Objective To evaluate the role of procalcitonin (PCT) in the diagnosis and treatment of infective endocarditis (IE).Methods It was a retrospective study of 20 cases diagnosed as IE with positive culture between June 2010 and June 2012 of First Affiliated Hospital of China Medical University,Department of Infectious Diseases.Results The concentration of C-Reactive Protein (CRP) and PCT in the dead group recorded on the first day and the fifth day in the treatment was significant higher than the survival group.The decreased degree of CRP and PCT concentration after treatment in the dead group was much deeper than the survival group.Moreover,the concentration of CRP and PCT in Staphylococcus aureus IE and negative bacilli IE were significant higher than Streptococcus viridans IE or Enterococcus faecalis IE,which was commonly above 2 μg/ml level.Conclusions Serum procalcitonin,lined with CRP,has the similar significance in the assessment of infective endocarditis severity,however,PCT is slightly better than CRP in assessing prognosis.The concentration of procalcitonin has implications to the strains of IE pathogen,in the mean time,it' s beneficial to guide the early use of antibiotics.

The innovation in each aspect of medical and public health territory in our state gradually becomes the social focus.We analyze the key issues in the new type medical innovation in this paper,including clarifying government-dominant leadership of the medical innovation,identifying public welfare property of station-owned hospitals as the direction of medical innovation,impelling public health agency to perform total amount of money budget,and setting everyone's enjoying elementary medical service as the ultimate target of the medical innovation.Meanwhile,some beneficial opinions are also introduced in the paper.

Objective To find out the factors that influence the mental health of the rural junior middle school students (JMSS).Methods 2406 JMSS in rural areas in Hunan province were assessed,using self-designed Demographic Data Recording Form, Adolescent Self-Rating Life Events Check List, Scale of APGAR, Perceived Social Support Scale,Simplified Coping Style Questionnaire,Eysenck Personality Questionnaire,Self-Esteem Scale and Scale of Mental Health.Results There were no significant difference between JMSS with different gender(P = 0.509 ), family income (P = 0.267 ), occupation of their fathers (P = 0.473 ), occupation of their mothers (P=0.105 ), education background of their mothers (P = 0.266 ).There were statistically significant difference between JMSS of different age (P = 0.000 ), grade (P = 0.000 ), whether their parents going out to work (P = 0.000 ),whether their parents divorced(P = 0.001 ) and education background of their fathers (P = 0.000 ); whether their parents going out to work (r = 0.095 ), life events (r = 0.522 ), family care (r =-0.146 ), the perceived social support (r =-0.186 ), positive coping style (r =-0.020 ), negative coping style (r = 0.369 ) and psychoticism (r = 0.322 ),internal and external(r =-0.132), emotional stability (r = 0.555 ), lie (r =-0.293 ) and self-esteem (r =-0.329)were significantly corrected with psychological health( P ＜ 0.01 ).Except age, grade, whether their parents going out to work and the education background and occupation of their parents,the remaining variables entered the regression equation,which could explained 51.2% of changes of the psychological health(F=227.809, P=0.000).Conclusion In order to promote the development of J MSS mental health, we can give then more care to reduce negative life events in their life,guide them to culture health personality and use active coping styles when encounter difficulties and setbacks through a series of health education, promote the healthy development of their personality.

Objective To analysis the relationship among stressors,stress medi-factors and mental health of left-behind junior middle school students( JMSS) ,and to built a structural equation model on psychological stress of left-behind JMSS. Methods 1309 left-behind JMSS in rural areas in Hunan were assessed,using self-designed Demographic Data Recording Form , Adolescent Self-Rating Life Events Check List, Scale of APGAR,Perceived Social Support Scale,Simplified Coping Style Questionnaire,Eysenck Personality Questionnaire,Self-Esteem Scale and Scale of Mental Health for Chinese Middle-school Student. Results Life events (r = 0.08) influenced mental health directly,and it influenced mental health indirectly by acting on negative coping styles(r=0.01) and APGAR (r= -0.02). Social support(r= -0.02) ,self-esteem(r = 0.03) ,negative coping styles(r=0.07) ,positive coping styles (r= -0.04),P (r = 0.03) and N (r = 0.04) also influenced mental health directly. E(r = 0. 21) ,N(r = -1.87) and P(r= -0.83) and APGAR(r=0. 10) influenced mental health indirectly by the mediation of self-esteem; APGAR(r = 4. 89) influenced mental health by the mediation of social support. Conclusion Personality (P,N),life events, social support, APGAR, positive and negative coping styles, self-esteem impact on mental health of rural junior middle school students in different ways.

