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.

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

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 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 provide a clinical anatomic basis for the bi-pedicled gastrocnemius myocuta- neous flap which is to be used to repair defects of the Achilles tendon and posterior skin of the ankle.Methods In anatomic study,out of 30 cadaver specimens,bi-pedicled V-Y gastrocnemius myoeutaneous flaps were harvested to measure the downward sliding lengths of the flap when the knee was at flexion of different degrees.In clinic,12 patients with the Achilles tendon and posterior ankle skin defects were repaired with the bi-pedicled gastrocnemius myocutaneous flaps.The areas of composite defects ranged from 10 cm?6 cm to 6 cm?4 cm.They were followed up for four months to 12 years.Results The maximal sliding length of the flap reached (9.2?0.9)cm when the knee was at flexion of 90?.All the clinical flaps survived and ambulation of the patients recovered.The dorsiflexion and plantarflexion of the ankles reached 11.0??1.4?and 35.0??4.6?respectively.Conclusion This flap is suitable for one-stage repair of composite Achilles tendon defects.

Objective To investigate the significance of cyclooxygenase-2 (COX-2),vascular endothelial growth factor(VEGF) protein expression and angiogenesis in hepatocellular carcinoma(HCC).Methods Tissue sec- tions from 40 HCC patients were examined immunohistochemically for protein expression of COX-2 and VEGF.Mi- crovessel density(MVD) was counted by endothelial cells immunostained by anti-CD34 antibody.Results The ex- pression of COX-2 protein in well differentiated HCC was stronger than that in moderately differentiated HCC and poorly differentiated HCC(P

Objective:China was categorized as one of the 68 countdown countries to achieve the United Nations Millennium Development Goals (MDG) 5. This paper aimed to analyze the situation of maternal survival, and coverage of proven cost effective interventions in China, where specific attention was paid to disparities. Methods: National maternal and child mortality surveillance data were used to estimate maternal mortality ratio (MMR). Coverage for proven interventions was analyzed based on National Health Services Survey, where experts' consultations were made for complementation. Results: There had been a significant reduction of MMR in China, however great disparities existed, with rural Ⅱ to Ⅳ areas experiencing 2 to 5 times higher maternal mortality risks than urban areas and accounting for over 70% maternal mortality burdens. Postpartum hemorrhage, pregnancy associated hypertension, embolism and sepsis were the leading causes, and over 75% of the maternal mortality was caused by preventable or curable causes. Maternal health services utilization decreased in accordance with region' s development level. Socioeconomic factors like financial difficulties were the main obstacles hindering access of care.Even those who made deliveries in hospitals faced different probabilities in receiving qualified care according to their socioeconomic standings. Conclusion: China is on track to achieve MDG 5, however great disparities exist. It is necessary to specifically target rural types Ⅱ to Ⅳ areas. Major causes of maternal mortality which can be prevented or averted through the provision of essential obstetrical care. Yet as compared with maternity health needs, insufficient coverage of maternal and child health (MCH) care services and poor service quality are the leading predisposing factors contributing to maternal mortality in China.

Objective To analyze the prevalence of peripheral arterial disease (PAD) in type 2 diabetic patients and its association with traditional and non-traditional risk factors. Methods A total of 420 type 2 diabetic patients with duration exceeding 1 year and without acute myocardial infarction, unstable angina,and infection were evaluated. PAD was diagnosed by ankle-brachial index ≤0.90. Risk factors included age, gender, body mass index, smoking, hypertension, diabetes duration,glycated hemoglobin A[C ( HbA_1C ), uric acid, triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol(HDL-C),high sensitive C reactive protein(hs-CRP),fibrinogen,and urinary albumin excretion rate (UAER). Results The prevalence rate of PAD was 16.4%(69/420). Older age, longer diabetes duration,lower HDL-C, higher UAER, hs-CRP and fibrinogen were associated with PAD. Multiple Logistic regression revealed that only age, UAER, hs-CRP and fibrinogen levels were independent risk factors. The prevalence rate of PAD was 4.7%(2/43), 12.9%(27/209) and 23.8%(40/168) in patients of less than 50 years old,50-70 years old and more than 70 years old, and was 7.9%( 14/177),9.3%( 11/118) and 35.2% (44/125) in different hs-CRP group (hs-CRP < 1 mg/L,l-3 mg/L, >3 mg/L), and was 9.7% (30/310) ,34.4%(33/96) and 42.9%(6/14) in normoalbuminuria, microalbuminuria and macroalbuminuria, and was 12.1%(43/356) and 40.6%(26/64) in different fibrinogen levels group (≤4 g/L and > 4 g/L). Conclusions The prevalence rate of PAD is higher in type 2 diabetic patients. Non-traditional cardiovascular risk factors may be involved in the development of PAD.