s Medicine is a kind of culture. The ideal settlement of practical medical problems must be built on medical cultural platform. The higher demand of modern medical practice to the talents is to cultivate their medical cultural quality. The medical cultural quality and its education is regular. Therefore, only by integrating medical humanistic education into medical cultural education can the medical humanistic education come into being and be enforced.

XIAOZHONG ZHITONG GAO is a soft inunctum used with the anti inflammatory and analgesic effects

Objective To explore the expression level and clinical significance of serum interleukin-2 (IL-2),IL-4,IL-6,IL-10,interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) in patients with chronic periodontitis and chronic periodontitis complicated with chronic obstructive pulmonary disease (COPD).Methods From August 2015-August 2016,31 COPD patients combined with chronic periodontitis were set as group A,31 patients with chronic periodontitis were set as group B,and another 31 healthy subjects were selected as the control group in Chaoyang Hospital.Each group extracted fasting venous blood 4 ml,serum inflammatory factors levels (IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α) were measured by cytometric bead array (CBA),periodontal condition [plaque index (PLI),clinical attachment loss (CAL),probing depth (PD),bleeding index (BI)] and lung function index [first 1 s forced expiratory volume％ of predicted value (FEV1％),first 1 s forced expiratory volume occupies the percentage of vital capacity (FEV1/FVC)] were compared.Results The PLI,CAL,PD and BI levels in group B were higher than those in control group,indicators of group A were higher than group B,the difference was statistically significant (P ＜ 0.05).There was no significant difference in FEV1 ％ and FEV1/FVC between group B and control group,indicators of group A were less than group B and control group,the difference was statistically significant (P ＜ 0.05).The serum levels of IL-4,IL-6,IFN-γ and TNF-α in group B were higher than those in control group,indicators of group A were significantly higher than group B,the levels of IL-2 and IL-10 in group B were significantly lower than those in control group,indicators of group A were significantly less than group B (P ＜ 0.05).Conclusions Periodontal status and lung function of chronic periodontitis and chronic periodontitis with COPD patients is not good,the serum levels of IL-4,IL-6,IFN-γ,and TNF-α were increased,and the serum levels of IL-2 and IL-10 were decreased,which might be important risk factors for chronic periodontitis and COPD happen and progress.Therefore,treatment regimen can be adjusted by detecting the levels of above indicators.

Objective? To explore the nursing cooperation of laparoscopic radical distal gastrectomy. Methods? From January 2014 to December 2017, we summarized the main points of nursing cooperation among 41 patients with laparoscopic radical distal gastrectomy at Xi'an Gaoxin Hospital. Results? Among 41 patients, all operations were successful except four of them with laparotomy because of difficult peripheral tissue isolation of stomach or uncontrolled bleeding. The operation time, intraoperative blood loss and postoperative hospital stay were 240 to 350 min, (200±42) ml and (7.0±2.3) d respectively. No patients developed surgical complications during their hospital stay. Conclusions? During operations, nurses are familiar with the surgical procedure, performance as well as methods of application of laparoscopic instruments, and cooperate reasonably and precisely in operation which is the key to carrying out laparoscopic radical distal gastrectomy successfully.

We integrate web-based learning with team based learning,which is called WTBL method (Web-based and team-based Learning). WTBL method is constructed and applied to the teaching practice of core curriculum group courses of clinical medicine. We build some small private online courses. The students can preview online and do the case discussions by teamwork in class. The application of WTBL teaching method has realized the flipping of classroom, and helps to enhance students' self-learning ability and teamwork ability.

Objective:To determine the ratio of ingerleukin(IL)-10 secreting regulatory B cells (B10 cells) and the levels of IL-10 in peripheral blood of periodontitis patients with or without chronic obstructive pulmonary disease (COPD), and to explore the function of B10 cells in the pathogenesis of the interaction between COPD and periodontitis.Methods:Forty-five periodontitis patients and healthy people were recruited and divided into three groups: COPD group, COPD+periodontitis group and health controls with 15 people in each group. Peripheral blood samples were collected to determine the B10 population. Another group of 93 periodontitis patients and healthy people were also collected and divided into the same 3 groups with 31 people in each group. Peripheral blood samples were collected to determine the cytokine IL-10.Results:After stimulation with lipopolysaccharide (LPS)+phorbol-12-myristate13-acetate+ionomycin+brefeldin A (PIB) for 5 h, the ratio of B10 in COPD+periodontitis group [(0.44±0.11)%] was significantly lower than that in the control group [(0.63±0.14)%] and periodontitis group [(0.62±0.13)%] ( P<0.01), respectively. The ratio of B10 cells showed no significant difference between periodontitis group and healthy control group ( P>0.05). After stimulation with LPS+PIB for 48 h, the ratio of B10 cells in COPD+periodontitis group [(7.59±1.33)%] was significantly lower than that in the periodontitis group [(10.14±2.02)%] and the healthy controls [(11.80±1.71)%] ( P<0.01), respectively. The ratio of B10 cells in periodontitis group was significantly lower than that in the healthy controls ( P<0.05). The levels of IL-10 in periodontitis group [(2.55±0.61) ng/L] and COPD+periodontitis group [(1.95±0.45) ng/L] were significantly lower than that in the control group [(3.96±1.15) ng/L] ( P<0.01) respectively. Moreover, the level of IL-10 in COPD+periodontitis group was significantly lower than that in the periodontitis group ( P<0.01). Conclusions:The dysfunction of immune system caused by the decreased proportion of B10 cells might be involved in the pathological process of COPD promoted by periodontitis.

Objective To explore the expression level and clinical significance of serum interleukin-2 (IL-2),IL-4,IL-6,IL-10,interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) in patients with chronic periodontitis and chronic periodontitis complicated with chronic obstructive pulmonary disease (COPD).Methods From August 2015-August 2016,31 COPD patients combined with chronic periodontitis were set as group A,31 patients with chronic periodontitis were set as group B,and another 31 healthy subjects were selected as the control group in Chaoyang Hospital.Each group extracted fasting venous blood 4 ml,serum inflammatory factors levels (IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α) were measured by cytometric bead array (CBA),periodontal condition [plaque index (PLI),clinical attachment loss (CAL),probing depth (PD),bleeding index (BI)] and lung function index [first 1 s forced expiratory volume％ of predicted value (FEV1％),first 1 s forced expiratory volume occupies the percentage of vital capacity (FEV1/FVC)] were compared.Results The PLI,CAL,PD and BI levels in group B were higher than those in control group,indicators of group A were higher than group B,the difference was statistically significant (P ＜ 0.05).There was no significant difference in FEV1 ％ and FEV1/FVC between group B and control group,indicators of group A were less than group B and control group,the difference was statistically significant (P ＜ 0.05).The serum levels of IL-4,IL-6,IFN-γ and TNF-α in group B were higher than those in control group,indicators of group A were significantly higher than group B,the levels of IL-2 and IL-10 in group B were significantly lower than those in control group,indicators of group A were significantly less than group B (P ＜ 0.05).Conclusions Periodontal status and lung function of chronic periodontitis and chronic periodontitis with COPD patients is not good,the serum levels of IL-4,IL-6,IFN-γ,and TNF-α were increased,and the serum levels of IL-2 and IL-10 were decreased,which might be important risk factors for chronic periodontitis and COPD happen and progress.Therefore,treatment regimen can be adjusted by detecting the levels of above indicators.