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Objective:To analyze the doctor-patient communication ability of medical interns, and to further explore the application value of strengthening doctor-patient communication education.Methods:Questionnaire and simulated doctor-patient communication were used to investigate students' doctor-patient communication ability according to whether they had received doctor-patient communication training (group A) or not (group B) at school. Doctor-patient communication education and skill training for three months were given to those interns, and questionnaires and simulated doctor-patient communication were conducted again to investigate the role in improving interns' doctor-patient communication ability and to analyze the application value of strengthening doctor-patient communication education.Results:Pre-training scores and pass rate in the group B were higher than those in the group A [(110.62±3.98) vs. (101.28±3.56), 88% vs. 58%], with statistical difference ( P<0.001). After the comprehensive training, the score and pass rate in the group A were significantly improved [(143.28±4.32) vs. (145.95±4.12), 97% vs. 100%], without significant difference between group B and group A before and after training ( P>0.05). Conclusion:Strengthening doctor-patient communication education and skill training is of great significance to improve the doctor-patient communication ability of medical students.
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Objective@#To explore the clinical value of serum autoantibodies and human leukocyte antigen (HLA-B27) molecular testing in Uygur patients with human immunodeficiency virus (HIV) infection.@*Method@#A total of 727 HIV-infected Uygur patients who visited Kuche infectious diseases hospital during May 2016 to March 2017 were include in this study. The other 390 healthy people were enrolled as controls. Serum antinuclear antibodies (ANA), anti-cyclic citrullinated peptide (CCP) antibody, anti-extractable nuclear antigen (ENAs) antibody and HLA-B27 molecule were tested.@*Result@#Among 727 HIV-infected Uygur patients, 317 were males and 410 were females with mean age (35.52±13.44) years old. The mean duration of disease was (6.34±3.05) years. There were 697 (95.87%) patients receiving highly active antiretroviral therapy (HAART) with mean duration of treatment (5.52±3.47) years. The mean CD4+T cell count was (520±271) cells/μl in 202 HIV-infected patients, and mean virus load was (108 139±20 498) copies/ml in 20 HIV-infected patients. Rheumatic manifestations were recorded in 238 (32.74%) HIV-infected Uygur patients, mainly with dry mouth and dry eye (15.41%) , alopecia (9.90%) , arthralgia (8.94%) , ect. Compared with the health controls, positive ANA was more common in HIV infected Uygur patients (33.43% vs. 17.43%, P<0.001) with low titers (ANA titer:1∶100) . HIV-infected Uygur patients had higher positive anti-u1-RNP antibodies positive rate (1.10%), but lower anti-SSA antibodies positive rate (0.14%) and anti-CCP antibodies positive rate (0.28%). Patients with positive ANA in HAART group were significantly less than that in non-treatment group (32.71% vs. 50.00%, P=0.049). There were no correlations between ANA and duration of HAART, CD4+T cell counts and virus load (r values 0.061, 0.047, 0.121, respectively. P>0.05). Only one female patient was HLA-B27 positive (0.14%), which was significantly lower than that in healthy controls (3.08%) (P<0.001). Also, only one patient was diagnosed with rheumatoid arthritis (RA).@*Conclusion@#Autoimmune manifestations are common in HIV-infected Uygur patients. Several autoantibodies are positive, but the coincidence of rheumatic diseases is rare. It′s noted that patients with autoimmune manifestations should be considered as a differential diagnosis of HIV infection.
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Objective:To explore the clinical value of serum autoantibodies and human leukocyte antigen (HLA-B 27) molecular testing in Uygur patients with human immunodeficiency virus (HIV) infection. Method:A total of 727 HIV-infected Uygur patients who visited Kuche infectious diseases hospital during May 2016 to March 2017 were include in this study. The other 390 healthy people were enrolled as controls. Serum antinuclear antibodies (ANA), anti-cyclic citrullinated peptide (CCP) antibody, anti-extractable nuclear antigen (ENAs) antibody and HLA-B 27 molecule were tested. Result:Among 727 HIV-infected Uygur patients, 317 were males and 410 were females with mean age (35.52±13.44) years old. The mean duration of disease was (6.34±3.05) years. There were 697 (95.87%) patients receiving highly active antiretroviral therapy (HAART) with mean duration of treatment (5.52±3.47) years. The mean CD4 +T cell count was (520±271) cells/μl in 202 HIV-infected patients, and mean virus load was (108 139±20 498) copies/ml in 20 HIV-infected patients. Rheumatic manifestations were recorded in 238 (32.74%) HIV-infected Uygur patients, mainly with dry mouth and dry eye (15.41%) , alopecia (9.90%) , arthralgia (8.94%) , ect. Compared with the health controls, positive ANA was more common in HIV infected Uygur patients (33.43% vs. 17.43%, P<0.001) with low titers (ANA titer:1∶100) . HIV-infected Uygur patients had higher positive anti-u1-RNP antibodies positive rate (1.10%), but lower anti-SSA antibodies positive rate (0.14%) and anti-CCP antibodies positive rate (0.28%). Patients with positive ANA in HAART group were significantly less than that in non-treatment group (32.71% vs. 50.00%, P=0.049). There were no correlations between ANA and duration of HAART, CD4 +T cell counts and virus load ( r values 0.061, 0.047, 0.121, respectively. P>0.05). Only one female patient was HLA-B 27 positive (0.14%), which was significantly lower than that in healthy controls (3.08%) ( P<0.001). Also, only one patient was diagnosed with rheumatoid arthritis (RA). Conclusion:Autoimmune manifestations are common in HIV-infected Uygur patients. Several autoantibodies are positive, but the coincidence of rheumatic diseases is rare. It′s noted that patients with autoimmune manifestations should be considered as a differential diagnosis of HIV infection.
