With the change of modern medical model and the rapid development of medical technology,medical humanities education in higher medical education has obviously been weakened and has obvious deficiencies.We should fully understand the importance and the necessity of medical humanities education during cultivating medical students.We should also improve medical humanities curriculum system,construct teaching staff combining with different majors,intensify the cultivation of humanistic quality in practice and organically combine ideological and political with humanistic education,and perfect evaluation system,etc.Inall We should explore the effective way of medical humanities education in many aspects.

Objective To investigate the capabilities of Plasmodium microscopic examinations of professional staff in medi-cal institutions in Wuxi City,so as to provide evidences for improving malaria control and elimination work in the future. Meth-ods The data of questionnaires for laboratorial staff in charge of Plasmodium microscopic examinations were collected and ana-lyzed in the medical institutions in Wuxi City in 2016,and the influencing factors related to the capabilities of Plasmodium mi-croscopic examinations were analyzed by the method of logistic regression. Results Totally 54 laboratorial workers in 54 medi-cal institutions in Wuxi City were investigated,16 of them were male,and 38 were female,and the ratio of male to female was 0.42:1. Among the 54 laboratorial workers,12 persons(22.22％)had the experience of detecting Plasmodium in the work. The multivariable analysis showed the ability to detect Plasmodium was associated with male laboratorial workers(adjusted OR =0.11,95％CI:0.02-0.53),laboratorial workers with intermediate or higher professional titles(adjusted OR=5.31,95％CI:1.04-27.19)and laboratorial workers from county and township medical institutions(adjusted OR=0.04,95％CI:0.01-0.98). Conclusions All of the medical institutions in Wuxi City have the capability of microscopic examinations of Plasmodium. How-ever,the ability of laboratorial staff in primary hospitals still should be improved.

Objective To investigate the clinical value of a three-dimensional motion analysis system by using the body segmental method for testing the balance of hemiplegic stroke patients.Methods Twenty stroke patients with hemiplegia were measured using the lower extremity Fugl-Meyer motor assessment (FMA-L),the Brunel balance assessment (BBA),the Berg balance sale (BBS) and a 5 m timed up-and-go test (5m-TUGT).The three-dimensional motion analysis system using the body segmental method was applied in three positions-sitting,standing and walking.Spearman's rank correlation coefficient was used to determine the extent of correlation between the values measured by the three-dimensional motion analysis system and the FMA-L,BBA,BBS and 5m-TUGT results.Results Some motion analysis variables (MSAx,MSVx,MSAy,MSVy and SPxy,SP3-D) are recorded in sitting and standing,while the center of gravity (COG) swing in the horizontal plane and some other variables (MSAx,MSVx and SPxy and SP3-D) are measured while walking.Anterior-posterior COG swing had a high negative correlation with the FMA-L,BBA and BBS scores and a high positive correlations with 5m-TUGT times.But except in sitting,MSAz and MSVz were both uncorrelated with FMA-L,BBA or BBS scores or with 5m-TUGT times.COG swing in the horizontal plane in sitting and standing apparently correlates with lower extremity motor function,balance,and walking ability.However,only the X axis swing parameters of the COG while walking correlated with lower extremity motor function,balance or walking ability.Conclusions A three-dimensional motion analysis system using the body segmental method can be used clinically to monitor patients' balance in real time and dynamically in different positions and activities,and it can be used to predict motor function and balance control in hemiplegic stroke patients.

