Moral education of medical students is facing many puzzles.In particular,the ecological-moral education of medical students is still just getting started.We should focus on the awareness of teachers,teaching materials,legal system construction and other aspects in order to strengthen the ecological-moral education of medical students.

It was generally considered that patients with chronic HBV infection and normal alanine aminotransferase (ALT) level had no or mild liver pathological changes,but in recent years,a large number of studies have found that such patients may also have marked inflammation and fibrosis in the liver.This article discusses the association between clinical features and liver pathological features in patients with chronic HBV infection and normal ALT level and points out that age,sex,HBeAg status,HBV DNA load,ALT level,and liver stiffness measurement are associated with liver pathological changes.Monitoring of these clinical indices helps with early detection of liver pathological changes in patients with chronic HBV infection and normal ALT level.

Objective The purpose of the study was to investigate the causes of hemoptysis and ex-plore the diagnostic procedures for hemoptysis in children. Methods The medical records of 42 children with hemoptysis admitted to the Respiratory Department of Hunan Children′s Hospital from June 2012 to June 2015 were collected by a retrospective study. The causes of hemoptysis were classified by pathogenesis,and the diagnosis of hemoptysis was evaluated in this study. The final diagnosis was divided into clear diagnosis and the cause was unknown. Results A total of 41(97. 6%) cases were diagnosed,1(2. 4%) case was not diagnosed. In 42 cases of hemoptysis,infection was the main cause of the disease,including 8(19. 0%) cases of pneumonia and 5(11. 9%) cases of bronchitis,and the following causes were bronchial artery fistula(10/42,23. 8%),idiopathic pulmonary hemosiderosis(8/42,19. 0%),bronchiectasis(5/42,11. 9%),pulmonary vascular malformation with pulmonary hypertension(3/42,7. 2%),pulmonary tuberculosis(2. 4%),bronchi-al foreign body(1/42,2. 4%) respectively. Thirteen cases of respiratory tract infection,and 5 cases of bron-chiectasis were diagnosed by chest CT,10 cases with pulmonary artery fistula were diagnosed by digital sub-traction angiography,8 cases of pulmonary hemosiderosis,1 case of pulmonary tuberculosis,and 1 case with bronchial foreign body were diagnosed by fiberoptic bronchoscopy. Three cases of pulmonary vascular malfor-mation and pulmonary hypertension were diagnosed by row helical CT angiography and cardiac color ultra-sound. Conclusion Hemoptysis in children is a heterogeneous group of respiratory disorders. Most causes could be identified by using the diagnostic procedures. Other factors, including medical history, CT, fiber bronchoscopy,multidetector CT angiography, cardiac color ultrasound and digital subtraction angiography, play important roles in the diagnosis of hemoptysis in children.

Objective To analyze results of blood test for first‐time blood donation volunteers and mutual‐aid blood donors in Anyang area ,in order to improve cognition of characteristics of different blood donors and safety of blood transfusion .Methods A total of 31 363 cases of first‐time blood donation volunteers(first‐time blood donation group) and 1 046 cases of mutual‐aid blood donors(control group) from January to December 2013 in Anyang area were collected .The results of blood tests were compared and related factors affected qualities of blood were analysed .Results A total of 1 160 cases of donors in the first‐time blood donation group were failed to pass the blood test and the unqualified rate was 3 .70% ,in the control group 17 cases of donors failed to pass the blood test and the unqualified rate was 1 .62% ;the difference was statistically significant (P<0 .05) .The test results of unqual‐ified blood samples shown that in the first‐time blood donation group the constituent ratios of alanine aminotransferase(ALT) ,anti‐body to hepatitis C virus(anti‐HCV) ,antibody to human immunodeficiency virus(anti‐HIV) ,hepatitis B surface antigen(HBsAg) and syphilis positive blood donors were 37 .67% ,12 .59% ,8 .79% ,31 .38% and 9 .57% respectively ,and those in the control group were 29 .41% ,17 .65% ,5 .88% ,35 .30% and 11 .76% respectively .The constituent ratio of ALT positive blood donors between the two groups had statistically significant difference(P<0 .05) .There were statistically significant differences in gender ,age and occu‐pations between unqualified blood donors in the two groups(P<0 .05) .Conclusion The first‐time blood donation volunteers might have relatively higher unqualified rate in blood test ,it is necessary to enhance blood screening and management before transfusion , in order to ensure safety of blood transfusion .

Survivin has been identified recently as a unique member of the inhibitor of apoptosis protein family. It is expressed during fetal development and in all common human cancers, but not in normal tissues. It can inhibit apoptosis induced by a variety of factors and play an important role during angiogenesis. Being a universal tumor-specific antiapoptosis inhibitor, survivin may serve as a potential target for gene-protein-based therapy of tumor.

