The main logical thread, logical thinking, logical structure of the teaching material of Ideological and Moral Cultivation and the Basis of Law make up the internal logic of this course. This internal logic embodies the guiding ideology, teaching objectives and teaching philosophy in practice teaching.so, grasping this internal logic contributes to better grasping the important and difficult points of the course in teaching practice and doing the effective teaching design and arrangement, which is helpful to enhancing the the actual effects of teaching of this course.

Actinic keratosis (AK) is a precancerous state of the skin, which shows epidermal dysplasia of different degrees. The cellular DNA content and proliferative activity of the skin lesions in 27 cases of AK were analyzed with flow cytometry. The results showed that the PI (proliferating index) in AK was higher than that in normal skin (P

Objective To investigate the impact of daily life ability, self-efficacy and social support on post-stroke depression. Methods This was a cross-sectional questionnaire survey. A convenience sample of stroke patients from neurology department was created. Data were collected from patients about their level of daily life ability, self-efficacy, social support and depression measured. Inferential statistics multiple regression analysis was used to estimate the relationships between the predictors and post-stroke depression. Results A total of 144 (96.00%) of 150 stroke patients completed the questionnaires. The level of depression was 14.19 ± 9.25 with 25.00% (36/144) of incidence of post-stroke depression. Self-efficacy scored 40.45 ± 11.41, social support scored 28.34 ± 8.02, which negatively predicted depression (r=-0.834 and-0.736, P<0.01 respectively). Self-efficacy had the most significant impact on depression (t=-6.433, P < 0.01), however, the impact from daily life ability scored 76.74 ± 22.12, which had not statistically significant impact on depression (t=-1.773, P=0.083). Conclusions During treatment and nursing management of post-stroke depression, attention should be paid to the psychiatric variable such as self-efficacy and social support.

Objective To discuss on the relationship among innovation,scientific nature and ethics in medical articles,in order to improve the academic quality of manuscripts.Methods Take Chinese Journal of Radiological Medicine and Protection as an example,innovation was emphasized in the field of radiation diagnosis and treatment,while the cases lack of innovation were pointed.However,the lessons from many papers showed that those papers only with innovation would be rejected because of defect in scientific nature and ethics.Results Innovation is the soul of the paper,and the scientific and ethical nature is the foundation and premise of innovation.Conclusions While the innovation is emphasized,the scientific nature and ethics of the thesis should be not ignored.These three aspects are integral.

OBJECTIVE: To understand the current situation of clinical drug use and to inspect the rationality of drug use and survey indices. METHODS: Twenty common diseases(1 530 cases ) treated in this hospital in 1995 were selected. Patierits were divided into three groups according to the sources of expenses: free of charge, self - expense, public - expense or into cases of internal medical and surgical departments. Using selected drug use indicators(SDUI) and self - designed indices, clinical drug use were surveyed and analyzed. RESULTS: There were no significant differences between each group jn main indices. It showed that irrational drug use was only different in degree. CONCLUSION: ①The indices adopted are practicable and rational for surveying and studying the rational drug use objectively. ②In any health care system and in any disease, the irrational drug use was serious.

OBJECTIVE To study the carbapenemase genotypes among Acinetobacter calcoaceticus isolates infected after liver transplantation. METHODS The 5.4 software was used to analyze the resistance of Acinetobacter species. Eight strains of imipenem-resistant A. calcoaceticus which were resistant to multiple drugs were collected. Analytical isoelectric focusing electrophoresis was used to measure the pI of the ?-lactamase. The homology of the isolates was determined by pulsed field gel electrophoresis(PFGE). blaTEM, blaSHV, blaIMP, blaVIM, blaOXA Genes for resistant isolates were amplified and sequenced. RESULTS Imipenem-resistant A. calcoaceticus infected after liver transplantation was resistant to multiple drugs. All of 8 strains were produced OXA-23 carbapenemases (pI of 6.7). The results of PFGE indicated there was a trend of resistant clone transmisstion in the transplantation ward. CONCLUSIONS There is a transmisstion of A. calcoaceticus producing OXA-23 carbapenemase in the transplantation ward of our hospital. It is important to monitor powerfully the bacterial resistance to control infection more effectively.

Objective To investigate the values of ultrasound measuring of the placenta thickness on evaluation of risks for alpha-thalassemia at the early pregnancy.Methods Two-dimensional ultrasound was performed to measure the thickness of placenta on 208 cases of fetuses with alpha-thalassemia and 52 cases of normal fetuses in control group.The placenta thickness was expressed as multiples of the median(MOM).Results At the early pregnancy,the group of fetuses with alpha-thalassemia had significantly higher placenta thickness compared to the fetuses without alpha-thalassemia(P＜0.001).However,there were no statistical significant difference in the placenta thickness between the other groups(P=0.100).Placenta thickness 1.18 MOM was the best critical point to predict alpha-thalassemia.The sensitivity and specificity of placenta thickness >1.18 MOM in prediction of alpha-thalassemia was 82.9%,84.7% respectively.Conclusions For those with high risks of alpha-thalassemia placenta thickness measuring is a safe,effective parameter for assessment because it could reduce unnecessary invasive procedures and improve the detecting rate of severe alpha-thalassemia.

Writing and publishing scientific papers is a very important part of the research work.The quality of the thesis is also an important indicator to measure the achievements of scientific research workers.The quality of the thesis mainly includes the academic quality and the writing quality,but some of the researchers are mostly proficient in practice and neglect the writing,so there are still many writing problems in the manuscript.By reading the submission specification,this article summarizes the common problems in the writing,so as to provide the reference value for the readers.

OBJECTIVE:To promote the rational application of antibiotics on pediatric outpatients.METHODS:Considering the fact of our hospital,taking the acute respiratory tract infection(ARI)as an example,and using retrospective document for analysis from the aspects of the dominant idea in medication,varieties of antibiotics,the ways of administration,the course of treatment and etc.RESULTS:Subjective mistakes gave rise to the abuse of antibiotics;the variety of pediatric drugs was limited by the adverse effects of antibiotics and the diversify of drug resistance;the situation of drug abuse by intravenous drop was serious; the main cause for course shortage was due to the particularity of ambulatory treatment,uncertainty of etiology and drug resistance.CONCLUSIONS:The rational application of antibiotics on pediatric outpatients can be improved by enhancing the publicity of rational drug use,writing drug administration guidance for pediatric antibiotics applicable to the local area,developing more specifications and dosage forms.

The Xidu Community Health Service Center has become the first general practice outskirt teaching site of Shanghai Zhongshan Hospital since May 2015; the Fudan University Shanghai Medical College Xidu General Practice Clinical Teaching and Training Base was formally established in May 2018. For last 6 years, with the cooperation with Zhongshan Hospital the Xidu Community Health Service Center has participated in teaching and training of general practice residents and general practitioners, which also greatly promoted the development of clinical service, disease prevention and scientific research of the center itself. This article introduces the "Fudan-Xidu" integrated model and its experiences in general practice teaching, focusing on the background, the organization, teaching implementation, achievements and future prospects, to provide a reference for talent training of general practice in grassroots institutions.