Under the background of Internet plus,the medical work emerged some unprecedented new work characteristics,medical workers' practice environment also changed,and then made the disadvantages of the culti-vation of humanistic spirit in medical students become more and more obvious.By analyzing the status quo of medi-cal diagnosis and treatment,the current situation of the cultivation of medical students,the importance of humanis-tic spirit in the cultivation of contemporary medical students,and how to make up for the lack of humanistic spirit in the context of Internet plus,this paper laid a foundation for the transformation of the cultivation of humanistic spirit in medical universities and pointed out the measures for the cultivation of humanistic spirit of medical students un-der the background of Internet plus:endowing humanistic spirit with a new era significance,creating new commu-nication dimension of humanistic spirit,shaping new educational idea of humanistic spirit,customizing new training mode of humanistic spirit,and improving new educational power of humanistic spirit.

Child ; History, 20th Century ; History, 21st Century ; Humans ; Nephrology ; history ; Pediatrics ; history ; Societies, Medical ; history

Thyroid cancer is the most frequent endocrine malignancy. The histologic subtype of thyroid carcinoma is mainly differentiated thyroid carcinoma. The treatment modality of thyroidectomy followed by 131I and thyroxine-suppressive therapy has been approved and applied widely. A brief introduction and a commentary on this topic is presented in this article.

BACKGROUND:For patients with lumbar spondylolisthesis combined with osteoporosis, appropriate fixation system for effective reset and good fixation stability is currently a hot issue of clinical concern. Pedicle screw screw-rod system after bone cement perfusion can achieve the effective fixation between pedicle screw system and the vertebral bone. OBJECTIVE:To observe the therapeutic effect of bone cement-augmented pedicle screw on patients with lumbar spondylolisthesis combined with osteoporosis. METHODS:17 cases of lumbar spondylolisthesis combined with osteoporosis were identified by bone density test. They received the posterior open reduction and internal fixation, and implanted with 68 bone cement-augmented pedicle screws. Their repair effects were observed by short-term fol ow-up. Patients were evaluated using low back pain Visual Analog Scale and lower limb Oswestry Disability Index before treatment, 1 week, 3 months and 1 year after treatment. Vertebral height, intervertebral height, screw loosening and bone cement leakage were observed using imaging.
RESULTS AND CONCLUSION:Compared with pre-treatment, low back pain Visual Analog Scale score and lower limb Oswestry Disability Index were significantly improved at 1 week, 3 months and 1 year after treatment (P<0.05). No significant difference was detected between post-treatment and fol ow-up (P>0.05), which indicated that clinical repair effect could be effectively maintained. At 3 months of fol ow-up, one screw loosening occurred in two patients. During fixation, mild bone cement leakage appeared in seven vertebral bodies with screw fixation, no symptoms or subsequent complications were observed. There were no significant differences in vertebral height and intervertebral height before and after treatment and during fol ow-up (P>0.05). These results suggest that bone cement-augmented pedicle screw for patients with lumbar spondylolisthesis combined with osteoporosis can effectively reset vertebral slippage, effectively provide good anti-pul-out force for a long term, and the effect was stable. Bone cement augmentation can perfectly strengthen fixation, shows good biocompatibility, and avoids osteoporosis around the screw-induced failure fixation.

OBJECTIVE:To explore the effects of risperidone combined Ningxin yizhi capsule on the cognitive function,neuro-logic function and living quality of cerebral infarction. METHODS:110 patients with cerebral infarction were randomly divided in-to control group(55 cases)and observation group(55 cases). All patients received aspirin,statins,penicillins,physical rehabilita-tion and other conventional treatment;based on it,control group orally received Risperidone tablet with initial dose of 0.5 mg, once a day,1 week later,the amount of drugs was adjusted according to the patient's tolerance and conditions,0.5 mg was in-creased every week,with maximum dose of less than 2 mg,no other antipsychotic drugs except risperidone. Observation group ad-ditionally received 0.9 g Ningxin yizhi capsule,3 times a day. The treatment course for both groups was 2 months. Montreal cogni-tive assessment (MoCA) score,neurobehavioral cognitive status tests scale (NCSE),National Institutes of Health Stroke Scale (NIHSS)score,activities of daily living scale(ADL)score and table of daily living-Barthel Index(Barthel-Index)before and af-ter treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:Before treatment,there were no signifi-cant differences in the MoCA scores,NCSE scores,NIHSS scores,ADL scores and Barthel-Index in 2 groups (P>0.05). After treatment,the MoCA scores,NCSE scores,ADL scores and Barthel-Index in 2 groups were significantly higher than before,and observation group was higher than control group,NIHSS scores were significantly lower than before,and observation group was lower than control group,the difference was statistically significant(P<0.05). And there was no significant difference in the inci-dence of adverse reactions(P>0.05). CONCLUSIONS:Based on the conventional treatment,risperidone combined Ningxin yizhi capsule can significantly improve the cognitive function,neurologic function and living quality of cerebral infarction,with good safety.

