OBJECTIVE To ensure the quality and safety of the blood purifcation center treatment,strengthen the prevention and management of the hospital infection,and prevent the infection.METHODS The measurese were taken to strengthen the management system of the hospital infection,and control the infection.RESULTS Strengthening the management of blood purification center was useful for the safety of the treatment and decrease of the hospital infection.CONCLUSIONS The scienctific management,is good for the safety of the patients and medical staff in blood purification center.

When revising Advertisement Law ( AL) of People's Republic of China, a basic principal is the comprehensive banning of direct or indirect tobacco advertising and implementing the WHO Framework Conven-tion on Tobacco Control ( FCTC) . After comparing the AL Revised Draft ( ALRD) with the AL, the Interim Man-agement Regulation for Tobacco Advertisements ( IMRTA) , and FCTC article 13 and its implementation guide-line, we found that ALRD did not ban all kinds of the tobacco advertising in all public places by using different channels, couldn’t clearly define the covert and false advertisements on tobacco, so that the epidemic of tobacco advertising cannot be curbed in China. In addition, this ALRD still permits the tobacco advertising in some places, and this does not satisfy the FCTC requirement. Therefore, China cannot honor its commitments as a re-sponsible big country. According to above analysis, we proposed some suggestions on comprehensive banning all the direct and indirect tobacco advertisements.

Objective To explore the effect of group psychotherapy on mental health of psychiatric nurses after violence.Methods Group psychosocial interventions were conducted on psychiatric nurses who were exposed to violence.The measures included observation and understanding,learning and self-understanding,self-acceptance,self-adjustment and behavioral improvement for 8 weeks,once a week,60-120 min each time.Before and after intervention,the mental health status of psychiatric nurses was evaluated by self-reporting inventory (SCL-90).Results The scores by SCL-90 in the psychiatric nurses before and after intervention were higher than those in the national norm with statistically significant difference (P ＜0.05).The scores by SCL-90 as well as all of dimensions after the intervention were all significantly higher than those before intervention (P＜0.05).Conclusion Group counseling intervention has a positive effect on improvement of mental health of psychiatric nurses after violent incidents.

Objective: To examine reliability and validity of Chinese Cognitive Ability Scale (CCAS).Methods:The CCAS was administered 321 children, 275 adults, 32 patients with brain damage, and 31 children with mental retardation.Out of them, 26 children were tested with WISC-CR and 26 adults with WAIS-RC.Results: The test-retest reliability coefficients of subtests and scales ranged from 0.732 to 0.894, 0.919 to 0.960 for children, 0.859 to 0.937, 0.968 to 0.981 for adults; The reliability coefficients for children (quick coding was omitted) ranged from 0.810-0.928 (Split-half), 0.737-0.923 (Cronbach's ?) and 0.737-0.945 (generalizability) for subtests, 0.939-0.976,0.898-0.965 and 0.898-0.965 for scales; Coefficients for adults ranged from 0.829-0.948, 0.747-0.941 and 0.747-0.941 for subtests, 0.945-0.979, 0.915-0.967 and 0.915-0.967 for scales; The CCAS IQs were high correlated with WAIS-RC IQs (VIQ=0.775,PIQ=0.621,FIQ=0.724) and WISC-CR IQs (VIQ=0.888,PIQ=0.779,FIQ=0.886) , the CCAS VIQ, PIQ, and FIQ were 5.3,9.2,and 7.8 points less than WAIS-RC, and 2.0,7.2,and 5.0 points less than WISC-CR; Comparing with normal groups, mean IQs of brain damaged adults(VIQ=80.50,PIQ=80.59,FIQ=78.91) and mental retardation children(VIQ=43.68,PIQ=49.77,FIQ=44.06)were much lower.Conclusion: The Chinese Cognitive Ability Scale has excellent retest stability, internal consistency reliability, convergent and discriminant validity.

