This paper reflected the development of modern medical technology from the view of ecology,indicating that the core idea of ecological medical model is that human and nature develop harmoniously. The theory basis,practical background and significance of ecological medical model are also described.

Objective To explore the efficacy of empathy training on the empathy and emotional intelligence in new employed nurses (engaged in clinical work within one year).Methods A total of 82 participants were randomly divided into the intervention group and the control group (n =41).The intervention group was conducted with empathy training in addition to routine clinical guidance,the control group was only conducted with routine clinical guidance.All subjects were assessed with the Interpersonal Reactivity Index (IRI-C) and Emotional Intelligence Scale (EIS) before and after intervention.Results Immediately after the intervention and 3 months after intervention,the scores of IRI-C in the intervention group were significantly higher than those of the control group((57.53 ±5.20) vs(50.50 ±7.64),(55.28 ±6.48) vs(46.90 ± 7.74),P ＜ 0.01).Samely,the scores of EIS in the intervention group were significantly higher than those of the control group((131.55 ± 10.49) vs(124.35 ±9.93) ;(126.27 ± 12.87)vs(119.38 ±9.45),P＜0.01).Conclusion Conducting empathy training can improve the empathic ability and emotional intelligence of new employed nurses.

Spinal sensory evoked potential(SSEP)and spinal motor evoked potential(SMEP)of the injured spinal cord of the host rats were determined on the 7th,15th,30th.60th,120th and 240th day after they received implantation of the embryonic spinal cord from the fetus of E14 rats.The motor function of the hind limbs of the host rats were also observed.The rats with simple cord injury and those with cord injury and implantation of a piece of skeletal muscle served as the controls.It was found that the locomotor function of the host rats could be recovered on the 30th day after implantation,but the latent period of both SSEP and SMEP became normal on the 240th day.At that time,the latent period of evoked potentials of the 2 control groups also recovered gradually.It is believed that embryonic spinal cord may have effects on the recovery of the locomotor function of the host rats but more sophisticated methods are imperative to clarify the interela-tionship between the host tissue and the graft.

Objective To observe the variation of the levels of γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis before and after treatment.Methods A total of 159 patients with brucellosis were enrolled from the Second People's Hospital of Tianjin between September 2009 and August 2014,of which 122 were with acute phase and 37 with subacute stage.γδT cells,CD4+ and CD8+ T lymphocytes in peripheral blood of all patients before and after treatment were detected by flow cytometry.Thirty healthy controls were also enrolled.Measurement data were analyzed using t test and nonparametric Kruskal-Wallis test.Results The medians of γδT cells,CD4+ and CD8+ T lymphocyte counts of brucellosis patients with acute stage before treatment were 84.0/μL,780.5/μL and 774.0/μL,respectively,and those with subacute stage were 76.0/μL,887.0/μL and 890.0/μL,respectively.Those in control group were 49.0/μL,772.5/μL and 592.5/μL,respectively.γδT cells (U=114.5,P =0.001) and CD8+ T lymphocyte counts (U=1 185.5,P =0.003) in acute phase group were elevated than control group.γδT cells (U=359.0,P=0.013),CD4+ T lymphocyte counts (U=325.5,P=0.004) and CD8+ T lymphocyte counts (U=316.5,P=0.003) in subacute phase group were increased than control group.CD4+ T lymphocyte counts in subacute phase group were elevated than acute phase group (U=1 619.0,P=0.009).There were 31 patients with acute phase and 30 patients with subacute phase who completed 6-week treatment.γδT cells ([120.7 ± 104.9]/μL vs [82.2 ±85.3]/μL;t=3.568,P=0.001),CD4+ T lymphocyte ([802.1±300.6]/μL vs [663.0±280.6]/μL;t=2.904,P=0.007) and CD8+ T lymphocytes counts ([908.1±422.7]/μL vs [651.1±241.7]/μL;t=3.885,P=0.001) of brucellosis patients with acute stage before and after treatment were significantly different.γδT cells ([67.1± 38.4]/μL vs [48.4±32.1]/μL;t=2.695,P=0.012),CD4+ T lymphocytes ([817.1± 147.4]/μL vs [650.8± 196.5]/μL;t=5.301,P＜0.01) and CD8+ T lymphocytes counts ([703.7±191.5]/μL vs [537.4±186.0]/μL;t=5.152,P＜0.01) of brucellosis patients with subacute stage after treatment were significantly decreased compared with those of patients before treatment.Conclusions γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis are all in a state of immune activation.The levels of activation are highly correlated with disease progression.And detection of the variation of these cells contributes to understand the immune state of the acute and subacute brucellosis.

