Professional personality is characterized by stability and plasticity,and it should make the entry point of the cultivation of medical students' professional personality on the training of doctor-patient communication skills.Meanwhile,doctor-patient communication skill is an important factor of the medical professional personality.This paper discussed the cultivation of doctor-patient communication skills among medical students from the perspective of analysis of doctor-patient communication obstacles.It should improve the doctor-patient communication skills of medical students and shape healthy medical professional personality,taking the education of cognition,emotion,will,and behavior as pathways.

The distribution of hepatitis B virus genotype in Hubei province and its clinical significance were investigated. HBV genotypes of 276 patients were detected by PCR-microplate sandwich hybridization-ELISA technique. The level of HBV DNA was detected by using PCR-fluorescence quantification test. Among 276 patients, there were 78 cases of HBV asymptomatic carriers, 110 cases of chronic hepatitis B (CHB), 62 cases of severe hepatitis (SH) or liver cirrhosis (LC) and 26 cases of hepatocellular carcinoma (HCC). The genotypes of HBV included C, B, mixtures (B+C, B+D, C+D) and D, accounting for 55.8%, 25.4%, 16.7% and 2.1% respectively. The average level of HBV DNA in genotypes C, B, mixtures and D was 1.20x10(6), 7.81x10(4), 3.26x10(5) and 5.01x10(4) copies/mL respectively. The ratio of SH, LC and HCC in genotype B, C and mixtures was 20%, 30% and 48% respectively. Statistical analysis revealed the percentage of genotype mixtures infection was significantly higher than that of genotype B infection. There was no significant difference in the percentage between genotype B and genotype C or between genotype C and mixtures. The distribution of genotype B, C and mixtures in SH, LC and HCC was significantly different. The frequency of HCC was zero in patients with co-infection. Genotype D was only related with SH and LC. The increased ALT could be converted to categorical grades of severity. From mild, moderate to severity, the prevalence of genotype C showed an opposite trend, although no statistically significant difference was observed. The HBeAg positive rate was higher in patients with genotype C infection than in those with genotype B, especially in the patients whose ages were from 31 to 40 years old. Compared with genotype B, genotype C showed a higher HBeAg positive rate in patients with SH and LC. The percentage of SH, LC and HCC was higher in patients with genotype C and mixtures infection. On the contrary, the percentage of genotype B was lower. The HBeAg positive rate in patients with genotype C infection was higher than those with genotype B infection. Genotype C and mixtures may be associated with development of severe liver disease.

Objective To explore the relationship between apolipoprotein E gene polymorphism and cerebral infarction in Taishun county.Methods Determination of 112 cases of Taishun Siqian cerebral infarction patients and healthy persons 88 cases of ApoE gene polymorphism,and the cerebral infarction patients were admitted to the hospital for different period of time after the NIHSS score.Results The cerebral infarction group and the control group were ApoE -/3 genotype most were 70.5%(79 /112)and 63.6%(56 /88),both had significant difference(P >0.05);The cerebral infarction group and the control group in terms of ApoE -up to 3,respectively 82.1%(92 /112)and 75.6%(66.5 /88),both had no significant difference (P >0.05).The cerebral infarction group epsilon 4 to 9.8%(11 /112),and was significantly higher than that of the control group 4.0%(3.5 /88);E2 was 6.2% (7 /112), which was significantly lower than that of the control group [19.3% (17 /88)],the differences were significant (χ2 =6.189,7.970,all P <0.05).Carrying ApoE -4 of the cerebral infarction patient each time period at the time of admission,admission 7d and 14d NIHSS scores were not carrying epsilon 4 patients increased significantly (t =7.853,6.185,5.165,allP <0.05);and at each time point carrying epsilon 2 gene in patients with and without carry-ing epsilon 2 patients NIHSS scores had no significant difference (P >0.05 ).Conclusion Cerebral infarction patients ApoE gene polymorphism and disease progression and prognosis are closely related,ApoE -4 Taishun Siqian cerebral infarction patients predisposing factors.At the same time,the detection of apoE genotype and NIHSS score is helpful to the prognosis of the patients.

