Objective: To study the relationship between negative behavior of preschool children and behavior of their mothers. Method.. 742 mothers of children in their 3 ～ 6 year old age were tested by self- made questionnaire. Results: Negative behavior was not significantly related to age and gender of children. It was negatively related to maternal supporting behavior and positively to maternal un- supporting behavior. The culture background (urban/rural), family income and mother' s occupation were found to be important factors mediating maternal un- supporting behavior. Conclusion: Negative behavior of preschool children is influenced by mother' s behavior, which in turn has its cultural - economical background.

Objective:To investigate the routine maintenance and inspection methods of magnetic resonance imaging (MRI) equipment, reduce the failure rate and improve the image quality, and ensure the normal operation of medical image diagnostic equipment.Methods:According to the characteristics of the equipment, to make maintenance inspection goals and complete the daily management of MRI equipment. According to the medical equipment management system requirements, to establish and maintain records to provide data to meet the requirements and the effective operation of quality management system, and to record the data for each equipment for continuity and traceability.Results: There are the potential problems through the management and analysis of MRI equipment data. And the problems were timely solved to make the device operate steady. It’s easy to get a clear and reliable image and to provide an objective and true diagnostic basis for clinical.Conclusion: The routine maintenance and inspection of MRI equipment is an indispensable and important work in medical engineering.

Objective To understand the current situation of multidrug-resistant organism (MDRO)infection in hospitalized patients in a tertiary first-class hospital,as well as efficacy of bundle intervention measures on preven-tion and control of infection. Methods Hospitalized patients who were infected with MDROs in this hospital during 2012-2014 were monitored and conducted bundle intervention. Results In 2012-2014,a total of 1909 MDRO strains were isolated. The isolation rates of MDROs in 2012-2014 were 30.69% ,31 .04% ,and 29.40% respec-tively,bedside intervention rates were 81 .02% ,92.05% ,and 94.23% respectively,implementation rates of clinical isolation were 69.97% ,82.98% ,and 93.04% respectively;MDRO isolation rates during 2012-2014 were not sig-nificantly different(P>0.05);bedside intervention rates and implementation rates of clinical isolation were both sig-nificantly different(both P<0.05). The top 3 isolated MDROs in 2012-2014 were extended-spectrumβ-lactamases (ESBLs)-producing Escherichia coli,multidrug-resistant Acinetobacter baumannii,and ESBLs-producing Klebsiel-lapneumoniae. Conclusion Bundle intervention measures,such as multi-department collaboration and strengthened on-site supervision,can promote more standardized management of healthcare-associated infection,enhance the im-plementation rate of clinical isolation,and effectively prevent and control the spread of MDRO in hospital.

Objective To investigate the correlation between the stage of hepatic fibrosis and the diameter of portal vein (DPV) and middle hepatic vein (DMHV) in patients with chronic hepatitis B.Methods 320 patients with chronic hepatitis B were evaluated by ultrasonography.The DPV and DMHV were measured,and their correlation with the degree of hepatic fibrosis was analyzed after liver biopsy.Results DPV was positively related with the degree of hepatic fibrosis(r =0.384,P =0.032),while DMHV was negatively related with the degree of hepatic fibrosis (r =-0.521,P =0.015).The DPV and HMDV in S4 were bigger than those of S0,S1,S2 and S3,and statistical differences existed among them (DPV∶z =0.334,P =0.032 ; DMH∶z =0.161,P =0.015).The best value of S4 diagnosing by DPV was 13mm.The best value of S4 diagnosing by DMHV was 6mm.The area under the curve of ROC for DPV and DMHV in ≥S2 was 0.753 and 0.758 respectively.It in≥S3 was 0.795 and 0.802 respectively.It in ≥S4 was 0.797 and 0.828 respectively.The area under the curve of ROC for combination of DPV and HMDV was 0.866,which was higher than that of DPV and HMDV.Conclusion There is a good correlation between DPV,DMHV and the stage of hepatic fibrosis in patients with chronic hepatitis B.Combination of DPV and HMDV has clinical significance for diagnosing early hepatic fibrosis.

