As a wide field of internet industry, the internet medical is sprouting prosperous with many advanta-ges still, namely promoting the medical resources integration and earlier disease prevention, providing more conven-ient health care services, etc. , but there are still many limitations. By analyzing the role of internet in the promotion of medical services, this article focused on the internet limitations. Ultimately, we put forward we should calmly oper-ate internet and make it as the auxiliary tool for medical care services instead of relying too much on it in order to pro-vide a reference and a basis for the prosperous development of internet medical.

Objective To discuss the impact of an iterative reconstruction algorithm (True X) implemented with point spread function (PSF) on image quality and SUV in 18F-FDG PET, and compare with other reconstruction algorithms.Methods A total of 79 hypermetabolic lesions from 37 cancer patients (23 males, 14 females, age (63.38±15.25) years) were retrospectively studied.The PET images were reconstructed using the following six reconstruction algorithms, including FBP, FBP+TOF, iteration, iteration+TOF, True X, True X+TOF.Paired t test was used for statistical analysis.Results All six reconstruction algorithms showed significant difference in lesion SUVmax.The adoption of PSF increased SUVmax by 15%-16%, and decreased the dispersion of SUV in the liver parenchyma remarkably.Conclusions Lesion SUVmax calculated from different reconstruction algorithms has significant differences.Caution should be taken in using PSF, as it can improve image quality but may also increase lesion SUVmax.

Objective To investigate the effects of bisoprolol combined with rosuvastatin on endothelial function and inflammation in patients with coronary slow flow (CSF). Methods Ninety CSF patients treated from August 2014 to October 2015 were randomly divided into control group, statin group and combined group, thirty cases in each group. The control group was given conventional therapy (aspirin 100 mg/d and isosorbide mononitrate 60 mg/d), statin group was given rosuvastatin 10 mg/d on the basic of control group, while the combined group was given bisoprolol 5 mg/d on the basic therapy of statin group. The serum concentrations of nitric oxide (NO), endothelin-1(ET-1), high-sensitivity c-reactive protein (hs-CRP) and interleukin-6 (IL-6) were detected before treatment and 8 weeks after treatment. The improvement of patients with angina pectoris was evaluated. Results After eight-week treatment, the NO levels were significantly increased in combined group and statin group, while the ET-1, hs-CRP and IL-6 levels were significantly decreased than those before the treatment (P<0.05). At the same time, comparing with the statin group and control group, the NO level was increased in combined group (P<0.05), while the ET-1, hs-CRP, and IL-6 levels decreased significantly (P<0.05). There were significant differences in the effective rates between the combined group (90.0%) and the statin group (83.3%), which were higher than those in control group (56.7%). Conclusion Bisoprolol combined with rosuvastatin can improve the endothelial function and anti-inflammatory in the treatment of CSF.

Objective To investigate the distribution and drug resistance of pathogens isolated from urine culture in 2013 and provide basis for clinical treatment .Methods MicroScan WalkAway 96 PLUS bacterial identification system was used to identify the pathogens and drug susceptibility testing .The data were analyzed by WHONET 5 .6 software .Results A total of 231 strains of pathogens were isolated from urine cultures ,including 51(22 .1% ) strains of gram‐positive bacteria ,170(73 .6% ) strains of gram‐negative bacteria ,and 10(4 .3% ) strains of fungi;Escherichia coli ,the coagulase‐negative Staphylococcus ,Klebsiella pneumoniae and E .faecalis were ranked the top four species of pathogens ,accounting for 48 .9% ,13 .0% ,9 .5% ,5 .2% ,respectively .MRCNS among CNS were 73 .6% .Staphylococcus had 100 .00% sensitivity to vancomycin and linezolid ;the antimicrobial resistance rate of E .fae‐calis to ampicillin was 8 .3% .E .faecalis had 100 .00% sensitivity to vancomycin and linezolid .the detectable rates of Escherichia co‐li ,Klebsiella pneumoniae of ESBLs were 52 .2% and 50 .0% ,and the strains had 100 .00% sensitivity to imipenem and meropenem . Conclusion Escherichia coli is a major pathogen in urine culture ,Bacterial resistance is serious .

Objective To investigate the distribution and antibiotic resistance of gram-negative bacilli for better antimicrobial therapy in our hospital.Methods A retrospective analysis was conducted for the 1 060 strains of gram-negative bacilli isolated from clinical specimens during 2013.Results Of the 1 060 gram-negative bacterial strains isolated during 2013,E.coli,K . pneumoniae,P .aeruginosa and A.baumannii were the leading pathogens,accounting for 29.3%,22.8%,11.5% and 9.9%,respectively.The prevalence of extended spectrum-lactamases (ESBLs)positive strains was 63.7%,32.2% and 28.0% in E.coli,K .pneumoniae and P .mirabilis,respectively.The Enterobacteriaceae strains were highly sensitive to carbapenems.The percentage of the P .aeruginosa isolates resistant to meropenem,imipenem or amikacin was lower than 30%.The percentage of the Acinetobacter spp.(A.baumannii accounted for 70.9%)strains resistant to meropenem and imipenem were 25.0% and 26.2%.Conclusions Most of the gram-negative bacilli are resistant to multiple antimicrobial agents. We should strengthen the monitoring of the antibiotic resistance of gram-negative bacilli and optimize antimicrobial therapy.

