History taking capability is a basic skill of clinician.During the Phased Empirical Research,NMEC redesigned the test station of History taking.On the basis of the same inquiry,we use SP,enlarge the question amount,score value,exam time,and also add the evaluation of comprehensive quality.By the new test,we can measure the history taking skill,communication talent and medical humanity competence of medical students.This paper raises a claim on humanistic quality education of medical students in order to prompt medical education to attach importance to the cultivation of medical humanity competence,to improve the medical humanistic education model,then improve the overall quality of medical students.

Objective To know the influence of psychological nursing on depression of patients with hypokalemic periodic paralysis.Methods Evaluated the mental condition by SDS for 46 patients with hypokalemic periodic paralysis and 30 health control, and then carried out certain psychological nursing measures for patients.Divided 46 patients with hypokalemic periodic paralysis into the intervention group and the control group randomly.There were 23 cases in each group.Psychological nursing cares and routine cares was used in the two group respectively, and then compared the incidence rate of depression in the two groups.Results The negative emotion in the patients with hypokalemie periodic paralysis was significant more obvious than that of in the health control.After the psychological nursing intervention, the SDS scores in the intervention group was released significantly than themselves before the intervention and the scores in the control group in the same time.Conclusions Depression was a common phenomenon in patients with hypokalemic periodic paralysis, characteristic psychological nursing intervention can effective release this kind of negative emotion, and then improve their rehabilitation.

Objective To evaluate the effect of health education on schistosomiasis in Kunshan City,so as to provide the ev?idence for making the consolidating strategy in the late stage of interruption of schistosomiasis transmission. Methods The resi?dents,middle school students and elementary school students were randomly sampled from one community,one middle school and one elementary school of each of two towns and they were investigated with interviews and questionnaires for the implementa?tion of health education on schistosomiasis prevention and control. Results A total of 452 middle school students(232 cases) and primary school students (220 cases) were surveyed. The awareness rate of total schistosomiasis knowledge was 98.21%among the students(the awareness rate of basic schistosomiasis knowledge was 98.42% and the awareness rate of preventive schistosomiasis knowledge was 98.01%). Among the 220 elementary school students,the awareness rate of total schistosomiasis knowledge was 97.21%(the awareness rate of basic schistosomiasis knowledge was 97.60%and the awareness rate of preventive schistosomiasis knowledge was 96.82%). Among the 232 middle school students,the awareness rate of total schistosomiasis knowledge was 99.17%(χ2 =34.661,compared with the rate of the elementary school students)[the awareness rate of basic schistosomiasis knowledge was 99.20%(χ2=13.045,compared with the rate of the elementary school students)and the aware?ness rate of preventive schistosomiasis knowledge was 99.14%(χ2 =21.796,compared with the rate of the elementary school students)]. There were significant differences between the elementary school students and middle school students in above?men?tioned awareness rates(all P<0.001). There were schistosomiasis health education materials or teaching plans in all the four schools. Among the 402 residents surveyed,the awareness rate of total schistosomiasis knowledge was 98.87%. Conclusion The effect of health education on schistosomiasis prevention and control is very well,and the total awareness rate of schistosomia?sis prevention and control knowledge among the population has reached the goal(more than 95%)of the medium?and long?term planning of schistosomiasis prevention and control in Kunshan City.

ObjectiveTo investigate the incidence of postoperative residual paralysis and respiratory function of patients undergoing neurosurgical anesthesia.Methods Three hundred andtwenty-eight patients undergoing neurosurgical anesthesia (ASA Ⅰ - Ⅱ ) were divided into vecuronium group (135 cases) and rocuronium group (193 cases) by random digits table.Anesthesia was maintained with propofol in combination with sevoflurane and intermittented intravenous infusion boluses of muscle relaxatant.Extubation of the intratracheal tube in operation room was performed under clinical criteria.The neuromuscular function were detected by acceleromyography with supramaximal train-of- four(TOF) stimulation of the ulnar nerve,and pulmonary function were measured in postanesthesia care unit(PACU).The TOF ratio and pulmonary function were compared between two groups.ResultsThe incidence of postoperative residual paralysis was 31.9％(43/135) in vecuronium group,and 14.5％(28/193) in rocuronium group.Hypoxemia and hypercapnia occurred in vecuronium group with TOF ＜ 0.9 were higher than in those with TOF ≥0.9[7.0％(3/43) vs.4.3％(4/92) and 44.2％(19/43) vs.18.5％(17/92),P ＜ 0.01 ],while in rocuronium group with TOF ＜ 0.9 were higher than in those with TOF ≥ 0.9 [ 3.6％( 1/28 ) vs.1.2％ (2/165) and 39.3％( 11/28 )vs.17.0％ (28/165),P ＜ 0.01 ].ConclusionsThere is a high incidence of postoperative residual paralysis according to the clinical criteria of recovery of neuromuscular function of patients undergoing neurosurgical anesthesia,which would impair respiratory function.

