目的 探讨晚期胰腺癌超级伽玛刀治疗的临床效果。方法 选取2015年1月—2019年1月我院收治的晚期胰腺癌患者46例,随机分为对照组(23例)与观察组(23例),对照组接受单纯化疗治疗,观察组患者接受超级伽玛刀方案治疗。收集两组患者的治疗有效率、生存时间的临床受益反应(CBR)等指标,进行对比分析。结果 接受不同治疗措施干预1个月后,对两组患者治疗总有效率进行比较。观察组患者治疗总有效率为60.87%,高于对照组患者治疗总有效率13.04%(P＜0.01)。观察组患者中疼痛程度改善阳性人数比例、KPS体力改善阳性人数比例和体质量改善阳性人数比例均高于对照组患者(P＜0.05),但两组患者镇痛药物消耗量改善阳性人数比例差异并无统计学意义(P＞0.05)。观察组患者无进展生存期中位时间为4个月(95%CI,2.124±5.274),对照组患者无进展生存期中位时间为3个月(95%CI,1.804±4.851)。观察组患者无进展生存期中位时间长于对照组患者(P=0.042＜0.05)。结论 基于立体定向伽马射线全身治疗系统的超级伽玛刀采用中等剂量分割方法治疗晚期胰腺癌,其临床效果切实,副作用相对较低,对患者生存治疗有明显提升效果,值得临床推广。

Objective To explore the clinical effect of super gamma knife in the treatment of advanced pancreatic cancer. Methods 46 patients with advanced pancreatic cancer admitted to our hospital from January 2015 to January 2019 were randomly divided into control group (23 cases)and observation group (23 cases). The control group received chemotherapy only; the observation group received super gamma knife treatment. We collected the clinical benefit response (CBR)and other indicators of treatment efficiency and survival time of the two groups for comparative analysis. Results One month after the intervention of different treatment measures, the total effective rate of the two groups was compared. The total effective rate of the observation group was 60.87%, which was higher than that of the control group (13.04%)(P<0.01). The positive rate of pain degree improvement, KPS physical strength improvement, body weight improvement in the observation group were all higher than those in the control group (P<0.05), but there was no statistical significance between the two groups in the positive rate of analgesic consumption improvement (P>0.05). The median time of progression free survival was 4 months (95% CI, 2.124±5.274)in the observation group and 3 months (95% CI, 1.804±4.851)in the control group. The median time of progression free survival in the observation group was longer than that in the control group (P = 0.042<0.05). Conclusion The super gamma knife based on the stereotactic gamma ray systemic therapy system uses the medium dose segmentation method to treat the advanced pancreatic cancer. Its clinical effect is practical, the side effects are relatively low, and the survival treatment of patients has a significant improvement effect, which is worthy of clinical promotion.

目的 探讨四金石灵膏联合间苯三酚治疗输尿管结石伴肾绞痛的应用价值。方法 随机将76例输尿管结石伴肾绞痛患者分为两组,以接受中药安慰剂联合间苯三酚治疗者为对照组,以接受四金石灵膏联合间苯三酚治疗者为观察组,每组38例。对比两组临床治疗效果,并分析尿液相关指标的变化情况。结果 两组7 d治疗过程中VAS评分及尿Ga水平呈降低趋势、WHOQL-BREF评分及尿OPN水平呈升高趋势(P<0.05),而治疗3 d及7 d后,治疗组VAS评分及尿Ga水平低于对照组、WHOQL-BREF评分及尿OPN水平高于对照组(P<0.05)。同时,治疗7 d后,观察组排石率高于对照组(P<0.05),而观察组排石时间及止痛时间短于对照组(P<0.05)。此外,治疗7 d后,治疗组治疗总有效率高于对照组(P<0.05),而两组间治疗不良反应发生率比较未见差异有统计学意义(P>0.05)。结论 四金石灵膏联合间苯三酚可有效的提高输尿管结石伴肾绞痛的临床治疗效果,具有较为理想的应用价值。

