Abstract: Objective To study the expression of E-selectin on vascular endothelial cells of nude mice liver induced by esophageal carcinoma cells, in order to find out the function of E-selectin in the metastasis of esophageal carcinoma into the liver. Methods Twelve Balb/c nude mice aged from 6 to 8 weeks with their weight ranged between 20 and 25 grams were selected in our research. The mice were equally distributed into the experimental group and the control group(n=6). EC9706 cell solution (5×10.6/0.02 ml) were injected beneath the splenic capsule of the mice in the experimental group. One hour later, spleen was removed. For the mice in the control group, after laparotomy, phosphate buffer without EC 9706 was injected beneath the splenic capsule and spleen was also removed one hour after the injection. Eight hour later, we resected the liver of the nude mice, and expression of E-selectin on vascular endothelial cells of the liver was detected with reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC). Results In the experimental group, 8 hours after injection of EC9706 cells (5×10.6), the results of RT-PCR showed expression of E-selectin mRNA in the liver, and IHC showed a positive protein expression of E-selectin in the cytosol and membrane of hepatic sinus vessels.However, no E-selectin mRNA expression was found in the control group and IHC showed a negative protein expression of E-selectin. Conclusion Human esophageal carcinoma cell line EC9706 can induce balb/c mice liver vascular endothelial cell E-selectin expression, which shows that EC9706 may stay in the liver and form etastatic focus.
We introduced the current doctor-patient relationship and analyzed its opposition and unification based on present medical practice. We suggested that evidence-based medicine should be an important in improving doctor-patient relationship in clinical practice. We urged health care professionals to learn and apply initiatively evidence-based medicine, so as to improve the patient-professional relationship.
【摘要】目的探討新型醫患溝通范式的臨床價值。方法分析新型醫患溝通范式的基本文書和臨床應用效果。結果自2002年1月2009年12月,新型醫患溝通范式應用于9800余例住院患者,無1起醫療事故發生。結論新型醫患溝通范式從形式上和內容上對患者知情權進行了充分的保障,對構建和諧醫患關系具有重大價值。【Abstract】Objective To explore the clinical value of new doctorpatient communication paradigms. Methods The primary documents and clinical application results of new doctorpatient communication paradigms were analyzed in our study. Results We applied the new doctorpatient communication paradigms to more than 9800 patients of inpatient from January 2001 to December 2009. No medical negligence was observed. Conclusion The new doctorpatient communication paradigms can ensure the patient’s right of informed consent in form and in content. Its value to construct harmony doctorpatient relationship is great.
Objective To provide scientific evidence for the establishment of medical specialist system in China by investigating the history, current situation, problems and countermeasures of medical specialties training at home and aboard. Method The principle and theroy of evidence-based medicine were adopted. The information before Dec. 31, 2003 of Pubmed, CBM, official website, some journals, most frequently used search engines and medical monograph were systematically reviewed. Included literatures were assessed and graded according to the pre-defined criterias. Results A total of 1 319 studies (1 298 in English, 21 in Chinese) were included, among which only 6 were related to the classification of medical specialties. Based on the information from official website of USA, Canada, UK, Singapore, Australia and China (including HK and Taiwan), it showed that China has the largest number of medical specialties, followed by that of USA. In China, the number of medical specialties has more than that of the disciplines in clinical field, which was followed by resident training programs. Some specialties were duplicate, or not international standardized. Conclusions The classification of medical specialties should be developed consecutively, which comprehensively considered the international trend, characteristics of doctor training and the current situation. Specialties whose training program are well-established and developed should initiate firstly. Others will be put into practice gradually after being fully exprienced.
Objective To explore the factors which affect shared decision-making and develop strategies to get patients actively involved in clinical decision-making. Methods We conducted a survey on 566 patients of a Class A Hospital in Sichuan with group random sampling method. The data were collected by the use of anonymous selfadministered questionnaires. We used SPSS 10.0 to analyse the data. Results A total of 600 questionnaires were distributed at random, of which 565 were completed. There were 68% patients who had some knowledge of the disease, and 93% who were willing to participate in clinical decision-making. The patients’ biggest concerns were: treatment effect, cost and doctors’ skills. The biggest difficulties that patients worried about were: long-time waiting in out-patient departments and limited time to communicate with doctors. Conclusion As more and more patients would like to involve in shared decision-making, doctors need to provide patients with more choices and help them make a right decision in their treatment.
ObjectiveTo explore the effect of doctor-nurse-patient communication area established in the ward. MethodsBefore (July to September 2013) and three months after (October to December 2013) the establishment of doctor-nurse-patient communication area, 30 doctors, 30 nurses and 216 patients or their family members were respectively investigated by questionnaires and interviews, and the data were collected and compared by t test. ResultsThirty questionnaires for doctors, 30 for nurses and 216 for patients or their family members were issued before and after the establishment of doctor-nurse-patient communication area. The response rate for the questionnaires was 100%. After the implementation of doctor-nurse-patient communication area, the satisfaction of patients' family members, nurses' awareness of the patients' condition and implementation of health education were significantly higher than those before the implementation (P < 0.05). ConclusionThe doctor-nurse-patient communication area established in the surgical ward can promote the trust between the patients and medical staff, create a good atmosphere to understand the needs of patients, meet patients' demand as far as possible and improve communication ability of medical staff, which makes doctors, nurses and patients more satisfied.
