This article discussed the importance and current dilemmas of the cultivation of medical students′consciousness of responsibility based on the special relationship between professionality and responsibility. The di-lemmas mainly included the followings:the motivation to select the Medicine specialty was impure, the humanistic quality was lacking, and the workplace showed reverse guidance. In addition, it expounded the methods to strengthen the cultivation of medical students′ responsibility consciousness from three aspects, which included the cultivation of social responsibility, the practical training teaching of humanities quality and the clinical teaching practice.

OBJECTIVE:To prepare gelatin drug carrier with biocompatible sugars as crosslinking agents and study its drug release characteristics.METHODS:Gelatin discs and microspheres cross-linked by glucose,dextran,oxidized glucose,and oxidized dextran were prepared and their swelling kinetics were determined as well.The encapsulation efficiency and drug loading rate were determined by UV spectrophotometry with aspirin and bovine serum albumin(BSA)as drug models respectively.The release rates of gelatin microspheres in simulated body were determined.RESULTS:The swelling degrees of gelatins cross-linked by glucose,oxidized glucose,dextran,and oxidized dextran were 204%,246%,166%,and 233%,respectively.The average drug-loading rate of aspirin gelatins was 8.73% as compared with 4.05% of BSA gelatin microspheres,with the average encapsulation rate of 62.55% vs.31.40%.The accumulate release rates in 2 h were 30%,14%,76%and 73% for aspirin gelatin microspheres as compared with 97.2%,86.6%,60.8% and 50.1% for BSA.CONCLUSION:All of 4 kinds of sugars can replace chemical crosslinkers for the preparation of gelatin microspheres.The natural sugar gelatin microspheres were superior to oxidized sugar in sustained release effect.

ObjectiveTo explore the applied effects of microsurgical treatment on mesial temporal lobe epilepsy(MTLE)under the guidance of the intraoperative magnetic resonance imaging neuronavigation system.MethodsThe anterolateral temporal lobe,hippocampus and amygdala was resected by microsurgery under the guidance of the intraoperative magnetic resonance imaging neuronavigation system in 26 patients with intractable MTLE,with the help of electrocorticography monitoring during operation.ResultsAnterolateral temporal lobes were all resected in postoperative MRI and mesial structures certified to have atrophy or cirrhosis by pathology.All the patients were followed up from 3 to 6 months after the surgery.In 26 patients,twenty-three cases (88.5％) belonged in Engel grade I,two cases (7.7％) in grade Ⅱ and 1 case (3.8％) in gradeⅢ.No severe complications occurred and nervous functions were preserved well.ConclusionMicrosurgical treatment on MTLE under the guidance of the intraoperative magnetic resonance imaging neuronavigation system is effective due to epileptic focus all resected and protection for nervous functions,resulting in an accurate and safe improvemention of operation.

Objective To investigate the impact of different treatment options on lumbar func-tion,pain intensity,and anterior vertebral height in elderly patients with thoracolumbar vertebral com-pression fractures.Methods The clinical data of 102 elderly patients with thoracolumbar vertebral compression fractures who completed 1-year follow-up were retrospectively analyzed.They were divided into conservative group(32 cases),percutaneous kyphoplasty(PKP)group(35 cases),and percuta-neous vertebroplasty(PVP)group(35 cases)based on different treatment options.One year after treatment,the clinical efficacy and complications of the three groups were evaluated.The Visual Ana-logue Scale(VAS)score,Japanese Orthopedic Association(JOA)score,Cobb angle,and anterior ver-tebral height were compared before and 1 year after treatment among the three groups.Results The ex-cellent and good rates of the PKP group and PVP group were higher than those of the conservative group(P＜0.05).There was no significant difference in the excellent and good rates between the PKP group and PVP group(P＞0.05).There was no significant difference in occurrence of complica-tions among the three groups(P＞0.05).One year after treatment,the VAS scores of the three groups were lower than before treatment,and the JOA scores were higher than before treatment,and the VAS scores of the PKP group and PVP group were lower than those of the conservative group,and the JOA scores were higher than those of the conservative group(P＜0.05).The VAS score of the PKP group was lower than that of the PVP group,and the JOA score was higher than that of the PVP group(P＜0.05).One year after treatment,the Cobb angles of the three groups were smaller than before treatment,and the anterior vertebral heights were higher than before treatment,and the Cobb angles of the PKP group and PVP group were smaller than those of the conservative group,and the anterior vertebral heights were higher than those of the conservative group(P＜0.05).The Cobb angle of the PKP group was smaller than that of the PVP group,and the anterior vertebral height was higher than that of the PVP group,the difference in anterior vertebral height was greater than that of the PVP group(P＜0.05).Conclusion Compared with conservative treatment,surgery can im-prove the clinical efficacy of elderly patients with thoracolumbar vertebral compression fractures.PKP is superior to PVP in reducing pain of patients,improving lumbar function and Cobb angle,and anterior vertebral height.Moreover,it has better safety.

Objective To investigate the impact of different treatment options on lumbar func-tion,pain intensity,and anterior vertebral height in elderly patients with thoracolumbar vertebral com-pression fractures.Methods The clinical data of 102 elderly patients with thoracolumbar vertebral compression fractures who completed 1-year follow-up were retrospectively analyzed.They were divided into conservative group(32 cases),percutaneous kyphoplasty(PKP)group(35 cases),and percuta-neous vertebroplasty(PVP)group(35 cases)based on different treatment options.One year after treatment,the clinical efficacy and complications of the three groups were evaluated.The Visual Ana-logue Scale(VAS)score,Japanese Orthopedic Association(JOA)score,Cobb angle,and anterior ver-tebral height were compared before and 1 year after treatment among the three groups.Results The ex-cellent and good rates of the PKP group and PVP group were higher than those of the conservative group(P＜0.05).There was no significant difference in the excellent and good rates between the PKP group and PVP group(P＞0.05).There was no significant difference in occurrence of complica-tions among the three groups(P＞0.05).One year after treatment,the VAS scores of the three groups were lower than before treatment,and the JOA scores were higher than before treatment,and the VAS scores of the PKP group and PVP group were lower than those of the conservative group,and the JOA scores were higher than those of the conservative group(P＜0.05).The VAS score of the PKP group was lower than that of the PVP group,and the JOA score was higher than that of the PVP group(P＜0.05).One year after treatment,the Cobb angles of the three groups were smaller than before treatment,and the anterior vertebral heights were higher than before treatment,and the Cobb angles of the PKP group and PVP group were smaller than those of the conservative group,and the anterior vertebral heights were higher than those of the conservative group(P＜0.05).The Cobb angle of the PKP group was smaller than that of the PVP group,and the anterior vertebral height was higher than that of the PVP group,the difference in anterior vertebral height was greater than that of the PVP group(P＜0.05).Conclusion Compared with conservative treatment,surgery can im-prove the clinical efficacy of elderly patients with thoracolumbar vertebral compression fractures.PKP is superior to PVP in reducing pain of patients,improving lumbar function and Cobb angle,and anterior vertebral height.Moreover,it has better safety.

The contents recorded in the rotation registration manual is not only the quantitative indicators for evaluating the quality of residency training, but also the important basis for training assessment and issuance of training certificates. In order to solve the problems of data authenticity, information delay, and repeated entry in the rotation registration manual for residency training, Shanghai East Hospital, Tongji University, launched a project to dock the electronic rotation registration manual with the hospital information system. Through the establishment of the project team, the development of working mechanisms, and the implementation of the project, data analysis was used for process reformation and system optimization, so as to continuously improve management efficiency and medical safety while solving problems and form a set of implementation system with reference significance in practice.