Objective To determine the cause, prevention and management of failed spinal deformity surgery, and evaluate the indication of spinal revision. Methods Thirty-one cases of failed spinal deformity surgery were treated surgically. There were 18 males and 13 females with an average age of 14.7 years(ranged from 4 to 35 years) at the present procedures. The average number of previous surgeries for this group of patients was 1.5 times. The duration between the first surgery and revision was 13-114 months, with an average of 47.9 months. There were 16 patients with consistent back pain which became worse after movement, 5 patients with implant complication (broken, loosing, explosing), 21 patients with failure of instrumentation and deterioration of deformity, 5 patients with decreased sensory and motor function. The average preoperative angel of deformity was 75.3 degrees for scoliosis and 76 degrees for kyphosis and the flexibility was 9.8% and 25.2%, respectively. All patients underwent reconstructive surgery with segmental vertebral osteotomy and trans-pedicular fixation and fusion in one or two stages according to the location and degree of the deformity. Results The average follow-up period for this group of patients was 31.8 months in 20 cases. The postoperative correction rate for scoliosis and kyphosis was 55.2% and 67.5%, respectively. There were 4 cases (12.9%) developed temporary neural dysfunction postoperatively and were recovered within 1-3 weeks after appropriate treatment. Instrumentation failure was occurred in two cases and there was no other complication in this group. Conclusion It is might be benefit to follow the principle of spinal deformity correction, fuse with adequate bone grafting and combine with proper pedicle fixation, especially for the congenital scoliosis patients, which are the efficial methods to prevent the failure of spinal deformation surgery. The management for the patients suffered from long-time back pain, spinal pseudarthrosis or progressive aggravated deformity postoperatively should be individuated depending on the degree of deformity, flexibility of the spine and the age of patients.

Objective To describe the structure and clinical application of the single arm suspended reduction fixation device(HOIST device) for spondylolisthesis. Methods HOIST device is composed of the hauling screw, open angle screw(upholding screw), blocker, angle connective bar and blocking ring. Through the different assembly of the angle screws and the connective bar, to increase or decrease the fixation angle of the angle screw which as an upholding arm and the connective bar to meet the needs of different lumbosacral angles and hauling screw reducing distance. Twenty three patients with an average slipping rate of 25％－ 50％ , were treated with the device, and among them, intervertebral implantation of BAK was done in 5 patients and intervertebral fusion was performed in 18 patients. Results The mean duration of follow up was 10.3 months. Olisthy was reduced completely, clinical symptoms disappeared and there was no serious complications. Conclusion This device only required fixation of the slipped and its inferior adjacent vertebral body, and then it causes little influence to the movement of the lumbar spine. The arm of force of the reduction is short, so it is especially indicated for mild and moderate spondylolisthesis.

