Excessive medical treatment goes against the human rights of patients and therefore must be stopped.Main reasons include the impulse of existing medical benefit mechanism,the morality decline of medical staff,and patients' eagerness to shake off physical pain and psychological advocating for high-cost medical expenditure.This paper also comes up with relevant countermeasures including reversing the current healthcare mechanism,establishing an evaluation system for medical ethics of medical staff,and building up a monitoring mechanism for the development of clinical guidelines of evidence-based medicine.

Objective To understand the situation of sexual behavior and STD in floating population attending STD clinics Methods Floating population in STD clinics were investigated by questionnaires.Results Sexual behavior rate was 60.0% in unmarried floating population.Sexual behavior rate was 47.6% before marriage at the first sexual time.46.8% of the patients had more than 2 sex partners,and the rate of condom use among them was under 50%.STD prevalence rate was 37.1%,Re-infection rate was 12.2% accounting for 32.8% in all investigated STD patients.Conclusions It is importent to standardize service in STD clinics,provide health information,raise prevention knowledge,change their sexual attitude,advocate safety sexual behavior in various ways in high risk groups.

Objective To further identify the isolated Mycoplasma genitalium (Mg) from the high risk population of STD in China. Mothods The morphology of Mg standard strains and clinical isolates were observed under electron microscopy (EM) and atomic force microscopy (AFM). Mg sample preparation for AFM was fixed on mica and AFM images of scanning observation were captured by contacting and tapping modes and operated under normal atmospheric pressure and temperature. Results and Conclusion Mg had a diversity of shapes, including flask, pear, spindle or round shape with projecting neck portion and slightly broadened terminal structure under EM. The morphologic features under AFM were similar to those observed by EM. The typical Mg showed shapes of flask and pear with noticeable narrow ring or mark in the neck portion. The size of Mg measured under EM and AFM was similar as well. Mycoplasma

Objective To analyze the perioperative conditions and long-term survival of patients with non-small cell lung cancer (NSCLC) after thoracoscopic lobectomy. Methods 119 patients with NSCLC underwent thoracoscopic lobectomy from January 2006 to December 2012 were enrolled in the study, then collecting and analyzing their perioperative indicators, pathological results and follow-up data. Results 9 patients converted to thoracotomy with a conversion rate of 7.0 %. The median operation time, the median intraoperative blood loss and off-bed activity time were 170 min (65~440 min), 90 ml (15~3 000 ml) and (32.9 ± 16.3) h after operation respectively. The time and amount of postoperative drainage, the length of hospital stay were (6.7 ± 3.2) d, (1 690.0 ± 410.5) ml, (9.2 ± 4.0) d respectively. The incidence of perioperative mortality and postoperative complications were 0.8 %, 13.4 % respectively. For postoperative pathological type, 96 cases of adenocarcinoma, 19 cases of squamous carcinoma, 2 cases of adenosquamous carcinoma and 2 cases of large cell carcinoma. For discharge patients, the median follow-up time was 34.5 months (0 ~ 102 months). The incidence of local recurrence and distant metastasis in observation group were 5.0 % and 17.6 % respectively. 1-year overall survival (OS) and disease free survival (DFS) were 85.3 % and 79.5 %, 3-year OS and DFS were 69.8 % and 64.8 %, 5-year OS and DFS were 60.8 %and 58.6 % respectively. There was no significant difference in 1-year, 3-year and 5-year OS and DFS between adenocarcinoma and squamous carcinoma (P > 0.05) while there were significant difference in local recurrence and distant metastasis among different stages (P < 0.05). In addition to slightly low OS, DFS of Ⅲ a , Ⅲ b and Ⅳ DFS and OS, the overall living conditions among all stage were similar. Conclusions The long-term survival condition of thoracoscopic lobectomy for NSCLC is ideal, and it’s a safe and effective operation, worthy of clinical promoting.