Objective To investigate the caries prevalence of the first permanent molars among pupils in Zhongshan City in order to improve the level of oral health and to provide the direction and evidence for prevention and treatment strategies of caries.Methods Oral first permanent molars were examined among 1731 pupils aged from 7 to 12 years old in Zhongshan Experimental Primary School. The data were analyzed by SPSS 10 0 for Windows.Results The mean caries prevalent rate of first permanent molars was 32 62% among 1731 examined pupils with the mean DMFT of 0 48.Thefemales’meancariesprevalentrateandDMFToffirstpermanentmolarswerebothhigherthanmales’ .Theseven -yearoldgrouphadthelowest cariesprevalentrateandDMFTthanotheragegroups .Theocclusalsurfacewasthemostcommonsurfaceamongthecariesfirstpermanentmolarwith percentageof 73 5 2 .Conclusion Toprotectthefirstpermanentmolar ,weshouldreinforceoralhealtheducation ,regularexaminationoralhealth ,car ryingoutthefitandfissureseal,andfillingthedecayedteethintime .

OBJECTIVE: To optimize the extraction technology of Huanggan decoction. METHODS: The extraction technology of Huanggan decoction was optimized by L9(33) orthogonal design with the concentration of alcohol, the amount of solvent and the extraction time as factors taking the contents of chlorogenic acid as indexes. RESULTS: The optimal extraction process was as follows: adding six and five-fold of 70% alcohol, extracting for 60 min and 45 min. CONCLUSION: The extraction technology has been proved to be reasonable, simple and feasible, and it provides theory evidence for production.

0.05).Both femur bone lengths in 3.2mm group were shorter than those in the 1.5 mm and 2.2 mm groups.No abnormalities of cartilage cells were observed,without obvious histological evidence of inflammation;only nonspecific foreign body reaction and macrophage infiltration were noticed.Conclusion: PDLLA rod itself does not cause any disturbance to the development of the epiphyseal plate.The growth disturbance of epiphyseal plate depends on the area of injured epiphyseal plate;a injured area over 7% of epiphyseal plate may cause the growth disturbance of epiphyseal plate.

Objective To determine the median effective dose of remifentanil for maintaining the tolerance to ProSeal laryngeal mask airway in awake and spontaneously breathing patients.Methods Sixty ASA Ⅰ orⅡpatients aged 20-55 years old were recruited.Sixty patients was randomized into six groups with 10 case each Remifentanil was infused in a dose of 0.061,0.048,0.039,0.03,0.025 or 0.02μg·kg~(-1) 5 minutes after inserting PLMA.Single dose of remifentanil 0.25/μg/kg was given before continuous intravenous infusion.Respiratory response subscore of comfort scale(CSRR)and Ramsay sedation scale(RSS)were recorded after 25 minutes.ED50 was calculated.Results The ED50 of remifentanil for ProSeal laryngeal mask airway tolerance was 0.027μg·kg~(-1)(95%CI:0.023-0.030μg·kg~(-1)·min~(-1)in awake and spontaneously breathing patients.Conclusion The patients tolerate stimulus of laryngeal mask with a low dose continuous intravenous infusion of remifentanil in awake.and can maintain the hemodynamics stable.

Objective To investigate the effects of esmolol and remifentanil on minimum alveolar concentration (MAC) of isoflurane in patients undergoing upper abdominal surgery. Methods One hundred ASAⅠorⅡpatients aged 18-60 yr undergoing upper abdominal surgery under general anesthesia were randomly divided into 5 groups (n=20 each):group A isoflurane alone; group B isoflurane + large dose esmolol; group C isoflurane + remifentanil; group D isoflurane + remifentanil + small dose esmolol and group E isoflurane + remifentanil + large dose esmolol. In group B and E esmolol was infused at 250 μg·kg-1·min-1 after a loading dose of 1 mg/kg (large dose esmolol). In group D esmolol was infused at 50 μg'kg-1·min-1 after a loading dose of 0.5 mg/kg (small dose esmolol). In group C, D and E remifentanil was infused at 0.05 μg·kg-1·min-1 after a loading dose of 0.25 μg/kg. As soon as the patients lost consciousness, tracheal intubation was facilitated with succinyl choline 1.5 mg/kg. The patients were mechanically ventilated (VT=8 ml/kg, RR 12 bpm, FiO2= 100% ). PET CO2 was maintained at 32-38 mm Hg and naso-pharyngeal temperature above 35.5℃. End-tidal isoflurane concentration was continuously monitored. If the patient moved his/her hand, foot, head or body within 60 seconds after skin incision was made the end-tidal isoflurane concentration was increased by 10% in the next patient; if the patient did not respond to skin incision the end-tidal concentration of isoflurane was decreased by 10% in the next patient. The initial end-tidal isoflurane concentration was 1.24% in group A and B, 0.78% in group C, D and E. Results The MAC of isoflurane was 1.24% ± O.14%, 1.22%±0.09%, 0.77%± 0.05%, 0.75% ±0.06%, 0.60%±0.05% in group A, B, C, D, E respectively. Remifentanil significantly reduced MAC of isoflurane in group C, D and E as compared with group A. The MAC of isoflurane was significantly lower in group E than in group C. Conclusion Remifentanil infusion at 0.05 μg·kg-1·min-1 combined with large dose esmolol can reduce MAC of isdlurane by 52% in patients undergoing upper abdominal surgery.