The clinical supervision of counseling and psychotherapy have a closely connection with clinical employment.Leading the way in clinical supervision,many clinical supervision models has been extrapolated by theories of various psychotherapy,relating to psychoanalysis theory,person-centered approach theory,cognitive and behavior psychotherapy theory,system theory,structuralism theory,and so on.Recently,especial,different clinical supervision models have to expand beyond psychotherapy,such as developmental model of supervision and society role model of supervision.The study has summarized clinical supervision models of the field,in order to offer literature index and concept frame.

The relationship between medical practitioners and padtients always changes with time and this shift becomes quite striking nowadays.The characteristics and underlying reasons of this trend are expounded from such aspects as the changes in medical service system,the alteration in definitions of medical practitioners and patients, the advent of market economy.It is precondition and guarantee of handling the relationship properly to consummate relevant laws and codes,establish medical insurance institution,classify hospitals and set moral restraint for both medical practitioners and patients.

Objectives To evaluate the fetal blood flow velocity waveforms (FVWs) in relation to the perinatal outcomes. Methods 46 normal term pregnant women and 32 high risk pregnant women were examined with colour doppler ultrasound for their FVWs of umibilical artery (UmA). middle cerebral artery (MCA) and renal artery (RA). Results The resistance index (RI),pulsatile index(PI) and ratio of systolic to diastolic flow velocity(S/D) of UmA and RA were higher and the PI,S/D of MCA were lower significantly in the high risk pregnancy group than that of normal pregnancy group (P

Objective To observe clinical effects and side reactions of Huayu pill combined with TC (Paclitaxel+Carboplatin) chemotherapeutic regimes on treating epithelial ovarian cancer. Methods All 60 patients with the epithelial ovarian cancer were randomly divided into the treated group (Huayu pill combined with TC chemotherapeutic, n=30) and the control group (TC chemotherapeutic regimes, n=30). Results The effective rate of the treated group and the control group was 46.7% and 37.9% respectively. The objective response rate (CR+PR+SD) was 86.7% in the treated group, while this rate was 68.9% in the control group (P

Objective: To evaluate the service competence of 99 smoking cessation clinics in Zhejiang Province, so as to provide reference for the improvement. Methods: The questionnaire, prepared by Tobacco Control Office of Chinese Center for Disease Control and Prevention, was used to investigate all the smoking cessation clinics in Zhejiang Province, to score the basic and developmental indicators, and to assess the qualified rates ( basic indicators >50 points and total scores >60 points ). Results: There were 99 smoking cessation clinics, with 52 in secondary hospitals and 47 in tertiary hospitals. The overall assessment scored from 11 to 96 points, with an average of ( 53.99±16.56 ) points. The smoking cessation clinics in secondary and tertiary hospitals scored ( 53.92±15.88 ) points and ( 54.06±17.45 ) points. The scores of basic and developmental indicators were ( 45.66±12.16 ) points and ( 8.33±5.39 ) points, with the scoring rates of 65.23% and 27.77%. The overall assessment of 43 smoking cessation clinics were qualified and the rate was 43.43%, which was 44.23% in secondary hospitals and 42.55% in tertiary hospitals. Conclusion The qualified rate of smoking cessation clinics in Zhejiang Province was 43.43%, which was similar between second hospitals and tertiary hospitals.

