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.

OBJECTIVETo investigate the effect of 8-aminolevulinic acid (ALA) photodynamic therapy (PDT) on the cell proliferation, apoptosis and collagen secretion in keloid fibroblasts and to provide the theoretical base for ALA-PDT treatment of keloids.

METHODSFibroblasts from keloid patients were cultured to the third generation in vitro and incubated in 0, 1, 3, 6, 9 mmol/L of δ-aminolevulinic acid for 3 h in the darkness. Then they were exposed to 635 nm wavelength red light ( 30 J/cm2 ) and continued incubation 24 h after irradiation. CCK-8 assay was used to detect proliferation inhibition rate of fibroblasts. The content of hydroxyproline was measured by colorimetric method. The expression of p-Akt and programmed cell death 4 ( PDCD4) were detected by Western blot.

RESULTSThe inhibition rate of keloid fibroblasts were respectively 0, (8.30 ± 1.01)%, (29.48 ± 3.27)%, (52.01 ± 5.34)%, (79.99 ± 5.85)% with the presence of difference concentrations (0, 1, 3, 6, 9 mmol/L) of ALA. The content of hydroxyproline were respectively (9.540 0 ± 0.352 42), (6.242 5 ± 0.224 85 ), (5.107 5 ± 0.534 88), (3.490 0 ± 0.623 48), (2.945 0 ± 0.514 10) μg/mg. The relative expression of p-Akt were respectively 1, 0.75 ± 0.12, 0.52 ± 0.14, 0.41 ± 0.18, 0.32 ± 0.09. The relative expression of PDCD4 were respectively 1, 1.18 ± 0.19, 1.51 ± 0.22, 0.15 ± 0.30, 2.44 ± 0.22. The difference was statistically significant when compared the group of 1, 3, 6, 9 mmol/L with 0 mmol/L (P < 0.05).

CONCLUSIONSIn concentration within the range of 1-9 mmol/L, ALA could inhibit the proliferation of fibroblasts significantly, promote fibroblasts apoptosis and reduce the content of hydroxyproline in a dose-dependent manner, indicating that 8-aminolevulinic acid photodynamic therapy may be a potential treatment for keloid.

Aminolevulinic Acid ; pharmacology ; Apoptosis ; drug effects ; Cell Culture Techniques ; Cell Proliferation ; drug effects ; Collagen ; secretion ; Fibroblasts ; cytology ; drug effects ; secretion ; Humans ; Keloid ; drug therapy ; pathology ; Light ; Photochemotherapy ; methods ; Photosensitizing Agents ; pharmacology

Objective:To investigate the application of three-dimensional visualization technology in preoperative assessment of hilar cholangiocarcinoma. Methods:Thirty-eight patients with hilar cholangiocarcinoma who underwent surgery from March 2014 to April 2016 were enrolled in the retrospective study. Among the cases, an observational group of 18 patients had preoperative three-dimensional visualization surgical planning, while a control group of 20 patients did not have the visualization surgical plan. The preoperative diagnostic results were analyzed with the actual intraoperative findings. Related surgicall indicators between the two groups were compared. Results:No significant difference in the accuracy rates of longitudinal and vertical infiltration of cholangiocarcinoma between was observed the observational group and control group. While the vascular and ductal branching pattern of all patients are consistent with intraoperative findings, the coincidence rate was higher in the observational group than that in the control group (100%vs. 70%, P<0.05). The estimated liver volumes were also exactly consistent with the actual liver volume (r=0.986, P<0.001). In comparison with the control group, the average intraoperative blood loss and operative time of the observational group were significantly lower. However, the potential curative resection between the two groups exhibited no significant difference. Conclusion:Three-dimensional visualization technology can accurately complete the preoperative evaluation of hilarcholangiocarcinoma.

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.