Objective To explore the application value of four-gold-stone-ling confection and phloroglucinol in the treatment of ureteral calculus with renal colic. Methods 76 patients with ureteral calculus with renal colic were randomly divided into two groups, with those receiving traditional Chinese medicine placebo combined with phloroglucinol as the control group, and those receiving four-gold-stone-ling confection combined with phloroglucinol as the observation group,38 cases in each group. The clinical treatment effects of the two groups were compared, and the changes of urine-related indicators were analyzed. Results The VAS score and urine Ga level of the two groups showed a decreasing trend during 7d treatment, and the WHOQL-BREF score and urine OPN level showed an increasing trend(P<0.05). After 3d and 7d treatment, the VAS score and urine Ga level of the treatment group were lower than that of control group, the WHOQL-BREF score and urine OPN level were higher than that of control group(P<0.05). Meanwhile, After 7d of treatment, the rate of stone drainage in the observation group was higher than that of control group(P<0.05), while the time of stone drainage and pain relief in the observation group was shorter than control group(P<0.05). In addition, after 7d treatment, the total effective rate of the treatment group was higher than control group (P<0.05), while the difference of incidence of adverse reactions between the two groups was not significant(P>0.05). Conclusion Four-gold-stone-ling confection combined with phloroglucinol may effectively improve the clinical effect of ureteral calculi with renal colic, and have ideal application value.

目的 分析高压氧治疗对面部填充术后血管并发症的疗效。方法 将62例面部填充剂注射后并发症患者根据高压氧介入时机分为A组和B组,A组在在常规治疗的基础上,48小时内进行高压氧治疗,B组在在常规治疗的基础上,48小时后进行高压氧治疗,在治疗结束后对两组患者进行疗效分析。结果 A组患者的治疗疗效较B组患者治疗疗效好,差异有统计学意义(P<0.05)。结论 高压氧治疗对面部填充剂注射后并发症疗效是肯定的,且高压氧介入时间越早效果越好。

Objective To analysie effect of hyperbaric oxygen therapy on vascular complications after facial filling. Methods 62 patients with complications after injection of facial filler according to the timing of hyperbaric oxygen intervention were divided into group A and group B.Group A was treated with hyperbaric oxygen within 48 hours on the basis of conventional treatment.Group B was treated with hyperbaric oxygen 48 hours later on the basis of conventional treatment to analysie the efficacy of the two groups of patients after the end of treatment. Results The efficacy of group A patients was better than that of group B, the difference was statistically significant P<0.05. Conclusion Hyperbaric oxygen therapy is effective in the treatment of complications after facial filler injection, and the earlier the hyperbaric oxygen intervention time is taken, the better the effect is.

目的 探讨Stanford B型胸主动脉夹层腔内修复(TEVAR)术后不同类型内漏的产生机制及处理措施。方法 收集整理2008年9月—2017年2月间在我院诊断为Stanford B型胸主动脉夹层并接受TEVAR术治疗的105例患者的临床及影像资料,分析术中及术后出现内漏的原因,根据内漏来源及渗漏量给予不同处理,观察处理后内漏的变化情况。结果 术中出现急性内漏11例,包括Ⅰ型内漏8例(7.6%)和Ⅱ型内漏3例(2.8%);迟发内漏3例,包括Ⅰ型内漏1例(1.0%)和Ⅱ型内漏2例(1.9%),内漏总发生率为13.3%。术后患者未出现支架移位、截瘫、肾动脉缺血等严重并发症。结论 根据内漏产生的原因不同,内漏分为5型,其中Ⅰ型及Ⅱ型内漏较为常见,不同类型内漏处理方式不同,正确判断内漏类型是合理、有效处理内漏的前提。

Objective To investigate the causes of different types of endoleak after thoracic endovascular aortic repair(TEVAR)for Stanford type B aortic dissection, and to discuss its management. Methods The clinical data and imaging data of 105 patients with Stanford type B aortic dissection, who were admitted to authors' hospital during the period from September 2008 to February 2017 to receive TEVAR, were collected and reviewed. Reasons of intraoperative endoleak or after operation were analyzed, different treatments for the source of endoleak and leakage were taken and the conversions followed were observed. Results Acute endoleak was occurred in 11 patients during operation, including endoleak typeⅠ (n=8,7.6%)and endoleak type Ⅱ (n=3,2.8%). Delayed endoleak was seen in 3 patients, including endoleak typeⅠ (n=1,1.0%)and endoleak type Ⅱ (n=2,1.9%). Both in-operative and postoperative endoleak occurred in 14 patients (13.3%). After TEVAR, no serious complications such as displacement of stent, paraplegia or renal artery ischemia occurred. Conclusion According to the different reasons, endoleak can be divided into five types, among them, type Ⅰ and type Ⅱ are most common. Different endoleak should be handle in different ways.Correct judgment of endoleak type is the premise of reasonable and effective treatment for endoleak.

