Poor communication between medical staff and patients is the main cause of medical disputes,and the clear emotional recognition and reasonable response of the patient needs psychology training and practice.Balint groups can create a good support environment and is an effective way to improve the communication ability and professional growth for medical staff.

Due to the shortcomings of traditional medical professionalism education,coupled with the impact of the reality,medical students' professional spirit produced some phenomenon in clinical practice such as weak professional faith,lack of professional value,poor career cognitive and so on.If medical professionalism education wants to make mental shaping function in medical students who are in the clinical practice,the traditional classroom teaching must be combined with Internet technology and thinking.On the one hand,Internet renovation must be applied to teaching system of systematic classroom teaching,teaching content of practicality,and extension of classroom,and so on.On the other hand,it should vigorously explore new way of Internet learning such as Moocs,micro-course online video,Network teaching center platform,live courses,and so forth.At the same time,it should pay attention to the recessive educational form,establish a perfect evaluation mechanism,attaches great importance to the subjectivity of entity class teaching and the combination of Internet in the process,and explore the Internet plus mode of medical professionalism education together.

Through expounding the definition of appreciate inquire,this paper discussed its principles when usedin medical humanities education including constructionism,simultaneity,poetry,preconception and optimism.Guided by optimistic themes,the benign development of medical humanistic education was realized by 4D circulation mode (discovery,dream,design,andrealization) of appreciative inquiry summit talks.

Objective To select a matrix modifier,which can effectively eliminate the matrix interference in the determination of chromium in cosmetics by graphite furnace atomic absorption spectrometry(GFAAS).Methods The orthogonal experiment design was used to define the best operation parameter of graphite furnace.Vitamin C,(NH4)H2PO4,(NH4)2HPO4,NH4Cl and Mg(NO3)2 were added respectively as the matrix modifiers.The effect of five matrix modifiers was compared by precision test.Results When(NH4)H2PO4 was taken as the chemical modifier,the determination result was satisfied.The characteristic mass was 5.68?10-12 g,relative standard deviation were from 2.11% to 4.46%.The rate of recovery of two cosmetics samples were 95.2% and 102.01%.Conclusion(NH4)H2PO4 can increase the ashing temperature,decrease the atomization temperature,eliminate the matrix interference and the result has good precision and accuracy.

Objective To investigate the difference in detection results of electrolytes and glucose among arterial blood plasma , venous blood plasma ,arterial blood serum and venous blood serum .Methods Arterial and venous anticoagulation blood and coagu‐lation blood were collected from 54 patients at the same time ,1 tube for each blood sample .The corresponding plasma and serum were isolated .The levels of K+ ,Na+ ,Cl-and glucose(GLU) were determined by using the Johnson VITROS 5600 automatic dry biochemical analyzer .The detection results were performed the comparative analysis by using the statistical method .Results When the sample was serum ,the concentrations of Na+ ,Cl- ,GLU and serum K+ had statistically significant difference between arterial and venous blood(P<0 .05) ,when the sample was plasma ,the concentrations of Na+ ,Cl- and GLU had statistically significance between arterial and venous blood(P<0 .05);but the K+ concentration had no statistically significant difference between serum and plasma(P>0 .05) .In addition ,the GLU and K+ detection results had statistical difference between arterial serum and plasma(P<0 .05) ,while the Na+ and Cl- detection results had no statistically significant difference(P>0 .05);similarly ,the GLU and K+ de‐tection results had statistical difference between venous plasma and serum (P<0 .05) ,while the Na+ and Cl- detection results had no statistical difference(P>0 .05) .Conclusion Some differences in the detection results of electrolytes and glucose exist among ar‐terial plasma ,venous plasma ,arterial serum and venous serum ,clinic should pay attention to make a difference among different types of sample and establish the suitable reference ranges .have certainly difference in different types of specimens even detected by the same system .So we recommend that appropriate reference range is necessary for various kinds of specimens .

Objective:To investigate the application of three-dimensional visualization technology in preoperative assessment of hilar cholangiocarcinoma. Methods:Thirty-eight patients with hilar cholangiocarcinoma who underwent surgery from March 2014 to April 2016 were enrolled in the retrospective study. Among the cases, an observational group of 18 patients had preoperative three-dimensional visualization surgical planning, while a control group of 20 patients did not have the visualization surgical plan. The preoperative diagnostic results were analyzed with the actual intraoperative findings. Related surgicall indicators between the two groups were compared. Results:No significant difference in the accuracy rates of longitudinal and vertical infiltration of cholangiocarcinoma between was observed the observational group and control group. While the vascular and ductal branching pattern of all patients are consistent with intraoperative findings, the coincidence rate was higher in the observational group than that in the control group (100%vs. 70%, P<0.05). The estimated liver volumes were also exactly consistent with the actual liver volume (r=0.986, P<0.001). In comparison with the control group, the average intraoperative blood loss and operative time of the observational group were significantly lower. However, the potential curative resection between the two groups exhibited no significant difference. Conclusion:Three-dimensional visualization technology can accurately complete the preoperative evaluation of hilarcholangiocarcinoma.