Objective To investigate the regulation of immune function in patients with acquired immune deficiency syndrome (AIDS) by the secretion of T cell 1 (Th1) gamma interferon gamma (IFN-γ) in patients with acquired immune deficiency syndrome. Methods From January 2011 to January 2014, 20 cases of laboratory-confirmed AIDS patients were collected for research. Patients with AIDS received highly active anti-retroviral therapy (HAART group), while 20 healthy volunteers were selected as control group. Before receiving highly active anti-retroviral treatment in six months and 12 months , the patients with AIDS were collected in blood study of peripheral blood mononuclear cells (PBMC) in separated culture group and IFN-γ co-culture group for testing culture differential expression of cytokines and immune cells in solution. Results Before treatment in 6 months and 12 months , the supernatants in the cultured alone group and IFN-γ co-culture group by IL-12, IL-21 levels were significantly lower than that in the healthy group (P < 0.05); After treatment in 6 months and 12 months , the supernatants in the IFN-γ co-culture group by IL-12 and IL-21 levels were significantly higher than that in the cultured alone group (PP < 0.05). Before treatment in 6 months and 12 months,the level of IP-10 and CD4 + CD25 + Foxp3Treg cells in the cultured alone group and IFN-γ co-culture group, were significantly higher than the healthy group (P < 0.05); After treatment in 6 months and 12 months, the supernatant in the IFN-γ co-culture group was significantly higher than the average in the cultured alone group in IP-10; CD4 + CD25 + Foxp3Treg cells in the IFN-γ co-culture group were significantly lower than that in the cultured alone group (P < 0.05). Conclusion Patients with AIDS received highly active anti-retroviral therapy can improve the immunity. IFN-γ may further stimulate the secretion of immune cytokine in patients with AIDS.

Objective To explore the relationship between cervical lesions in patients with high -risk human papilloma virus(HPV)infection and serum interleukin -1 beta(IL -1 ),interleukin 2(IL -2),interleukin 10(IL -10).Methods 180 cases of cervical lesions were treated in our hospital from August 2013 to August 2015. Among them,105 cases were infected with HPV,and 75 cases were not infected by HPV.The serum levels of IL -2, IL -10 and IL -1βwere observed in two groups,and compared the levels of serum IL -2,IL -10 and IL -1βin patients with different DNA hr -HPV load,the correlation between DNA hr -HPV load and IL -1β,IL -2 and IL -10 levels was analyzed.Results The levels of IL -1β,IL -10,IL -2 were (0.85 ±0.23)ng/L,(182.35 ± 10.02)ng/L,(38.97 ±5.23)ng/L in patients with HPV infection,the levels of IL -1β,IL -10,IL -2 in patients without HPV infection were (0.62 ±0.18)ng/L,(305.42 ±11.13)ng/L,(25.18 ±3.16)ng/L.The levels of IL -1β,IL -10 were significantly higher in HPV group than in without HPV infection group,the level of IL -2 in HPV group was significantly lower than that of uninfected HPV group,and the differences were statistically significant (t =7.222,20.328,-7.558,all P <0.01).There were significant differences in the load of DNA hr -HPV between different pathological changes of cervical lesions,and the DNA hr -HPV load increased significantly with the increase of the degree of disease(t =6.214,19.097,33.906,6.952,6.274,all P <0.05).IL -1βand IL -10 levels from high to low were DNA hr -HPV load volume >1 000,100 -1 000 and <100,IL -2 levels from high to low were DNA hr -HPV load <100,100 -1 000 and >1 000.DNA hr -HPV load was positively correlated with serum IL -1βand IL -10 levels in patients with cervical lesions and HPV infection(r =0.452,0.422,P =0.035,0.019),and nega-tively correlated with IL -2 level(r =-0.398,P =0.027).Conclusion hr -HPV infection is closely correlated with serum IL -1β,IL -2,IL -10 levels in cervical lesions patients,IL -1,IL -2 and IL -10 can be used as impor-tant index for clinical monitoring.

Objective To explore the lymphcyte subsets distribution in cerebrospinal fluid in patients with HIV infection ,and to investigate the clinical significance of the lymphocyte subsets in cerebrospinal fluid in HIV central nervous system complication . Methods 34 patients with HIV infection ,including 20 patients without nervous system symptoms (simple HIV group) and 14 pa‐tients with nervous system symptoms (neurological HIV group) ,and 15 cases of healthy people (control group) were selected . Flow cytometry was used to detect lymphocyte subsets ,and immunoturbidimetry was used to detect the level of IgG in cerebrospinal fluid .Results The percentage of CD8+ T cells was higher and percentage of CD4+ T cells was lower in the simple HIV group and neurological HIV group than those in the healthy control ,with statistically significant differences (P<0 .01) .The level of IgG in pa‐tients with HIV infection was higher than that in the healthy control group (P<0 .01) .While no significant difference were found in the percentage of B cells and NK cells among the there group (P>0 .05) .There were also no significant differece between the sim‐ple HIV group and neurological HIV group in the ratio of each lymphcyte subset in cerebrospinal fluid (P>0 .05) .Conclusion The immune disorder in cerebrospinal fluid in patients with HIV infection may appear in the early time before the nervous system com‐plication .The changing trends of lymphocyte subsets are consistent with the peripheral blood ,which demonstrate that the T lym‐phocyte subsets may be correlated with the nervous system symptoms of HIV .

