This paper reflected the development of modern medical technology from the view of ecology,indicating that the core idea of ecological medical model is that human and nature develop harmoniously. The theory basis,practical background and significance of ecological medical model are also described.

Objective To explore the efficacy of empathy training on the empathy and emotional intelligence in new employed nurses (engaged in clinical work within one year).Methods A total of 82 participants were randomly divided into the intervention group and the control group (n =41).The intervention group was conducted with empathy training in addition to routine clinical guidance,the control group was only conducted with routine clinical guidance.All subjects were assessed with the Interpersonal Reactivity Index (IRI-C) and Emotional Intelligence Scale (EIS) before and after intervention.Results Immediately after the intervention and 3 months after intervention,the scores of IRI-C in the intervention group were significantly higher than those of the control group((57.53 ±5.20) vs(50.50 ±7.64),(55.28 ±6.48) vs(46.90 ± 7.74),P ＜ 0.01).Samely,the scores of EIS in the intervention group were significantly higher than those of the control group((131.55 ± 10.49) vs(124.35 ±9.93) ;(126.27 ± 12.87)vs(119.38 ±9.45),P＜0.01).Conclusion Conducting empathy training can improve the empathic ability and emotional intelligence of new employed nurses.

Objective To describe the structure and clinical application of the single arm suspended reduction fixation device(HOIST device) for spondylolisthesis. Methods HOIST device is composed of the hauling screw, open angle screw(upholding screw), blocker, angle connective bar and blocking ring. Through the different assembly of the angle screws and the connective bar, to increase or decrease the fixation angle of the angle screw which as an upholding arm and the connective bar to meet the needs of different lumbosacral angles and hauling screw reducing distance. Twenty three patients with an average slipping rate of 25％－ 50％ , were treated with the device, and among them, intervertebral implantation of BAK was done in 5 patients and intervertebral fusion was performed in 18 patients. Results The mean duration of follow up was 10.3 months. Olisthy was reduced completely, clinical symptoms disappeared and there was no serious complications. Conclusion This device only required fixation of the slipped and its inferior adjacent vertebral body, and then it causes little influence to the movement of the lumbar spine. The arm of force of the reduction is short, so it is especially indicated for mild and moderate spondylolisthesis.

Objective To Introduce the principle, structure and observe the effects of clinical application of Scofix instrumentation. Methods Scofix instrumentation consists of different size of open up pedicle screws, open up pedicle hooks, connecting rods, blockers and devices of transverse connection. The open up pedicle screws can be inserted continuously or intermittently, fixed by the connecting rods in the scoliotic segments, and then distraction, compression and derotation manipulation can be performed to correct the spinal deformity. Thirty three patients were treated with this methods. The average age at surgery was 14.4 years. The mean preoperative Cobb angle in idiopathic and congenital scoliosis was 70 and 68 degrees,respectively. According to the degree of deformity and spinal flexibility, the correction was done at one setting or in stages. Results Postoperative Cobb angle and the corrective rate in 19 cases of idiopathic scoliosis were 29.4?and 59.1%, respectively while in 14 cases of congenital scoliosis the figures were 33.3?and 52.3%, respectively. No severe complications occurred. Conclusion Scofix instrumentation which is designed by the principle of CD instrumentation and in conformity with the spinal structural features of Chinese adolescence has the function of distraction, compression and derotation and can be used for internal fixation of scoliosis in different ages. Because of the high risk and the great difficulty, the thoracic pedicel screws should be used carefully, and can be replaced by pedicle hooks if necessary.