Objective To explore the relationship between obstructive sleep apnea syndrome(OSAS)and the left ventricular diastolic dysfunction.Methods 20 consecutive newly diagnosed middle-aged OSAS patients(OSAS group)with neither controllable factors nor conditions affecting left ventricular diastolic function and 15 healthy control subjects(control group)were examined with echocardiography.Results The OSAS group exhibited left ventricular diastolic dysfunction compared with the control group,including increase of isovolumic relaxation time(P<0.05)and mitral deceleration time(P<0.05),decrease of E/A.There was no difference between tow groups in interventricular systolic thickness,posterior wall thickness,left ventricular systolic diameter,left ventricular diastolic diameter and others.Conclusion OSAS may be related with the left ventricular diastolic dysfunction.

ObjectiveTo observe the incidence and mechanism of postoperative hypoxemia in the patients after transsphenoidal pituitary tumor resection.Methods579 postoperative patients in postanesthesia care unit (PACU) in March, 2009～June, 2010 were investigated retrospectively using PACU databank. The incidence and mechanism of hypoxemia were analyzed.ResultsThe incidence of hypoxemia was 5.2%. Upper airway obstruction, change of breath mode, residual effects of anesthetics, bronchiospasm, aspiration, acute pulmonary edema and lung disease were the main reasons of postoperative hypoxemia after transsphenoidal pituitary tumor resection.ConclusionCareful monitor and treatment are the key to prevent hypoxemia after transsphenoidal pituitary tumor resection.

Objective To analyse the prognostic factors of ST-elevation acute myocardial infarction men and women. Methods The data of 904 in-hospital patients with ST-elevation myocardial infarction were collected from the database of our hospital during 2003-2004 and 728 of them were followod-up. The patients were divided into groups of male and female. Results Women had more accompanying diseases such as diabetes mellitus (DM) and hypertension than men; left ventricular ejection fraction(LVEF) was lower in female. The rate of successful reperfusion was lower in women than men (P < 0.05). Mortality rate was higher in women. 728(202 female) patients were followed up. The use of β-blockers were statistically different between two groups during follow-up. In the female group, LVEF was lower significantly and the rate of reodmission for heart failure and myocardial infarction as well as that of mortality was higher (P< 0.05). Multivariate analysis showed that sex difference was an independent risk factor for in-hospital mortality (OR = 2. 130,95% CI 0. 954-4.754, P = 0. 045) , but not for mortality in the followed-up period and readrnission. Conclusion There are many factors leading to the poor prognosis of ST-elevation acute myocardial infarction in women. It is essential to pay more attention to its clinical characteristics and begin intervention of the risk factors earlier so as to improve the prognosis.