ObjectiveTo explore the effect of the individualized intervention for the anxiety-depression after cardiovascular diseases. Methods80 inpatients with cardiovascular diseases were surveyed with Hospital Anxiety and Depressions Scale (HAD). The patients with anxiety-depression received individualized psychological intervention. Results14 of them suffered anxiety-depression. 13 cases recovered after the intervention. ConclusionThe individualized psychological intervention can improve anxiety-depression in the inpatients with cardiovascular diseases.

Objective To study the value of flow cytometry in identifying metastatic CK positive and negative nonhematopoietic neoplasms in bone marrow. Methods Twenty-six cell lines representing ten epithelial neoplasms, one lymphoma cell line and one human T cell lymphoblast-like cell line were purchased from American Tissue Culture Collection. From July 2009 to June 2010, five nonhematopoietic neoplasms,fifteen hematopoietic neoplasms and fifteen control patients with complete remession after hematopoietic stem cell transplantation were collected in Beijing Daopei Hospital. Cryopreserved cell lines were thawed and cultured until they entered log phase. After permeabilization, cell lines were analyzed by staining with cytoplasmic CK-FITC antibody using four-color flow cytometer. The percent CK positivity was measured by comparing with negative control. Bone marrow samples were stained with membrane and cytoplasmic antibodies according to our routine methods. Based on lineage markers and blast markers as well as CK expression, the relevant hematopoietic diseases were diagnosed or excluded according to 2008 World Health Organization diagnosis standards. Results All epithelial neoplasm cell lines expressed CK, with average positive percentage 81.1%. All the lymphoid tumor cell lines didn't express CK. Two epithelial neoplasms were CK positive, 100. 0% in thyroid carcinoma and 98. 2% in lung carcinoma, respectively. Hematopoietic tumor and control samples didn't express CK. They expressed relevant hematopoietic markers, such as CD45 as well as lineage markers, or CD138 and cytoplasmic immunoglobulin light chain. Three nonepithelial nonhematopoietic neoplasms didn't express CK. CK positive or negative nonhematopoietic neoplasms didn't express hematopoietic markers such as CD45, HLA-ABC and HLA-DR DP DQ, as well as lineage specific markers. Besides, CK positive might be helpful to suggest epithelial origin. Conclusion Flow cytometry with hematopoietic markers and CK can effectively exclude hematopoietic tumor and identify metastatic CK positive and negative nonhematopoietic neoplasms in bone marrow.

Objective To analyze the clinic data of peripheral CIK cell increased abnormally in adults and discuss the function of the laboratory indexes on disease diagnosis ,monitoring and therapeutic intervention .Methods The peripheral blood of patients was collected to analysis .The flow cytometry instrument was used to detect lymphocyte subgroup .every patient was conducted bio‐chemical analysis ,function of blood coagulation tests and examination of marrow cell and the patient′s medical record was analyzed retrospectively .Results The total number of leukocyte and the percentage of lymphocyte in peripheral blood of patient were in‐creased;immunophenotyping results showed that lymphocytes was mainly T lymphocyte ,T8 cell number was increased and number of T4 cell was decreased;CIK(CD3+56+ ) cells were in the majority .the number of CIK cells was decreased after treatment and ranged from 28 .6% to 59 .7% .there was no obvious anomaly in examination of marrow cell before and after treatment .TNF‐α,IgM were increased mildly ,C4 was decreased mildly ,and other indicators were no obviously abnormal .Conclusion It is the first time that cases with CIK cells idiopathic increased .The monitoring of flow T lymphocyte subgroup can provide clinical diagnosis ,effect monitoring and it is worth to promote .

Objective: To investigate the effect and safety of interleukin-2 combined with cisplatin in the treatment of malignant pleural effusion.Methods: Totally 86 patients with malignant pleural effusion were randomly divided into the observation group (44 cases) and the control group (42 cases).The control group was treated with cisplatin, and the observation group was treated with interleukin-2 additionally.The treatment course was 3 weeks.The ascites relief, quality of life, survival status and tumor markers before and after the treatment, and the adverse drug reactions were compared between the groups.Results: The total ascites remission rate and the effective rate in the observation group were significantly higher than those in the control group (P<0.05).Compared with those before the treatment, CEA, CA19-9 and CA450 decreased significantly after the treatment in both groups (P<0.05), those in the observation group were significantly lower than those in the control group (P<0.05).After the treatment, the physiological function, physiological occupation, emotional function, body pain and the other life quality scores in the observation group were significantly higher than those in the control group (P<0.05).The 24-month survival rate in the observation group was significantly higher than that in the control group (P<0.05).There were no significant differences in adverse drug reactions between the groups (P>0.05).Conclusion: Interleukin-2 combined with cisplatin can effectively relieve ascites and improve quality of life, which can also prolong the survival time of patients.