Analysis of Barriers on Doctor-patient Communication in China / 中国医学伦理学

From four aspects of the social and cultural barriers,the skills and role barriers of medical workers,patient needs and knowledge barriers,and the weakened third person functions in the conflict between doctors and patients,this paper concluded that the old doctor-patient communication mode,the weakening of the trust rela-tionship,the conflict between traditional moral education and modern society characteristics,the lack of communi-cation skills of medical works,the fixation of doctor's identity and role,the diversity of patient's needs,the con-flict between informed consent rights and the mastery of medical information,the weakening functions of third per-son and other barrier factors that affected the smooth communication between doctors and patients.And this paper put forward that in the process of social transformation,both doctors and patients will advance towards common or even shared communication,and the doctor-patient relationship will develop more harmoniously.

Discussion on the "Five Points" in the Construction of Harmonious Mediation Mechanism / 中国医学伦理学

After several in -depth investigations on the third party mediation mechanism of "Guangdong mode" in Guangdong Harmony Medical Dispute Mediation Committee and combined with the analysis of the domes-tic and foreign medical dispute disposal experience , this paper summed up five points that successful construction of harmonious mediation mechanism should grasp .The five points include the fairness of harmonious mediation thoughts , the feasibility of harmonious mediation paths , the justice of harmonious mediation mechanism , the suita-bility of harmonious mediation environment and the success of harmonious mediation results .Only when grasp these five points, couldit create a gradually harmonious doctor -patient relationship .

Expression of miR-34a in the myocardium of mice received Danggui Buxue Decoction therapy following myocardial infarction / 实用医学杂志

Objective To investigate the effect of Danggui buxue decoction on ventricular remodeling and miR-34a expression after myocardial infarction in mice. Methods Mice myocardial infarction model were estab-lished by the left anterior descending coronary artery embolization. Then the mice were divided into Danggui buxue Decoction group and model group. Mice in Danggui buxue decoction group were given Danggui buxue decoction , and mice in the model group were given the equal volume of saline for 8 weeks. Cardiomyocyte apoptosis was detect-ed by TUNEL staining. Myocardial fibrosis was detected by Masson staining. The expression of miR-34a was detect-ed by quantitative PCR and the expression of Sirt1 was detected by Western blot assay. Results Compared with the model group ,the EF value of the mice was significantly improved (P < 0.05),the myocardial cell index decreased(P<0.05),the content of collagen fibers decreased(P<0.05),the expression of miR-34a decreased, but the expression of Sirt1 increased(P<0.05)in Danggui buxue Decoction group. Conclusion Danggui buxue decoction can effectively inhibit ventricular remodeling of mice following myocardial infarction ,which is associated with the suppression of miR-34a and the increase of Sirt1.

Expression of miR-34a in the myocardium of mice received Danggui Buxue Decoction therapy following myocardial infarction / 实用医学杂志

Objective To investigate the effect of Danggui buxue decoction on ventricular remodeling and miR-34a expression after myocardial infarction in mice. Methods Mice myocardial infarction model were estab-lished by the left anterior descending coronary artery embolization. Then the mice were divided into Danggui buxue Decoction group and model group. Mice in Danggui buxue decoction group were given Danggui buxue decoction , and mice in the model group were given the equal volume of saline for 8 weeks. Cardiomyocyte apoptosis was detect-ed by TUNEL staining. Myocardial fibrosis was detected by Masson staining. The expression of miR-34a was detect-ed by quantitative PCR and the expression of Sirt1 was detected by Western blot assay. Results Compared with the model group ,the EF value of the mice was significantly improved (P < 0.05),the myocardial cell index decreased(P<0.05),the content of collagen fibers decreased(P<0.05),the expression of miR-34a decreased, but the expression of Sirt1 increased(P<0.05)in Danggui buxue Decoction group. Conclusion Danggui buxue decoction can effectively inhibit ventricular remodeling of mice following myocardial infarction ,which is associated with the suppression of miR-34a and the increase of Sirt1.

Discussion on the "Five Points" in the Construction of Harmonious Mediation Mechanism / 中国医学伦理学

After several in -depth investigations on the third party mediation mechanism of "Guangdong mode" in Guangdong Harmony Medical Dispute Mediation Committee and combined with the analysis of the domes-tic and foreign medical dispute disposal experience , this paper summed up five points that successful construction of harmonious mediation mechanism should grasp .The five points include the fairness of harmonious mediation thoughts , the feasibility of harmonious mediation paths , the justice of harmonious mediation mechanism , the suita-bility of harmonious mediation environment and the success of harmonious mediation results .Only when grasp these five points, couldit create a gradually harmonious doctor -patient relationship .

