Objective:To explore the effect of family education in medical ethics education, further to study on the influence of parenting pattern on medical students′ competitive attitude. Methods: A sample of 550 college students was selected with the method of stratified random sampling. The subjects were invested using Egna Minnan Barndoms Uppfostran and Competitive Attitude Scale. Results: Good parenting pattern contributes to the form of benign com petitive attitude. Parents′denial and mother′s favor have predictive effect on benign competition atti-tude. Father′sdenial, father′s over-protection, and mother′s over-interference have predictive effecton vicious competition attitude. Conclusion:In the family education of medical students ,parents should change the education concept in order to form a good competitive attitude.

Objective To determine the special diagnostic superiority of PCT test over CRP and WBC count test for neonatal sepsis .Methods 46 newborn inpatients diagnosed neonatal sepsis in the neonatal department of Dalian Central Hospital from Janu‐ary 2013 to January 2014 and contemporaneous 50 uninfected neonatal inpatients as control group were collected .The PCT and CRP concentrations and WBC count were simultaneously measured at admission .Results The WBC count had no statistical difference between the two groups ,but the PCT and CRP detection showed the statistical difference between the two groups (P<0 .01) ,the sensitivity of PCT test was 87% ,which was significantly higher than 63% of CRP test ,but the specificity of PCT test was 87% , which was slightly lower than 90% of CRP test .The Youden index of PCT test was obviously higher than that of CRP test and WBC count .Conclusion PCT is superior to CRP and WBC count in diagnosing neonatal sepsis .

Purpose]To explore the paste treated postpartum body pain in curative effect. [Methods]By fol owing professor Zhang diagnosis ,the paper summarized with herbal paste for gynecology as the methods of treatment of postpartum body pain, and listed 2 proven cases.[Result]Postpartum woman is weak in both qi and blood, paste has an advantage in taking the fast-rising tonifying deficiency and curing correction,and it is superior to the liquid form, convenient for long-term use, paste treating pantalgia after childbirth in the disease has a unique advantage, and because of its smal side effects, especial y suitable for women. [Conclusion]Herbal paste in chronic disease of department of gynaecology modulation has a unique advantage due to the efficacy of comprehensive,and takes into consideration the physiological and pathological features of menstruation,leucorrhea,pregnancy and delivery. She focuses on the individual syndrome differentiation,and attaches great importance to the balances of relationship between pathogenic factors and healthy qi,yin yang heat cold,viscera and meridians qi blood,to achieve the aim of preventing and treating diseases,regulating the body ,and is worth promoting.

Objective To study the inter-allelic recombination event occurring in the HLA-C locus in a family of Chinese Han nationality, and to evaluate the molecular genetic background of the new HLA allele.Methods Peripheral blood samples were collected from a Chinese leukemia woman patient, as well as her healthy parents and two brothers.HLA-A, C, B, DRB1 and DQB1 alleles were typed by high-resolution PCR-sequence-based typing (SBT) method using Atria Genetic AlleleSEQR HLA SBT kits.The Protrans S4 HLA-C single allele-specific sequencing strategy was used to separate the two HLA-C alleles and to determine novelty of the allele.The full length sequences of HLA-C alleles of the patient and her parents were further analyzed using cloning and haplotype sequencing method. The HLA five loci linked haplotypes and the recombination site were analyzed by family study, meanwhile the full length sequences of the five HLA-C alleles were compared with the IMGT/HLA database by the program BLAST.Results The two haplotypes of the father and mother were a:A*0207-C*010201-B*550201-DRB1*090102-DRQ1*030302 and b:A*240201-C*120202-B*5201-DRB1*1502-DRQ1*0601, c:A*300101-C*060201-B*130201-DRB1*0405-DRQ1*0401 and d:A*110101-C*070201-B*4001-DRB1*080302-DRQ1*0601,respectively.The two brothers inherited their parent′s haplotypes a, d and b, c respectively.The two haplotypes of the patient were the maternal c and paternal recombinant a/b haplotype.The recombinant a/b haplotype A*240201-C*new-B*550201-DRB1*090102-DRQ1*030302, A*240201 came from the paternal haplotype b,while B*550201-DRB1*090102-DRQ1*030302 came from the other paternal haplotype a.When comparing the full length sequences of the HLA-C new allele with the father′s allele C*010201 and C*120202, it could deduce that the recombinant a/b haplotype derived from a recombination event occurring between the paternal chromosome 6 during meiosis.The crossover site was between genomic nt273 and nt330 of HLA-C alleles, which created a HLA-C new allele and the fifth haplotype of the family, and inherited it to the patient.The full length sequences of the new allele had been submitted to Genbank, and officially named C*0121 by WHO nomenclature committee.Conclusion This study demonstrates a rare inter-allelic recombination event occurring in the HLA-C locus within a Chinese Han family and illustrates the process of novel allele and haplotype, and provides direct theory for further studying the mechanisms of gene recombination and HLA polymorphism.

Capillary Leak Syndrome ; complications ; Cholestasis, Intrahepatic ; complications ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications

Objective To evaluate the effects of soybean protein and animal protein on renal function of patients with diabetic nephropathy.Methods In this Meta-analysis,literatures on the effects of soybean protein and animal protein on renal function of patients with diabetic nephropathy published during January 1980 and November 2011 were reviewed and analyzed quantitatively and synthetically by using Metaanalysis RevMan 5.0 software.Results Five case-control studies met the inclusive criteria and entered into random effect model.In comparison with animal protein,soybean protein significantly improved endogenous creatinine clearance rate (weight mean difference (WMD) =-11.51,95％ confidence interval (CI)-16.37 to 6.65),proteinuria (WMD =-0.96,95％ CI-1.36 to-0.58),urine creatinine (WMD =-1.11,95％ CI-1.91 to-0.30),glomerular filtration rate (WMD =0.28,95％ CI-0.12 to 0.68),serum urea nitrogen (WMD =-0.20,95％ CI-0.60 to 0.19) and serum creatinine (WMD =-0.22,95％ CI-0.54 to 0.10).Conclusions Soy protein seems to have potential to improve urine creatinine clearance,urine creatinine,proteinuria and serum urea nitrogen.However,animal protein may contribute to increased glomerular filtration rate.

