Physiology is an important and basic course in medicine.In order to foster graduates with high quality for human society,teachers should strengthen moral culture education in the process of physiological teaching.

It is necessary for hospital development and capturing initiative control in medical market to build "satisfactory project for patients",take patient's satisfaction as a target of medical service,analyze and consider patient's right and requirement from their own viewpoints,carry out an after-discharge(outpatient service and perinatal period) investigation and related medical symposiums on patient's satisfaction degree on medical service,and promptly resolve problems appearing in medical activities.

Objective To compare the effect of three different analgesic techniques on hyperglycemia and stress response to cholecystotomy so as to select a more reasonable analgesic modelMethods Thirty patients after cholecystotomy ,were randomly divided into three groups using three different analgesic techniques:postoperative intravenous morphine patient-controlled analgesia(PCA)(group M),postopetative epidural PCA(group E),and pre-emptive clonidine combined with postoperative epidurral PCA(group P)Blood glucose,plasma levels of stress hormones such as cotisol,insulin,glucagon,epinephrine and norepinephrine were measured at various timesResults All three analgesic techniques produced satisfactory pain reliefHyperglycemiawas inhibited more efficiently in group E and P than in group MThe secretions of stress hormoneswere less suppressed in group M than in other two groupsThe epidural analgesics requirement in group P was lower than in group E(P

ObjectiveTo investigate the effect and outcome of critically illness with acute kidney injury (AKI) treated with continuous veno-venous hemodiafiltration (CVVHDF) in children.Methods Twenty-four cases of critically illness with AKI were treated with CVVHDF in our pediatric intensive care unit from Jan 2008 to Dec 2010.The levels of creatinine (Cr),blood urea nitrogen (BUN),K +,Na + and HCO3- were observed before CVVHDF and 6,12,24,48,72 h after CVVHDF.ResultsCatheter was successfully established for CVVHDF in 24 cases of AKI.The average duration of CVVHDF was 46 h ( 16 ～142 h).The blood levels of Cr and BUN were significantly decreased at 6 h after CVVHDF [ ( 196.3 ±112.4) μmol/L,( 13.3 ± 8.5 ) mmol/L] and 12 h after CVVHDF [ ( 106.1 ± 84.2) μ mol/L,( 10.2 ± 9.7 )mmol/L] as compared to those before treatment [ (340.6 ±298.2) μmol/L,(31.6 ± 11.3) mmol/L] (P ＜0.05,P ＜ 0.01 ).After 48 h of CVVHDF,the Cr,BUN returned to normal range.The imbalance of blood K +,Na +,and HCO3- improved at 6 h after CVVHDF and returned to nomal levels at 24 h.Total 28 d fatality rate was 29.2％ (7/24),and all death cases were complicated with multiple organ dysfunction syndrome.ConclusionCVVHDF therapy for AKI can quickly clear Cr,BUN and excess water,correct electrolyte disorders,improve kidney function in children.

The policies of healthcare big data and their common and respective characteristics in USA, Britain, France, Japan, Republic of Korea, and Singapore were analyzed in aspects of their strategic planning, infrastruc-ture construction, R&D of key technologies, professional training, and privacy protection with 5 suggestions put for-ward for improving the policies of healthcare big data in China , namely transforming thinking , establishing opera-tional systems, working out construction criteria, building platform for big data sharing, and attaching importance to professional training .

Objective To evaluate skin barrier function in children with atopic dermatitis (AD) as well as healthy children from two communities in Shanghai and to assess the relationship between skin barrier function and AD severity.Methods Totally,169 children with AD and 142 healthy children aged 3-12 years were recruited from two communities (Changning Xining community and Jiading Juyuan community) in Shanghai,China.Transepidermal water loss (TEWL) and stratum corneum hydration were measured in normal appearing nonlesional skin at four body sites (dorsal and volar forearm,cheek and anterior shin) of the patients,as well as in normal skin at the same sites of the controls.AD severity was evaluated by using the severity scoring of atopic dermatitis (SCORAD) index.Results Compared with the healthy children,the patients with AD showed higher TEWL value at all of the four body sites (all P ＜ 0.05),but lower water content in stratum corneum at dorsal forearm and anterior shin (both P ＜ 0.05).In patients with AD,the SCORAD index was positively correlated with mean TEWL value,but negatively correlated with the mean water content in stratum corneum.Conclusion Skin barrier function may serve as an index for evaluating the severity of AD.

In order to investigate the role of Twist gene in the metastasis of hepatocellular carcinoma (HCC), total RNA was respectively extracted from three HCC cell strains with different metastatic potentials, HepG2, MHCC-97L and MHCC-97H. The first strand cDNA was synthesized by reverse transcription, which was then used as template to perform fluorescent quantitative polymerase chain reaction (FQ-PCR). The quantity of Twist gene expression was normalized by that of the housekeeping gene, GAPDH for each sample. ANOVA was used to estimate the relationship between Twist gene and metastasis potential of HCC. The results showed that the normalized initial cDNA concentrations of Twist gene in HepG2, MHCC-97L and MHCC-97H were (9.45+/-0.25)x10(-4), (1.82+/-0.41)x10(-3), (3.06+/-0.62)x10(-3), respectively. FQ-PCR revealed significant differences in the expression level of Twist among HCC cell strains with different metastatic potentials. It was concluded that high expression level of Twist was closely associated with more aggressive behaviors of HCC. Twist provides a novel indicator for HCC metastasis.
Carcinoma, Hepatocellular/*metabolism ; Cell Line, Tumor ; DNA, Complementary/metabolism ; Dose-Response Relationship, Drug ; Gene Expression Regulation, Neoplastic ; Liver Neoplasms/*metabolism ; Neoplasm Metastasis ; Nuclear Proteins/*biosynthesis ; Polymerase Chain Reaction ; RNA/metabolism ; Twist Transcription Factor/*biosynthesis

OBJECTIVE: To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury (TBI). METHODS: In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version (CCMD-3). RESULTS: Fifty-two subjects (13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature, injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model (OR = 0.044, 95% CI: 0.017-0.114; OR = 2.145, 95% CI: 1.201-3.832, respectively). CONCLUSION The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury.
Brain Injuries/psychology* ; Humans ; Psychotic Disorders/etiology* ; Risk ; Syndrome

Objective To analyze the etiology of pseudoachalasia.Methods Patients who were diagnosed as having pseudoachalasia in Endoscopy Center of The Affiliated Zhongshan Hospital of Fudan University from September 2010 to June 2015 were retrospectively analysed.Results A total of 12 patients were enrolled in this study,6 males and 6 females.The median age,median disease duration and median Eckcardt score was 54.5(24.0～71.0) years old,2.5(0.2～ 10.0) years and 4(3～9),respectively.Seven cases were caused by malignant tumors,2 had benign tumors,and 3 peptic stricture.Conclusion The most common cause of pseudoachalasia is malignant tumors.Accurate diagnosis relies on the comprehensive medical history and complete examinations.