In the background of the crisis of doctor-patient relationship and the effectiveness of medical humanities education doubts we need to think about how to achieve,transform and reflect the value of doctors' understanding on their professional meaning,how to realize the functional significance of doctorpatient cooperation and how to make doctors put themselves in patients' place by the curriculum and its operating mechanism.This paper discussed the external environment and the microcosmic environment from the externality and connotation of the humanities curriculum.And the way to reflect and achieve the value transformation of the medical humanistic curriculum in the mechanism of education was considered.This paper put forward combining the institutional mechanism of policy leading,the subject mechanism that is the basis of the curriculum,the constitutive mechanism of curriculum system and the cultural mechanism to make students study and internalize,and made some suggestions.

0.05, while the differences between 2 groups in cooling effects on the points of cooling 2.5 hours and 4.0 hours were significant, F

Objective To investigate the clinical value of high frequency ultrasound in discovering secondary pathological changes in infant with developmental dysplasia of the hip (DDH).Methods Thirtyfour infants with 36 dislocation hips were involved.Among them,32 were with unilateral dislocation of hip joint,2 were with bilateral dislocation of hip joint.High frequency ultrasound were used to observe the morphological changes of hip glenoid labrum,adipose hyperplasia in acetabulum,thickness variation of articular capsule,and development of the ossification center of the femoral head.Besides,the morphological changes of hip glenoid labrum and adipose hyperplasia in acetabul were compared with those from MRI.Results The sensitivity and specificity of ultrasound in diagnosing glenoid labral introversion were 82 ％ and 100％ respectively.The coincidence rate of diagnosing glenoid labral introversion and glenoid labral extroversion were both 83％.Adipose hyperplasias in acetabul were clearly seen in 31 hips using ultrasound.The thickness of articular capsule in the affected hip and in the healthy hip was (2.8 ± 0.6)mm versus (1.7 ± 0.4) mm,and the difference was obviously significant (P ＜0.01).The ossification center of the femoral head in the 34 infants were classified as the following four types:① which was smaller in the affected side than in the healthy side (22/34);②which was shown in the healthy side (7/34) but not in the affected side;③ which in both sides were not shown (4/34);④ which in both sides were small (1/34).Conclusions Ultrasound is a method of simple,rapid,non-invasive in diagnosing DDH,and it can be used to discover secondary pathological changes in infant with DDH,which provide important reference for clinical diagnosis and treatment.

Objective To identify the specific proteins in two hydrophis (l#and 2#) with a simple differential proteins display method. Method By means of SDS-PAGE and Western blot, combined with analysis, the specific proteins in two hydrophis were obtained and been sequencing.Result The specific proteins of l#are 14.6kD and 8.7kD components and of 2#are 16.7kD. 10.2 kD components. The amino acid sequences of 14.6 kD and 10.2 kD components were assayed respectively. Conclusion Differential proteins can be obtained and used to identify the Chinese traditional medicinal crops by means of one-dimensional electrophoresis combined with antigen analysis .

AIM:In order to ensure the quality stability of Fructus Polygoni Orientalis,to study the determination method of the fingerprint of Fruetus Polygoni Orientalis and to establish the fingerprint of Fructus Polygoni Orientalis.METHODS:The HPLC assay was used to establish the fingerprint of Fructus Polygoni Orienlalis and 28 pieces of goods were compared.RESULTS:The fingerprint of Fructus Polygoni Orientalis with 7 common peaks was established.The relative retention time and the ranges of relative area of the common peaks were determined.CONCLUSION:The established fingerprint can be used for the quality control of Fructus Polygoni Orientalis.

