Poor communication between medical staff and patients is the main cause of medical disputes,and the clear emotional recognition and reasonable response of the patient needs psychology training and practice.Balint groups can create a good support environment and is an effective way to improve the communication ability and professional growth for medical staff.

Due to the shortcomings of traditional medical professionalism education,coupled with the impact of the reality,medical students' professional spirit produced some phenomenon in clinical practice such as weak professional faith,lack of professional value,poor career cognitive and so on.If medical professionalism education wants to make mental shaping function in medical students who are in the clinical practice,the traditional classroom teaching must be combined with Internet technology and thinking.On the one hand,Internet renovation must be applied to teaching system of systematic classroom teaching,teaching content of practicality,and extension of classroom,and so on.On the other hand,it should vigorously explore new way of Internet learning such as Moocs,micro-course online video,Network teaching center platform,live courses,and so forth.At the same time,it should pay attention to the recessive educational form,establish a perfect evaluation mechanism,attaches great importance to the subjectivity of entity class teaching and the combination of Internet in the process,and explore the Internet plus mode of medical professionalism education together.

Through expounding the definition of appreciate inquire,this paper discussed its principles when usedin medical humanities education including constructionism,simultaneity,poetry,preconception and optimism.Guided by optimistic themes,the benign development of medical humanistic education was realized by 4D circulation mode (discovery,dream,design,andrealization) of appreciative inquiry summit talks.

This article reviewed the digestive system characteristics,enteral nutrition style,milk choice,the starting time of enteral nutrition,the velocity of milk volume increased and the ideal growth velocity of very low birth weight infants.The aim was to investigate the effect of the different starting time of enteral nutrition on their digestive function and the growth velocity,in order to find the suitable starting time of enteral nutrition,providing the basis for clinical enteral nutrition program of very low birth weight infant.

Objective To investigate the incidence of urological malignancy in renal allograft recipients and explore the mechanism of increased incidence in China and the management. Methods A retrospective study was performed on 22 patients with urological malignancy in renal allograft recipients between 1978 and 2010. Results Twenty-two cases of urological malignancy were diagnosed by pathologic evidence, including 9 cases of transitional cell carcinoma (TCC) of bladder, 1 case of squamous cell carcinoma of bladder, 1 case of adenocarcinoma of bladder, 1 case of TCC of pelvis, 1 case of TCC of bladder and pelvis, 1 case of TCC of ureter complicated with adenocarcinoma of bladder, 2 cases of TCC of ureter, 2 cases of TCC of ureter and bladder, 3 cases of clear cell carcinoma of kidney, and 1 case of undifferentiated carcinoma of kidney. All the malignancies belonged to native organs. All the patients suffering bladder cancer had normal function of allograft. Five patients with TCC of pelvis or ureter survived and 2 cases died early after operation. All the patients suffering renal carcinoma deceased within 6 months after diagnosis. One-year survival rate was 73. 7 % after the diagnosis of urological malignancy. Conclusion Urological malignancy ranked highest in malignancy in renal allograft recipients, and rare pathological types of urological malignancy in non-renal allograft recipients are often demonstrated. The strategy of treatment should take consideration of the relationship between the usage of immunosupressive agents and the preservation of allograft function. It is critical for the therapy of malignancies to possess satisfactory allograft function. The prognosis of renal cell carcinoma is poor.

ObjectiveTo evaluate the correlation between ultrasound detected fetal heart abnormality and chromosomal abnormality.Methods The data of 3307 cases of prenatal fetal echocardiography and karyotype analysis results were retrospectively analyzed.The correlation between heart abnormality and chromsomal abnormality was analyzed.ResultsIn 3307 cases d pregnant women,194cases (5.87％) were found signs of fetal heart abnormality,and 3113 cases (94.13％) were not found any sign of fetal heart abnormality.And 124 cases(3.75％) were found chromosomal abnormality.The rate of chromosomal abnormality in fetus with heart abnormality was higher than that in fetus without heart abnormality[ 19.59％ (38/194) vs.2.76％ ( 86/3113 ),P ＜ 0.01 ],the relative risk ratio was 7.0903.One hundred and twenty-four cases of chromosomal abnormality in the 18-three-body(42 cases) and 21-three-body(36 cases) were the most common.ConclusionsFetal heart abnormality incidence of chromosomal abnormality is high relatively.When the signs of heart abnormality are found,it is suggested that the fetus should examine karyotype analysis.