Objective To determine the cause, prevention and management of failed spinal deformity surgery, and evaluate the indication of spinal revision. Methods Thirty-one cases of failed spinal deformity surgery were treated surgically. There were 18 males and 13 females with an average age of 14.7 years(ranged from 4 to 35 years) at the present procedures. The average number of previous surgeries for this group of patients was 1.5 times. The duration between the first surgery and revision was 13-114 months, with an average of 47.9 months. There were 16 patients with consistent back pain which became worse after movement, 5 patients with implant complication (broken, loosing, explosing), 21 patients with failure of instrumentation and deterioration of deformity, 5 patients with decreased sensory and motor function. The average preoperative angel of deformity was 75.3 degrees for scoliosis and 76 degrees for kyphosis and the flexibility was 9.8% and 25.2%, respectively. All patients underwent reconstructive surgery with segmental vertebral osteotomy and trans-pedicular fixation and fusion in one or two stages according to the location and degree of the deformity. Results The average follow-up period for this group of patients was 31.8 months in 20 cases. The postoperative correction rate for scoliosis and kyphosis was 55.2% and 67.5%, respectively. There were 4 cases (12.9%) developed temporary neural dysfunction postoperatively and were recovered within 1-3 weeks after appropriate treatment. Instrumentation failure was occurred in two cases and there was no other complication in this group. Conclusion It is might be benefit to follow the principle of spinal deformity correction, fuse with adequate bone grafting and combine with proper pedicle fixation, especially for the congenital scoliosis patients, which are the efficial methods to prevent the failure of spinal deformation surgery. The management for the patients suffered from long-time back pain, spinal pseudarthrosis or progressive aggravated deformity postoperatively should be individuated depending on the degree of deformity, flexibility of the spine and the age of patients.

Objective To observe the variation of the levels of γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis before and after treatment.Methods A total of 159 patients with brucellosis were enrolled from the Second People's Hospital of Tianjin between September 2009 and August 2014,of which 122 were with acute phase and 37 with subacute stage.γδT cells,CD4+ and CD8+ T lymphocytes in peripheral blood of all patients before and after treatment were detected by flow cytometry.Thirty healthy controls were also enrolled.Measurement data were analyzed using t test and nonparametric Kruskal-Wallis test.Results The medians of γδT cells,CD4+ and CD8+ T lymphocyte counts of brucellosis patients with acute stage before treatment were 84.0/μL,780.5/μL and 774.0/μL,respectively,and those with subacute stage were 76.0/μL,887.0/μL and 890.0/μL,respectively.Those in control group were 49.0/μL,772.5/μL and 592.5/μL,respectively.γδT cells (U=114.5,P =0.001) and CD8+ T lymphocyte counts (U=1 185.5,P =0.003) in acute phase group were elevated than control group.γδT cells (U=359.0,P=0.013),CD4+ T lymphocyte counts (U=325.5,P=0.004) and CD8+ T lymphocyte counts (U=316.5,P=0.003) in subacute phase group were increased than control group.CD4+ T lymphocyte counts in subacute phase group were elevated than acute phase group (U=1 619.0,P=0.009).There were 31 patients with acute phase and 30 patients with subacute phase who completed 6-week treatment.γδT cells ([120.7 ± 104.9]/μL vs [82.2 ±85.3]/μL;t=3.568,P=0.001),CD4+ T lymphocyte ([802.1±300.6]/μL vs [663.0±280.6]/μL;t=2.904,P=0.007) and CD8+ T lymphocytes counts ([908.1±422.7]/μL vs [651.1±241.7]/μL;t=3.885,P=0.001) of brucellosis patients with acute stage before and after treatment were significantly different.γδT cells ([67.1± 38.4]/μL vs [48.4±32.1]/μL;t=2.695,P=0.012),CD4+ T lymphocytes ([817.1± 147.4]/μL vs [650.8± 196.5]/μL;t=5.301,P＜0.01) and CD8+ T lymphocytes counts ([703.7±191.5]/μL vs [537.4±186.0]/μL;t=5.152,P＜0.01) of brucellosis patients with subacute stage after treatment were significantly decreased compared with those of patients before treatment.Conclusions γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis are all in a state of immune activation.The levels of activation are highly correlated with disease progression.And detection of the variation of these cells contributes to understand the immune state of the acute and subacute brucellosis.

