The difference in history of development, the curriculum and teaching content of medical humanities education have been compared and researched among the United States, Britain and China, and the questionnaire survey have been conducted to the students from HeBei Medical University, to find the disadvantages and willingness to reform in medical humanities education in China. Based on the successful experience on Medical Humanistic Education from foreign countries, suggestions were put forward such as increased emphasis on medical humanities education, reasonable arrangements for medical education curriculum, creating a good atmosphere on campus, making the medical education to match the social demand, and providing scientific basis for the development of medical humanities education.

Background and purpose:Radical surgery remains the main treatment for the patients with pancreatic and duodenal cancer,but resectability rate is low when clinically diagnosed,portal vein/superior mesenteric vein or inferior caval vein invaded by tumors are a few of the main reasons.How to increase resectability of pancreatic cancer and duodenal cancer still is very challenging to the clinician.This study was done to explore the feasibility of the new surgical approach for the treatment of pancreatic and duodenal cancer with portal vein/superior mesenteric vein or inferior caval vein invasion.Methods:5 patients received pancreatoduodenectomy with vascular reconstruction between February 2002 and June 2005.Three patients with pancreatic head cancer underwent pancreatoduodenectomy combined with portal vein/SMV resection and vascular reconstruction and two patients with duodenal cancer underwent pancreatoduodenectomy combined with inferior caval vein resection and vascular reconstruction.Results:There was no surgery related death.The serious complications such as artificial blood vessel infections or obstructions were not experienced.After surgery,one patient died 10 months later,one patient died 24 months later,two patients survived for over 3 years and one patient over 4 years.Conclusions:Pancreatoduodenectomy with vascular reconstruction for patients with carcinoma of the pancreatic head or duodenum invading portal vein/superior mesenteric vein or inferior caval vein has been proved to be a safe treatment,it could improve the resectability of the tumor and prolong survival.

Objective To investigate the preoperative diagnosis,surgical treatment and results of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA).Methods We retrospectively analyzed the clinical data of 9 patients with ALCAPA who had undergone surgical treatment in Shanxi Children's Hospital from June 2010 to March 2014.Results There were 3 males and 6 females,aged from 4 months to 4 years old and 6 months,average age (1.14 ± 1.33)years,body weight from 5.6 to 18.0 kg,average weight(8.06 ± 3.99) kg.Echocardiography and spiral CT angiography were performed in all patients,one of which underwent cardiac catheter angiography.The cases of mitral regurgitation were mild in 2 cases,mild to moderate in 5 cases,and moderate to severe in 2 cases.Electrocardiogram showed abnormal Q wave,ST segment change and T wave inversion in lead Ⅰ,AVL and V4-6 in 9 cases.The X-ray sign was significant heart enlargement(C/T ratio 0.56-0.73,mean 0.61 ± 0.05).Echocardiography indicated ALCAPA,significant enlargement of left ventricle and decreased myocardial contractility(ejection fraction less than 50％).End diastolic diameter of left ventricle were more than 35 mm in 8 cases and aneurysm formation of left ventricular apex in 1 case.One case was confirmed ALCAPA by catheter angiography.Six cases had radioactive nuclide myocardial imaging,which showed different degree of myocardial infarction.All patients underwent reimplantation of left coronary artery into the aorta,mitral valvoplasty in 7 patients.One case died for low cardiac output syndrome.Others recovered and discharged.Postoperative complications included low cardiac output syndrome in 2 cases,pneumonia in 3 cases and supraventricular tachycardia in 1 case.During a followup of 3 months to 2 years,well development,good heart function,mitral valve regurgitation and ejection fraction improved in all case.Conclusion Echocardiography has important value in diagnosis of ALCAPA,which are confirmed by spiral CT angiography and catheter angiography.Preoperative nuclide examination for determinant of survival myocardium is helpful for surgery and prognosis.Reimplantation of left coronary artery into the aorta is the most ideal surgical procedure.

The authors conceive of dispersing and transferring medical risks by means of insurance. They suggest developing two modules of insurance business, including malpractice insurance and medical accident insurance. They also discuss such basic issues as risk financing, financial compensation and choice of insurance undertakers.