Acute kidney injury (AKI) is a serious clinical problem with high morbidity and mortality. Renal replacement therapy (RRT) is an important tool for treating patients with AKI. The 2011 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for AKI points out that RRT should be discontinued when renal function has recovered enough to meet the body needs or when RRT is no longer consistent with treatment goals. However, the specific reference index of weaning RRT is unclear. The guiding roles of traditional indicators such as urine output (> 400 mL/24 h), serum creatinine (SCr, decreasing trend), creatinine clearance (CCr, > 20 mL/min), and novel biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL), hepatocyte growth factor (HGF), interleukins (IL-6, IL-10), kidney injury molecule-1 (KIM-1), kynurenic acid, etc. for discontinuation of RRT in AKI patients were reviewed. Particularly, the importance of biomarkers for this purpose was highlighted.

Objective To observe the neuro-ophthalmological features of intracranial aneurysm.Methods 169 patients with intracranial aneurysm were retrospectively studied.45 patients, including 18 men and 27 women, had neuro ophthalmological symptoms or signs.Their average age was (56.21 ± 16.11) years and 32 (71.11％)patients' age was more than 50 years.The onset time ranged from 30 minutes to 20 years.20 (44.44％) patients' onset time was among 24 hours.CT, CT angiography, MRI, MRI angiography and cerebral digital subtraction angiography were performed alone or combined in all 45 patients.Visual acuity, pupil reflex and eye movement were examined.Clinical data including general condition, initial symptoms, neuro-ophthalmological changes, imaging data and treatment effects were recorded.Results 26.63％ of the 169 patients had neuro-ophthalmological symptoms or signs.There were 6 patients (13.33％) with neuro ophthalmological changes as their first manifestation and 39 patients (86.67 ％) with neurologic changes as first manifestation.Neuro-ophthalmological symptoms included vision loss (10 patients, 22.22％), diplopia (4 patients, 8.89％) and ocular pain (2 patients, 4.44％).The most common neuro-ophthalmological sign was pupil abnormality which was found in 31 patients (68.89 ％).The second most common sign was eye movement disorder (16 patients, 35.56％).The other signs included ptosis (8 patients, 17.78％), nystagmus (2 patients, 4.44％), exophthalmos (1 patient, 2.22％) and disappeared corneal reflection (1 patient, 2.22％).Imaging examination indicated that intracranial hemorrhage happened in 29 patients (64.44％).The most common neuro-ophthalmological features were pupil abnormality, eye movement disorder and vision loss in both patients with or without intracranial hemorrhage.The incidence of pupil abnormality was higher in patients with intracranial hemorrhage than that without intracranial hemorrhage, the difference was statistically significant (x2=7.321, P=0.007).Pupil abnormality and vision loss were common in patients with internal carotid artery aneurysm, and eye movement disorder was common in patients with internal carotid artery aneurysm and posterior communicating aneurysms.Conclusions Patients with intracranial aneurysm have different neuroophthalmological features.The most common features are pupil abnormality, eye movement disorder and vision loss.

OBJECTIVE To get knowledge of the distribution and drug-resistance of Stenotrophomonas maltophilia in our hospital and improve the level of diagnosis and treatment.METHODS The automatic drug sensitive test and the paper spreads medicine sensitive test were carried on to 162 strains of S.(maltophilia) with the index of the VITEK system.RESULTS In all clinical samples,S. maltophilia isolated from phlegm was the most(90%),then was from secretion and swab.The majority of 162 strains were multidrug resistant.But to the(trimethoprim)-sulfamethoxazole and ciprofloxacin,the drug resistance was low((20.4%) and 22.2%,respectively).CONCLUSIONS S.maltophilia is the prevalent pathogen of nosocomial infection in ICU.And most of it are(isolated) from phlegm.So use antibiotics correctly,(reduce) invasive examinations or treatments and strengthen drug-resistant monitoring,are helpful to prevent and control S.maltophilia nosocomial infection.

Objective To investigate the corelationship between proton pump inhibitors (PPI) and the incidence of hospital-acquired pneumonia (HAP) in abdominal surgical patients. Methods A total of 283 cases admitted from 2010 to 2014 were divided into PPI group (n = 326) and HRA group (n = 92). In PPI group, patients were divided into omeprazole subgroup (subgroup A, n = 146), lansoprazole subgroup (subgroup B, n = 102) and pantoprazole subgroup (subgroup C, n = 78) by the types of PPI. In HRA group, patients were divided into famotidine subgroup (subgroup D, n = 58) and ranitidine subgroup (subgroup E, n=34) by the types of histamine-2 receptor antagonist (H2RA). The incidence of stress ulcer bleeding (SUB) and HAP were calculated, while mechanical ventilation period (MV), ICU stay and 28-day-mortality were compared. Results There were lower incidences of SUB and HAP, shorter MV and ICU stay and lower 28-day-mortality in PPI group than those in HRA group (P < 0.05). In three subgroups of PPI group, there were no significant difference on incidence rate of SUB and HAP, as well as MV, ICU stay and 28-day-mortality. Conclusion The incidence rates of SUB and HAP are lower by using PPI than H2RA in abdominal surgical patients, as well as MV, ICU stay and 28-day-mortality. Different types of PPI have no effect on the incidence rate of HAP in abdominal surgical patients.