Objective To find out the differences between left -behind and non left-behind junior middle school students (JMSS) on Coping Style,Personality and Self-Esteem,and to analysis the influence of coping style,personality and self-esteem on mental health of left-behind JMSS.Methods 2406 JMSS in rural areas in Hunan were assessed,using self-designed Demographic Data Recording Form,Simplified Coping Style Question-naire,Eysenek Personality Questionnaire,Self-Esteem Scale and Scale of Mental Health for Chinese Middle-school Student.Results Score of positive coping style was lower(1.58±0.45 vs 1.64±0.46,P=0.011),while the score of negative coping style was higher(1.14±0.49 vs 1.09±0.48,P=0.022) for left-behind JMSS than for non-left-behind JMSS;the there were no significant differences on Pschoticism (P) (4.96±3.26 vs 4.83±3.23,P=0.357) ,Extraversion(E) (16.39±3.87 vs 16.61±4.06,P=0.592)and Lie(L) (2.77±3.76 vs12.84±3.71,P=0.447),while score of Neuroticism(N) (10.94±4.83 vs 10.46±5.03,P=0.020)for left-behind JMSS was higher than non-left-behind JMSS;score of self-esteem was loweR 26.67±3.55 vs 27.27±3.56,P=0.001)for left-behind JMSS than non-left-behind JMSS.Mental health of left-behind JMSS was signifi-candy correlated with positive coping style(r=-0.044),negative coping style(r=0.383),P(r=0.331),E(r=-0.113),N(r=0.548),L(r=-0.292) and self-esteem(r=-0.315) ;N (β=0.396),negative coping style (β=0.220),P(β=0.118),aelf-esteem (β=-0.146),positive coping style(β=0.074) and L(β=-0.071)entered the multiple linear regression equation,which can explained 41.1% of the changes on mental health of left-behind JMSS(F=150.602,P=0.000).Conclusion With parents going to cities to work,rural left-behind JMSS used negative coping styles to solve difficulties more,their developments of personality were un-healthier and their score of self-esteem were lower than non-left-behind JMSS,that interfered the development of their mental health.

Objective To find out the differences between left-behind and non left-behind junior middle school students (JMSS) on life events.Methods 2406 JMSS in rural areas were assessed in Hunan,using self-designed Demographic Data Recording Form ,Adolescent Self-Rating Life Events Check List and Scale of Mental Health for Chinese Middle-school Student.Results Stress from studying and interpersonal relationship were the major life events for rural JMSS,scores of the total score and all the factors of life event for left-behind JMSS were higher than non-left-behind JMSS' ;with the exception of the loss factor (5.13±2.56 vs 4.94±2.33,P=0.095),the difference on the total score of life events (49.22±13.25 vs 46.42±12.67,P=0.000),relation-ships(10.28±3.74 vs 9.86±3.49,P=0.009) ,learning pressure(11.52±3.66 vs 11.03±3.66,P=0.014),being published (11.84±4.47 vs 11.28±4.12,P=0.005),health adaption (6.18±2.19 vs 5.36±1.82,P=0.000)and other factor(6.12±2.26 vs 5.73±2.09,P=0.000) were significant;Scores of mental health for left-behind JMSS were higher than non left-behind JMSS,the difference was significant(2.18±0.56 vs 2.07±0.57,P=0.000);scores of international relationships (r=0.437) ,learning pressure (r=0.373),being published (r=0.345),less(r=0.199),health adaption(r=0.338),other factors(r=0.380) were significantly correlated with mental health of left-behind JMSS,relationships(β=0.229),learning pressure(β=0.177),health adap-tion (β=0.152) and other factor(β=0.117) entered the multiple linear regression equation,which can ex-plained 26.4% of the changes on mental health of left-behind JMSS.Conclusion Compared with the non-left-be-hind JMSS,the negative life events of left-behind JMSS were more frequently,with greater negative impact,lesse-ning the occurrence of negative life events in life of left-behind JMSS was one of the effective way to develop their mental health.