目的 比较压力控制通气(PCV)中不同吸气流速对单肺通气(OLV)患者呼吸功能及炎症因子的影响。方法 本研究为2018—2019年对75例单肺通气患者的前瞻性研究。患者在麻醉和单肺通气(OLV)后随机分为吸气流量30 L/min(A组)、50 L/min(B组)或70 L/min(C组)。比较OLV前(T₀)、OLV后30 min(T₁)、60 min(T₂)和120 min(T₃)的呼吸力学、呼吸功能、血流动力学和血气分析,中心静脉血检测分析IL- 6、IL-8、TNF-α和sICAM-1,观察术后3天肺部并发症和ARDS的发生情况。结果 三组一般情况、血流动力学指标差异均无统计学意义(P＞0.05);B组、C组PaCO₂较A组降低(P<0.05);与T₀时比较,T₁-T₃时三组PaO_2、SVO₂均降低(P<0.05);三组PH、SO₂和HB差异均无统计学意义(P>0.05)。与A组比较,B组、C组ΔVT增大(P<0.05);三组Ppeak差异无统计学意义;与A组比较,B组、C组PEEP均增大(P<0.05);与A组比较,T₁-T₃时B组、C组V_D/V_T减少(P>0.05);与T₀比较,T₁-T₃时三组Qs/Qt增加(P<0.05);与A组比较,T₁-T₃时B组、C组Cdyn增大(P<0.05);与T₀相比,T₁-T₃时三组PaO₂/FiO₂降低(P<0.05);与T₀相比,T₁-T₃时三组IL-6、IL-8、TNF-α和sICAM-1的浓度增多(P<0.05),但A组、B组低于C组(P<0.05)。三组患者发生术后肺部并发症和ARDS差异均无统计学意义。结论 在PCV模式下通过增加吸气流速能增加VT,减少死腔率,促进 CO₂的交换,并且改善肺动态顺应性,但并不能很好的改善氧合及肺内分流。吸气流速50 mL/L在较小炎症反应的情况下达到上述改善呼吸功能和呼吸力学,可推荐应用于进行OLV患者。

Objective The effects of different inspiratory velocity PCV on respiratory function and inflammatory factors in patients with one-lung ventilation OLV were compared. Methods This was a prospective study of 75 patients with one-lung ventilation in 2018-2019. The subjects were randomized to the inspiratory velocity 30(group A),50(group B)or 70(group C)L/min after anesthesia and one-lung ventilation OLV. Respiratory mechanics,respiratory function,hemodynamics and blood gas parameters were compared between the three groups pre-OLV(T₀)and after 30 (T₁), 60 (T₂), and 120 (T₃)minutes of OLV.Center venous blood was collected to measure interleukin (IL)-6, IL-8,tumor necrosis factor (TNF)-α,andsoluble intercellular adhesion molecule-1 levels.Observation of pulmonary complications and occurrence of ARDS 3 days after operation were made. Results Hemodynamic and general patient status were similar between the three groups (all P>0.05). PaCO₂was lower in the group B and group C compared with the group A (P<0.05). Compared with T₀, PaO₂ and SVO₂were lower at T₁-T₃of the three groups(P<0.05). PH, SO2 and HB were similar between the three groups (all P>0.05).ΔVT was higher in the group B and group C compared with the group A (P<0.05);Ppeak were similar between the three groups (all P>0.05). PEEP was higher in the group B and group C compared with the group A (P<0.05); V_D/V_T decreased in the group B and group C compared with the group A (P<0.05).Compared with T₀,Qs/Qt increased at T₁-T₃ of the three groups (all P<0.05). Cdyn increased at T₁-T₃ of the group B and group C(all P<0.05). PaO₂/FiO₂ decreased at T₁-T₃ of the three groups(all P<0.05).Compared with T₀, the concentrations of Il-6, Il-8, TNF-α and sICAM-1 increased at T₁-T₃of three groups (P<0.05), and in group A and group B were lower than those in group C (P<0.05).The number of patients who had postoperative pulmonary complications PPCS or acute respiratory distress syndrome(ARDS)were similar between the three groups (all P>0.05). Conclusion In PCV mode, it can increase VT by increasing the inspiratory velocity, reduce the V_D/V_T, promote the exchange of CO₂, and increase the Cdyn, but it cannot improve the oxygenation and Qs/Qt.Inspiratory velocity of 50 mL/L to achieve the above improvement in respiratory function and respiratory mechanics in the case of a smaller inflammatory response. It may be recommended for use in patients undergoing OLV.

