The former comprehension of bio-psycho-social medical model was essentially static,which neglected the dimension of dynamic historical thinking. This shortage made it difficut to find the revolutionary idea that was contained in modern medical model. Only in the perspective of historical materialism, based on the human practice, will the theoretical and practical value of modern medical model be comprehended completely and deeply.

Objective: Through summarizing the main problems and challenges faced in the medical health system reform in China , suggestions are given: the government needs to erhance the health investment and play the role of market mechanism , make the use of electionical information technique, further change the community system of implementing medicine community system, implement the medical service supervision system.

Objective To explore the characteristics of community empty-nesters sleep quality and psychological defense mechanism,and the correlation between them.Methods 230 empty-nest elderly and 181 nonempty nesters were assessed with Pittsburgh sleep quality index (PSQI) and Defense style questionnaire (DSQ).Results PSQI score of empty-nest ehlerly was (14.33±2.48),higher than that of non-empty nesters(t=17.857,P＜0.01).Factor score of immature psychological defense style in DSQ was (3.92± 1.20),for the mediate defense style was (4.49± 1.11),for the wrapping factor was (3.38± 1.92).All of them were higher than the scores for nonempty nesters,and the differences were statistically significant (t=4.463,6.937,5.404,P＜0.01).Factor score for mature psychological defense style in DSQ was (3.96±1.45),and lower than the score for non-empty nesters(t=7.472,P＜0.01).hnmature defense mechanism of empty-nest elderly was positively related with subjective sleep quality,sleep continuity,sleep disorders,using sleep medicine,dysfunction in the daytime,and the total score in PSQ1 (r=0.533,0.145,0.605,0.521,0.497,0.734).Mature defense mechanism was negative related with sleep latency,sleep continuity,and the total score in PSQI (r=-0.129,-0.542,-0.104).The mediate defense meehanism was positively related with subjective sleep quality,sleep latency and the total score in PSQI (r=0.186,0.294,0.131),while negative related with sleep efficiency(r=-0.188).The wrapping factor had a positive correlation with subjective sleep quality,using sleep medicine and the total score in PSQI (r=0.440,0.431,0.564).Conclusion Empty-nesters tend to adopt immature defense styles,and most of them have a poor sleeping,which are closely related with each other.

The contrast-enhanced ultrasound(CEUS) been equipped in most commercial ultrasound system, is a newer technology which could evaluate the blood flow of soft tissue. It could not only make qualitative and semi-quantitative analysis, but also the quantitative analysis could be acquired. At present, it has been applied on cardiovascular imaging and tumor perfusion assessment in clinical. The clinical usage of CEUS in rheumatoid arthritis(RA) was summarized in the paper which included its common clinical type, dose of ultrasound contrast agent and various method of usage described. Besides, the paper not only introduced the evaluation of the synovitis in RA with the parameters resulted from CEUS, but also illuminated the progress of the researches. Through compared these parameters, indexes and methods, this summary revealed the limitation and application value of CEUS to RA, and more exploration need be done in future.

Objective To explore a surgical procedure of reduction mammary plasty to assure the viability and sensory of the nipple-areolar complex (NAC) after transposition and to keep the lactiferous function partly. Methods Reduction was accomplished by using perforating vascular branches from the pectoralis major muscle and its fascia supplying the nipple and breast parenchyma instead of the subdermal plexus. The central vascular pedicle supplying the nipple-areola complex was preserved. And the sensory nerve of the NAC was not injured. The erection of the nipple could be observed in operation. Lactation was possible because of preservation of the lactiferous ducts. The technique had been used in 17 patients since 1996. Results The nipple-areola complex was safely transposed with great freedom, and the amount of resection was accurately adjusted for symmetry. No cases of nipple-areola complex sensory change occurred postoperatively in all 17 patients. Breast-feeding was possible at least in one patient after operation. Conclusion This method is ideal for the patients, which keeps the viability and sensory of the nipple-areolar complex and the function of lactation. In another case, the amount of resection is easily adjusted for symmetry.

BACKGROUND: Restriction is a reliable means in the study of psychological stress, and restriction stress can suppress cellular immunity of T lymphocytes through hypothalamus-pituitary-adrenal axis.OBJECTIVE: To investigate the changes of Th1/Th2 balance due to restriction stress in cancer-loaded rats and the growth of cancer so as to explore the effect of psychological stress on cancer cells.DESIGN:Case control study based on experimental animal as subjects.SETTING: Teaching and Research Department of Microbiology and Immunology of Beijing University of Traditional Chinese Medical.MATERIALS: This study was carried out in the Immunology Laboratory of Beijing Traditional Chinese Medical University. Kunming rats of 6-8weeks old were selected. They were raised for 3 days before experiment to adapt to the environment and numbered according to their weight. Rats with the highest and lowest body weight were excluded, and the rest were randomly divided into 4 groups of 16 rats (8 male rats and 8 female rats)weighing 18 to 20 g.METHODS: S180 cancer cells were collected at 7 days of celiac subculture and rinsed with normal saline before made into cell suspensions of 1×1010 L-1 with RPMI 1640 medium. Rats were given subcutaneous injection of 0.2 mL cell suspension at the right axilla in cancer group and cancer-combined restriction group. Meanwhile, the same dosage of normal saline was used instead in normal control group and pure restriction group in the same way. After injection, movements of rats in pure restriction group and cancer-combined restriction group were restricted in specially-made tubes for 8 hours a day. Ten days later rats were killed to remove the tumor and thymus which were then weighed for calculating the thymus index. MTT colorimetry and mitogen-activated immunoblast method were used to examine the proliferation of spleen T lymphocytes and the production of Thl-type cytokines, such as interleukin-2(IL-2), interferon-γ (IFN-γ); meanwhile,ELISA technique was used to detect the level of serum Th2-type cytokines,such as interleukin-4(IL-4) and interleukin-10(IL-10).MAIN OUTCOME MEASURES: Primary outcomes: effect of restriction stress on T lymphocyte' production of IL-2 and interferon-γ, and on IL-4and IL-10 as well as the effect in promoting the cancer growth in cancer-loaded rats. Secondary outcomes: effect of restriction stress on T-lymphocyte proliferation and thymus index.RESULTS: Restriction stress significantly increased the cancer weight and decreased thymus index and the proliferation of spleen T lymphocytes. Meanwhile, IL-2 and IFN-γ produced by spleen cells also decreased, with serum IL-4 and IL-10 level obviously increased in cancer-loaded rats.CONCLUSION:The cellular immunity of cancer-loaded rats was obviously suppressed due to restriction stress, which was presented by decreased Thl-type cytokine production and increased Th2-type cytokine production,resulting in Thl/Th2 cytokine imbalance towards Th2. It may be the important mechanism of its promoting effect on the growth of cancer.