Objective To investigate the expression and significance of intermedin (IMD) and its.receptors CRLR,RAMP1,RAMP2 and RAMP3 in cancer tissues of patients with non-small cell lung cancer.Methods The mRNA gene expressions of IMD,CRLR,RAMP1,RAMP2 and RAMP3 were detected by realtime quantitative RT-PCR in cancerous and para-cancerous tissues from 27 patients with lung cancer.Results Real-time quantitative PCR detection results showed that the expression of IMD,CRLR,RAMP1,RAMP2 and RAMP3 in cancer tissues were [(59±7.9)×10-8,(96±2.7)×10-6,(29±3.9)×10-9,(14±2.6)×10-6,(65±1.1)×10-6]which were higher than those in adjacent tissues[(40±4.7)×10-10,(21 ±3.9)×10-6,(53±7.8)×10-10,(64±1.9)×10-8,(36±1.3)×10-9] to some extent (all P ＜ 0.05); the higher expression of RAMP3 was found is higher expressions than RAMP1 and RAMP2 in cancer tissues (all P ＜ 0.05).Conclusion The expressions of IMD and its receptors in cancer tissues are higher than those in paracancerous tissues.IMD may play an important role in the development of cancer by activate RAMP3 which is the most high expressed receptor in cancer tissues.Therefore,it might be helpful for the investigation of new gene thereapy in non-small cell lung cancer.

The optimal bariatric surgery is still not acquired although the obesity epidemic has become a worldwide problem. The recentness studies on obesity focused on mass balance regulated by central nervous system, in which an important circuit is vagus nerve. This review provides progress on obesity mediated by vagus nerve simulation and vagal blocking.

Objective To summarize the clinical experience in treatment of malignant tumors of renal allograft recipients. Methods A retrospective study was performed on renal allograft recipients who received immunosuppressive treatment at least half a year between 1978 and 2005. Results Fifty-eight cases of tumors were found in 1812 cases undergoing renal transplantation, 50 cases of them who had complete clinical data were included into analysis. Forty-four cases, that included 19 cases in rological system, 14 cases in digestive system, 5 cases in blood system, 6 cases in other systems, were diagnosed as having malignant tumors by pathological analysis. Most of them were treated with surgery. One-year survival rate was 68.0% after the diagnosis of malignant tumor. The longest survival time was 6.5 years. Most of the survivals possessed normal function of allograft. Conclusion Systemic follow-up is important for renal allograft recipients who suffered malignant tumors. Surgical operation is still the main therapy for those solid tumors. It is critical for the therapy of malignancies and quality of life to possess satisfactory allograft function. The strategy of treatment should take consideration of the relationship between the decrease dose of immunosuppressive agents and the preservation of allograft function.

Objective Gamma amino butyric acid (GABA) signaling pathway related genes mRNA expression and promoter methylation of GABRB2 gene in peripheral blood were investigated to explore the mechanisms involved in schizophrenia (SZ) and antipsychotics treatment. Methods DNA was isolated from blood samples of 53 SZ patients and 53 gender-and age-matched healthy controls. 12 out of 25 SZ patients were followed 8 weeks antipsychotic treatment. The quantitative GABRB2 promoter methylation was analyzed using the high-throughput mass spectrometry on matrix-as?sisted laser desorption/ionization time-of-flight (MALDI-TOF) mass array before and after treatment. Results The GA?BRB2 promoter methylation pattern of case and control group was not significantly different (P>0.05). However, signifi?cant differences of the methylation levels of CpG_28 in the GABRB2 promoter between two groups were found in males [(0.215±0.084) vs. (0.264±0.103), P<0.05]. After 8 weeks antipsychotics treatment, a significant decrease of GABRB2 pro?moter methylatin was detected in the patients [(0.088±0.037) vs. (0.121±0.063), P<0.01]. Conclusion A down regulation of GABRB2 promoter methylation in blood of SZ patients after-treatment supports that GABRB2 promoter methylation in blood may be associated with the mechanisms of antipsychotics treatment in SZ.