With the gradual transformation of the American medical model from biomedical medel to bio-psycho-social model,the advancement both in the medical security and service system,preventire medicine as well as the protection of environment have been emphasized,while the revolution of the medical education has been carried out according to the divemified requirements of the bio-psyeho-social model,and the focus of health care has been moved forward.

Medical science is both scientific and humanistic,and medical humanities education is an ever-lasting theme.To enhance residents'health,a new health service reform is being carried out by the government to promote the transformation towards the bio-psycho-social medical model.Social reality,mental environment and social factors have significant effects upon health.To impart medical humanities knowledge and cultivate quality of humanities are the missions of higher education.Based upon the practice of medical humanities education in Sun Yat-sen University and the experience of developed countries and regions,and by elaborating the theory to deepen understanding of medical humanities the author is to deal with the real needs and to enhance educational effectiveness of countermeasures.

Objective Based on the technique of computer network communication,to design and construct a mini medical picture archiving and communication systems (mini-PACS) in radiological department.Methods Radiologic information networks were composed of Anke SCT scanner, GMS and SHIMADZU digital radioscopy, SGI picture workstation, laser film printer, Dell server and report terminal computers with DICOM 3.0. Mini-PACS was constructed with radiological networks mentioned above and local area networks (LAN) existing in our hospital. Network parameters were set and network communication software FTP2000 was used to transport data. Radiological diagnosis and report program was edited with Visual Basic 6.0 (VB6.0).Results Five functions such as image acquirement, data transport and share, data archiving, report and print, register and statistics could be realized by mini-PACS. The system was stable for about 2600 cases during 420 days and no obstacle could be found after simple maintenance.Conclusion The mini-PACS can realize the five functions. Mini-PACS is practical, stable, safe and easy to maintain. It playes an important role in economic management and scientific research.

Invasive aspergillosis is one of common causes of death in patients with hematologic malignancies and bone marrow transplant recipients .The high mortality is due in part to difficulties in timelydiagnosis because signs and symptoms are often nonspecific or are attenuated as a result of medication such as corticosteroids.In addition to the profound and persistent net state of immunosuppression in patients who develop invasive aspergillosis,intrinsic or secondary antifungal resistanceand the toxicity may also account for high mortality.

Objective To discuss the nursing intervention effect on reducing anxiety of patients with amputation due to trauma. Methods 30 trauma patients needing amputation were given pertinent nursing intervention according to the psychological problems existing in them by special nurses from admission to operation.Self-rating anxiety scale (SAS)was used to evaluated the anxiety of patients ten minutes after informing them of the operation and ten minutes before the operation.The anxiety level was compared before and after the intervention. Results After the nursing intervention,the level of anxiety was alleviated compared with that on admission. Conclusions Strengthening the nursing intervention can effectively reduce the anxiety level of patients with amputation due to trauma before operation,and improve the initiative and compliance of treatment in patients.

ObjectiveTo find out the antimicrobial resistance of clinical sequential isolates of Serratia marcescens,investigate the primary antimicrobial resistant mechanism of Serratia marcescens to β-lactams antibiotics.MethodsReview the antimicrobial resistance data of 247 Serratia marcescens isolates collected sequentially from different clinical wards during 2007 to 2010 in the First Hospital of Ningbo,which their antimicrobial susceptihility testing was got by using Vitek2-Compact system and matching products of gram-negative susceptibility card (GNS).The antimicrobial resistant genes of 20 carbapenems resistant isolates were detected by PCR.Results The Serratia marcescens resistant rates to ceftriaxone,aztreonarn and ciprofloxacin in our hospital were 70.4％ ( 174/247 ),64.8％ ( 160/247 ),57.4％ ( 142/247),respectively,the resistant rates were lower to amikacin,gentamicin,imipenem and meropenem,which were 3.5％ ( 8/229 ),5.4％ ( 13/241 ),5.9％ ( 14/237 ),8.1％ ( 20/247 ),respectively.PCR experiment showed that the expression levels of the AmpC gene in 4 strains were higher than that of the negative reference strains.The expression levels were 98.3,102.3,121.5,87.3 times compared to the negative reference strains,respectively.Twelve strains (strain no.2,3,5,6,9,10,14,15,16,17,18 and 19)produce bothblaCTX-MandblaKPC-2 enzymes.Highly detecedhlaCTX-Mof Serratia marcescens in our hospital included CTX-M1,CTX-M2,CTX-M9.Isolates no.7 and 18 were carrying blaSHV gene,Isolates no.8 and 13 were carrying blaSME,Isolates no.11 and 20 were carrying blaTEM.There were 5 strains (no.3,4,5,7 and 16) lose the outer membrane protein (OMP) genes ompC and ompF.Two strains( no.1 and 12 ) lose OMP gene ompF only,and one strain ( no.20 ) was lose OMP gene ompC only.ConclusionsThe cause of β-lactam antibiotics resistance of Serratia marcescens was complicated,and the most important mechanism is producing β-1actams and loss of OMP.Understanding the evolution and drug resistant mechanisms will help for best use of antibiotics and reducing the selection of antibiotics to resistant isolates.