Background phacoemulsification combined with limbal relaxing incision (LRI) is reported to be effective for the management of coexisting cataract astigmatism,but the influence of after phacoemulsification with LRI on corneal high-order aberration is still rarely reported.Objective This study was to evaluate the effect of cataract surgery with LRI for preoperative astigmatism or on corneal high-order aberration.Methods A selfcontrolled serial cases observational study was designed.A total of 35 cataractous eyes of 35 patients with astigmatism ≥ 1.0 D before cataract surgery were enrolled in Tianjin Medical University Eye Hospital from August 2014 to April 2015 under the informed consent of patients.LRIs were performed on the eyes during the phacoemulsification and IOL implantation.The uncorrected visual acuity (UCVA),BCVA and optometry were recorded before operation and 1 day,1 week,1 month,3 months after operation.Pentacam was employed to measure the maximal and minimal diopters,astigmatism and high-order aberrations within 3 mm of the anterior corneal surface at above-mentioned time points.All the results were compared among different time points.The optometry outcomes and the anterior corneal surface astigmatism change were analyzed using vector analysis method.Results The UCVA was 0.34 ±0.22,0.38 ± 0.25,0.43±0.27,0.42±0.28 in 1 day,1 week,1 month and 3 months after operation,which was significantly higher than 0.08 ±0.09 before operation;and the BCVA was 0.54 ± 0.27,0.64 ± 0.29,0.67 ± 0.29,0.71 ± 0.32 in 1 day,1 week,1 month and 3 months after operation,showing a significant increase in comparison with 0.22±0.51 before operation(F=54.457,P=0.000;F =62.653,P =0.000).The refractive cylindrical error and corneal astigmatism were significantly decreased after operation in comparison with before operation (F =31.061,P =0.000;F =113.043,P=0.000).High order aberrations (HOA) at postoperative 1 day,1 week,1 month,3 months were all higher than those in preoperation (F =11.189,P =0.000) under the 4 mm pupil diameter.Compared with preoperation,the vertical coma,secondary vertical coma and three leaf clover were significantly increased(all at P＜0.05),but the horizontal coma and primary spherical aberration were not significantly changed (all at P＞0.05) under the 6 mm pupil diameter.Conclusions Phacoemulsification combined with LRI can reduce the corneal astigmatism effectively and steadily,and the increase of corneal aberrations does not affect visual acuity.

A Raman spectrum fitting method based on Voigt function was proposed. The method can be used to fit the profile of Raman spectrum produced by unknown components in sample based on Voigt functions. In the experiment, pure methanol was added by various volume fraction ( 2. 5% -80. 0%) into three base-gasoline with different compositions. It can be applied to fit the background Raman spectrum produced by basic-gasoline comprised of unknown compositions. The remained spectrum, after deducting the fitted spectrum from the mixture spectrum, was considered as the contribution attributed only to methanol. And then a linear calibration model was built based on 4 training samples to predict the concentration of methanol. The root mean square error of prediction (RMSEP) was 1. 86% (V/V) and the correlation coefficient (R2) was 0. 987. Results show that it is an effective method to solve the problem of strong spectral overlap in mixture, and it has the advantages of high generalization and few training samples.

Objective To investigate the application of OSCE evaluation system on the medical skills examination of clinical medical students and the significance of this system on the training of their medical skills.Methods 20 teachers examed 150 students by the OSCE evaluation system with 4 test stations,by comparing the score of the students of different test stations by one-way ANOVA and evaluating the system by questionnaire survey with Likert 5 on the degree of satisfaction and Likert 3 on effects and intrinsic influencing factors of the system.Results The score of the first and forth test stations was lower than that in the other stations(P＜0.05).8/5.48％ students and 1/5％ teachers were not satisfied with the system.The OSCE evaluation system could exam the psychological diathesis,ability of communication,cooperation,and clinical thinking,practical skill of the students and its effects are moderate (the score was more than 2.0).Evaluation on the intrinsic influencing factors:Students considered the questions were more difficulty in the 2nd,3rd,1st,4th test stations order.4/20％ teachers considered the questions of the second test station was easy.8/40％ teachers considered the duration of the second test station was too long.More than 70％ students and teachers considered the other indexes were rational.Conclusion The OSCE evaluation system can play an effective role in directing the teaching and learning.It can also help to culture the comprehensive capacity of the students.We should gradually improve the design of the system by considering the intrinsic influencing factors.