Objective To summarize the clinical and laboratory features of chronic manganese poisoning. Methods A retrospective analysis was conducted on the clinical data of 4 cases with chronic manganese poisoning, including gener?al information, medical history, clinical manifestations, laboratory examination such as electrophysiological and imaging. Results Patients with chronic manganese poisoning mainly presented with mild mental disorder and autonomic nerve dis?order during early stage and then gradually developed extrapyramidal symptoms and signs. The laboratory examination of chronic manganese poisoning lacked of specificity. EMG showed neurogenic damage in 3 cases and normality in 1 case. EEG showed slightly increased full guide slow wave in 1 case and normality in 3 cases. cranial MRI revealed the damag?es in bilateral symmetry of the basal ganglia nuclei in 4 cases of Chronic manganese poisoning. There was no significant correlation between the changes of urinary manganese level before or after treatment and the clinical manifestations. Conclusions Although there is lack of specific clinical manifestations of chronic manganese poisoning, the possibility of this disease should be considered when patients with mild mental disorders or autonomic nerve disorder with or without extrapyramidal symptoms. The main treatment of chronic manganese poisoning includes excretion of manganese, symp?tomatic and supportive treatment. Patients usually have the sequelae of tremor, muscle tension, and other symptoms.

Objective To study the identification of rare Nocardiaotitidiscaviarum and its drug sensitivity .Methods Morpho-logical ,physiological and biochemical phenotype identification methods combined with 16S rRNA sequence analysis were employed to identified the bacteria strains .Broth method was used to detect their drug sensitivity .Results The clinically isolated Nocardia strain was identified as Nocardiaotitidiscaviarum which was resistant to piperacillin ,erythromycin ,ceftazidime ,cefoperazone ,gen-tamicin ,cefoxitin ,piperacillin/tazobactam ,and was sensitive to vancomycin ,levofloxacin ,imipenem ,etimicin ,ciprofloxacin ,amika-cin ,sulfamethoxazole .Conclusion 16S rRNA gene sequence analysis can be used to identify Nocardia otitidiscaviarum ,and sulfa drugs shows good therapeutic effect .

Objective To investigate the clinical efficacy and experiences of laparoscopic hepatectomy (LH) for segment Ⅶ and Ⅷ liver tumors.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 94 patients who underwent LH for segment lⅦ or Ⅷ liver tumors in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from June 2010 to August 2016 were collected.The operating space for operation was built under laparoscopy.According to liver cirrhosis grading,tumor size,adjacent relationship with major blood vessels and residual liver volume,non-anatomical and anatomical hepatectomies were selected by patients.During the operation,tumors were precisely pinpointed and plane of liver resection was determined,and then proper instruments of liver partition and techniques of hepatic inflow occlusion were selected.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up and survival situation.Follow-up using outpatient examination and telephone interview was performed to detect the patients' survival up to July 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (interquartile range).Survival rate was caculated by the Kaplan-Meier method.Results (1) Surgical and postoperative recovery situations:all 94 patients received successful operations,without perioperative death,including 73undergoing non-anatomical hepatectomy and 21 undergoing anatomical hepatectomy.Fourteen patients had conversion to open surgery and 27 received hepatic inflow occlusion.The median operation time,median volume of intraoperative blood loss and cases with intraoperative blood transfusion were respectively 187.5 minutes (75.0minutes),200 mL (200 mL) and 15.Eighteen patients had postoperative complications,including 6 with pleural effusion,6 with abdominal effusion,1 with wound infection,1 with abdominal infection,1 with venous thrombosis,1 with bleeding,1 with coagulation disorders and 1 with hepatic insufficiency.Clavien-Dindo classification of complications:11,1,5 and 1 patients were detected in grade Ⅰ,lⅡ,Ⅲ and Ⅳ,respectively.All complications were improved by symptomatic treatment.The median duration of hospital stay was 7 days (6 days).(2) Postoperative pathological examination:results of tumor pathological examination showed that 45,5,9 and 35 patients were respectively confirmed as hepatocellular carcinoma,cholangiocarcinoma,metastatic hepatic carcinoma and benign liver tumor.(3) Follow-up and survival situation:59 patients with malignant tumors were followed up for 6.0-52.0 months,with a median time of 42.6 months.Postoperative 1-and 3-year overall survival rates of 59 patients with malignant tumors were 98.3％ and 84.7％,respectively.Conclusions LH for segment Ⅶ and Ⅷ liver tumors which is conducted in experienced medical center is safe and feasible,with definite effects.Building operating space for operation under laparoscopy,determining precise positioning of the tumor and plane of liver resection,and selecting proper instruments of liver partition and techniques of hepatic inflow occlusion are the key points of successful operation.