Objective To compare the effect of different methods of anesthesia on cerebral autoregulation in patients undergoing neurosurgery.Methods Sixty-nine ASA Ⅱ orⅢ patients with brain tumor, aged 23-62 yr, scheduled for neurosurgery under general anesthesia, were randomly divided into 3 groups ( n = 23 each) : propofol-remifentanil group (group PR), sevoflurane-remifentanil group (group SR) and propofol-sevoflurane-remifentanil group (group PSR) . Anesthesia was induced with target-controlled infusion (TCI) of propofol (target plasma concentration3 μg/ml, PR and PSR groups) or inhalation of 8% sevoflurane (group SR) and iv injection of remifentanil 1 mg/kg and atracurium 0.5 mg/kg. The patients were mechanically ventilated after tracheal intubation. PETCO2 was maintained at 32-35 mm Hg. Anesthesia was maintained with TCI of propofol (target plasma concentration 2.0-3.5 μg/ml) in group PR, with inhalation of 1.5%-2.5% sevoflurane in group SR, with TCI of propofol (target plasma concentration 1.5-3.0 μg/ml) and inhalation of 1% sevoflurane in group PSR, and with TCI of remifentanil (target plasma concentration 2.0-4.5 ng/ml) and iv infusion of atracurium at 6 μg · kg-1 · min-1 in all groups. Auditory evoked potential index was maintained between 40-45. The middle cerebral artery time-average peak flow velocity was recorded before induction (baseline) , immediately after intubation, immediately before craniotomy and at the beginning of skin suture. The unilateral carotid artery was compressed for 7 s at the corresponding time points mentioned above. The transient hyperemic response ratio (THRR) was calculated to reflect cerebral autoregulation. Results Compared with the baseline value at T0, THRR was significantly increased at T2in group PR and decreased at T2,3 in group SR (P <0.05) ,while no significant change was found in THRR at T1-3in group PSR (P >0.05). The THRR was significantly lower in SR and PSR groups than in group PR, and higher in group PSR than in group SR ( P < 0.05). Conclusion Propofol-remifentanil anesthesia can improve cerebral autoregulation, sevoflurane-remifentanil anesthesia can reduce cerebral autoregulation, and propofol-sevofluraneremifentanil anesthesia exerts no effect on cerebral autoregulation in patients undergoing neurosurgery.

Since portal vein arterialization(PVA) was firstly introduced as a treatment in patients with portal hypertension due to liver cirrhosis, the concept of PVA has drawn much attention. In special situations, in hepatobiliary surgery, this procedure remains useful. However, PVA is unphysiological and there is much controversy on its use.This article reviews the current status of PVA in hepatic artery resection or injury, in acute liver failure and in liver transplantation, and suggests future directions in research in PVA.

