There are objective causes in the close management of regular ward of psychiatric department,which are related to several ethical problems that will hamper the relationship between doctors and patients of psychiatric depart?ment.We should perfect the mode of management constantly to promote the development of psychiatry.

Objective To explore the effects of repetitive transcranial magnetic stimulation ( rTMS ) on cognitive function in patients with mild cognitive impairmen ( MCI).Methods Fifty patients with MCI were randomly divided into rTMS treatment group ( rTMS group ) and piracetam treatment group ( control group ) , 25 patients in each group .The stimulated point of rTMS treatment were in the bilateral prefrontal area , for one time a day, continuous treatment for 6 d as a courses in rTMS group patients .Two courses of treatment was interval of 3 weeks, a total of 4 courses.The patients of control group were treated with piracetam 0.8 g, 3 times a day, for taking 16 weeks.Before and after treatment, the event-related potentials P300 and Montreal Cognitive Assessment (MoCA) scale examination were taken in two group respectively .Results Compared with before treatment , the P300 latency significant was significantly shortened and amplitude increased , scores of MoCA scale and delay memory were significantly increased (P<0.05-0.01) after treatment in the rTMS group.Compared with the control group, the difference of those had statistical significance ( all P<0.05 ) .The difference of those had no statistical significance before and after treatment in control group .Conclusion rTMS treatment can improve memory and cognitive in patients with MCI .It can delay the progress of dementia to some extent .

Objective To study the clinical manifestations,endoscopic features,pathological features,treatment and prognosis of patients with duodenal neuroendocrine carcinoma (DNEC).Methods The clinical data of 9 patients with duodenal neuroendocrine carcinoma who were admitted to our hospital from December 2006 to December 2014 were retrospectively analyzed.Results There were 6 males and 3 females.The mean age was 61.5 years (range 48 ～75 years).The clinical manifestations were abdominal pain (n =7),jaundice (n =4),melena (n =1) and asymptomatic (n =1).The DNEC was usually solitary in the duodenum.The operations included duodenopancreatectomy (n =5),surgical resection (n =2),subtotal gastrectomy (n =1),and 1 patient was palliated by common bile duct stenting using an endoscopic retrograde cholangio-pancreatographic (ERCP) approach.The patients were followed up for 3 ～ 40 months after operation.For the 5 patients who underwent radical excision 4 were alive.One patient died from liver metastasis.For the 4 patients who underwent palliative therapy,one was alive,two died and one lost to follow-up.Conclusions The clinical manifestations of duodenal neuroendocrine carcinoma were non-specific.Endoscopic,pathologic and immumohisotochemical tests were important in the diagnosis.Surgical resection improved the prognosis of these patients.

Objective To design a POCT quality management system based on the Internet of things so as to standardize POCT quality management.Methods The existing problems in POCT quality management were analyzed.Taking portable blood glucose meters as an example,the quality management system of POCT-Internet of things was designed based on the all aspects of data acquisition,transmission,server management and storage,etc.Results The POCT quality management system based on the Internet of things and medical cloud technology was designed.The system could implement the management of POCT operators and devices,monitor the realtime quality control data and reports,and facilitate the administrators to analyze the quality problems in the whole process of POCT management.Conclusion The designed POCT quality management system based on the Internet of things has the theory feasibility.

Objective To investigate the clinical effect of zirconia all -ceramic crown for anterior teeth restoration,and its influence on the quality of life .Methods Eighty-four patients with anterior teeth repair [4 cases were lost during the follow-up,and there were 80 cases (106 teeth)] were selected.According to different surgical methods,they were divided into control group (56 teeth) and study group (50 teeth).The control group used Ni Cr alloy porcelain crown,the study group used two zirconia all -ceramic crown.The patients were followed up for 1 year, the repair effect ,incidence rate of adverse reactions and quality of life score were compared between the two groups .Results After 1 year of crown restoration , the color, integrity, edge coloring in the study group were significantly better than those in the control group(all P<0.05).The incidence rate of adverse reactions such as gingivitis ,peri-odontitis,root fracture,allergies of the study group was 7.5%,which was significantly lower than 45.0%of the control group(χ2 =5.129,P<0.05).There were no statistically significant differences in quality of life scores between the two groups before repair(all P>0.05).The quality of life scores in the study group after repair were significantly higher than those in the control group (t=18.623,22.389,20.724,10.190,all P<0.05).Conclusion The clinical effect of zirconia all-ceramic crown for anterior teeth restoration is better .It can improve the aesthetic effect ,safety and quality of life score of patients .It is worthy of popularizing and application in clinic .