Objective: To analyze the epidemic trend of viral hepatitis in Nanjing from 1989 to 2019 and predict the incidence in 2020, so as to provide reference for the prevention and control of viral hepatitis. Methods: The incidence data of viral hepatitis in Nanjing from 1989 to 2019 was retrieved from Nanjng Center for Disease Control and Prevention and National Infectious Disease Reporting System. The epidemic trend was analyzed by estimating the annual percent change ( APC ) and the average annual percent change ( AAPC ). The seasonal incidence of different types of viral hepatitis was analyzed by seasonal index. The autoregressive integrated moving average model ( ARIMA ) was built to predict monthly incidence rate of viral hepatitis in 2020. Results: The annual incidence rate of viral hepatitis was 62.00/100 000 in Nanjing from 1989 to 2019, showing a downward trend ( AAPC=8.4%, P<0.05 ). From 1998 to 2019, the annual incidence rates of hepatitis A, B, C and E were 1.98/100 000, 14.31/100 000, 2.30/100 000 and 2.60/100 000. The incidence of hepatitis A and B showed downward trends ( AAPC=-11.81%, -6.02%, both P<0.05 ); the incidence trend of hepatitis C was not obvious ( P>0.05 ); the incidence of hepatitis E showed an increasing trend ( AAPC=4.82%, P<0.05 ). From 2015 to 2019, the third and fourth quarters were the epidemic seasons of hepatitis A, B and C, while the first and second quarters were the epidemic seasons of hepatitis E. The ARIMA model predicted that the monthly incidence rates of viral hepatitis in 2020 would range from 1.26/100 000 to 3.69/100 000, among which hepatitis B ranged from 1.21/100 000 to 2.58/100 000, hepatitis C from 0.20/100 000 to 0.48/100 000, hepatitis E from 0.09/100 000 to 0.25/100 000. Conclusions The incidence of viral hepatitis in Nanjing shows a downward trend. Among different types of hepatitis, hepatitis B has a higher incidence. All types of hepatitis have epidemic seasons. It is predicted that the monthly incidence rates of viral hepatitis will be 1.26/100 000 to 3.69/100 000 in 2020.

Objective:To investigate the role of SDF-1/CXCR4 in metastasis of renal cell carcinoma and to observe the intracellular location of different CXCR4 segments in renal carcinoma cells.Methods:The potential nuclear localization sequences of different CXCR4 were discovered by nuclear localization software and experiments.Full length and truncated forms of CXCR4 were fused with green fluorescent protein pEGFP-N1 and their influence on subcellular localization was examined by confocal microscopy after transfecting them into renal carcinoma cell line A498.Results:Analysis with PSORT Ⅱ Prediction revealed that the nuclear localization sequence region of CXCR4 was located between amino acids 146 and 149(RPRK).Expression products of the recombinant plasmids with SDF-1 stimulation,including EGFP-CXCR4(1-510 bp),EGFP-CXCR4(1-765 bp) and wild-type EGFP-CXCR4,were mainly located in the cell nuclei.However,expression product of EGFP-CXCR4(1-267 bp) with SDF-1 stimulation was mainly located in the renal cell cytoplasm.Expression product of wild-type EGFP-CXCR4 full length plasmid without SDF-1 stimulation was mainly located in the cell cytoplasm;these results accorded with the results of bioinformatics analysis.Conclusion:Nuclear localization sequence of CXCR4 is located in the amino acids 90 to 170,which provides a theoretical basis for further clarifying the nuclear localization sequences of CXCR4 in renal cell carcinoma cells and for finding new potential target for inhibiting the metastasis of renal cell carcinoma.

OBJECTIVE: To observe waveform differences among ocular vestibular evoked myogenic potentials (ACS-oVEMP) elicited by different types of air conducted sound in normal young Chinese subjects. METHOD: Twenty-two adult volunteers (44 ears) were recruited as research subjects including 12 males and 10 females aged between 18 and 35. Five hundred Hz tone burst, 125 Hz tone burst and click were employed as stimulus for conventional ACS-oVEMP examinations in bilateral ears of each subject. The response rate, threshold, n I latency, p I latency, n I-p I latency interval, amplitude and inter-aural asymmetry were recorded and compared among groups. RESULT: The response rate was 100% (44/44) in 500 Hz tone burst group, 40.9% (18/44) in 125 Hz tone burst group and 29.6% (12/44) in click group There were statistical significant differences between the 500 Hz tone burst group and the other groups (P < 0.05). Waveform amplitude was the largest in the 500 Hz tone burst group (7.3 +/- 5.5) muV than that in the 125 Hz tone burst group (3.8 +/- 1.5) muV and that in the click group (5.8 +/- 1.3) muV, which had statistically significant differences between the former and the later two groups (P < 0.05). Other waveform parameters presented similar differeces. CONCLUSION ACS-oVEMP waveforms could be largely affected by different stimulus. 500 Hz tone burst was the best stimulus with highest response rate, biggest amplitude and therefore most easily recognizable waveform in ACS-oVEMP examination.
Acoustic Stimulation ; Adolescent ; Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Male ; Vestibular Evoked Myogenic Potentials ; Young Adult

