Education of medical morality is an important part of medical education and must be through the whole career life of medical workers.Now our society is in the period of transition,but education of medial morality fails to get enough attention.Based on the present situation,the paper first makes a systematic exposition of the importance,intension,element and process of the reception of medical morality education of medical workers,then points out the rule of this reception and the approach to realize the validity of medical morality education.

Acupuncture Points ; Adult ; Electroacupuncture ; Female ; Head ; innervation ; Humans ; Neuritis ; therapy

Objective:To observe the clinical efficacy and safety of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) combined with traditional medicine retention enema for treatment of chronic radiation proctitis.Methods:A total of 128 patients pathologically diagnosed as cervical cancer and endometrial cancer with grade 1-2 chronic radiation proctitis at Xiangyang Central Hospital from October 2017 to October 2019 were enrolled in a random, single-blind, control trial. The patients were divided into the control group and the experiment group according to the random number table, and the control group was given the treatment regimen of gentamicin + dexamethasone + Yunnan Baiyao retention enema, and the experimental group was given the treatment regimen of rhGM-CSF + gentamicin + dexamethasone + Yunnan Baiyao retention enema; both regimens treated twice daily for three weeks. The clinical symptom before and after enema treatment based on the subjective, objective, management and analytic (SOMA) scale was scored and the efficacy was evaluated by combining with stool routine and rectoscopy.Results:According to the SOMA scale, the scores of hematochezia, diarrhea, tenesmus, abdominal pain after enema were lower than those before enema, and the differences were statistically significant (all P<0.05); however, the scores of all symptoms before treatment of both groups were not statistically significant different (all P>0.05). The score of hematochezia in the experimental group after enema was lower than that in the control group [(0.33±0.15) scores vs. (0.48±0.32) scores, t=2.045, P=0.022], and the scores of other symptoms in both groups were not statistically significant different (all P>0.05). The overall effective rate was 79.69% (51/64) in the control group and 90.63% (58/64) in the experimental group, and difference was statistically significant (χ 2=6.485, P=0.026). All patients had no obvious adverse reactions. Conclusions:rhGM-CSF combined with traditional medicine retention enema for treatment of chronic radiation proctitis in patients with cervical cancer and endometrial cancer is highly effective and easy to operate, and patients are well tolerated, which is worthy of clinical promotion.

Objective:Marrow mesenchymal stem cells differentiates into neuron-like cells when induced by Gastrodia,which verifies the multipotentiality of the stem cells.Here to detect the immunogenic properties of the neuron-like cells after differentiation.Methods:Human mesenchymal stem cells were isolated from bone marrow by wall sticking method,amplified by in vitro culture,and differentiated into neuron-like cells by oriented induction with Gastrodia.The morphology of cells was observed under light microscopy.Neuron-specific enolase (NSE),nestin and glial fibrillary acidic protein (GFAP) were detected by imnunocytochemistry.The expression of HLA-DR protein after induction was tested by flow cytometry(FCM).The immunogenic properties of the neuron-like cells induced from hMSCs were detected by one-way mixed lymphocyte reaction(MLR).Results:Human mesenchymal stem cells could be separated and amplified in vitro.After being induced by Gastrodia for 3 hours,most of the cells would be differentiated into neuron-like cells,revealing cytodendrite.By immunochemical staining,the cells showed positive of NSE,nestin,and negative of GFAP.HLA-DR was not detectable on differentiated hMSCs by FCM.MLR assays demonstrate that differentiated hMSCs fail to stimulate proliferative response of hPBLs.Conclusion:Human mesenchymal stem cells could be induced to differentiate into neuron-like cells by Gastrodia.MLR assays demonstrate that differentiated hMSCs fail to stimulate proliferative response of hPBLs.They are low immunogenic.