目的 比较一线伊马替尼疗效欠佳的慢性髓性白血病慢性期(CML-CP)患者,继续伊马替尼原方案或转换为尼洛替尼治疗后的疗效及安全性。方法 收集伊马替尼疗效欠佳的 45 例患者,分为伊马替尼组22例及尼洛替尼转换组23例,22例伊马替尼组患者继续接受原方案伊马替尼治疗,剂量均为400 mg qd,又将尼洛替尼转换组分为早期尼洛替尼转换组7例,晚期尼洛替尼组转换有16例。尼洛替尼转换组的23例患者接受尼洛替尼的剂量均为400 mg,q12h。所有入组患者首诊时测定 Sokal 评分,在治疗过程中随访观察定期监测血液学、细胞遗传学及分子学缓解情况(FISH 和 RQ-PCR),并对患者用药后的基本情况、临床表现及不良反应进行记录。结果 转换尼罗替尼治疗3个月时,早期尼洛替尼转换组中国际标准化 BCR-ABL1融合基因转录本水平(BCR-ABL1^IS)＜10%的患者有 5 例(71.4%),晚期尼洛替尼转换组BCR-ABL1^IS＜10%的患者有6例(37.5%),差异无统计学意义(P＞0.05)。中位观察6(3～12)个月,尼罗替尼组中有17例(73.9%)获得部分细胞遗传学反应,9例(39.1%)患者获得主要分子学反应。伊马替尼组中有9例(40.9%)获得部分细胞遗传学反应,2例(9.1%)患者获得主要分子学反应,尼洛替尼组部分细胞遗传学反应、主要分子学反应患者优于伊马替尼组(P值分别为0.027、0.020)。45例患者中达到完全细胞遗传学反应的患者与未达到完全细胞遗传学反应相比,Sokal 评分偏低(P=0.032)。结论 尼洛替尼可使伊马替尼疗效欠佳的 CML-CP 患者达到更好的疗效,因此需要及时对伊马替尼疗效欠佳的 CML-CP 患者进行评估后及时更换为尼洛替尼等二代酪氨酸激酶抑制剂。

Objective To assess the clinical efficacy and safety of original scheme or switching to nilotinib in patients with chronic myeloid leukemia in chronic phase(CML-CP)with suboptimal response of first-line imatinib. Methods 45 patients with suboptimal response of imatinib were collected and divided into 22 patients who continued to use original scheme and 23 patients who switched to nilotinib therapy. All the 22 patients of imatinib group received imatinib 400 mg once a day. And the 23 patients of nilotinib group were divided into early switch group and late switch group. Early switch group had 7 patients, late switch group had 16 patients. Both early and late switch to nilotinib group were subsequently to nilotinib 400 mg q12h. Sokal scores of all the enrolled patients were measured at the first diagnosis. Hematology, cytogenetics and molecular remission (FISH and RQ-PCR)were monitored, and the patients' basic information, clinical manifestations and adverse reactions were recorded regularly during the treatment. Results After switching to nilotinib for 3 months,there were 5 patients (71.4%)whose BCR-ABL1^IS<10% in the early nilotinib switch group, while 6 patients (37.5%)in the late nilotenib switch group.There was no statistical difference(P>0.05).With a median observation period of 6(3～12)months,there were 17 (73.9%)patients achieved partial cytogenetic response and 9 (39.1%)patients achieved major molecular response in the nilotinib group,there were 9 patients (40.9%)achieved partial cytogenetic response and 2 patients (9.1%)achieved major molecular response in the imatinib group. Patients who achieved partial cytogenetic response and major molecular response in the nilotinib group were more than those in the imatinib group (P values were 0.027 and 0.020, respectively).Sokal scores of 45 patients who had achieved complete cytogenetic response were lower than those who had achieved it (P=0.032). Conclusion Early switch to nitotinib is feasible and effective to patients who didn't have optimal response to imatinib. It is necessary to assess patients regularly in order to have the proper timing switching patients to nilotinib therapy.