Objective To study the reliability and validity of using sacral markers in evaluating the balance function in standing and walking of stroke patients with hemiplegia.Methods Twenty-one hemiplegic stroke patients were recruited and their baseline mean sway amplitude (MSA) and mean sway velocity (MSV) were measured using sacral markers and center of gravity analysis assuming a segmented body,thegold standard for such analysis.The data were analyzed using Bland-Altman plots to obtain the 95％ limits of agreement (LOA).Results ①Test-retest reliability:The 95％ LOA of the MSA in standing was (-4.42,5.14) on the X axis,(-6.04,4.52)on the Y axis,and (-1.75,1.31) on the Z axis.The MSV in standing was (-0.08,0.09) on the X axis,(-0.10,0.08) on the Y axis and (-0.03,0.02) on the Z axis.The 95％ LOA of the MSA in walking was (-185.74,105.53) on the X axis,(-22.57,2.76) on the Y axis and (4.43,2.76) on the Z axis.The MSV in walking was (-3.10,1.76) on the X axis,(-0.38,0.54) on the Y axis and (-0.07,0.02) on the Z axis.②Validity:The 95％ LOA of the MSA in standing was (-3.62,2.55) on the X axis,(-3.95,3.94) on the Y axis and (-7.35,19.43) on the Z axis.For the MSV in standing it was (-0.06,0.04) on the X axis,(-0.07,0.07) on the Y axis and (-0.12,0.32) on the Z axis.The 95％ LOA of the MSA in walking was (-4.40,4.74) on the X axis,(-17.35,4.14) on the Y axis and (-17.35,4.14) on theZ axis.For the MSV in walking itwas (-0.07,0.08) on the X axis,(-0.29,0.07) on the Y axis and (-0.12,0.18) on the Z axis.The 95％ LOAs of the variables representing their reliability and validity are small enough to be acceptable in clinical application.Conclusions The sacral marker method can be used in assessing the balance of stroke patients.

Objectives:To investigate the pathogenesis of Chlamydia pneumoniae (C.pneumoniae) pneumoniae with immunohistochemical staining of tissue biopsies. Methods:The Icr mice were inoculated with C.pneumoniae, strain CWL 029, by the intranasal or intravenous routes. After a single inoculation, mice were killed on the 1st, 3rd, 7th, 14th, 21st, 28th and 60th day separately. Lung specimens were obtained from the acute stage of C.pneumoniae pneumonitis and stained using a C.pneumoniae specific monoclonal antibody. Results:In the intranasal inoculation of mice, the immunoperoxidase staining of C.pneumoniae in lung tissue was positive on day 3,7,14. The positive staining of inflammatory lung tissue was not even but local. The positive expressions of C.pneumoniaewas were mainly in the alveolar macrophages, the interstitial cells and the lymphoid tissues surrounding the bronchi. After iv inoculation, a similarly changes were found but the degree was lighter than that of intranasal inoculation group. The positive expressions of C.pneumoniaewas were mainly in the alveolar macrophages and the interstitial cells. Conclusions:Immunohistochemistry is beneficial to the diagnosis of the acute stage of C.pneumoniae pneumonitis in the mice, and the pathogenesis of infection in intranasal inoculation group was more serious than that of iv inoculation group.

BACKGROUND:With the development of microsurgical techniques, free flap transplantation has been widely used, which can solve the problem of insufficient local tissues.
OBJECTIVE:To observe the clinical effects of latissimus dorsi free flap transfer on the repair of al kinds of body surface defects, as wel as the role in complete tissue and functional reconstruction.
METHODS:From 2010 to 2013, 18 cases of various types of body surface defects were selected and using the microsurgical techniques, these complex wounds were repaired with free latissimus dorsi myocutaneous flaps. According to defect reason, primary wounds were treated for arteriovenous separation in the recipient zone. Most of the flaps were latissimus dorsi myocutaneous flaps at the affected side which were cut according to the wound size. If the cut muscle flap had a larger size and secondary wounds were difficult to be directly sutured, free skin grafts could be used to cover the residual secondary wounds.
RESULTS AND CONCLUSION:After transplantation, al the flaps survived with normal blood supply and wel-recovered function. Patients were more satisfied with the flap appearance. Latissimus dorsi myocutaneous flaps characterized as large donor area and secluded location have a great advantage in the repair of complex wounds using microsurgical techniques that can improve the survival rate of latissimus dorsi myocutaneous flaps.