Objective:To explore the effectiveness and recurrence prevention of esomeprazole at different doses in the patients with reflux esophagitis ( RE) . Methods:Totally 240 patients with RE were divided into mild or severe group with 120 cases in each accord-ing to the illness severity. The two groups were respectively divided into four groups according to the random number table, namely the full dose treatment group, half dose treatment group, intermittent treatment group and on-demand treatment group. The groups were fol-lowed up for 6 months, and GERD-HRQI scores, the recurrence rate and incidence of adverse reactions in all the groups were com-pared. Results:After the 6-month follow-up, the differences in the GERD-HRQI scores, recurrence rate and incidence of adverse re-actions among the groups with different doses were statistically significant (P<0. 05). The GERD-HRQI scores and RE recurrence rate in on-demand treatment group were significantly higher than those in the other groups(P<0. 05), and the incidence of adverse re-actions in the total dose treatment group was significantly higher than that in the other groups (P<0. 05). Conclusion: Intermittent treatment with esomeprazole at small dose can effectively prevent RE recurrence, reduce the incidence of adverse reactions and treat-ment costs, which is worthy of promotion.

Sepsis is systemic inflammatory response syndrome(SIRS)associated with the presence of pathogenic microorganisms or their toxin.Lipopolysaccharide(LPS)is an important component of the outer membrane of Gram negative bacteria and has a pivotal role in inducing Gram negative sepsis.Macrophages play an essential role in infection and inflammation.Specific recognition of LPS is of particular importance in the defense system and pattern recognition receptors(PRR)have been considered to be important in initial steps for cellular recognition of LPS and consequence initiation of LPS responses.In the past few years,intense research in the fields of PRR and their recognition mechanism has been achieved.In this review,we attempt to expound recent research advances of macrophage PRRs for LPS recognition and their mechanism.

Levothyroxine monotherapy for primary hypothyroidism has gratifying effects.Doctor should recommend the optimal timing of taking levothyroxine to patients for individualized therapy according to the medical history,the pharmacokinetic characteristics of levothyroxine,and various factors affecting its absorption.After reaching the therapeutic goal,most of patients could live,study,work,marry,and bear as healthy subjects.

Objective To investigate the value of the three-dimensional endorectal ultrasonography (3D-ERUS) in the tumor staging before transanal endoscopic microsurgery (TEM).Methods The clinical data of 30 patients with rectal cancer who underwent 3D-ERUS before TEM at the Nanjing Hospital of Traditional Chinese Medicine from April 2012 to December 2013 were retrospectively analyzed.The accuracy,sensitivity and specificity of the 3D-ERUS were evaluated according to the results of the postoperative pathological examination.The consistency of the results of the 3D-ERUS and postoperative pathological examination were compared by Kappa consistency test.Results Of 30 patients,25 patients in stage T0,3 in stage T1 and 2 in stage T2 were diagnosed by preoperative 3D-ERUS.There were 2 patients (stage pT0) with inflammatory polyp by postoperative pathological diagnosis,6 patients (stage pT0) with tubular adenoma,16 patients (stage pT0) with villioustublar adenoma,2 patients (stage pTis) with carcinoma in situ,2 patients (stage pT1) with tectal adenoma and 2 patients (stage pT2) with rectal adenoma.There were 2 patients with excessive tumor staging by 3D-ERUS,1 patient in stage pT0 was misdiagnosed in stage T1,1 in stage pT1 was misdiagnosed in stage T2 and 1 in stage pT2 was misdiagnosed in stage T1 with insufficient tumor staging.The accuracy of 3D-ERUS in the preoperative tumors staging of TEM was 90.0％ compared with the resuls of postoperative pathological examination.The accuracy,sensitivity and specificity of 3D-ERUS in stage pT0,pTl,and pT2 of TEM were 96.7％,90.0％,93.3％ and 96.2％,50.0％,50.0％ and 100.0％,92.8％,96.4％,respectively.There was a significant difference in the consistency between preoperative 3D-ERUS and postoperative pathological examination (κ =0.685,P ＜ 0.05).Conclusion 3D-ERUS is an accurate clinical method in the preoperative tumors staging of TEM,and can be used as the preoperative assessment for TEM.

ObjectiveTo analyze the clinical characteristics of atypical acute myocardial infarction,improve the diagnosis of myocardial infarction. MethodsTo analyze the main clinical characteristics of the patients with atypical acute myocardial infarction in our hospital in the past 3 years ,which compared to the typical acute myocardial infarction. ResultsAtypical acute myocardial infarction includes atypical symptom and atypical ECG, atypical symptoms is more prevail. Compared with typical acute myocardial infarction, the women, elderly people and hypertension patients is more common, fewer anterior myocardial infarction and poorer prognosis ( P ＜ 0.05 ). ConclusionTo improve the understanding of atypical acute myocardial infarction,was benefit of reducing the misdiagnosis and mistreatment of acute myocardial infarction.