目的 探讨高频经颅磁刺激治疗对 PSD 伴失眠患者的抑郁情绪及睡眠质量的疗效。方法 对63例PSD患者随机分为联合组32例(10Hz高频rTMS+艾司西酞普兰)及药物组31例(艾司西酞普兰+假刺激),每周5次,共治疗4周。于治疗前及治疗后4周末分别对两组患者进行HAMD、PSQI评分及多导睡眠监测。。结果 rTMS 治疗前,2组HAMD、PSQI评分及睡眠参数比较均无差异;治疗后第4周末,两组HAMD评分、PSQI评分、总睡眠时间、睡眠效率及快眼动睡眠期比例均较治疗前改善;研究组HAMD评分下降幅度较对照组明显,而PSQI评分下降幅度及相关睡眠参数改善无差异。结论 高频rTMS治疗对PSD的抑郁症状疗效更明显,而对睡眠质量及睡眠结构的改善则与药物治疗疗效相当。

Objective To investigate the effect of high frequency transcranial magnetic stimulation on depression and sleep quality in poststroke depression patients with insomnia. Methods 63 patients with PSD were randomly divided into observation group (n=32)and control group (n=31). Both groups were treated by 10~20 mg escitalopram citalopram for 4 weeks. The patients in observation group also accepted 10 Hz rTMS 10 times (i.e., as a course), while the patients in control group were treated by sham stimulation. At the baseline and 4th week, the 17-item Hamilton depression scale (17-HAMD), Pittsburgh Sleep Quality Index (PSQI)and polysomnography (PSG)were evaluated. Results The sleep parameters, PSQI scores and HAMD scores among two groups had no significant difference at baseline. After 4 weeks treatment, the HAMD score, PSQI score, total sleep duration, sleep efficiency and proportion of rapid eye movement sleep in both groups were improved compared with those before treatment. The descend range of HAMD score in observation group was larger than that in control group (t=2.590,P=0.012), while the descend range of PSQI scores(t=0.897,P=0.373)and the change of the sleep parameters in the two group had no obvious difference. Conclusion High frequency rTMS has better curative effect than antidepressant therapy on depressive symptoms of PSD,while there was no difference on the effect to improve the sleep quality and sleep structure of PSD between these two treatments.

目的 探讨细胞毒素-1(Cytotoxin-1,CTX-1)对人卵巢癌SKOV-3细胞增殖凋亡的影响。方法 利用0、4、8、12 μg/mL浓度 CTX-1处理SKOV-3细胞6、12、24 h,MTS法检测细胞活性,8 μg/mL CTX-1处理SKOV-3细胞24、48 h,Hoechst-33258荧光染色观察细胞核染色质形态。取处理 6、12 h 后细胞,利用流式细胞仪检测SKOV-3细胞的凋亡率。结果 4、8、12 μg/mL的CTX-1可抑制SKOV-3细胞活性及增殖,呈时间-剂量依赖。Hoechst-33258染色观察可见细胞染色质呈固缩或碎裂状、染色质着色不均、核形态各异,随时间增加而更趋明显。8 μg/mL CTX-1处理细胞,6 h细胞坏死率为(1.90±0. 27)%,晚期凋亡率为(10.96±1. 56)%,而早期凋亡率为(1.52±0.39)%;12 h细胞坏死率为(10.62±0.96)%,晚期凋亡率(15.07±1.23)%,而早期凋亡率为(1.88±0.17)%,与对照组比较,差异有统计学意义 (P<0.0 1)。结论 CTX-1可以抑制人卵巢癌细胞活性、抑制其体外增殖、诱导其发生凋亡,该作用呈剂量依赖和时间依赖,主要引起细胞晚期凋亡和坏死。

Objective To investigate the effect of cytotoxin-1 (CTX-1)on the proliferation and apoptosis of ovarian cancer SKOV-3 cells. Methods SKOV-3 cells were treated with CTX-1 at concentrations of 0, 4, 8, 12 μg/mL for 6, 12, and 24 hours respectively. Cell viability was measured by MTS method. SKOV-3 cells were treated with 8 μg/mL CTX-1 for 24 and 48 hours, by Hoechst-33258 fluorescence staining to observe the morphology of nuclear chromatin. The apoptotic rate of SKOV-3 cells was detected by flow cytometry after 6 and 12 hours of treatment. Results CTX-1 at 4, 8, and 12 μg/mL inhibited the activity and proliferation of SKOV-3 cells in a time-dose-dependent manner. Hoechst-33258 staining observation showed that the apoptotic cell chromatin was condensed or fragmented chromatin, the chromatin was unevenly colored, and the nuclear morphology was different. It became more obvious with time. 8 μg/mL CTX-1 treated cells, the 6 h cell necrosis rate was (1.90±0.27)%, the late apoptosis rate was (10.96±1.56)%, and the early apoptosis rate was (1.52±0.39)%; 12 hours cell necrosis rate was (10.62±0.96)%, late apoptosis rate was (15.07±1.23)%, and early apoptosis rate was (1.88±0.17)%, compared with the control group, the difference was statistically significant (P<0.01). Conclusion CTX-1 may inhibit the activity of human ovarian cancer cells, inhibit its proliferation in vitro, and induce its apoptosis. The effect is dose-dependent and time-dependent. Mainly it causes late apoptosis and necrosis of cells.