Objective The article was to promote the rational use of antibiotics by comparative analysis on antimicrobial us -age before and after the special rectification on clinical application of antibacterial drugs in our hospital . Methods Medical record data of 132 inpatients before the rectification and 167 inpatients after the rectification were randomly collected for the rational compara-tive analysis on microorganism submission rate for treatment , usage of antibiotics and medication for typeⅠandⅡincisions . Results The microorganism submission rate was much higher , especially the special grade antibiotics (81.5 %vs 32.1%).There was also a remarkable decrease in the percentage of antibiotics use , the strength of utilization and the average drug cost .The amount of antibiotic prophylaxis without indication and the length of medication for typeⅠincisions showed a remarkable decrease (P<0.05).Remarkable decrease was also observed in the irrational usage rate of antibiotic prophylaxis , dosage, medication time and drug replacement for typeⅠand Ⅱincisions (P<0.05). Conclusion The special rectification measures are effective and practical , which can promote the rational use of antibiotics .

Objective To understand the distribution and characteristics of historical Oncomelania hupensis snail environ-ments and wetland environments in Wuxi City since 1952 so as to provide the evidence for formulating the monitoring strategy after the schistosomiasis transmission was interrupted. Methods A cross-sectional survey was conducted to collect the informa-tion of historical O. hupensis snail environments and wetland environments. Google Earth was used to present and analyze the distribution and characteristics of them. Results There were 2 124 historical O. hupensis snail environments in Wuxi City and the accumulative area was 2 995.7 hm2. In 2013 there were 61 surveillance sites of wetland with the area of 32.8 hm2 totally 1 695 snails were caught and no O. hupensis snails were found. Conclusion The historical O. hupensis snail environments were distributed widely and covered a large area in Wuxi City. The surveillance should be focused on the key environments and wetland.

Objective:To investigate the clinicopathological features and differential diagnosis of 2 patients with renal epithelioid angiomyolipoma (AML), representing 5.4 % of a series of 37 patients undergoing biopsy for renal tumors. Methods:The histopathological, immunohistochemical and clinical characteristics of renal epithelioid angiomyolipoma were studied by immunohistochemical stain for melanoma marker (HMB45), (Pan)melanoma marker Ab-1,cytokeratin (CK), smooth muscle actin (SMA), epithelial membrane antigen (EMA),vimentin (Vim), p53, proliferating cell nuclear antigen(PCNA), Ki67 antigen. Results:Two patients,aged 31 and 39,were alive for 8 and 10 months,respectively.Microscopically, both tumors were mainly made up of diffuse sheets of epithelioid cells and scattered thick-walled blood vessels, necrosis was account for up to 30% of the mass. The epithelioid cells had huge, extremely pleomorphic nuclei with abundant eosinophilic cytoplasm. Scattered tumor giant cells with prominent nuclei were also seen. The epithelioid AML regions of these tumors were immunoreactive for HMB45, (Pan)melanoma marker Ab-1, SMA, Vim and PCNA. Neither atypical epithelioid cells nor typical AML cells were immunoreactive for cytokeratin (CK) and epithelial membrane antigen (EMA).Conclusion: The results of this study suggested that the renal epithelioid AML was a mild malignant tumor before distant metastases. The differential diagnosis between renal malignant AML and sarcomatoid renal cell carcinoma was established by immunohistochemical findings.

Objective:To investigate the LOH at regions on chromosomal arm 8p22,11p15,17p13 and its relationship with clinicopathological parameters. Methods:Thirty-four paraffin-embedded tumor and corresponding noncancerous tissues were analysed. PCR was used to amplified three microsatellite markers D8S136,D11S988 and TP53 located at these chromosomal regions. PCR products were electrophoresed on 6%polyacrylamide gel and detected using silver staining. The P53, c-erBb-2,PR,ER status were determined by immunohistochemistry. Results:Of the three markers we studied, D8S136 was detected LOH at a frequency of 12 in 34 tumors(35.29%). D11S988 and TP53 were detected LOH at a frequency of 5 in 34 tumors(14.71%). There were no obvious associations between LOH at D11S988、TP53 and clinicopathological parameters, but the tumors with LOH at D8S136 were significant larger than that without LOH(P=0.0049). Conclusion: Invasive ductal carcinoma of the breast has a frequent LOH on chromosome 8p22. The loss or inactivation of putative tumor suppressor genes on 8p22 may contribute to the excessive growth of the tumors.