Objective To study the current situation of doctor-patient communication education for medical undergraduates, and meanwhile to analyze the students’ satisfactory degree to communication education and its influencing factors, so as to provide sound suggestions to promote the students’ clinical communication abilities. Methods Using simple sampling, 50% of the students who majored in clinical medicine in grade 2006-2009 in West China Medical School of Sichuan University were selected as respondents. The investigation was conducted by face to face talk with a self-designed questionnaire. The data were input using EpiData 3.0 software and the results were analyzed by SPSS 13.0 software. Results A total of 450 questionnaires were distributed, and 404 were validly retrieved (89.78%). Among the respondents, 74.3% of them were satisfied with the current situation of doctor-patient communication education; 75.7% of them begun to know doctor-patient communication education since the stage of learning basic knowledge; 49.8% of them were trained by means of problem-based-learning (PBL); and 65.5% of them were trained with auxiliary standardized patient (SP). “Grade”, “Gender”, “SP used” and “PBL used” were the main factors affecting the satisfactory degree to current doctor-patient communication education (P=0.029, 0.023, 0.012, and 0.029, respectively). Conclusion The medical undergraduates’ satisfactory degree to current doctor-patient communication education is generally high, but it is also affected by various factors. Although doctor-patient communication education has started early, the training system is still problematic and the teaching resources coverage is limited. So in order to make a further systematic, standardized, overall designed education for students’ cognition and communication skills, the medical colleges should open integrated doctor-patient communication curriculum that combines with both PBL and SP auxiliary teaching methods, and covers all the undergraduate learning stage.
ObjectiveTo systematically review the current status of doctor-patient conflicts in China.MethodsWe searched CNKI and CSSCI databases to collect literatures about the doctor-patient conflicts from inception to April 23rd, 2017. The literatures were categorized by the published time, the high-frequency vocabulary, the citation frequency, the researching discipline, the researching facility, the quality of literature, the theme of literature and so on. The current research status of the doctor-patient conflicts was analyzed.ResultsA total of 226 literatures were included, in which 72 defined and classified the doctor-patient conflicts, 122 analyzed the causing reasons of doctor-patient conflicts, and 160 analyzed the governance paths of doctor-patient conflicts. The research disciplinary vision was limited to the policies, regulations and the medical education and so on, and the researches in psychology or economics disciplinary vision were insufficient. The medical and comprehensive universities were the main research units of the studies of the doctor-patient conflicts. The frequency and quality of the researches about doctor-patient conflicts were low.ConclusionThe classified studies of doctor-patient conflicts are insufficient, so the scientific and manageable classified criterions are needed in the further studies. Systematic studies in influential factors of doctor-patient conflicts are insufficient, so the occurring mechanisms of conflicts are needed to be done by systematical researches on patient-centered way. The studies of governance paths of doctor-patient conflicts are insufficient, so the strategies of classified and systematical management which according to the different conflicting forms and entire process of the conflict occurrence should be put forward.
Objective To investigate patients in gynecological endocrinology clinic with the following three pieces of information: how did they provide their symptom information, how did they understand diagnostic and therapeutic information, and what was their attitude towards the visit, and to get to know about the situation and problems in doctor-patient communication, so as to aim directly at improving the efficiency of diagnosis and treatment. Methods A total of 403 patients, who visited Prof. HAN Zi-yan’s clinic in the hospital from April to August 2010, were evaluated using self-edited Assessment on Doctor-patient Communication in Gynecological Endocrinology Outpatient Clinic. Results a) As to the situation of patients providing symptom information as well as understanding diagnostic and therapeutic information, when doctor asked, only 29% (118/403) of patients could narrate their treatment history clearly, and 38% (152/403) could tell their examination history exactly. After doctors’ explanation, only 21% (86/403) understood their examination results correctly, and 27% (108/403) understood management and therapeutic advice. The result of correlation analysis showed the accuracy of patients in providing disease information and accepting diagnostic and therapeutic information was higher in patients aged from 21 to 40 rather than those younger than 20, in patients well- educated rather than those with little education at the primary school, and in patients who were also engaged in medical work, All differences were significant (all Plt;0.05); and b) As to patients’ attitude towards visit, 55% (222/403) of patients hoped to get more attention from doctor, and 37.5% (151/403) overly expected the visit. Conclusion In the professor’s gynecological endocrinology outpatient clinic, many patients can’t clearly provide their treatment and examination history, neither understand exam situation and therapeutic advice at that visit, which are influenced by their age, education and occupation. In addition, psychological needs of patients should be concerned, too
This article briefly introduces the status and problems of research and application on medical professionalism in China; proposes the concept of translational medicine and the challenges of introduction of translational medicine to physician professionalism research and translation. Some measurements or approaches to promote research translation on medical professionalisms are proposed to shorten the distance from research outcomes to practical application, in order to carry out evidence-based construction of modern medical professionalism of Chinese characteristics and build a harmonious doctor-patient relationship.