Objective To investigate the diagnosis and treatment value of digital subtraction angiography (DSA) and transcatheter arterial embolization (TAE) for post pancreatectomy hemorrhage (PPH),and influencing factors of severity of PPH.Methods The retrospective case-control study was conducted.The clinicopathological data of 20 patients with PPH who were admitted to the Zhongshan Hospital of Fudan University from August 2009 to November 2016 were collected.Patients with PPH in the early stage underwent reoperations for hemostasis;patients with PPH in the later stage received conservative treatment,and then DSA and TAE were considered when patients had the stable vital signs.Observation indicators:(1) DSA situations:overall times,positive rate and bleeding sites;(2) TAE situations:successful rate of hemostasis,operating time and postoperative complications;(3) follow-up situations;(4) influencing factors analysis of severity of PPH.Follow-up using outpatient examination and telephone interview was performed to detect occurrence of complications after discharging from hospital up to April 2017.Measurement data with skewed distribution were described as M (range).Count data were evaluated by the ratio and proportion.The univariate analysis was done using the Fisher exact probability.Results (1) DSA situations:all the 20 patients underwent DSA,with overall times of 27.The direct sign was 18 times extravasation of the contrast medium,with a positive rate of 66.7％ (18/27).Of 18 times positive DSA,clear bleeding sites were located in 5 times gastroduodenal artery (3 times with pseudoaneurysm of gastroduodenal artery stump),in 4 times common hepatic artery (3 times with pseudoaneurysm of common hepatic artery),in 3 times superior mesenteric artery,in 2 times splenic artery,in 1 time left gastric artery,in 1 time right gastric artery,in 1 time left hepatic artery (pseudoaneurysm of left hepatic artery) and in 1 time inferior mesenteric artery.(2) TAE situations:of patients with 18 times positive DSA,patients with 15 times positive DSA received TAE,with a successful rate of hemostasis of 13/15,and patients with 5 times positive DSA received successful hemostasis by reoperation.A median operating time of TAE for patients with 15 times positive DSA was 30 minutes.There was no occurrence of adverse reaction,including fever,abdominal pain,melena,elevated aminotransferase and liver abscess.One patient complicated with splenic abscess after transcatheter splenic arterial embolization underwent puncture drainage and then had a good recovery.Of patients with 9 times negative DSA,patients with 8 times negative DSA were cured by conservative treatment and patient with 1 time negative DSA received successful hemostasis by operation.All the 20 patients were cured and then discharged from hospital.(3) Follow-up situations:20 patients were followed up for 4-92 months,with a median time of 24 months.During the follow-up,20 patients recovered well,without long-term complications.(4) Influencing factors analysis of severity of PPH:the results of univariate analysis showed that gender,age,preoperative blood sugar,preoperative combined jaundice,preoperative albumin (Alb),preoperative prothrombin time (PT) extended,preserving pylorus,pancreatic duct stent placement,pancreatic operation time,volume of intraoperative blood loss,intraoperative blood transfusion,property of tumor,postoperative pancreatic fistula and time of PPH were not factors affecting the severity of PPH (P＞0.05).Conclusion DSA is minimal-invasive in the diagnosis for PPH,and TAE is safe and effective for patients with positive DSA.

Objective To study the effects of vitamin E(VitE) on TNF-?,IL-1? and nitric oxide(NO) secretion from human monocytes stimulated by advanced glycation end products.Methods Human peripheral blood monocytes(PBMCs) from 20 hemodialysis(HD) patients and 15 normal volunteers were isolated.These PBMCs were cultured in vitro with advanced glycation end products(AGE) and vitamin E.All of these PBMCs were divided into control group,AGE-inducing group,different doses VitE group and different culture VitE group.The levels of TNF-? and IL-1? in supernatants were detected by ELISA.The levels of NO were detected by biochemical method.Results The basal secretion of TNF-?,IL-1? in monocytes from HD patients was more than those from normal volunteers.AGE induced significantly more secretion of TNF-? and IL-1?(P