Objective To find out the differences between left-behind and non left-behind junior middle school students (JMSS) on family APGAR index (APGAR),perceived social support (PSSS) and mental health (MH);and to analysis the relationship among APGAR,PSSS and MH of left-behind JMSS.Methods 2406 JMSS in rural areas were assessed in Hunan,using self-designed Demographic Data Recording Form,Family AP-GAR Index,Perceived Social Support Scale and Scale of Mental Health for Chinese Middle-school Student.Results Left-behind JMSS' PSSS(59.27±11.78 vs 60.55±11.88,P=0.009),family support (19.12±4.69 vs 19.72±4.59,P=0.012),other support (20.29±4.59 vs 20.69±4.57,P=0.033) were lower;APGAR ((4.79±2.32 vs 5.08±2.46,P=0.014) and Adaptation (0.77±0.62 vs 0.87±0.62,P=0.001) lower;mental health status score higher (2.18±0.56 vs 2.07±0.57,P=0.000) than non-left-behind JMSS.APGAR was signifi-cantly correlated with PSSS(r=0.368,P<0.000) ;APGAR (r=-0.098),in which Adapt;on (r=-0.123),Growth (r=-0.074) and qmidu (r=-0.080,PSSS (r=-0.149),in which family support (r=-0.151),friend support(r=-0.089) and other support (r=-0.137)were significantly correlated with MH of left-behind JMSS(P<0.01),family support (β=-0.126) and adaption (β=-0.086)entered the multiple linear regression equation,which can explained 16.2% of the changes on mental health(F=20.049,P=0.000).Conclusion In order to improve mental health of JMSS,parents,caregivers,should give them more family care,schools and soci-ety should pay more attention to left-behind JMSS,and give them more help and a health environment in life,teach them to find social support and solve problems in life by them through a series of mental health education.

In view of the present hospital professional and technical personnel in the making , performance e-valuation , salary management , personal development , health management , department management , as well as on the management of some of the ethical issues , analyzes its reason: hospital professional and technical personnel management ethics idea misunderstanding , hospital professional and technical personnel subject ethics value status unclear , hospital professional and technical personnel managers′ethical level is not high .And put forward the con-crete solving measures:strengthen dominated by social responsibilities of ethical supervision and management , es-tablish the principle of fairness , justice , ethics of competition system , director of the department , carried out by both efficiency and fair ethics idea of performance and salary rank management activities , to achieve individual all-round development as the goal of ethical career management , to strengthen the management of managers ethical education .

Objective To compare the contents of guanosine and adenine in peels of three strains of Trichosanthes kirilowii Maxim.;To provide references for germplasm resources evaluation and breeding of the Chinese medicinal materials. Methods HPLC method was used to determine the contents of guanosine and adenine with Waters AtlantisT3-C18 column (4.6 mm×150.0 mm, 5 μm). The mobile phase was methanol and water, and the detection wavelength was 254 nm. Results The contents of guanosinein in peels of three strains of Trichosanthes kirilowii Maxim. were 0.159 4, 0.159 6, 0.134 1 mg/g, respectively;the contents of adenine were 0.097 1, 0.127 9, 0.093 4 mg/g, respectively. Conclusion There were significient differences in the contents of adenine among three strains of Trichosanthes kirilowii Maxim.. Strain Ⅱ is with higher level of guanosine and adenine, which implies that the breeding of the Chinese medicinal materals is one way to improve the quality of Trichosanthis Exocarpium.

Medical ethics is a set of behavioural principles which regularized medical workers' relationships to patients and society and that between themselves under social ethics and the development of medical science.It is an essential constituent of the social ethical system and plays an important role in medical activity.By studying the current situation of the ethics-oriented education on medical students,the author re-analyzed the current state of medical ethics and proposed some creative and feasible methods on improving the quality of medical ethics of the students.