Objective To investigate the difference in detection results of electrolytes and glucose among arterial blood plasma , venous blood plasma ,arterial blood serum and venous blood serum .Methods Arterial and venous anticoagulation blood and coagu‐lation blood were collected from 54 patients at the same time ,1 tube for each blood sample .The corresponding plasma and serum were isolated .The levels of K+ ,Na+ ,Cl-and glucose(GLU) were determined by using the Johnson VITROS 5600 automatic dry biochemical analyzer .The detection results were performed the comparative analysis by using the statistical method .Results When the sample was serum ,the concentrations of Na+ ,Cl- ,GLU and serum K+ had statistically significant difference between arterial and venous blood(P<0 .05) ,when the sample was plasma ,the concentrations of Na+ ,Cl- and GLU had statistically significance between arterial and venous blood(P<0 .05);but the K+ concentration had no statistically significant difference between serum and plasma(P>0 .05) .In addition ,the GLU and K+ detection results had statistical difference between arterial serum and plasma(P<0 .05) ,while the Na+ and Cl- detection results had no statistically significant difference(P>0 .05);similarly ,the GLU and K+ de‐tection results had statistical difference between venous plasma and serum (P<0 .05) ,while the Na+ and Cl- detection results had no statistical difference(P>0 .05) .Conclusion Some differences in the detection results of electrolytes and glucose exist among ar‐terial plasma ,venous plasma ,arterial serum and venous serum ,clinic should pay attention to make a difference among different types of sample and establish the suitable reference ranges .have certainly difference in different types of specimens even detected by the same system .So we recommend that appropriate reference range is necessary for various kinds of specimens .

From the beginning of the 20th century, Alois Alzheimer, a German doctor, discovered Alzheimer′s disease, so far, the isease-related research has been the focus of researchers all over the world. From Alzheimer's disease to mild cognitive impairment, then to subjective cognitive impairment, the attention phase of the disease is also being advanced. Subjective cognitive impairment, as a stage earlier than mild cognitive impairment, has important implications for the early diagnosis and intervention of Alzheimer′s disease.This article will summarize the research progress of conception and screening instruments for subjective cognitive impairment at home and abroad.

A novel approach of vaccination against cancer is to exploit dendritic cells (DC) as the best antigen presenting cells (APC) and actively immunize cancer patients with a sample of autologous or allogeneic DC primed with tumor antigens. DC vaccination is still at its early stage, however, valuable proofs of concept have been obtained with respect to the capacity of DC to expand cancer directed immune responses. The methods for preparing DC are being improved continuously, and there are many opportunities to improve efficacy at the level of DC biology. An increased number of clinical studies will drive the development of this new area. This paper reviews the production of dendritic cell tumor vaccines and their use in clinical trials, as well as emphasizes some unresolved questions in this immunotherapy.

Objective To analyze the clinical value of microRNAs applied in the early diagnosis of pancreatic cancer.Methods The expression of mir-155,mir-196a,mir-181a,mir-181b in three pancreatic cancer cell lines PANC-1,PaCa-2,AsPC-1 pancreatic cancer,normal pancreatic cells and plasmas of 100 patients with pancreatic cancer ,100 normal volunteers were detected by Real-time PCR,and the results were analyzed.The expression of mir-155,mir-196a,mir-181a,mir-181b in 100 pancreatic cancer tissues and 100 normal pancreatic tissues were detected by immunohistochemical,and the results were analyzed. Results Real-timePCR test results showed that compared with normal pancreatic cells,mir-155,mir-196a expression in three pancreatic cancer cells PANC-1,PaCa-2,AsPC-1 were significantly increased(P<0.05).Compared with healthy volunteers,mir-155,mir-196a,mir-181a,mir-181b expression of plasma in pancreatic cancer patients were significantly higher(P<0.05).Immunohistochemistry results showed that mir-155,mir-196a mir-181a and mir-181b expression in pancreatic tissue were significantly higher than that in normal pancreatic tissue (P <0.05 ).Conclusion The expression of mir-155,mir-196a,mir-181a and mir-181b are high in pancreatic cancer tissues and pancreatic cancer cell lines,which are closely related to the development of pancreatic cancer.Those microRNAs are expected to be cancer markers for early diagnosis of,pancreatic cancer,have highly diagnostic value and broad clinical application.