Objective To investigate the clinical characteristics,distribution and drug sensitivity of pathogens causing intravenous catheter-related bloodstream infections (CRBSIs) in pediatric intensive care unit (PICU) so as to use antibiotics reasonably.Methods All patients with CRBSIs in PICU of Guangdong General Hospital from September 2009 to September 2014 were investigated and the drug resistance profiles of pathogens causing CRBSIs were also analyzed retrospectively.Results Between 2009 and 2014,there were totally 10 834 catheter days and 23 episodes of CRBSIs with an incidence of 2.1 infections per 1 000 catheter days.Catheter indwell time ＜ 7 days in 9 cases (39.1％),8 to 14 days in 10 cases (43.5％),14 to 21 days in 4 cases (17.4％).There were 13 strains (56.6％) of gram-positive bacteria,5 strains (21.7％) of gram-negative bacteria and 5 strains (21.7％) of fungi.The main pathogens causing CRBSIs were coagulase negative Staphylococci (7 strains,30.4％),Staphylococcus aureus (3 strains,13.0％),Candida albicans(3 strains,13.0％),Candida parapsilosis(2 strains,8.7％),and Enterobacter cloacae (2 strains,8.7 ％).The susceptibility to Vancomycin,Linezolid and Teicoplanin of coagulase negative Staphylococ cus such as S.epidermidis and to Imipenem,Piperacillin/Tazobactam,Cefoperazone/ Sulbactam and Amikacin of gram-positive bacteria arrived at 100.0％,respectively.The candida were 100％ susceptible to Amphotericin B,5-Flucytosine,Fluconazole and Voriconazole.Twenty-one cases (91.3％) received antibiotic treatment versus no antibiotic in 2 cases (8.7％).The average number of antibiotic kinds administered on the patients with fungal infection was 4.4,bacteria were 1.4.Ten cases (43.5％) treatment with 1 kind of antibiotic,4 cases (17.4％) with 2,4 cases (17.4％) with 3,5 cases (21.7％) with more than 3.Twenty-two cases (95.7％) cured and 1 case died (4.3％).Conclusions The major species of pathogen causing CRBSIs was coagulase negative staphylococci in PICU.It is critical for clinicians to guard against fungal infection because of prolonged catheter indwelling time and more antibiotics administered before indwelling catheter.It is effective way to prevent the CRBSIs by reasonably using antibiotics and shortening the time of catheter indwelling.Monitoring CRBSIs pathogenic bacteria distribution and drug susceptibility helps reasonable administration of antibiotics in the earlier time.

Objective: To assess the quality of syphilis case reporting from hospitals in Hunan Province .Methods The syphilis cases reported by 126 middle second-class and above hospitals in the year 2010 and 2017 were retrieved from unified infectious case reporting network and compared with original reporting cards,medical records and laboratory testing records according to the Diagnostic Criteria for Syphilis （WS 273-2018）and the Guidelines for the Clinical Diagnosis and Treatment of Sexually Transmitted Diseases. The accuracy of syphilis diagnosis and classification were evaluated between different reporting years,types of hospitals,levels of hospitals and departments . Methods: The syphilis cases reported by 126 middle second-class and above hospitals in the year 2010 and 2017 were retrieved from unified infectious case reporting network and compared with original reporting cards,medical records and laboratory testing records according to the Diagnostic Criteria for Syphilis （WS 273-2018）and the Guidelines for the Clinical Diagnosis and Treatment of Sexually Transmitted Diseases. The accuracy of syphilis diagnosis and classification were evaluated between different reporting years,types of hospitals,levels of hospitals and departments . Results: There were 8 947 syphilis cases reported in 2010 and 13 552 syphilis cases reported in 2017. The accuracy of syphilis diagnosis and classification were 98.81% and 98.66% in 2017,which were higher than 36.39% and 36.10% in 2010 （P<0.01）. The accuracy of syphilis diagnosis in the provincial,municipal and county-level hospitals in 2017 were 99.07%,99.20% and 98.17%;the accuracy of syphilis classification were 98.91%,99.03% and 97.99%;the accuracy of syphilis diagnosis and classification were significantly different in different levels of hospitals（P<0.01）. The accuracy of syphilis diagnosis in the general hospitals,traditional Chinese medicine hospitals and maternal & child health hospitals in 2017 were 99.25%,96.92% and 97.57%;the accuracy of syphilis classification were 99.13%,96.72% and 97.30%;the accuracy of syphilis diagnosis and classification were significantly different in different types of hospitals（P<0.01）. The accuracy of syphilis diagnosis in the department of dermatology and non- dermatology in 2017 were 99.13% and 98.74%;the accuracy of syphilis classification were 99.02% and 98.58%;the accuracy of syphilis diagnosis and classification were not significantly different in different departments（P>0.05） . Conclusion The accuracy of syphilis diagnosis and classification have been improved in 2017,which varies in different levels and types of hospitals.