Objective This paper deals with the problem of human movement characteristics of target acquisition. Method A hypothetical model was posed by using experimental data. Result The conception of final target size was put forward, an equation for calculating the movement time of target acquisition was obtained, and a new definition of index of difficulty was given. Conclusion Analysis of experimental data showed that this equation could give a better description of target acquisition in a wide range.

Objective To develop the ego depletion aftereffects scale (EDA-S) and test its validity and reliability.Methods Based on literature analysis and the open questionnaire survey this study compiled the preliminary questionnaire.A sample of 801 subjects coming from a university in Beijing was investigated with preliminary questionnaire and 406 students were retested for test-retest reliability with 2 week interval.Results The EDA-S was composed of 38 items in nine factors,which were emotional regulation difficulty,social withdrawal,low efficacy,working memory impairment,low processing fluency,work burnout,fatigue,somatic distress and low adherence.The eleven factors explained 72.09％ of the variances.Furthermore,the result of CFA indicated that the model fitted the data with well construct validity(x2 =1744.62,df=629,x2/df =2.77,RMSEA =0.06,NFI =0.98,NNFI =0.98,CFI =0.98,IFI =0.98,GFI =0.85,SRMR =0.05) and its factors scores were positively correlated with the SFR-S scores(r=0.31-0.59,P＜0.001).The Cronbach α coefficients were 0.95 for the total questionnaire and 0.73-0.91 for the eleven factors.The test-retest reliabilities were 0.60 for the total questionnaire and 0.26-0.57 for the nine factors.Conclusion It suggests that the EDA-S is reliable and valid enough to be applicable to measure the depletion degree of adolescents.

Objective To develop the state-owned enterprise worker's stressor scale and assess its reliability and validity.Methods Combined qualitative and quantitive methods,the state-owned enterprise worker's stressor scale was developed based deep interviews.Data were collected from 6400 state-owned enterprise workers in China.The initial sample was split randomly into two samples (n 1 =2835 ; n 2 =2834).The first data were used to set for exploratory factor analysis (EFA) and the second data were used for confirmatory factor analysis (CFA).3 subscales (anxiety,depression and somatization) of symptom checklist 90(SCL-90) were used for testing criterion validity.Results The state-owned enterprise worker's stressor scale got 4 factors and 15 items,including job stressor,relationship stressor,development stressor and family stressor.The Cronbach α coefficients of the full scale and its four factors were 0.66 ～ 0.86.The results of CFA showed RMSEA =0.066,NFI =0.97,NNFI =0.97,CFI =0.97,IFI =0.97,GFI =0.95.In addition,stressor and its four factors had significant positive correlations with anxiety,depression and somatization (r =0.29-0.43,P ＜ 0.01).Conclusion The stateowned enterprise worker's stressor scale meets psychometric criteria and is an effective tool.

Objective To explore the relationship among psychological capital,job burnout and job engagement of knowledge workers.Methods According to convenience sampling principle,727 information enterprise knowledge workers in Beijing were tested by Psychological Capital Scale,Maslach Burnout Inventory-General Survey (MBI-GS),Utrecht Work Engagement Scale(UWES),and the impact of psychological capital on job burnout and job engagement with correlation analysis and multivariate stepwise regression analysis were explored.Results The level of each dimension of the knowledge workers psychological capital (self-efficacy (4.72 ± 0.72),hope (4.62 ± 0.77),hardness (4.68 ± 0.72),optimism (4.36 ± 0.55)) were above average.The psychological capital total score and all dimensions were negatively correlated with job burnout,and positively correlated with job engagement.Stepwise multiple regression analysis showed that,after controlling three demographic statistics variables of gender,age,marital status,psychological capital could predict job burnout negatively,and predict job engagement positively; self-efficacy,hardness and optimism could significantly predict the three dimeusions of job burnout,hope could predict reduced personal accomplishment negatively;and self-efficacy could positively predict vigor,dedication and absorption,hardness could positively predict dedication and vigor.Conclusion Psychological capital can reduce the level of job burnout of knowledge workers,and improve their level of job engagement.