0.05), higher than those in the nighttime (t=3.63,3.16;P

Objective To investigate the allele polymorphism and characteristic of HPA-1-17 genotyping of Li ethnic on Hainan island,and to evaluate the HPA mismatched ratio between donor and recipient in randomly chosen cases of blood transfusion,in order to investigate the platelet transfusion refractoriness in Li population.Methods Genotyping tests of A-1—17 allele of the blood sample from 180 Lis were conducted with PCR-SSP.Results A total of 180 blood samples were genotyped successfully in HPA genetic system,among which 0.9972 were HPA-2a,0.0028 were HPA-2b,0.4889 were HPA-3a,0.5111 were HPA-3b,0.9667 were HPA-5a,0.0333were HPA-5b,0.9972 were HPA-6a,00028 were HPA-6b,0.4250 were HPA-15a,0.05750 were HPA-15b,and they all showed polymorphism. But polymorphism was not detected out in other allelic genes,such as HPA-1,-4,-7—14,-16,and -17. The bb homozygous were detected in two alleles,among which 0.2834 was HPA-3 and 0.3667 was HPA-15,but it wasn't detected in the others systems. In the randomly chosen cases of blood transfusion,the mismatch rate of HPA-3 ,HPA-15 and HPA-5 was 37.49%,36.93% and 6.23%,respectively.Conclusion This research revealed the distribution of HPA gene in Li population on Hainan island,and found the allelic frequency and thier characteristics. According to our findings,HPA-2,HPA-3,HPA-5 and HPA-15 genes between donor and recipient should be matched in order to avoid platelet transfusion refractoriness.

Objective To analyze the peripartum complications,frequency of neonatal abnormalities and the associated factors in patients with primary Sj?grenˊs syndrome (SS). Methods The chart of 39 patients with primary SS who were admitted to the hospital for delivery were retrospectively reviewed. The clinical data, obstetrical outcome and the frequency of neonatal abnormalities as well as the possible associated factors were analyzed. Results There were 76 pregnancies and 41 deliveries among these 39 patients. Two patients (5%) had pregnancy-related hypertension, 1 (3%) had gestational diabetes and 1 (3%) had eclampsia. Twenty-eight(72%) patients had at least one episode of complication. In which, 27(68%) were induced abortion, 2 (5%) were premature birth, 6 (21%) were amniotic fluid volume abnormalities, 2 (5%) were post-partum bleeding, 5 (13%) were premature rupture of membrane, 6 (21%) were intra-uterine distress and 3 (8%) had intra-uterine growth retardation. Fetal abnormality was detected in 7(18%) patients, in which 3 fetus (8%) died before delivery, 2 fetus (5%) were small than gestational age and 2 (5%) had fetal deformity. Compared to the reports in the literature, the rate of abortion and fetal death was higher, but the rate of growth retardation , induced abortion was lower. Conclusion The frequency of peri-partum complication and fetal abnormality is increased in patients with primary SS. Pregnancies in patients with primary SS should beclosely monitored by rheumatologists.

The paper centered on the background,objectives,key actions of the policy and the relationships between policy objectives and key policy actions.Further analysis went on to the three phases of policy implementation and phased achievements,as well as the opportunities and challenges of the policy.These efforts aim at supporting sustainable development of the drug supply support model and hospital reform stage of greater risks and challenges with policy recommendations in Sanming city.

Objective To assess the risk factors for the occurrence of hypokalemia in patients with hepatic cancer after transcatheter arterial chemoembolizaion (TACE) therapy,and to discuss the corresponding nursing countermeasures.Methods The clinical data of 214 patients with hepatic cancer,who received TACE during the period from August 2014 to February 2015,were retrospectively analyzed.The risk factors causing hypokalemia were analyzed.Results Among the 214 patients,post-TACE hypokalemia occurred in 23 (10.7％).The main risk factors that could cause hypokalemia included anorexia,hydration,vomiting,ascites drainage,sweating.After actively symptomatic treatment,the serum potassium level returned to normal in 22 patients.One patient developed hepatic encephalopathy coma complicated by hepatorenal syndrome,the patient's family members gave up treatment and,according to family members' will the patient left hospital.Conclusion anorexia,vomiting,hydration,ascites drainage,sweating are the risk factors that can cause hypokalemia in patients with hepatic cancer after TACE therapy.The use of low potassium risk scale is helpful for the formulation of nursing countermeasures.

Objective:To develop the intelligent management system for diabetes medication knowledge base with the help of community hospital information platform.Methods:Based on the China Type 2 Diabetes Prevention Guide (2013 edition),National Essential Drugs (2012 edition) and the relevant package inserts,the knowledge base of diabetes medication was established.Results:The information platform could make interception beforehand,warning in the process of medication and provide attentions for physicians after treatment to determine rational medication.Conclusion:The intelligent management system for diabetes medication knowledge base can promote physicians to firmly grasp the principles of drug treatment,simplify treatment regimen,select effective drugs with reasonable prices and provide individualized treatment.