Purpose To investigate the effects of chemotactic factor CCR4 on the abi1ity of pro1iferation,ce11 cyc1e,invasion,and mi-gration of human ga11b1adder cancer ce11. Methods Western b1ot was used to detect the expression 1eve1 of CCR4 in ga11b1adder carci-noma ce11s. Ga11b1adder carcinoma ce11s was infected by means of s1ow virus,the CCR4 gene si1encing was conducted using siRNA-CCR4 interference techno1ogy. Ga11b1adder carcinoma ce11s GBC-SD were divided into three groups( GBC-SD,GBC-SD/CCR4-RNAi and GBC-SD/contro1). CCL17,a 1igand of CCR4,was used to act on these three groups of ce11s. CCK8 method was used to detect the ce11 pro1iferation abi1ity of three groups. F1ow cytometry was used to test ce11 cyc1e. Tanswe11 assay was app1ied to detect ce11 migration and invasion abi1ity. Western b1ot was performed to detect the expression of its corresponding 1igands CCL17 and CCL22 proteins. Re-sults CCR4 gene si1ence did not inf1uence ce11 cyc1e and pro1iferation of ga11b1adder ce11 GBC-SD,but can significant1y inhibit GBC-SD ce11 invasion and movement abi1ity,CCR4 gene si1ence had no inf1uence on the expression of CCL17 and CCL22 gene in tumor ce11s. Conclusion Ga11b1adder carcinoma ce11s GBC-SD express chemokine receptor CCR4,chemokine receptor CCR4 can promote the invasion and metastasis of GBC-SD ce11s.

Objective To investigate the effects of salvianolate lyophilized injection(SLI) on neural functional recovery and the expression of microtubule associated protein-2(MAP2) after focal cerebral ischemia-reperfusion injury in the diabetic rats.Methods Diabetes model was made by intraperitoneal injection of streptozotocin (STZ) and cerebral ischemia-reperfusion model was developed by Longa suture occluded method in the middle cerebral artery of diabetic rats.The rats were randomly divided into five groups: sham operation group, model group, SLI (21.0 mg.kg-1,10.5 mg.kg-1) treatment groups, and edaravone (6 mg.kg-1) treatment group.3 hours after ischemia,rats were respectively given normal saline or drugs followed by the injection once a day for 14 days and the neurological impairment was assessed.2 h after the last injection,the rats were decapitated and the brains were collected.The expression of MAP2 protein and mRNA in the bilateral hippocampal ischemia and infarcted area was detected with immunohistochemistry and RT-PCR.Results Severe neurological dysfunction was found in diabetic rats that had been subjected to cerebral ischemic injury (1.850±0.457).A significant improvement on neurological function was found in the SLI treatment groups (1.581 ± 0.314, 1.345 ± 0.425) compared with model group(P＜0.01, P＜0.05).Moreover,the expression of MAP2 in ischemia bilateral hippocampal CA1 and penumbra was represented by the average optical density value respectively (0.743±0.250,0.561± 0.224).In the hippocampal CA1 region, the number of MAP2-positive cells (0.781 ± 0.420 , 0.851 ± 0.136) in the treatment group showed significant increase than those in model group (P＜0.01, P＜0.05).In the ischemic penumbra region,the number of MAP2-positive cells (0.753±0.235,1.203±0.326) in the treatment group showed significant increase than those in model group (P＜0.01, P＜0.05).Conclusion The SLI can promote the post-injury neurocognitive function in diabetic rats.The increase of MAP2 expression may be involved in the mechanisms.

Objective To evaluate the frequency of pncA gene mutations in pyrazinamide-resistant (PZA-resistant)Mycobacterium tuberculosis(M.TB)isolates.Methods The isolates were tested for PZA susceptibility with absolute concentration method.The pncA gene was amplified and the products were cloned into T-vector,followed with sequencing.Results In all the 36 M.TB isolates,there were 25 PZA-resistant strains and 11 PZA-susceptible strains.Mutations of the pncA gene were found in 10 PZA-resistant isolates,four of which belonging to high PZA-resistant strains.The wild type pncA sequence was present in 3 PZA-susceptible strains, synonymous mutations of pncA gene were detected in two PZA-susceptible strains.Additionally,11 PZA-resistant strains and 2 PZA-susceptible ones showed putative regulatory mutations in the upsteam of pncA gene.Condusions The mutation of the pncA gene can cause the PZA resistance.However.there ale other drug resistance mechanism except this mutation.