The pilot work urban workers medical network settlement of Anhui province has launched in full scale,effectively facilitating the population seeking medical service elsewhere.In this regard,the medical settlement of a pilot hospital is cited as an example to introduce the networked medical settlement in remote places,summarizing problems encountered,and coming up with proposals accordingly.

Objective To observe the effect of functional exercise guided by self muscle strength in early rehabilitation on patients after total knee arthroplasty (TKA). Methods From September, 2014 to September, 2015, 62 patients after TKA were randomly divided into ex-perimental group (n=31) and control group (n=31). The control group received conventional rehabilitation training, while the experimental group received rehabilitation training under the guidance of their own muscle strength standard. The degrees of swelling and pain seven days after TKA; the muscle strength seven and 15 days after TKA; the range of motion (ROM), the Keen Society Score (KSS) 15 days after TKA;and the postoperative hospital stay were compared. Results There was no significant difference in all the indexes above between two groups before TKA (t<0.960, P>0.05), and all of them improved after TKA (t>3.470, P<0.01). There was no significant difference in the de-grees of swelling (t=1.800, P=0.077) and pain (t=0.840, P=0.404) seven days after TKA. The score of quadriceps strength was higher in the experiment group than in the control group (t>2.280, P<0.05) seven and 15 days after TKA. There was no significant difference in the ROM of the knee and the score of knee between two groups (t>0.850, P>0.05), and the functional score was higher in the experiment group than in the control group (t=5.870, P<0.001) 15 days after TKA. The postoperative hospital stay was shorter in the experiment group (t=7.65, P<0.01). Conclusion Functional exercise under the guidance of their own muscle strength standard could contribute to the improvement of postoperative muscle strength and knee joint function, and shorten the hospitalization stay.

Objective To invetigate clinical characteristics,pathogenesis and its risk factors of neuropsychi-atric lupus erythematosus(NPLE).Methods 160 cases of SLE patients,including 30 cases of diagnosed NPLE,were analyzed retrospectively.The relationship between the appearance of NPLE and common autoantibodies,other organ involvement and SLE disease activity score(SLEDAI)were analyzed.Results Such antibody positive rates of anti nuclear antibody(ANA),anti Sm antibody,anti -RNP antibody,anti SSA antibody,anti ds -DNA antibody had no significant difference between NPLE and non NPLE,the value of χ2 was 0.947,0.013,1.194,0.023,0.745 respectively,the value of P was 0.194,0.910,0.274,0.879,0.388 respectively.Renal involvement,raynaud phenomenon,interstitial pneumonia,pulmonary thromboembolism,oral ulcer,arthritis,facial erythema,pleuritis,pericarditis,fever,pulmonary hypertension,photo -allergy and alopecia in the two groups had no difference,the value of χ2 was respectively 0.419,1.383,0.721,0.201,1.368,1.194,0.055,0.946,0.262,2.503,0.628,2.898 and 0.075,the value of P was 0.517,0.324,0.396,1.000,0.242,0.274,0.815,0.331,0.609,0.114,0.428,0.089 and 0.785 respectively.But the occurrence of hand and foot vasculitis in NPLE was significantly higher(χ2 =3.996,P =0.046).SLEDAI of NPLE was higher than non NPLE(t =8.446,P =0.000).Conclusion There was no correlation with the occurrence of NPLE and common autoantibodies,other organ involvements.Hand and foot vasculitis and higher SLEDAI(more than 15 points)were the risk factors of NPLE.Encephalopathy may be the initial manifestation to some of SLE cases. Early diagnosis and methylprednisolone pulse treatment combined with immunosuppressive therapy can effectively improve the remission of the disease,reduce mortality and improve prognosis.

objectives To provide the reference for the Research & Development departments of hospitals by analyzing the quantity of publications and their cited status for the top 20 hospitals in SCl and MEDLINE.and top 100 hospitals in domestic publications in 2006.Methotis The number of publications and their cited times for the first 20 hospitals in SCI and MEDLINE.and the top 100 hospitals in domestic publications in 2006 were analyzed with bibliometric analysis.Results In 2006.the average increased ratio of publications in SCI for top 20 hospitals was 47.58%.but the number of articles in MEDUNE WaS decreased.For top 100 hospitals.the increased number of domestic publications was 71.25,the number of cited publications WaS increased 160.14.Conclusions The SCI publications from top 20 hospitals increased sharply,but publicatiOils indexed by MEDLINE decreased respectively.