Objective A close relationship between atherosclerosis and plasma levels of advanced oxidation protein products (AOPP) has been demonstrated in patients with chronic renal failure. The present study was performed to investigate the effect of AOPP on human endothelial cells. Methods Human umbilical vein endothelial cell line ECV304 was incubated with different concentrations of AOPP-BSA, which prepared by combining BSA with HOCl at different molar ratios. Cell viability was measured by MTT assay. Intracellular production of reactive oxygen species (ROS) was evaluated kinetically using VICTOR Wallac 1420 mutilabel counter. Results AOPP-BSA decreased endothelial cell viability, which was dependent on the molar ratio of BSA/HOCl and the concentration of AOPP-BSA. AOPP-BSA also enhanced the intracellular ROS production in ECV304. AOPP-induced ROS production was correlated with the molar ratio of BSA/HOCl and the concentration of AOPP-BSA. Pretreatment of cells with a small molecular glutathione peroxidase mimic (ebselen) reduced AOPP-induced ROS production by 53% with preservation of cell viability. Conclusion AOPP decreased endothelial cell viability via induction of oxidative stress.

Objective To investigate the siRNA interference of S100A4 mRNA of human pancreatic cancer cell radiosensitivity.Method Cultured human pancreatic BxPC-3,AsPC-1 in vitro,logarithmic phase cells as the experimental object,were divided into three groups:normal control group (without any treatment),negative control group (transfected with negative control fragment),interference group (transfected S100A4 protein fragment siRNA),the chemical synthesis siRNAS100A4 fragment interference of S100A4 mRNA 0,1,2,3,5,7,10 Gy given 6MV X-ray irradiation,the use of clone formation assay,Giemsa stained colony formation rate is calculated and SF2,and the fitting cell survival curve.Results The siRNA interference S100A4 after BxPC-3 cells SF2 value are:the control group 0.68±0.02,negative control group 0.65±0.01.interference group,0.38±0.02,P＜0.05.AsPC-1 cells SF2 value:control group 0.48±The0.02,negative control group 0.47±0.02; interference group:0.37±0.04,P＜0.05.Conclusion siRNA interference S100A4 after increased radiosensitivity of human pancreatic cancer cell lines.

AIM: To study the effects of insulin and glucose on tissue-type plamingen activator (tPA) and its inhibitor-1 (PAI-1) secretion in cultured human endothelial cells. METHODS: Human endothelial cell line ECV-304 was cultured with glucose and/or insulin at different concentrations with or without hypoxic exposure. RESULTS: The tPA, PAI-1 secretion and ratio of tPA/PAI-1 increased in endothelial cells during hypoxia. Insulin and glucose increased the tPA and PAI-1 secretion in endothelial cells exposed to hypoxia, and increase in tPA/PAI-1 ratio was also observed at 4 h and 8 h. CONCLUSION: Hypoxia stimulates the release of tPA and PAI-1. Insulin and glucose also stimulate the tPA and PAI-1 secretion during hypoxia.

OBJECTIVE:To observe clinical efficacy and safety of Kangfuxin liquid in the treatment of pediatric hand,foot and mouth disease. METHODS:128 children with hand,foot and mouth disease were randomly divided into observation group and control group,with 64 cases in each group. Control group was given routine treatment as herpes and oral care,antibiotics for infec-tive children reflected by hemogram elevation,fluid infusion and non-steroidal analgesic-antipyretic agent based on disease condi-tion. Observation group was additionally given Kangfuxin liquid,3 ml for below 3 year-old,tid and 5 ml for more than 3 year-old,tid. Clinical efficacy of 2 groups were observed as well as CRP,lactic acid,Ig,the level of myocardial enzyme before and after treatment;the time of symptoms and signs disappearance and ADR were compared between 2 groups after treatment. RE-SULTS:The total effective rate of observation group(89.06%)was significantly higher than that of control group(70.31%),with statistical significance(P<0.05). There was no statistical significance in CRP,lactic acid,Ig and myocardial enzyme before treat-ment and IgM level after treatment between 2 groups,with statistical significance(P>0.05). CRP,lactic acid creatine kinase and lactate dehydrogenase level of 2 groups decreased significantly,while IgA and IgG levels increased significantly,and the observa-tion group was higher than the control group,with statistical significance(P<0.05). Antipyretic time,hand foot skin rash subsided time and oral ulcer healing time of observation group were significantly shorter than those of control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Kangfuxin liquid is effective in the treatment of hand,foot and mouth disease in children,and can effectively improve CRP,Ig,lactic acid,and myocardial enzyme level with good safety.