tested with rabbit red cells,the optimal pH for haemolytic activity was 7.5,and its haemolytic function dependents on Ca2+ apparently.

The present paper proposed a central-driven structure of upper limb rehabilitation robot in order to reduce the volume of the robotic arm in the structure, and also to reduce the influence of motor noise, radiation and other adverse factors on upper limb dysfunction patient. The forward and inverse kinematics equations have been obtained with using the Denavit-Hartenberg (D-H) parameter method. The motion simulation has been done to obtain the angle-time curve of each joint and the position-time curve of handle under setting rehabilitation path by using Solid Works software. Experimental results showed that the rationality with the central-driven structure design had been verified by the fact that the handle could move under setting rehabilitation path. The effectiveness of kinematics equations had been proved, and the error was less than 3° by comparing the angle-time curves obtained from calculation with those from motion simulation.
Biomechanical Phenomena ; Humans ; Models, Biological ; Robotics ; Stroke Rehabilitation ; Upper Extremity

OBJECTIVE:To provide reference for promoting the priority use of essential medicines. METHODS:The use amount ratio of essential medicines in 2 third-level grade-A hospitals in Beijing from 2011 to 2013 was statistically investigated. And the literatures related to policies of essential medicines and application were retrieved for in-depth analysis. RESULTS:The use amount ratios of essential medicines in the outpatient and emergency departments in Beijing Hospital of Ministry of Health from 2011 to 2013 were respectively 24.04%,23.10% and 22.76%;and the use amount ratios of essential medicines of inpatients were respectively 16.56%,14.52% and 12.04%. The use amount ratios of essential medicines in the outpatient and emergency depart-ments in Beijing Friendship Hospital(a pilot hospitals of cancelling drug addition medical reform)in the 3 years were respectively 21.59%,19.85% and 22.93%;the use amount ratios of essential medicines of inpatients were respectively 17.70%,17.62% and 15.89%. The use amount ratios of essential medicines did not meet 25%-30% of the requirements. CONCLUSIONS:Cancelling the drug addition and adjusting the types and quantity of essential medicine list had no obvious effects on the use amount ratios of gen-eral third-level grade-A hospitals. It is suggested to promote the priority use of essential medicines by systems of medical insurance total amount prepayment,single disease payment or diagnosis related groups-based prepayment and the free policy of essential medi-cines,rather than administrative order.

In recent years,laparoscopic total gastrectomy (LTG) with lymphadenectomy is increasingly utilized for the management of gastric cancer located in the middle or upper third of the stomach.However,esophagojejunostomy is the key technical difficulty in operation.Compared with conventional extracorporeal esophagojejunostomy via mini-laparotomy,pioneers are attempting to perform intracorporeal anastomosis in order to gain better manipulation and minimally invasive benefits,as well as reducing the difficulties in digestive tract reconstruction.

Objective To establish the rapid purification of Coxsackievirus A16 using ultracentrifugation .And To prepare and i‐dentify the neutralizing monoclonal antibody against CA16 .Methods The CA16 culture supernatant was harvested and then con‐centrated by 100K capsule .The concentration of CA16 was purified by cesium chloride ultracentrifugation .Purification of CA16 were identified by transmission electron microscopy .BALB/c mice were immunized with inactivated CA16 .Spleen cells were harves‐ted and fused with SP2/0 myeloma cells ,hybridoma cell strain secreting mAb against CA16 were objected to screening .Character‐ization of the prepared mAb were analyzed by ELISA and microneutralization assay .Results The purified CA16 method of cesium chloride gradient ultracentrifugation was established ,TEM analysis was showed that CA16 particles have icosahedral structure ,the diameters of the viral particles were approximately 20-30 nm .Two hybridoma cell strains secreting mAb against CA16 were ob‐tained ,the subtypes of two mAbs were IgG2a ,the binding titers of Anti/CA16/5 and Anti/CA16/10 were 103 and 104 respectively . Neutralizing titer of the two mAbs were 1∶256 and 1∶1 024 respectively .Conclusion Establishment method of cesium chloride gradient ultracentrifugation was performed to purify CA16 ,the two mAbs with neutralizing ability to against CA16 may become ap‐plication of treatment and vaccine .

The paper introduces the system design of internet platform in novelty assessment and selective dissemination of informa-tion of medical science and technology project in Zhejiang province, including the exploitation of environment , processing of novelty as-sessment and selective dissemination of information as well as main function design. This system has noticeable advantages, such as com-prehensive functions, multiple participation, transparent service process, which could finish the relevant work on the internet, improve the quality of information service and enhance the efficiency.

Objective To investigate the prevalence and spectrum of β-thalassemia mutations in C, uangdong province, and provide a reference for prenatal diagnosis and genetic counseling in this population. Methods Three thousand two hundred and forty-seven blood samples were randomly selected from Guangzhou and 2984 blood samples from Shenzhen from January in 2005 to January in 2009. PCR and reverse dot blot hybridization (RDB) were adopted for detection of β-thalassemia mutations in Guangzhou and Shenzhen city. Results Seven hundred and fifty-one individuals in Guangzhou were found to have β-hemoglobin gene mutations, the detection rate was 23.13%(751/3247); 10 different mutations were identified, namely CD41-42(-TCTT), IVS-Ⅱ-654(C→T), -28(A→G), CDI7(A→T), CD71-72(+A), 13E, IVS-I-1(G→T), CD43(G→T), -29(A→G), CDI4-15(+G), which accounted for 42.53% (336/790) ,25.19% (199/790), 12.66% (100/790), 10.89% (86/790) ,3.29% (26/790), 2.15%(17/790), 1.27%( 10/790), 1.14%(9/790) ,0.51%(4/790) ,0.38%(3/790), respectively; the most common mutation was CD41-42(-TCTT), which accounted for 42.53%(336/790). In Shenzhen, 179 individuals were found to have β-thalassemia mutations, the detection rate was 6.00% (179/2984); 8 different mutations were identified excluding CD43 (G→T) and CD14-15 (+G); the most common mutation, however, was IVS-lI--654(C→T), which accounted for 40.44% (74/183). Conclusions The β-thalassemia mutations in Guangdong province are not only frequent, but also obviously heterogeneous, and the mutations differ from region to region. CD41-42 (-TCTT),ⅣS-Ⅱ-654(C→T), -28(A→G), CD17(A→T) were the 4 predominant mutations.

Objective To explore the diagnostic and prognostic significances of platelet parameters changes in Kawasaki disease(KD).Methods The platelet total(PLT),mean platelet volume(MPV),platelet distribution width(PDW)and plateletcrit(PCT)were measured in 23 cases of KD on acute febrile phase and early recovery phase.It was compared with 33 cases suffered from other febrile diseases during the same period and in similar ages.Each KD child should accept the cardiology ultrasonic examination.Results The level of PLT,PCT increased in KD patients.It was more significant in early recover period than in acute febrile period(P0.05).PLT negatively correlated with MPV,PDW(r=0.358,0.268 Pa0.05).Conclusions The changes of platelet parameter play a very important role in diagnosis of KD.But it still can not be certain that whether the changes can help us estimate the variety of the patients condition and prognosis of KD children.It requires further study.