Objective To Introduce the principle, structure and observe the effects of clinical application of Scofix instrumentation. Methods Scofix instrumentation consists of different size of open up pedicle screws, open up pedicle hooks, connecting rods, blockers and devices of transverse connection. The open up pedicle screws can be inserted continuously or intermittently, fixed by the connecting rods in the scoliotic segments, and then distraction, compression and derotation manipulation can be performed to correct the spinal deformity. Thirty three patients were treated with this methods. The average age at surgery was 14.4 years. The mean preoperative Cobb angle in idiopathic and congenital scoliosis was 70 and 68 degrees,respectively. According to the degree of deformity and spinal flexibility, the correction was done at one setting or in stages. Results Postoperative Cobb angle and the corrective rate in 19 cases of idiopathic scoliosis were 29.4?and 59.1%, respectively while in 14 cases of congenital scoliosis the figures were 33.3?and 52.3%, respectively. No severe complications occurred. Conclusion Scofix instrumentation which is designed by the principle of CD instrumentation and in conformity with the spinal structural features of Chinese adolescence has the function of distraction, compression and derotation and can be used for internal fixation of scoliosis in different ages. Because of the high risk and the great difficulty, the thoracic pedicel screws should be used carefully, and can be replaced by pedicle hooks if necessary.

Objective To investigate the effect of CT angiography on the qualitative and differential diagnosis in small pulmonary nodules.Methods 120 patients with pulmonary small nodular lesions from September 2014 to October 2015 in our hospital were selected,and they were divided into the observation group and control group according to pathological type.the patients with malignant pathology were in the observation group,with totaling 64 cases;the patients with benign pathology were selected as a control group,with a total of 56 cases.Lesion type,sensitivity,vascular sign type,CT enhancement value and the ratio of enhancement value to aorta value in the two groups were compared and analyzed after the CT scan.Results In the observation group,positive CT angiography sign was 50 cases while negative ones was 14 cases,the sensitivity was 78.1%;In the control group,CT angiography sign was positive in 16 cases,negative in 40 cases,with the sensitivity of 28.6%.Comparing of two vascular symptoms sensitive case, there was a significant difference(χ2 =6.781,P =0.012).Vascular symptoms genotyping were compared in vascular symptoms positive patients,the results showed significant differences(χ2 =7.694,6.964,5.993,6.012,all P <0.05).Enhanced CT scan value of patients showed positive signs in the observation group was (40.07 ±3.72)Hu, with the control group of (10.54 ±4.83)Hu,the difference was statistically significant(t =11.783,P =0.019).The ratio of enhancement CT value to aorta value in patients with positive reaction showed 24.96% in the observation group,and 4.01% in the control group,the difference was statistically significant(χ2 =7.460,P =0.012).Conclusion
CT angiography features has played a very important role in qualitative and differential diagnosis of small nodular lesions in the lungs.It is of great significance in the clinical diagnosis and treatment,and is worth further promotion.

Transplantation of embryonic spinal cord was performed with microsurgical technique in rats after they were inflicted with acute spinal cord injury.Then the favorable factors affecting the acceptance of the transplanted cord were investigated with morphological technique.It was found that among the gestation ages from EH to E20,the spinal cord taken from the rats with the gestation age of E14 showed the highest survival rate of 70.83%.None of the transplants taken from the rats with the gestation age older than E14 survived.The connective tissue attached to transplants severely interfered with their acceptance and growth.The severity of the pathological manifestations of the injured spinal cord exerted unfavorable influence on the survival and growth of the transplants too.It is believed that in order to assure the success of the transplantation,besides the attention on the technical performance of the surgery,it is essential to determine the differentiation state of the embryonic spinal cord to be transplanted.

Hyperlipidemic pancreatitis (HLP) has an increasing incidence.Primary HLP is common in patients with familial difficiency of lipoprotion lipase or apo-C Ⅱ.While for secondary HLP,the common reasons are excessive drinking,diabetes,obesity,fat-rich diet and special medications.Lipidlowering drugs,plasma exchange (PE) or continuous veno-venous hemofiltration (CVVH),low molecular heparin as well as insulin,have been widely used for the treatment of HLP.Changing of diet and lifestyle,in addition to controlling risk factors are the keys to preventing HLP.This article summarizes the latest perspectives and research progress of HLP.