Objective:To explore the components of medical professionalism among excellent physicians , and discuss the approaches and ways of cultivating professionalism of physicians .Methods: We designed a question-naire, on the basis of literature retrieval , to investigate 50 excellent clinical doctors that came from 8 class 3A hos-pitals in Shanghai .Then we interviewed 20 famous doctors of them , who had good reputation and prestige .Re-sults:The components of excellent physician's professionalism include moral quality character , achievement behav-ior character and interpersonal communication character .And each character consists of a collection of different competencies .Conclusions:There is a stable positive correlativity relationship between the degree of excellence and physician's professionalism .The cultivation of medical professionalism should be based on ability , practice and humanistic quality , and through various ways and measures .

Objective:To observe the changes of alveolar cells apoptosis and the expression of Fas/FasL protein in pulmonary injury induced by ischemia/reperfusion in rabbbits,and to explore the related mechanism of pulmonary injury.Methods: The left pulmonary arteries of 30 healthy New Zealand rabbits(either sex) were obstructed and reperfused by inflating and discharging gas of 5F Berman sacculus catheter.The rabbits were then randomly divided into 5 groups: sham operation group,ischemia 1 h group,ischemia 2 h group,ischemia 2 h and reperfusion 1 h group,and ischemia 2 h and reperfusion 2 h group.Another 6 healthy rabbits were taken as control.The pulmonary tissues were harvested after experiment and the lung wet/dry ratio was determined.Alveolar cells apoptosis and Fas/FasL protein expression were determined using flow cytometry and immunocytochemistry techniques,respectively.Results: The lung cell apoptosis was obviously increased in ischemia groups compared with that in the control and sham group.The reperfusion after ischemia further increased the cell apoptosis compared with simple ischemia groups,and the apoptosis was positively related with the reperfusion time(P

Objective To study the effect of early rehabilitation on dysphagia in the patients with acute stroke. Methods 126 patients with acute stroke were divided into 2 groups: rehabilitation group (n=63) and control group (n=63). The rehabilitation group was trained with the swallowing function immediately after inhospital. They were evaluated with the drinking water test before and a month after treatment. Results The swallowing function improved in the rehabilitation group (P<0.01), and the incidence of aspiration pneumonitis decreased (P<0.01) compared with those in the control group. Conclusion Early rehabilitation of dysphagia in the patients of acute stroke can improve the function of swallowing, and reduce the incidence of aspiration pneumonitis.

Objective To evaluate if the assay of platelet-associated immunoglobulin G (PAIgG) can improve the sensitivity of monoclonal antibody immobilization of platelet antigens assay (MAIPA) in immune thrombocytopenic purpura (ITP).Methods Anti-GP Ⅱb/Ⅲa and anti-GP Ⅰb/Ⅸ autoantibodies were detected by a modified MAIPA;PAIgG was detected by competitive ELISA.MAIPA and PAIgG were done simultaneously in 190 patients with thrombocytopenia,in which 132 were diagnosed as ITP according to the diagnostic criteria Kappa test was used to analyze the concordance between MAIPA and PAIgG.Results The sensitivities of PAIgG alone or in parallel with MAIPA to ITP were 32.6% and 37.2% higher than MAIPA alone respectively,while their specifieities were 51.7% and 56.9% lower respectively.The sensitivity,specificity,positive predictive value,negative predictive value of PAIgG in series with MAIPA were all not superior to MAIPA alone.The kappa values between MAIPA and PAIgG in ITP and non-immune thrombocytopenia were 0.129 and 0.012 respectively,which meant the concordance between them was poor.Conclusion The detection of PAIgG should not be used as screening before MAIPA in distinguishing immune from non-immune thrombocytopenia.

To ensure the quality of direct digital radiography images, the management and control of image quality, basic adjustment of facilities post-processing, and raising technicians' professional quality mut be performed. To protect patients from radiation should be emphasized in medical staffs. Radiation should be reduced when ensuring the images' quality, and green examination concepts should be advised.

Objective Our study aimed at the role of p27 on the hypertrophy of mesangial cell (MC) cultured in high glucose. Methods The p27 protein of MC lysate was detected with western blotting analysis. The degree of cultured MC hypertrophy was estimated through [3H]-thymidine incorporation and [3H]-leucine incorporation. The effect of reducing p27 expression on cell hypertrophy was analysed with p27 antisense oligodeoxynucleotide (ODN) phosphorothioate. Results in MC cultured in high glucose (450mg/dl) serum-free DMEM compared with MC cultured in normal glucose (100mg/dl) serum-free DMEM, p27 increased, [3H]-leucine incorporation increased and[3H]-thymidine incorporation decreased;p27 antisense ODN transfection reduced [3H]leucine incorporation, increased [3H] thymidine incorporation of MC cultured in high glucose senumfree DMEM. Increasing medium osmolarity with D-mannitol failed to induce p27 expression of MC. Conclusion p27 protein increased in MC cultured in high glucose. High level of p27 played an important role in MC hypertrophy induced by high glucose. Because the cell cycle is controlled by the interaction between the positive cell cycle regulatory proteins(CCRP) and negative CCRP, further research is needed to study the expression of the positive and negative CCRP in MC in order to better understand the role of CCRP in MC hypertrophy.

Objective To investigate the feasibility and superiority of the lecture based learning (LBL)combined problem-based learning (PBL)for endocrinology teaching practice. Methods Totally 150 clinic medical undergraduates were randomly divided into three groups:LBL group (n=50),PBL group (n=50)and LBL+PBL group (n=50). Questionnaires,written and oral tests were employed to evaluate the teaching effect. ANOVA was used to compare the indicator scores and chi-square test was used to compare grades and passing rate. Results Teaching efficiency,mater of knowledge,capabilities of analysis,teaming and collaboration ability and medical diagnosis thinking cultivation were better in LBL and PBL group than in the other two groups. There were statistical differences in total score(F=4.69, P=0.010)and passing rate(χ2=8.94,P=0.030)among three groups. Conclusions LBL+PBL guarantee the teaching quality and cultivate the comprehensive quality of students; therefore it is superior to LBL and PBL.

Objective To investigate the association between the target organ damage and morning blood pres- sure surge(MBPS) in the elderly hypertensives.Methods Three hundred thirty-two patients submitted to 24 h ambulatory blood pressure monitoring were categorized as with MBPS (n=173),and non-MBPS(n=149).Total cholesterol,body mass index(BMI),left ventricular mass index (LVMI),carotid endothelial medium thickness (CCA-IMT and ICA-IMT) and corrected QT dispersion(QTcd) were determined.Results 24 h,day and night mean systolic blood pressure in MBPS group were significantly higher than that in the non-MBPS group(P

[Objective]A new device of gear-distraction plate (GDP) for spine reduction and fixation was designed and its biomechanical characteristics was evaluated.[Method]The GDP implants were made of titanium alloy (TC4,Ti6AL4V) and the instruments were made of stainless steel after design.Eighteen fresh calf lumbar specimens were randomly divided into three groups, the GDP group had a biomechanical test contrast to control group(CD, Steffee) in load-responsive change, load-displacement, strength, stiffness, torsion intensity and ultimate strength.[Result]Results It is better than control group in load-responsive change, load-displacement, strength, stiffness, torsion intensity and ultimate strength, there was a significant difference between them (P