At present, a series of problems such as education utilitarianism and non humanization caused by the lack of the humanities education idea has exerted a serious influence on the existence and development of the universities themselves and their role on the development of social process. Therefore there is an urgent need to reconstruct the humanities education idea around four centre concepts of value: humanization,personalization, synthesization and socialization to give full play to the university′s humanities education function and recreate the spirit of the universities.

Relations between doctors and patients are the most basic and important human relations in medical practice.Some reports indicate that non-technical medical factors result in most cases of physician-patient conflicts.In this paper we analyzed non-technical medical factors from the fields of society,ethics and mentality,and concluded main reasons for physician-patient conflicts are the lack of "being discreet when alone",the absence of "patients-oriented service concept",the ignorance of responsibility of "life-saving",and the missing of humanity care.

Donation of relique is important to not only medicine development,but the social civilization also.But the development of it is late and laggard in China.According to investigation and analysis in some regions,we find several factors restricting the donation of relique such as the obstacle of morals,the lag of legislation,lack of the humanistic care.These are the keys for us to change the behindhand situation of relique donation in China.

Objective To investigate the best operative approach in the treatment of myasthenia gravis (MG) by comparing surgical effects of median sternotomy, trans-sternal surgery and video-assisted thoracoscope surgery (VATS). Methods One hundred and nine patients who received thymectomy for MG were divided into median sternotomy group,trans-sternal group and VATS group according to the way of operative incision. The clinical features, such as operative time, operative blood loss, postoperative drainage volume and drainage time, postoperative hospitalization time, postoperative pulmonary infection, incisional infection, MG crisis, postoperative chronic pain and upper limb's movement disorder were retrospectively analyzed to evaluate the effect of the surgery. Results The operative blood loss, postoperative drainage volume and drainage time,and incisional infection in VATS group [(77.5 ± 18.0) ml, ( 100.8 ± 11.8) ml,( 2.3 ± 0.5 ) d, 0 ] were superior to those in trans-sternal group[ (97.4 ± 14.3 ) ml, ( 175.8 ± 18.3 ) ml, ( 3.1 ±0.7 ) d, 6.2% ( 2/32 ) ] and median stemotomy group [ ( 130.1 ± 24.0) ml, ( 379.0 ± 45.6 ) ml, (4.2 ± 0.6) d,13.8% (9/65)] (P ＜0.05),and median sternotomy group was the worst. The incidence of postoperative pulmonary infection, MG crisis, upper limb's movement disorder and postoperative hospitalization time in VATS group were superior to those in trans-sternal group and median sternotomy group (P ＜0.05).Conclusions Three mini-incision surgical approaches are safe, feasible and effective. VATS is more advantageous and is worth popularizing in large and medium-sized hospitals. Trans-sternal surgery is the better choice for primary hospitals without advanced technology and equipments.

Objective To describe the interpositional omentum and demonstrate its clinical significance.MethodsCT and clinical data of the cases whose suprahepatic gaps widen were reviewed and the contrast of CT was adjusted to observe further.ResultsIn 1 916 cases with upper abdominal CT data,suprahepatic gap was widen in all 152 cases,and 119 cases showed fat density(6.21％ ).There were 3 cases of trauma and 3 cases of acute abdomen in the 119 cases CT in the 119 cases displayed free gas under diaphragma,but displayed fat density after contrast adjusted.There were 11 cases undergoing operations,1 for sigmoid rupture 4 liver cirrhosis and portal hypertension,3 gastric cancer,and 1 acute cholecystitis,1 bile duct carcinoma and Ⅰ case congenital cystic dilatation of common bile duct.The other 108 cases did not undergo surgical operation.ConclusionsInterpositional omentum is a clinical phenomenon that the omentum was shift in suprahepatic gap covering the liver surface.It is not rarely,the incidence rate being 6.21％ ( 119/1 916) in our study.The occurrence mechanism may be similar to that of Chilaiditi syndrome.It is difficult to differentiate interpositional omentum from free gas under diaphragms on CT plain scan picture,but it is easy after contrast adjusted of CT.Free gas under diaphragma should not be identify incorrecdied and patients should not undergo unnecessary surgical procedure.

Objective To investigate the condition of exercise, medicine compliance and the rehabilitation of patients with arteriosclerosis obliterans (ASO) in lower extremity after the surgery, and also to study the influence of self-efficiency and social support to their rehabilitation. Methods The questionnaire survey was performed in 102 patients who had surgical or interventional therapy of arteriosclerosis obliterans in the lower extremity in our hospital, investigated the general information of the patients, their knowledge of postoperative rehabilitation, medicine compliance, exercise condition, general self-efficiency and social support. Results The postoperative time for the patients with arteriosclerosis obliterans was 2 to 22months, the knowledge rate for postoperative rehabilitation was 7.8%-46.1%.The Morisky score for the patients of taking medicine for the treatment of vascular disease was 2.0,and there was only 6 patients(5.9%)with good medicine compliance. There were 22 patients(21.0%) had completed the ambulation training according to the guidelines, and there were 25 patients(24.5%) had completed the Buerger training. The self-efficiency score of the patients was 2.78 ± 0.76, and the gross score of social support was 32.38 ± 7.89. Spearman correlation analysis shows that the Morisky score for the patients of taking medicine for the treatment of vascular disease was in positive correlation with self-efficiency (r=0.289, P=0.003), but in negative correlation with social support (r=–0.286, P=0.006). Conclusions Most of the patients with arteriosclerosis obliterans have poor medicine compliance, and do not do exercise as required by the guidelines. Patients with high self-efficiency demonstrates medicine noncompliance, however the enhancement of social support will help patients improve their medicine compliance.