Objective To summarize the clinical experience in treatment of malignant tumors of renal allograft recipients. Methods A retrospective study was performed on renal allograft recipients who received immunosuppressive treatment at least half a year between 1978 and 2005. Results Fifty-eight cases of tumors were found in 1812 cases undergoing renal transplantation, 50 cases of them who had complete clinical data were included into analysis. Forty-four cases, that included 19 cases in rological system, 14 cases in digestive system, 5 cases in blood system, 6 cases in other systems, were diagnosed as having malignant tumors by pathological analysis. Most of them were treated with surgery. One-year survival rate was 68.0% after the diagnosis of malignant tumor. The longest survival time was 6.5 years. Most of the survivals possessed normal function of allograft. Conclusion Systemic follow-up is important for renal allograft recipients who suffered malignant tumors. Surgical operation is still the main therapy for those solid tumors. It is critical for the therapy of malignancies and quality of life to possess satisfactory allograft function. The strategy of treatment should take consideration of the relationship between the decrease dose of immunosuppressive agents and the preservation of allograft function.

The optimal bariatric surgery is still not acquired although the obesity epidemic has become a worldwide problem. The recentness studies on obesity focused on mass balance regulated by central nervous system, in which an important circuit is vagus nerve. This review provides progress on obesity mediated by vagus nerve simulation and vagal blocking.

ObjectiveTo evaluate the correlation between ultrasound detected fetal heart abnormality and chromosomal abnormality.Methods The data of 3307 cases of prenatal fetal echocardiography and karyotype analysis results were retrospectively analyzed.The correlation between heart abnormality and chromsomal abnormality was analyzed.ResultsIn 3307 cases d pregnant women,194cases (5.87％) were found signs of fetal heart abnormality,and 3113 cases (94.13％) were not found any sign of fetal heart abnormality.And 124 cases(3.75％) were found chromosomal abnormality.The rate of chromosomal abnormality in fetus with heart abnormality was higher than that in fetus without heart abnormality[ 19.59％ (38/194) vs.2.76％ ( 86/3113 ),P ＜ 0.01 ],the relative risk ratio was 7.0903.One hundred and twenty-four cases of chromosomal abnormality in the 18-three-body(42 cases) and 21-three-body(36 cases) were the most common.ConclusionsFetal heart abnormality incidence of chromosomal abnormality is high relatively.When the signs of heart abnormality are found,it is suggested that the fetus should examine karyotype analysis.

Objective To analyze the clinical value of microRNAs applied in the early diagnosis of pancreatic cancer.Methods The expression of mir-155,mir-196a,mir-181a,mir-181b in three pancreatic cancer cell lines PANC-1,PaCa-2,AsPC-1 pancreatic cancer,normal pancreatic cells and plasmas of 100 patients with pancreatic cancer ,100 normal volunteers were detected by Real-time PCR,and the results were analyzed.The expression of mir-155,mir-196a,mir-181a,mir-181b in 100 pancreatic cancer tissues and 100 normal pancreatic tissues were detected by immunohistochemical,and the results were analyzed. Results Real-timePCR test results showed that compared with normal pancreatic cells,mir-155,mir-196a expression in three pancreatic cancer cells PANC-1,PaCa-2,AsPC-1 were significantly increased(P<0.05).Compared with healthy volunteers,mir-155,mir-196a,mir-181a,mir-181b expression of plasma in pancreatic cancer patients were significantly higher(P<0.05).Immunohistochemistry results showed that mir-155,mir-196a mir-181a and mir-181b expression in pancreatic tissue were significantly higher than that in normal pancreatic tissue (P <0.05 ).Conclusion The expression of mir-155,mir-196a,mir-181a and mir-181b are high in pancreatic cancer tissues and pancreatic cancer cell lines,which are closely related to the development of pancreatic cancer.Those microRNAs are expected to be cancer markers for early diagnosis of,pancreatic cancer,have highly diagnostic value and broad clinical application.