Objective To study the effect of radiotherapy and prognostic factors for patients with post-operative loco-regional recurrence of esophageal carcinoma. Methods From 2000 to 2005,91 patients with esophageal carcinoma who developed post-operative loco-regional recurrence were analyzed retrospectively. The interval between surgery and recurrence was 1 -35 months, with a median interval of 11.1 months. There were 4 patients with anastomosis relapse, 6 with anastomosis and mediastinal lymph nodes relapse,4 with abdominal lymph node relapse, 20 with supra-clavicular lymph node relapse, 34 with mediastinal lymph node relapse, and 23 with mediastinal and supra-clavicular lynph node relapse. There were 56 and 35 patients who received conventional and three-dimensional conformal radiation therapy respectively, with a total radiation dose of 50 -70 Gy. Sixty-eight patients received adjuvant chemotherapy.Results The follow-up rate was 95%. The 1-,2-and 3-year overall survival rates were 52%, 20% and 14%, respectively. In univariate analysis, the recurrence time (P = 0. 001), postoperative stage (P =0. 000), radiation dose (P =0. 001) ,overall response rate (P =0. 000) ,T stage (P =0. 028), and N stage (P = 0. 003) were related with prognosis. Multivariate analysis showed that the recurrence time (P =0. 014), postoperative stage (P = 0. 006), radiation dose (P = 0. 009), overall response rate (P = 0. 000)were independent prognostic factors for survival. Conclusions Radiotherapy may improve the survival of esophageal carcinoma patients with postoperative recurrence. Patients with long recurrence-free time, early stage, high response rates, and radiation dose of higher than 60 Gy have better prognosis.

With the change of medical model and the transfer of health to communities and rural towns,the expanding enrollment of colleges and universities makes collegiate internship progrms more and more difficult Clinical College of Guilin Medical University explores the new methodology of teaching practice,constructs and practises the new molde of internal madichine teaching,Combines the coummunity internship programs with hospital internship programs.and was improved the quality of practice teaching

Background Obstructive meibomian gland dysfunction (OMGD) is due to the meibomian gland duct obstruction and/or meibum abnormal secretion.Meibomian gland morphological change is important to clinical observation.Objective This study aimed to image the meibomian gland structures and the morphological changes in eyes with OMGD using a non-contact infrared meibography system (Keratograph 5M).Methods A case-control study was performed in Tianjin Medical University Eye Hospital from January to June in 2015.Sixty OMGD patients and 60 age-matched healthy controls were recruited.Ocular Surface Disease Index (OSDI) questionnaire was employed for the assess of ocular surface symptoms,and slit-lamp examination was performed for the observation of lid margin and meibomian gland orifices.Meibomian gland secretion scores and Keratograph 5M examination the morphological changes of the meibomian glands.According to OSDI questionnaire,the patients of OMGD were classified into mild group (12.0 ＜ OSDI ≤ 22.0) (23 eyes),moderate group (22.0 ＜ OSDI ≤ 32.0) (21 eyes) and severe group (32.0 ＜ OSDI ≤ 100.0) (16 eyes).Partial or complete loss of the meibomian glands (meibomian dropout) was scored from grade 0 (no loss) through out grade 3 (lost area was ＞2/3 of the total meibomian gland area).Written informed consent was obtained from all subjects before the examination.Results The OSDI,meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores were significantly higher,and BUT was dramatically shorter in the OMGD group than those in the normal group,showing significant differences between the two groups (Z =-9.425,-8.954,-7.781,all at P＜0.05).The BUT was (6.10± 1.91) s and (10.67-±2.11)s,and meibomian gland dropout scores were 1.35±0.90 and 0.88±0.64 in the OMGD group and normal control group,showing significant differences between the two groups (t=3.276,-12.418,both at P＜0.05).OSDI,meibomian gland secretion scores and meibomian gland dropout scores were significantly in three intergroups (H=52.121,13.642,37.180,all at P＜0.05).BUT,meibomian gland orifices were significantly different among the mild,moderate and severe OMGD (F=58.191,8.474,both at P＜0.05).OSDI showed a significantly high positive correlation with meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores (r =0.708,P =0.000;r =0.759,P =0.000;r =0.270,P =0.003).BUT showed negative correlation with meibomian parameters (r=-0.692,P=0.000;r=-0.691,P=0.000;r=-0.192,P=0.036).Conclusions Keratograph 5M provides an effective noninvasive method in assessing the image of the meibomian gland structures and meibomian gland dropout.There are differences in the ocular surface and meibomian glands between the OMGD patients and normal persons.