Congresses as Topic ; Head ; surgery ; Neck ; surgery ; Otolaryngology ; Periodicals as Topic

Cytokines ; metabolism ; Humans ; Leukocytes, Mononuclear ; immunology ; secretion ; Ubiquitin ; blood

Objective To investigate doctor-patient communication skills status and the influencing factors so as to pu forward to develop the proposal.Methods We selected undergraduate students in fourth grade which participated in the 2012 Shanghai Jiaotong University School of Medicine OSCE examinations before practice of clinical medicine by cluster sampling 1 and we selected four western and chinese medicine hospitals randomly sample 2,which are three level of first-class hospitals in Shanghai.We design the questionnaire and observe sampling with the SEGUE framework.Application of SPSS 13.0 data for statistical analysis,descriptive statistics analysis,u test,t test,ANOVA,rank sum test and correlation analysis method.Results The test with SEGUE framework shows that the scores of samplingl were 12.54 points(out of 24),the score rate is low which was 52.25％,and in the score rate of the dimensions,the end of inquiry dimension is 4％ which is the lowest.There are significant statistical differences between different groups of influencing factors such as Medical occupation interest score and so on.There is no statistically significant difference between the SEGUE score of traditional Chinese medicine and western medicine clinical Intern.The communication skills of western medical students are higher.Doctor-patient communication skills related factors such as recognition of the importance of doctor-patient communication skills and other groups are statistically significant,the correlation coefficients are very small which is between 0.1 and 0.3.Conclusion The overall level of doctor-patient communication skills on clinical internship are not high,through the guidance and training on the occupation interest of medical students,we can strengthen the recognition of the importance of doctor-patient communication skills,so that we will improve the doctor-patient communication skills for the medical students.SEGUE framework should be used to routine medical students communication skills evaluation.

Asian Continental Ancestry Group ; Head ; surgery ; Humans ; Neck ; surgery ; Otolaryngology

Objective To study the Ile796Val polymorphism in human SCAP gene in Hubei area, and analyze its correlation with coronary heart disease (CHP) and hypertension and the relationship between polymorphism and lipid metabolism. Methods Using PCR RFLP, we detected genotypes of Ile796Val polymorphism in human SCAP gene. Results The allele A frequencies of Ile796Val in human SCAP gene for controls, CHD patients and the hypertension patients were 0.32, 0.45 and 0.42 respectively. The allele G frequencies were 0 68, 0.55 and 0.58 respectively. There were significant differences in frequencies of genotype and alleles between controls and hypertension group. And there was significant difference in the level of TC, LDL C and ApoB. In CHD group, there was significant difference in the TC level between different genotypes. In hypertension patients, although a difference was noted in genotype, there was no significant difference in allele frequencies and lipid level exceps a significant difference in the levels of TC, LDL C and ApoB in hypertension patients. Conclusion Ile796Val polymorphism in human SCAP gene may be a great agent to cause disorder in the lipid level of blood and lipid metabolism of tissue. It is of great significance in disorder in lipid metabolism of inter cellular and genetic investigation of hyperlipidemia.

OBJECTIVE:To study the classification of deviation in drug production. METHODS:From the perspective of dom-inant and hidden deviation,combining with the theory of risk management,risk of deviation was evaluated with different risk man-agement tools to define the severity of the deviation,and it was handled by different methods. RESULTS & CONCLUSIONS:Ac-cording to the identifiability of deviation in actual management,the deviation was divided into dominance and hidden deviation. The dominant deviation can be divided into deep and shallow level. Whether the causes of deviation could be cleared and the conse-quences could be estimates were judged after the shallow level classification,and the deviation was further divided into simple and complex deviation. As for deviation complex,it could be evaluated with the tools of risk management to define the deviation severi-ty. As for hidden deviation,it needed beforehand preventing with the tools of risk management directly to define deviation levels and provide reference for preventive measures. In the process of deviation management,key point is to relay on the scientific meth-od to identify and classify deviation,and divide the influence levels. Combining the theory of risk management to select and use risk tools is the effective way to solve the problem.

Cochlear Implantation ; Hearing

Objective To evaluate the differences, including clinical symptoms, endoscopic and histopathologic findings, status of Helicobacter pylori (Hp) infection and cytokeratin (CK) expressions, be-tween Barrett esophagus (BE) and heterotopic gastric mucosa (HGM) in upper esophagus. Methods Clinical data of 152 patients with BE and 52 patients with HGM in upper esophagus diagnosed from February 2004 to September 2005 were retrospectively studied. The parameters being compared include-ed clinical manifestations, conventional and magnifying endoscopic findings, histopathological findings, Hp infection determined by rapid urease test and Warthin-Starry staining and expression of CK phenotypes detec-ted by immunohistochemistry. Results Gastro-esophngeal reflux was observed in 64. 5% of patients with BE (98/152), higher than that in patients with HGM ( 13.5%, 7/52, χ2 = 40. 36, P < 0. 01 ). Endoscopic faveolus of BE mucosa included 46 cases of spot pattern, 65 striations and 41 villiform patterns, while those of HGM were all striation patterns. The histologic classification in BE included 56 cases of fundic type, 39 junction type and 57 specialized intestinal metaplasia, while in HGM mucesa, 31 cases of fundic type, 16 junction type and 5 antrum type were diagnosed, and no goblet cells were found. Moderate and severe infil-tration of inflammatory cells in BE mucosa was 63.2% (96/152), which was significantly higher than that in HGM mucosa (15/52, 28. 8%, P<0. 01). However, no difference was found in gastric antrum inflam-mation between the two groups (44.7%, 68/152, vs. 51.9%, 27/52, P>0.05). No difference was ob-served in prevalence of Hp infection between BE and HGM groups (P >0. 05 ), either in involved mucosa or in antrum. CK7 was not expressed in HGM or normal squamons mucosa, but was expressed in BE. CK20 and CK19 were expressed in both HGM and BE, and CK13 expression was found in some BE nmcosa including gas-tric metaplesia (55/95) and intestinal metaplasia (29/57) but not in HGM mucosa. Conclusion There are differences between HGM and BE, in regarding of reflux symptoms, magnifying endoscopic findings, histo-logical types and CKs expressions, which may be indicators to make differential diagnosis.

Epiretinal membrane (ERM) is a relatively common macular disease that forms along the surface of the internal limiting membrane (ILM) of the retina to some reason.The pathogenesis is not clear.Microincision vitrectomy surgery has been confirmed as a minimally invasive and very safe modality of treatment.Deciding when to perform a vitrectomy can be difficult.There are many factors which can affect the postoperative visual acuity,such as age,the thickness of macular,integrity of photoreceptor inner segment/outer segment (IS/OS) junction.

History, 20th Century ; History, 21st Century ; Otolaryngology ; Periodicals as Topic ; history