目的 探讨二氢丹参酮Ⅰ在胃癌细胞中的抗癌作用。方法 采用 3-(4,5-二甲基噻唑-2)-2,5-二苯基四氮唑溴盐法(MTT法)测定细胞活力。流式细胞术检测细胞内活性氧(ROS)水平。荧光法测定Caspase活性。裸鼠胃癌模型验证DHTS的抗癌活性。结果 MTT实验结果表明,DHTS对HCG27和AGS细胞活力具有明显的剂量依赖性和时间依赖性。在DHTS处理的HCG27和AGS细胞中,细胞内ROS水平升高,凋亡细胞增多。 在DHTS处理的HCG27和AGS细胞中发现caspase-3和caspase-8活性增高,caspase-9活性不变。用N -乙酰半胱氨酸阻断ROS生成可显著逆转DHTS诱导的细胞凋亡。DHTS显著抑制小鼠肿瘤瘤体体积的增加。结论 所有的研究结果都有力的说明,DHTS可以在HCG27和AGS人胃癌细胞中启动活性氧生成,诱导氧化应激和细胞凋亡,值得作为抗癌药物进一步开发。

Objective To evaluate the anticancer actions of dihydrotanshinone Ⅰ(DHTS)in gastric cancer cells. Methods Cell viability was determined using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)assay. Intracellular reactive oxygen species (ROS)levels were determined using flow cytometry. Caspase activities were measured with fluorometric assay. The anticancer activity of DHTS in nude mouse gastric cancer model was verified. Results MTT assay showed that DHTS greatly inhibited HCG27 or AGS cell viability in dose- and time-dependent manners. Elevated intracellular ROS levels and increased apoptotic cells were observed in DHTS-treated HCG27 or AGS cells. In addition, activation of caspase-3 and caspase-8, rather than caspase-9, were noticed in DHTS-treated HCG27 or AGS cells. Furthermore, blocking ROS generation with N-acetylcysteine markedly reversed DHTS-induced cell apoptosis. DHTS inhibited the increase of tumor volume in mice. Conclusion All the findings strongly suggest that DHTS may initiate ROS generation and induce oxidative stress and cell apoptosis in HCG27 or AGS human gastric cancer cells, which deserves to be further developed as an anticancer agent.

目的 调查临床医学生医患沟通能力的现状,分析其影响因素。方法 采用《医患沟通技能评价表（SEGUE量表）》对广州市某三甲医院的155名临床医学生进行调查。结果 临床医学生沟通技能总成绩得分率只有58.9%,在5个维度中,沟通结束方面得分率最高,为82.9%,而理解病人方面得分率最低,只有45.5%。性别、接受医患沟通相关培训次数不同的临床医学生,其沟通能力差异有统计学意义（P﹤0.05）。结论 临床医学生的医患沟通能力总体水平有待提高,特别是在理解病人方面。性别和参加医患沟通培训次数是临床医学生沟通能力的影响因素,应加强对医学生在共情能力、情感支持、移情等方面能力的培训,以提高医患沟通能力。

Objective To investigate the status of medical students' doctor-patient communication skill and analyze the influencing factors. Methods An investigation on 155 clinical medical students in a level 3 hospital in Guangzhou was conducted using the Doctor-patient Communication Skills Evaluation Scale （also called SEGUE Scale）. Results The clinical medical students’ scoring rate of communication skill was only 58.9%. Among the five dimensions, the scoring rate of communication skill end was the highest, which was 82.9%, while the scoring rate of understanding patients was the lowest, which was only 45.5%. The difference in communication skill between clinical medical students with different gender and the training times related to doctor-patient communication was statistically significant （P<0.005）. Conclusion The overall level of doctor-patient communication skill among clinical medical students was needed to be improved, especially on understanding patients. Gender and training times on doctor-patient communication training were the influencing factors of communication skills of medical students. Medical students’skills include empathy and doctor-patient communication skills, etc.