Research on Status and Pushing Approach of Credibility of the Third-party Mediation in Medical Disputes / 中国医学伦理学

The credibility of the third-party mediation agencies in medical disputes lies in their own advantages of efficiency,neutrality,professionalism and objectivity.However,because of the differences of actual operation,the credibility of the third-party mediation agencies often is questioned by both doctors and patients and the public.Aiming at these,this paper would study the status and the pushing approach of the third-party mediation agencies credibility from the perspective of professionalism and neutrality,legislation,fundraising channels and supervision.

Clinical Observations on Continual Needle Knife Treatment for Cervical Spondylosis / 上海针灸杂志

ObjectiveTo investigate the clinical efficacy of continual needle knife treatment for cervical spondylosis and whether it increases adverse reactions and the number of treatments.MethodNinety-two patients with cervical spondylosis were randomly allocated to a treatment group of 47 cases and a control group of 45 cases. The treatment group received continual needle knife therapy once every day and the control group, interrupted needle knifetherapy once 10 days.ResultThere were no statistically significant differences in the number of treatments, the total efficacy rate and postoperative adverse reactions between thetwo groups (P>0.05). There were statistically significant differences inthe treatment period and cure rate between the two groups (P<0.05). The treatment period was significantly shorter in the treatment group than in the control group(P<0.05). The cure rate was significantly higher in the treatment group than in the controlgroup(P<0.05).ConclusionContinual needle knife therapy cannot increase postoperative adverse reactions and the number of treatments. It can significantly shorten the treatment period, avoid another injury and increase the cure rate in the patients.

Ethanol inhibiting the NLRP3 inflammasome activation to protect coronary heart disease / 实用医学杂志

Objective To examine whether ethanol modulates the intracellular processes involved in the secretion of IL-1α,and then exert a protective effect against coronary heart disease. Methods THP-1 cells in human were cultured for 2-3 generations , and put in PMF for 72 h to induce THP-1 into macrophage. ELISA was applied to detect effects for secretion of IL-1α by LPS, cholesterol and ethanol. In the light of ELISA re-sults, western blot was applied to detect the effects of ethanol on caspase-1 and NLRP3. Results Compared with the control group, the secretion of IL-1α in LPS group and LPS + CHOL group increased. Compared withLPS + CHOL group, the concentration of IL -1α in LPS + CHOL + etha group significantly decrease(P < 0.01). The results of western blot showed that ethanol significantly inhibited caspase-1 and NLRP3 activation. Conclu-sion Ethanol can inhibit the NLRP3 inflammasome activation in macrophages , which may represent a biological pathway underlying the protective effect of moderate alcohol consumption on coronary heart disease.

Regulation of mesenchymal stem cells derived from umbilical cord on natural killer cells-mediated cytotoxicity against dendritic cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of mesenchymal stem cells derived from umbilical cord (UC-MSCs) on natural killer (NK) cells-mediated cytotoxicity against dendritic cells (DCs) and explore the mechanism.</p><p><b>METHODS</b>MSCs were isolated from human umbilical cord by collagen digestion and cultured in vitro. NK cells were separated from healthy human peripheral blood by magnetic bead sorting. Mononuclear cells from healthy human peripheral blood were cultured in the presence of granulocyte and macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) to obtain the immature DCs. The DCs were then co-cultured with UC-MSCs in the presence of tumor necrosis factor α (TNFα) for 2 days, and the expressions of CD11c and CD86 on DCs and IL-12 level in the culture medium was detected using flow cytometry and ELISA, respectively. The cytotoxicity of NK cells against DCs was analyzed by LDH-releasing assay, and the expressions of ligands for killer activator receptor (MICA/B and ULBP1-3) on the DCs were detected with flow cytometry.</p><p><b>RESULTS</b>Compared with the cytokine-induced DCs, the DCs induced by co-culture with UC-MSCs showed an identical CD11c expression but lowered CD86 expression and IL-12 secretion. The natural killer cells produced a stronger cytotoxicity against UC-MSCs-induced DCs than against cytokine-induced DCs. The UC-MSCs-induced DCs also showed increased expressions of MICA and MICB on the surface.</p><p><b>CONCLUSION</b>UC-MSCs can enhance NK cells-mediated cytotoxicity against DCs possibly by inhibiting DC maturation and up-regulating the ligands for killer activator receptor on the surface of the DCs.</p>

Insights on further reforming the business model of the hospital / 中华医院管理杂志

This paper analyzed the economic background,contents and effects of the existing business model of the hospital.On this basis,further study and reform are made on optimal business model of the hospital.The authors recommended that appropriate regional health scale,appropriate technical service,appropriate pricing for charges,appropriate operating cost and appropriate incentive constraints be adopted.These measures will safeguard state assets,public benefit nature of the hospital,enhanced hospital power in general,and compliance in operations,making the people satisfied and healthy.