Objective To investigate the distribution and antimicrobial resistance of the clinical isolates from Children's Hospital of Chuzhou during 2014.Methods A retrospective analysis was conducted with the bacterial strains isolated from various clinical specimens in 2014.Results A total of 382 clinical isolates were collected during 2014, of which gram positive organisms and gram negative organisms accounted for 37.4 % and 62.6 %, respectively. The top 5 most frequently isolated microorganisms were E. coli (18.8 %),K. pneumoniae (16.8 %), coagulase negative Staphylococcus (13.1 %),S. pneumoniae (9.4 %) and S. aureus (9.2 %). The prevalence of MRSA was 28.6 % in S. aureus and the prevalence of MRCNS was 76 % in CNS. All staphylococcal strains were susceptible to daptomycin, linezolid and vancomycin. All the E. faecalis and E. faecium isolates were sensitive to daptomycin, linezolid and vancomycin. All the S. pneumoniae strains were susceptible to penicillin. The prevalence of extended spectrum-lactamases (ESBLs) positive strains was 58.3 % in E. coli and 28.1 % in K. pneumoniae. The Enterobacteriaceae strains were highly sensitive to carbapenems. Only 3 (1.6 %) carbapenem-resistant strains were identified in the Enterobacteriaceae isolates. About 13.3 % and 6.7 % of theP. aeruginosa isolates were resistant to piperacillin and levofloxacin, respectively. All the P. aeruginosa strains were sensitive to the other antimicrobial agents. The percentage of carbapenem-resistantAcinetobacter strains was lower than 10 %. Only one carbapenem-resistant A. baumannii strain was identified.Conclusions Gram negative microorganisms account for most part of the clinical bacterial isolates in 2014. The antimicrobial resistance is still very serious in this hospital, especially the emergence of carbapenem-resistant Enterobacteriaceae, which is of great concern.

Objective To investigate the prognostic value of lymph node status evaluated by computed tomography (CT) in cervical carcinoma treated with radical chemoradiation therapy.Methods 209 patients with FIGO stage Ⅰ B-ⅣA uterine cervical carcinoma treated with radical chemo radiation therapy were enrolled.Lymph node status was evaluated based on site,number and size respectively by CT.Kaplan-Meier method was used to analyze the impact of lymph node status as well as other pathoclinical factors on overall survival (OS).Cox regression model was used to explore the relationship between independent prognostic factors and OS.Results Lymph node metastasis rates for stage Ⅰ B,Ⅱ,Ⅲ and ⅣA patients were 16.7 ％ (1/6),48.2 ％ (68/141),57.4 ％ (31/54) and 87.5 ％ (7/8),respectively.Variate analysis showed that FIGO stage,anemia before treatment,para-aortic lymph node metastasis,and the number (≥3) and size (maximum diameter ≥ 2.0 cm) of CT positive lymph node were significant unfavorable prognostic factors for OS (P ＜ 0.05).FIGO stage,the number of lymph nodes metastasis,pathologic diagnosis and treatment regimen were identified to be independent prognostic factors in multivariate analysis.Conclusion Under current therapeutic strategy of concomitant chemoradiotherapy,lymph node metastatic status evaluated by pretreatment CT is still a significant and independent prognostic factor for cervical cancer.

Objective To explore the relationships among post traumatic stress disorder(PTSD),gratitude and posttraumatic growth (PTG) for terminal cancer patients.Methods Totally 119 advanced cancer patients were investigated with the self-demographic questionnaire,posttraumatic growth inventory (PTGI),the PTSD cheeklist-civilian version (PCL-C) and the Gratitude Questionnaire-6 (GQ-6).Results For terminal cancer patients,the total score of PCL-C was 34.02±12.49.The scores on re-experience,avoidance/numbness,hypervigilance were 9.79±3.78,13.85±5.68,10.36±3.80.The total score of gratitude was 29.37±7.48.The total score of PTG was 51.34± 13.57.The scores of life appreciation,personal relationship and self-strength were 8.00± 2.99,21.18± 5.84,22.16± 6.10.The total scores of PTG were significantly statistical significance among different PTSD groups(F=16.267,P＜0.01)and gratitude groups(F=43.674,P＜0.0 1).The total scores of PCL-C (r=-0.694,P＜0.01),re-experience (r=-0.664,P＜0.01),avoidance/numbness (r=-0.671,P＜0.01),hypervigilance (r=0.753,P＜0.01) and gratitude(r=-0.611,P＜0.01) were all correlated with PTG.The total score of PCL-C and gratitude could explain 66.6％ variation of PTG.For the relationship between PTSD and PTG,the moderation effect of gratitude was not significant (P ＞0.05).Conclusion The gratitude and PTSD were important influence factors for terminal cancer patients' PTG,while the moderation effect of gratitude was not significant,so in clinical intervention we should pay more attentions to the actual effects of gratitude,and we should not pursuit gratitude education blindly.

Objective To analyze the assets and liabilities of secondary public hospitals of Wuhan city in Hubei province ,in order to provide references to control the debt scale of such hospitals .Methods Twenty‐one public secondary public hospitals of Wuhan city were analyzed using official statistics on their asset and liabilities from 2012-2014 .Results Such a timeframe witnessed a year‐on‐year growth of both total assets and liabilities of these hospitals ,yet the growth rate of total assets(35.15% ) falls behind that of total liabilities (53.62% )significantly ;significantly slower growth rate of non‐current assets since 2013 ;higher current liabilities than long‐term liabilities on yearly basis ;year‐on‐year grow th of liquidity rate and quick ratio in general ;significant rise of debt‐to‐assets ratio .Conclusions The overall debt scale of such hospitals keeps growing ,a trend deserving actions and correction .

As an important part of the hierarchical medical system in China ,urban secondary hospitals play as a pivot between tertiary hospitals and community healthcare centers.By describing the overall development status of such hospitals in China ,the paper discussed the problems existing in the development of urban secondary hospitals and put forward strategies in the hope of providing reference for the transformation of these hospitals .