Objective To investigate the effect of human hepatocellular carcinoma HepG2 cell-derived Exosome on the differentiation of mesenchymal stem cells(MSC)into cancer-associated myofibroblasts(CAF)and the impacts of CAF on liver cancer cell proliferation,migration,and invasion. Methods The protein expression of HepG2 cell-derived Exosome was detected by Western blotting. MSCs were separated from human adipose tissue and cultured with HepG2 cell-derived Exosome(100 ng/nl)to initiate differentiation. The expressions of mesenchymal markers and several interleukins were also detected by Western blotting. HepG2 cells were co-cultured with the conditioned media(CM),in which HepG2 Exosome induced the differentiation of MSC into CAF. The expressions of epithelial and mesenchymal markers were detected by real-time polymerase chain reaction(PCR)and Western blotting. Cell proliferation was assessed using MTS assay. Transwell chambers were used in the in vitro migration and invasion assay. Results HepG2 cell-derived particles expressed CD63,70 kilodalton heat shock proteins,and 90 kilodalton heat shock proteins. With the treatment of HepG2 cell-derived Exosome,the expressions of mesenchymal marker α-smooth muscle actin,fibroblast activation protein α,interleukin(IL)-6,IL-8,and IL-1β were up-regulated,while vascular endothelial growth factor had no significant change. The conditioned media which HepG2 Exosome induced MSC differentiation CAF(CAF-CM)could significantly promote HepG2 cells proliferation(1.075±0.104),compared to BSA control(0.874±0.066,P=0.023)and MSC-CM(0.649±0.034,P=0.0005). CAF-CM could significantly enhance cell migration [(42.5±9.1) cells vs.(18.5±3.1) cells,P=0.001] and invasion [(29.0±3.5) cells vs.(13.1±3.7) cells,P=0.009] compared to its control group. Moreover the conditioned medium which HepG2 Exosome induced MSC to differentiate into CAF could also promote the expressions of mesenchyme-related genes Smad interacting protein 1(P=0.040),β-catenin(P=0.038),fibronectin(P=0.029),and Vimentin(P=0.013)and inhibit the expression of epithelial related genes zonula ocdudens-1(P=0.010).Conclusions Exosome extracted from HepG2 cells can induce human adipose-derived MSC to differentiate into cancer-associated myofibroblasts. CAF-like cells can promote the migration of the liver cancer cell line HepG2.

Objective To assess the value of the myocardial segment number of color change in the bull's eyes of three-dimensional speckle tracking echocardiography (3D-STE)in the detection of multi-vessel coronary stenosis at the resting state.Methods A total of 125 consecutive patients were enrolled and divided into the following three groups according to the coronary angiography(CAG):multi-vessel coronary stenosis group (n=48),single-vessel stenosis group(n =34)and control group (n =43).All patients underwent two-dimensional (2D)and three-dimensional echocardiography (3D)and three-dimensional speckle tracking echocardiography (STE).The bull's eyes of left ventricular 17 myocardial segments including longitudinal strain(LS),circumferential strain (CS),area strain(AS)and radial strain(RS)were acquired by 3D-STE.The homogeneous colors were regarded as normal wall motion myocardial segment (LS,CS,AS is a uniform red,RS for uniform blue ),the colors were uneven or shallower,or changes were regarded as abnormal wall motion myocardial segment.The myocardial segment number of color change in the bull's eyes can be calculated.Receiver operating characteristic (ROC ) curves were computed to determine optimal strain cutoff values to predict multi-vessel coronary stenosis.Results The myocardial segments of abnormal wall motion in the bull's eyes (LS,CS,AS,and RS)were significantly increased compared with the control group(P <0.001).In particular,the multi-vessel coronary stenosis group were dramatically increased than the single-vessel coronary stenosis group.Meanwhile,these parameters were higher in patients with multi-vessel coronary stenosis than in those with single-vessel coronary stenosis (P <0.05).ROC analysis demonstrated areas under the curve of 0.84 for 3D GLS,0.89 for 3D GCS,0.95 for 3D GAS,and 0.89 for 3D GRS.An optimal cutoff value of magnitude,sensitivity and specificity were LS,12,89.6%,76.7%;CS,11,89.6%,74.4%;AS,12,91.7%,88.4%;RS,13,81.2%,86.0%,respectively. Conclusions The myocardial segment number of color change in the bull's eyes by 3D-STE is useful to detect multi-vessel coronary stenosis,where in GAS are more valuable indicators with higher sensitivity and specificity.

Objective To investigate the influence of telephone follow-ups on the compliance of syphilis patients.Methods The 120 patients diagnosed with syphilis during February 2010 to December 2011 were randomly divided into experiment group and control group with 60 cases in each group.The control group was given disease-related education during outpatient visits,while the experimental group received nursing intervention by phone calls.The two groups were compared in respect of curative compliance. Result The curative compliance of the experiment group after follow-ups was significantly better than that of the control group (P<0.01).Conclusion The telephone follow-ups can significantly improve the curative compliance of syphilis patients,which can significantly prevent the spread of syphilis.