Spinal sensory evoked potential(SSEP)and spinal motor evoked potential(SMEP)of the injured spinal cord of the host rats were determined on the 7th,15th,30th.60th,120th and 240th day after they received implantation of the embryonic spinal cord from the fetus of E14 rats.The motor function of the hind limbs of the host rats were also observed.The rats with simple cord injury and those with cord injury and implantation of a piece of skeletal muscle served as the controls.It was found that the locomotor function of the host rats could be recovered on the 30th day after implantation,but the latent period of both SSEP and SMEP became normal on the 240th day.At that time,the latent period of evoked potentials of the 2 control groups also recovered gradually.It is believed that embryonic spinal cord may have effects on the recovery of the locomotor function of the host rats but more sophisticated methods are imperative to clarify the interela-tionship between the host tissue and the graft.

Tumor lysis syndrome (TLS) is the rapid dissolution of tumor cells and cell contents, and its metabolite is rapidly released into the blood, causing a series of complications such as high uric acid, high potassium, high phosphorus, hypocalcemia and acute renal insufficiency. TLS is commonly seen in patients with rapidly growing malignant tumors that are sensitive to chemotherapy, and which is rare in solid tumors. We found one case of primary liver cancer with acute TLS, who was given hemodialysis to protect the liver and symptomatic treatment, and the patient is on the mend.

Objective To determine the effectiveness of ETCD ( endoscopic transpapillary cyst drainage) in treatmen! of pancreatic pseudocysts. Methods Twenty-six patients with pancreatic pesudocysts were selected. They are presented some indications for treatment and the pesudocyst were ranged in size from 1.5 to 15 cm. Of 23 cases 38 sessions of ETCD were performed. In two of thirty-eight cases the cyst bulges were invisible in the stomach or duodenum due to its compression. In one case ETCD was employed after percutaneous drainage of the pseudocyst, the other one was treated after combination therapy of plastic stent ing because of jaundice. Results Improvement of abdominal pain, changes in appetite, body weight and fat in stool were recorded in follow-ups of 60 ~ 850 days. There was only one asymptomatic recurrence. One case was complicated with pancreatic abscess. There was no mortality related to the procedure. Surgical intervention became necessary in three cases because of inadequate drainage or complication. Conclusion ETCD treatment of symptomatic pancreatic pseudocysts with ductal communication, the transpapillary pancreatic duct stenting is a safe, effective modality and should be considered as the first line therapy; on the other hand for those pancreatic pseudocyst without communication to the main pancreatic duct it is not effective.

Objective To explore the mechanism of long chain noncoding RNA RORin regulating prolifer-ation and apoptosis of pancreatic cancer cell. Methods Pancreatic cancer cell line BxPC-3 was selected. The RNA level of lncRNA ROR and notch1 was detected by RT-PCR.Notch1 protein level was detected by Western blot. The regulating relationship between lncRNA ROR and notch1 was analyzedby RNAhybird and luciferase re-porter assay. At last ,CCK-8 and TUNEL were applied to detectthe proliferation and apoptosis of cell line. Re-sults lncRNA ROR and notch1 were highly expressed in pancreatic cancer tissue ,compared with normal tis-sues. There was positive correlation between them. lncRNA ROR was over-expressed in BxPC-3,cell proliferation activity was increased and the percentagesof DNA damaged positive cells was decreased ,accompanied by in-creased levels of notch1 mRNA and protein. Luciferase assay confirmed that ROR could bind to notch1and inhibit its activity by miR-137. Compared with control group ,the proliferation of pcDNA-ROR + si-notch1 cells reduced and the proportion of TUNEL positive cells increased. The differences were statistically significant. Conclusionl ncRNA ROR regulated the proliferation and apoptosis of pancreatic cancer cells by promoting the expression of notch1.