Objective To investigate the distribution and antimicrobial resistance of Coagulase-negative staphylococci ( CoNS) isolated from cerebrospinal fluids in neurosurgical patients.Methods CoNS strains isolated from cerebrospinal fluids of neurosurgical patients were collected from Beijing Tiantan Hospital of Capital Medical University during January 2013 and December 2015.CoNS infection was diagnosed according to the standards of US Centers for Disease Control and Prevention, and the distribution and antimicrobial resistance of pathogenic CoNS strains were analyzed. Results A total of 19 756 cerebrospinal fluid specimens were collected and 1 386 bacterial strains were isolated, in which 650 (46.9%) were CoNS.Among 650 CoNS strains, 130 were diagnosed as the pathogen, and the top 4 CoNS species were Staphylococcus epidermidis (77/130, 59.2%), Staphylococcus hominis (18/130, 13.8%), Staphylococcus haemolyticus (11/130, 8.5%) and Staphylococcus capitis (9/130, 6.9%).The rest 520 CoNS strains were contaminating strains.According to antimicrobial susceptibility test, there were 103 strains of methicillin-resistant CoNS (MR-CoNS) accounting for 79.1% (103/130).And among 77 Staphylococcus epidermidis isolates, 67 were MR-CoNS strains (87.0%) .More than 90.0%Staphylococcus epidermidis isolates were sensitive to vancomycin and linezolid, and the rest CoNS strains were also highly sensitive to these two antibacterial agents.Conclusions CoNS plays an important role in post-surgery infection in neurosurgical patients, and Staphylococcus epidermidis is the dominant CoNS species.Most CoNS strains are methicillin-resistant, but are highly sensitive to vancomycin and linezolid.

ObjectiveTounderstandthetrendsandepidemiologicalcharacteristicsofsexuallytransmitteddiseases(STDs)inChinaandprovidescientificbasisformakingcontrolstrategies.MethodsDuringtheperiodof1991～2001,thecase-reportingdataof8kindsofnotifiableandmonitoringSTDs,collectedfrom31provinces,autonomousregionsandmunicipalities,wereanalyzedwithepidemiologicalmethods.Results①Epidemictrends:Duringthisperiod,theincidenceof8kindsofSTDssteadilyincreasedfrom175528(15.48per100000population)in1991to859040(68.91per100000population)in2000.Theaverageannualgrowthofincidencewas19.30%,witharangeof2.59%～36.88%.However,thereportedcasesin2001were795612withadecreaseof7.38%comparedwiththosein2000,anditwasthefirstdecreasesinceSTDcaseswerereportedfrom1987.②Geographicaldistribution:Thehigh-incidenceareasweretheZhujiangRiverDelta,YangtzeRiverDelta,MinjiangRiverValley,NortheasternChina,andBeijing,Tianjin,andChongqingManicipalities,withtheincidencerateofover70～100casesper100000populationafter1997,andtherewereveryhighratesofincidenceover1000casesper100000populationinsomeareas.Thelow-incidenceareaswerenorthChina,partsofCentralChina,NorthwesternChinaandSouthwesternChina,withtheincidenceratesoflowerthan30～50per100000population.③Populationdistri-bution:Themaletofemaleratiodecreasedfrom1.60∶1～1.69∶1intheearly1990sto1.35∶1～1.40∶1inthelate1990s.STDincidencerateswerehighestinthe20～39agegroup,andthereportedSTDcasesofthisagegroupaccountedforover80%oftotalcases.ConclusionSexuallytransmitteddiseasesinChinahavebecomeaseriouspublichealthproblemandtheeffectiveinterventionprogrammesagainstSTDsmustbeimplementedacrossthecountry.

Objective: To explore the association between excite seeking personality and alcohol use, and provide reference basis for intervention measures of drinking behavior. Methods: Totally 5966 college students in 8universities [2180 males, mean age (20 ± 1) ] were selected from Hunan province by using multi-stage stratified cluster random sampling method. We Chat-based anonymous questionnaire survey was conducted by using general questionnaire, excite-seeking personality scales, alcohol questionnaire, and alcohol use disorders identification test. Results: The rate of 12-month alcohol drinking, binge drinking, hazardous and harmful drinking among college students were 47. 5％, 24. 5％, 7. 4％, respectively. High degree of excite seeking personality had more likelihood to having had alcohol drinking, binge drinking, hazardous and harmful drinking (Ps ＜ 0. 01). Excite seeking personality was an independent risk factor of 12-month alcohol drinking, binge drinking, hazardous and harmful drinking. Conclusion: It suggests that excite-seeking personality may be a related factor of alcohol drinking behavior.