Objective To investigate the clinical features ,diagnosis and treatment of cesarean scar pregnancy (CSP) .Methods We retrospectively analyzed the medical history ,clinical manifestation ,diagnoses ,treatments and outcomes of 42 patients with ec‐topic pregnancy in the cesarean scar .Results All cases got diagnosed by transvaginal ultrasound .The error rate of first diagnosis was 40 .4% (17/42) .There were 25 cases of conservative therapy ,in which 12 cases were resolved with laparoscopic surgery and 1 case resolved with open surgery ;in the first process 15 cases were carried out laparoscopic surger in which 1 case were converted to laparotomy ;abdominal surgery were underwented in 1 case and were cured .Only one case underwent abdominal total hysterectomy as of failure after uterine artery embolization .After initial conservative treatment 3 cases were hospitalized again and 2 cases under‐went reoperation .41 patients were successfully retained the uterus and normal menstrual cycle returned at two months after opera‐tion .Conclusion The early diagnosis for CSP mainly depended on ultrasound and the thickness of incision muscle layer is an impor‐tant basis for choice of treatment .Checking the thickness of incision muscle layer for CSP mainly depended on ultrasound ,and lapa‐roscopic surgery is an ideal method for diagnosis and treatment of CSP .

Objective To investigate the characteristics of department distribution and antibacterial resistance of multidrug‐re‐sistant(MDR) pathogens in hospital ,and take specific measures for the prevention ,treatment and infection cntrol .Methods Data of 1 816 MDR isolates detected in the hospital from January to December in 2014 were analyzed retrospectively .Results Among the 1 816 MDR strains ,extended‐spectrum β lactamases(ESBLs) producing Escherichia coli ranked first(665 strains ,36 .62% ) ,fol‐lowed by methicillin‐resistant Staphylococcus aureus(387 strains ,21 .31% ) ,MDR Acinetobacter baumannii(295 strains ,16 .22% ) , MDR Pseudomonas aeruginosa(195 strains ,10 .74% ) ,carbapenem‐resistant Enterobacteriaceae(144 strains ,7 .92% ) ,ESBLs pro‐ducing Klebsiella pneumoniae(130 strains ,7 .16% ) .MDR strains were mainly distributed in general department of urology surgery (384 strains ,21 .14% ) ,burn unit(325 strains ,17 .90% ) ,intensive care unit(ICU )(266 strains ,14 .52% ) and department neurosur‐gery(110 strains ,6 .04% ) .Vancomycin and linezolid resistance were not found in methicillin‐resistant Staphylococcus aureus ;less than 2 .9% of the ESBLs producing Escherichia coli and Klebsiella pneumonia strains were resistant to carbapenems .The resistance of carbapenem‐resistant Enterobacteriaceae to amikacin ,sulfamethoxazole‐trimethoprim ,meropenem and tetracycline were relatively low (39 .6% -60 .7% ) .The resistance of MDR Acinetobacter baumannii to levofloxacin ,tetracycline ,sulfamethoxazole‐trime‐thoprim and cefoperazone‐sulbactam were relatively low (48 .9% -76 .5% ) .The resistance of MDR Pseudomonas aeruginosa to amikacin ,ceftazidime ,gentamicin and ciprofloxacin were relatively low(45 .3% -66 .7% ) .Conclusion The MDR pathogens should be monitored in high‐risk department ,preventive measures should be taken ,and antibiotics should be used according to the results of drug susceptibility tests .