Objective To investigate the relationship of pulmonary function and metabolic indexes in overweight as well as obesity people.Methods Three hundred and five health examination adults were selected as our subjects.The basic parameters,metabolic indexes and pulmonary function were measured.Of which,pulmonary function indexes include forced vital capacity (FVC),forced expiratory volume in one(FEV1),peak expiratory flow(PEF),the ratio of the forced expiratory volume in the first one second to the forced vital capacity (FEV1/FVC),the ratio of the forced expiratory volume in the first one second to the vital capacity(FEV1/VC),maximal expiratory flow after 50％ of the FVC (MEF50),maximal expiratory flow after 25％ of the FVC (MEF25),and each index value of lung function was expressed the ratio of the measured value/the predictive value.Metabolic indexes include triglycerides (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),fasting plasma glucose (FPG)),C-reactive protein (CRP),high-sensitivity C-reactive (hs-CRP),superoxide dismutase(SOD),systoloc blood pressure (SBP) and diastolic blood pressure (DBP).Statistical analysis methods include one-way analysis of variance and Spearman correlation analysis.Results The levels of FVC,FEV1,FEV1/FVC in overweight and the obesity group were (85.74 ± 13.94)％ and (82.85±13.34)％,(84.52 ± 14.62)％ and (82.74 ± 14.18)％,(103.40 ± 13.05)％ and (103.17 ±8.99)％respectively,lower than that of normal weight group [(95.79 ± 26.83) ％,(92.65 ± 26.93) ％,(99.98± 11.88) ％,all P values less than 0.05)].Compared with the normal weight group,the levels of TG,SBP,FPG in overweight group and the obesity group were significantly increased.The levels of LDL-C,DBP,hs-CRP in obesity were (5.05 ± 0.83) rmtmol/L,(86.64 ± 10.49) mmHg,(3.74 ± 5.51) mg/L respectively,higher than that of normal group [(3.08 ±0.96) mmol/L,(77.69 ± 13.20) mmHg,(2.33 ±4.67) mg/L,P ＜0.05)].SOD activities in overweight and obesity group were (140.82 ± 13.16),(144.89 ± 13.82) U/L respectively,significantly lower than that of normal weight group[(148.64 ± 14.94) U/L,P ＜0.05)).The levels of SBP,DBP,hs-CRP in the over weight group were (127.77 ± 19.07) mmHg,(80.87 ± 12.21) mmHg,(2.31± 3.73) mg/L),higher than that of obesity group.Among metabolic indices,TG,SBP,DBP,FBG,CRP,hs-CRP and SOD were related with FVC (r =-0.129,-0.129,-0.136,-0.180,-0.220,-0.217 respectively,P ＜ 0.05 or P ＜ 0.01).There was negatively correlated relationship between SBP,FBG,CRP,hs-CRP and FEV1 (r =-0.128,-0.127,-0.148,-0.198 respectively,P ＜0.05 or P ＜0.01),So were SBP,CRP,hs-CRP and PEF (r =-0.137,-0.117,-0.133 respectively,P ＜ 0.05).Negatively correlated relationship between hsCRP,SBP and MEF50 were seen (r =-0.126,-0.124,P ＜ 0.05).Meanwhile there was negatively correlated relationship between SOD and FVC,FEV1/FEV,PEF,MEF50 (r =0.149,0.094,0.119,0.141,0.129respectively,P ＜ 0.05 or P ＜ 0.01).Conclusion Impaired pulmonary function and metabolic disorders were showed in the overweight and obesity people.Metabolic indexes were related with pulmonary function.

The Medical Care Act of Japan has undergone five major revisions since it went into effect in 1947. Each revision has been designed to target and tackle main problems found in the medical and health sector in the country. These problems range from the making of regional healthcare plans to the establishment of the hospital with specific functions, from the division of rehabilitation beds to the establishment of nursing insurance scheme, from the birth of medical corporations to the establishment of social medical corporations, and from strengthening of non-profit nature of medical institutions to the construction of medical information system. These efforts were made to provide a safe and convenient health service for the Japanese people. These revisions are closely related to hospital management, and its experiences prove useful for the health reform in China.

The clinician training system in Japan is different from that in China as their medical students are allowed to take medical doctor examination immediately following their graduation.But they must undergo at least two years of training in basic clinical knowledge and skills prior to taking any clinical practice.This training system is inspirational for us as follows:China should include standardized training of residents into the law of medical practitioners,and medical graduates must take two years of knowledge training in full medicine before they are qualified for clinical practice.On top of this training,they need to undergo at least three years of specialized doctor training,making them competent clinicians with comprehensive knowledge coverage and outstanding skills in specific areas following such staged training.

For medical insurance systems, medical expense examination is a key measure to keep medical expenses under control. In 1948, Japan established an examination authority of legal person status to operate the medical expense examination. Based on years of modifications and improvement in the organizational system and operation mechanism, the system is running smoothly by now. Authors of this paper made a detailed introduction to the specific operations of such a system, and to China's local features as well. On such basis, the study proposed to build in China a third-party medical expense examination institution as a legal entity, and practice the reexamination system and information disclosure system, in an effort to safeguard legitimate rights of insurance organizations and medical institutions.