In this paper,Western developed countries'education of humanities sciences including school-running model,cultivating objects,curriculum,teaching methods,etc. has been discussed and the status quo of marginalization of medical humanities education in China has been analyzed. Based on the discussion and analysis,the proposals for the reform of medical education in humanities sciences in China are given with the modern teaching theories and methods as the reference.

BACKGROUND: Anterior subtotal vertebrectomy and fusion using titanium mesh cage (TMC) is an effective surgical treatment for cervical spondylosis, while TMC subsidence usually occurs. The risk factors for TMC subsidence and its effect on the treatment outcomes remain controversial. OBJECTIVE: To investigate the TMC subsidence after anterior subtotal vertebrectomy and TMC fusion and its effect on the treatment outcomes, thereby understanding the underlying mechanism and related risk factors. METHODS: Clinical data of 34 patients undergoing anterior subtotal vertebrectomy and TMC fusion in the Second Department of Spine, Shanghai Changzheng Hospital Affiliated to the Second Military Medical University from March to September 2015 were analyzed retrospectively. After 12-month follow-up, the height of the fused segments was measured, and the neurologic outcomes were evaluated using the Japanese Orthopedic Association scores. The loss of the fused segments subsided more than 3 mm compared with that at 1 day postoperatively was considered as TMC subsidence, and all patients were allotted to TMC subsidence and control (without TMC subsidence) groups.RESULTS AND CONCLUSION: (1) Totally 19 patients (56%) experienced TMC subsidence that occurred in postoperative (6.00±3.73) months averagely. (2) No significant differences were found in the age, sex or the level of fused segments between two groups (P=0.731, 0.672, 0.053). (3) The Japanese Orthopedic Association recovery ratio in the control group was significantly higher than that in the TMC subsidence group (P=0.01), suggesting that TMC subsidence might be correlated with the poor improvement of neurologic function after surgery. (4) To conclude, TMC subsidence is a common complication after anterior subtotal vertebrectomy, which does harm to the treatment outcomes.Moreover, age, sex or the level of fused segments are not independent risk factors for TMC subsidence.

Objective To observe the dynamic levels of IL-2,IL-5 and IL-6 produced by Balb/ c mice infected with DEN_2 clinical strains and to study their relation.Methods The Balb/c mouse in- feetion model was established by multiple-site subcutaneous injection with various doses of DEN_2 clini- cal strain.Mouse plasma samples collected from different experiment groups at various time after in fection were tested for IL-2,IL-5 and IL-6 levels with sandwich ELISA.Results After primary in- feeted with DEN_2 B strain,the levels of IL-2,IL-5 and IL-6 of all experimental groups were not sig- nificantly higher than the normal control group while the levels of experimental groups increased sig- nificantly after re-infection.The level of IL-2 reached to peak[average value of(101 522.44?10 465.375)pg/ml]at the 4th day after re-infection(the 20th day after the primary infection),and then the level gradually reduced.The levels of IL-5 in the Balb/c mice of the group 1 and 2 reached to peak at the 1st day after re infection(the 16th day after the primary infection),and there was signifi- cant difference between these two groups and the control group(P＜0.05).The levels of IL-6 in all experimental groups reached to peak at the 1st and the 2nd day after re-infection.The peak value of the third group is the highest comparing with the normal control group(P＜0.05).Conclusion Th2 response was predominant in the second infection phase.

Objective To form a concise and useful warning scale of suicide ideation of inpatients with somatic disease.Methods 2 677 inpatients who were more than 15 years old were randomly selected in a comprehensive hospital during the period of 2010.11-2013.02.Self-rating Depression Scale (SDS),Self-rating Anxiety Scale(SAS) and self-designed questionnaires which included general information,suicide risk factors and somatic disease were applied.Chi square test,partial correlation analysis,t test,correlation analysis and ROC curve analysis were used for statistical analysis.Results 1.The warning scale of suicide ideation which contained 18 items was formed.2.The Cronbach's Alpha reliability of the warning scale was 0.84 and its split-half reliability was 0.60.Criterion-related validity studies showed that the scores of the 18 items were positive correlated with SDS and SAS(r SDS =0.50,r SAS =0.54,P＜0.01).This scale also had good structure validity.3.The ROC curve concluded that the area under curve was 0.83,the sensitivity was 68.40％ and the specificity was 79.20％.Positive and negative predictive values were 21.22％ and 96.83％ respectively.Conclusion The reliability and validity of the warning scale entirely accorded with psychometric demands.It also has good specificity and negative predictive value,so it is suitable for clinical promotion.