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Objective To compare the effectiveness of CO2 laser treatment and routine scalpel procedure for facial sebaceous cyst (SC),and to compare cosmetic effect of laser welding and routine suture skin incision.Methods Two hundred patients with SC were randomly divided into two groups:CO2 laser operative treatment group (laser group),and routine scalpel operative treatment control group (control group),with 100 patients in each group.For the laser group,skins of SC were incised and cyst were extirpated using CO2 laser beam (power 20 W,diameter of light spot 0.2 cm and power density 637 W/cm2).If cyst wall was broken,then CO2 laser was used to gasify the residual.After cleaning skin incision,both border of incision with anastomat of laser welding skin was performed,next to welding skin incision with CO2 laser (power 1 W,diameter of light spot 0.2 cm and power density 32 W/cm2) scanning radiating 2 mm/s.For the control group,skins of SC were incised and cyst or residual wall were extirpated with single-use scalpel,and skin incisions were sutured with 1-0 silk thread by whole layer interrupted suture.Results For the laser group,97 cases (97 ％) were cured,3 cases (3 ％) improved.For the control group,87 cases (87 ％) were cured,9 cases (9 ％)improved and 2 cases (2 ％) had no improvement.Cure rate of laser group was obviously higher than that of the control group (P＜0.05).The cosmetic effect of the laser group was also better than that of the control group (P＜0.01).For the laser group,successful rate of welding skin incision was 100 ％.Conclusions Surgical removal of SC on face and welding skin incision with CO2 laser is very effective.The chances of recurrence and cicatrisation are greatly reduced.In particular,laser welding skin incision establishes a new non-suture reparable method of skin incision,which has important value for the cosmetic and plastic surgery.
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Objective To observe the effect of treatment and cosmetology in cbildren patients with strawberry hemangioma (SH) on face by three kind of infrared wavelength lasers.Methods In 300 children patients aged from 5 to 12 years with SH on face were randomly divided into a semi con ductor laser group (100 cases),a Nd ∶ YAG laser group (100 cases) and a CO2 laser group (100 cases).The parameters of laser were the same in the three groups,such as 10 W,light spot 0.2 cm in diameter and 318 W/cm2.According to size of area in the semiconductor laser and Nd ∶ YAG laser groups SH were coagulated by semiconductor laser and Nd ∶ YAG laser,and in the CO2 laser group it were gasified by CO2 laser,respectively.Children patients with SH were followed up for observation of cicatrzation and evaluation of the effect of therapeutics and cosmetology at six months after laser treatment.Results The cure rates were 89 ％ in the semiconductor laser group,83 ％ in the Nd ∶ YAG laser group and 69 ％ in the CO2 laser group (P＜0.05).The excellent and faworahle rates of cosmetic effect were 87.0 ％ in the CO2 laser group,86.5 ％ in the semiconductor laser group and 57.8 ％ in the Nd ∶ YAG laser group (P＜0.01).The analysis also showed that average therapeutic time,operative time and quantity of bleeding in the semiconductor laser group were less than that of in the Nd ∶ YAG laser and CO2 laser groups (P＜0.01).Conclusions The semiconductor laser (wave length 830 nm and power 318 W/cm2) for the treatmet of children patients with SH on face has many advantages,such as higher cure rate,shorter operative time,less bleeding in operation and better cos metic effects.It might become a first selective therapy for children patients with SH on face.
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Objective To compare the effect of treating chronic colonitis diarrhea (CCD) using He-Ne laser irradiation of acupoints with routine drug treatment. Methods Two hundred patients with CCD were randomly divided into a laser irradiation group (laser group) and a routine drug treatment group (control group) with 100 patients in each group. The laser group patients were treated with a He-Ne laser ( power density 478 mW/cm2 )through coupling fiberoptic cable radiating onto the Shenque (REN8) , bilateral Tianshu (ST25) and Dachangshu (BL25) acupoints, each for 10 min daily for 10 days. Control group patients were treated with routine drugs such as antibiotics, astringents, antidiarrheals, antispasmodic analgesics, vitamins and Chinese herbal enemas. Three months after treatment the patients were examined by fibercoloscope to evaluate the therapeutic efficacy in the two groups. Results In the laser group 66 cases (66%) experienced a short-term cure, 27 cases (27%) improved and7 cases (7%) showed no effect. In the control group 33 cases (33%) were short-term cures, 43 cases (43%) improved and 24 cases (24%) had no effect. These differences were statistically significant. In both groups the effects for patients with short histories was better than for those with longer histories. In the laser group the pathological changes in the distal colon were significantly better than in the proximal colon, but this difference wasn't significant in the control group. The average days of total treatment to achieve short-term cure and improvement in the laser group were significantly less than in the control group. In the laser group the average days to the disappearance of abdominal pain and diarrhea in the short-term cure patients of was significantly fewer than in the control group. Conclusions Laser irradiation was more effective than routine drug treatment, especially for stopping diarrhea, spasmolysis and analgia.