This paper introduced the present situation and the existing problems of palliative care and hospice care system in Russia.The coverage of palliative is narrow,regional development is not balanced,the medical professionals in palliative care is lack,the professional skills should be improved urgently,the training system of palliative care is not perfect and the quality of training is not high,the medical professionals have high work pressure,the brain drain is serious,the social cognition is not enough,the volunteer service system is underdeveloped,and the acquisition rate of mental and narcotic drugs is low.On the basis of the above,this paper introduced the development strategy of Russian palliative care,and discussed the enlightenment to our country.For example,government departments should attach importance to the introduction of legal norms of palliative care,perfect the service system of palliative care,establish the supporting facilities,reasonably plan palliative care system,implement the integration of service management and scientific research,and bring the guarantee palliative care fund into the national budget.

Objective To detect the spatial clustering and high risk areas of pulmonary tuberculosis (PTB) in Sichuan province in 2018 and,to compare the effects of application on both SaTScan 9.4.1 software and FleXScan 3.1.2 software to detect the PTB spatial clusters.Methods Geographic information database was established by using the incidence data of PTB and demographic data reported in the'China disease prevention of infectious disease reporting information management system'in Sichuan province in 2018.Spatial clustering analysis was conducted using the Poisson model in software SaTScan 9.4.1 and FleXScan 3.1.2 to detect the high risk areas of PTB by software ArcGIS 10.5.Differences of clusters locations and scopes in the two scanning methods were compared.Results The reported incidence rate of PTB was 57.34/100 000 (47 601 cases) in Sichuan province in 2018,presenting an obvious clustering distribution.SaTScan and FleXScan scanned 8 and 10 clusters showed statistically significant differences (P＜0.05),with log-likelihood ratio (LLR) as 24.62-2 416.05 and 1.48-2 618.96,respectively.Results from scanning of the two methods showed that the most likely clusters appeared in the Daliangshan and Xiaoliangshan of Liangshan Yi ethnic aggregation areas.The other clustering areas would include some minority areas in the western Sichuan plateau,detected by both two methods differences in the shape and scope of the clustering were detected by both methods.The clustering scopes detected by SaTScan covered some counties,in which the actual incidence was not high.FleXScan could distinguish the clusters and detect more irregular shaped clusters.Conclusions Obvious spatial clusters of PTB distribution were found in Sichuan in 2018.Areas of Daliangshan,Xiaoliangshan and the minority areas in Western Sichuan plateau appeared at high risk,suggesting these were the key areas for prevention and control.FleXScan seemed more conducive in accurately distinguishing the "cold spot" areas in the highly aggregated areas,and more suitable for the application of spatial clustering detection for TB,in Sichuan province.

Objective To explore the effect of Internet+cardiac rehabilitation on hypertension patients with coronary heart disease.Methods 80 patients with hypertension and coronary heart disease admitted to our hospital from January 2022 to April 2023 were randomly divided into the combined group(n=40)and the conventional group(n=40).Both groups were given routine cardiac rehabilitation interventions.The combined group combined adoptionof the Internet for continuous interventionson the basis of routine cardiac rehabilitation interventions.Compare the oxygen uptake,blood pressure,compliance,and self-management scores between two groups before intervention and three months after discharge.Results The AT Mets,AT VO2,peak VO2,and expected value compliance ratio in the combined group were all higher than those in the conventional group(P<0.05);The systolic and diastolic blood pressure in the combination group were lower than those in the control group,and the proportion of complete compliance was significantly higher than that in the control group(P<0.05);The self-management scores of the joint group were higher than those of the conventional group(P<0.05).Conclusion The continuous interventions of Internet plus cardiac rehabilitation can control the blood pressure of patients with hypertension and coronary heart disease,and patients'compliance behavior is significantly im-proved,andthus improving patients'self-management ability,which can be used for reference and promotion in clinical practice.

Objective To analyze the spatial and temporal distribution of smear positive pulmonary tuberculosis (PTB) in Liangshan Yi autonomous prefecture in Sichuan province from 2011 to 2016. Methods The registration data of PTB in 618 townships of Liangshan from 2011 to 2016 were collected from"Tuberculosis Management Information System of National Disease Prevention and Control Information System". Software ArcGIS 10.2 was used to establish the geographic information database and realize the visualization of the analysis results. Software OpenGeoda 1.2.0 was used to conduct the analyses on global indication of spatial autocorrelation (GISA) and local indication of spatial autocorrelation (LISA). Software SaTScan 9.4.1 was used for spatio-temporal scanning analysis. Results From 2011 to 2016, the registration rate of smear positive PTB in Liangshan declined from 56.97/100000 (2666 cases) to 21.11/100000 (1038 cases). The global spatial autocorrelation coefficient Moran's I ranged from 0.25 to 0.45 and the difference was significant (all P=0.000). Local autocorrelation analysis showed that"high-high"area covered 43, 34, 37, 34, 42 and 61 townships from 2011 to 2016, respectively, mainly in Leibo county. Spatial temporal clustering analysis found one class Ⅰ clustering in the area around Bagu township of Meigu county and two class Ⅱ clustering in the areas around Liumin and Hekou township of Huili county, respectively (all P=0.000). Conclusion Obvious spatial temporal clustering of smear positive PTB distribution was found in Liangshan from 2011-2016. Hot spot areas with serious smear positive PTB epidemic and high spread risk were mainly found in northeastern Liangshan, including townships in Leibo and Meigu counties. Targeted TB prevention and control should be conducted in these areas.