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.

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.

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.

Taking into account the near infrared spectra(NIR) on numerous predictor variables with serious collinearity and having nonlinear quantitative relationship with the chemical compositions, a novel nonlinear partial least squares(PLS) approach, termed as Spline-PPLS, was constructed by combining the penalized partial least squares(PPLS) regression with B-splines transformation. Firstly, the observed spectral predictors were considered as discrete observations of curves of the wavelength and were nonlinearly transformed using B-spline basis functions. The choice of the degree of the polynomial pieces and of the number of knots was performed using the cross-validation strategy. Then, the PPLS algorithm was performed on the high dimensional transformed data matrix to build the calibration model by imposing a penalty term to the optimization criterion of PLS. The roughness penalty term indeed controlled the curvature of the functions and its smoothing parameter could also be obtained by the cross-validation. Finally, the proposed Spline-PPLS approach was applied to the wheat NIR diffuse reflectance spectra reconstruction and quantitative analysis. The result indicates that the Spline-PPLS approach not only can yield high accuracy reconstructing spectrum, but also improves the model prediction accuracy in the case of nonlinear relationships.

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.

Objective To explore the correlation between the parameters of ambulatory blood pressure monitoring (ABPM) and prostatic volume in elderly patients with essential hypertension.Methods The 131 elderly patients with essential hypertension from March 2007 to December 2009 were enrolled in this study, including 102 benign prostatic hyperplasia (BPH) patients and 29 nonBPH (NBPH) patients. All patients underwent ABPM and ultrasound examination of prostate.Prostatic volumes (PV) were calculated and were compared between BPH group and NBPH group.Correlation between parameters of ABPM and PV was analyzed. Results (1)The maximal mean artery pressure (MAPmax) at night was higher in BPH group than in NBPH group [( 104.7 ± 12. 0)mm Hg vs. (99.6± 10. 1) mm Hg, P= 0.039]. (2)There were correlations between PV and MAPmax in all-day (r=0. 184, P=0. 035), MAPmax at daytime (r=0. 183, P=0. 037), MAPmax at night (r=0. 181, P=0. 040), respectively. Conclusions MAPmax of ABPM may be associated with PV in elderly patients with essential hypertension.

The choledocho-pancreatico-duodenal junc-tion is located at the central part of choledocho-pancreatico-duodenal region. During early embryogenetic stage, the primary duodenum develops from the end of foregut and the beginning part of the midgut. The dorsal pancreas, hepatic diverticulum and the ventral pancreas which arises from the basic part of hepatic diverticulum are growing and rotating following the duodenum. During the course, the formations of the choledocho-pancreatico-duodenal region and the central part of choledocho-pancreatico-duodenal junction are complete. The injuries in cho-ledocho-pancreatico-duedenal junction may be caused by metal probe or lithotomy forceps for exploring, dilatating the distal bile duct or taking out the stones from the bile duct. Even if the injuries of choledocho-pancreatico-duodenal junction are deve-loped in a limited scope of several centimeters, several adjacent organs may be involved. Injuries in choledocho-pancreatico-duo-denal junction are hard to be identified during operation and may develop into serious pathological procedures.