Objective To analyze the use of antibiotics in perioperative period of cesarean section,and to summarize the experience of scientific intervention to promote rational drug use.Method 192 cesarean section included in the study were inpatients in December 2015 to December 2016 in our hospital,were grouped according to the order of admission,divided into control group(95 cases)and observation group(97 cases),were given routine perioperative antibiotic treatment.The observation group was treated with scientific medication intervention,and the control group was not intervened.The two groups of white blood cell count,postoperative body temperature and hospitalization time were counted,the infection types and infection rate were counted,and the treatment costs of the two groups were counted.Results The white blood cell count of the observation group was significantly higher than the control group,postoperative body temperature recovery time and hospitalization time was significantly shorter than the control group,the difference was significant(P<0.05); after two groups appeared infection phenomenon,including urinary tract infection,incision infection and puerperal infection as well as intrauterine infection,and two groups in different types of infection and the infection rate by comparison there was no statistically significant difference; statistical analysis and comparison of treatment related costs of the two groups of patients,to observe antibacterial drug group,the total cost of expenses and hospitalization costs were significantly lower than that of the control group,and patients with antimicrobial drugs accounted for the total proportion of drugs were significantly lower than the control group,the difference was statistically significant(P<0.05).Conclusion Cesarean section perioperative use of antibiotics in the process,through the implementation of scientific intervention can obtain ideal effect,promote rational and normative clinical medication,reduce hospitalization expenses and antimicrobial drug costs,promote the recovery of patients after surgery,and does not increase the infection after operation.

OBJECTIVE:A method was established for determining the content of estriol in estriol suppositories.METHO_ DS:Using three wavelength spectrophotometry.RESULTS:The detecting wavelengths were296nm,281nm and276nm;the average recovery rate of estriol was99.2%(RSD=0.5,n=6).CONCLUSION:The method is accurate,quick and suitable for detecting estriol in intermediate material of estriol suppositories.

Objective To study the characteristics of respiratory impedance in patients with chronic obstructive pulmonary disease (COPD),obstructive sleep apnea hypopnea syndrome (OSAHS).Methods The respiratory impedance were measured by Impulse Oscillometry(IOS) technique and polysomnography(PSG) were done synchronously in 11 COPD patients,15 OSAHS patients,4 overlap syndrome patients(COPD+OSAHS) and 10 control group. Results Zrs、R5、Rc and RP in COPD group,OSAHS group and COPD+OSAHS group were higer than those in contml group.Zrs、R5、R5-20、Fres.Rc and Rp in COPD group and COPD+OSAHS group were significantly higerthan those in OSAHS group.R20 and Rc in OSAHS group were higher than those in COPD group and control group (P<0.05).Rc in OSAHS group was still significantly higher than that in COPD group (P<0.05). The level of sleep efficiency was positive correlated with FEVl/pre% of COPD(r=0.632),while the levels of rouse frequence (r=-0.672),time of SaO2 <90% (-0.868) and ODI (-0.846) were negative correlated with FEVl/pre% of COPD.Condusion For OSAHS patients, there is some dysfunction in peripheral airway tract;For COPD patients,ODI and time of SaO2<90% are good index for the severity of disease.

Over-expression of APP and Swedish mutation could cause some familial early onset AD. In this study, a primary screening was conducted of effective small interference RNAs (siRNAs) targeted wild type APP (APPwt) and Swedish mutant APP (APPswe). One siRNA targeting APPwt and the other siRNA targeting APPswe were designed. All these siRNAs were endogenously expressed by siRNAs expressing plasmids. COS-7 cells were transiently co-transfected with APP-GFP recombinant plasmids and siRNA expression vector. The silencing effect of each siRNA was quantitatively assessed by the level of expression of green fluorescent protein (GFP). It was found that the siRNAs silenced APPwt and APPswe to different degrees. siRNA directed against APPswe was more effective in suppressing the expression of fusion gene of APPswe than that of APPwt. The silencing effect of siRNA directed against APPswe indicating allele-specific silencing property of the siRNAs. Therefore, siRNAs directed against APP play an important role both in the therapeutic study of Alzheimer disease and functional exploration ofAPP gene.

ObjectiveTo evaluate left ventricular (LV) function and dyssynchrony in patients with dilated cardiomyopathy (DCM) and complete left bundle branch block (CLBBB) by three-dimensional speckle tracking imaging(3D STI).Methods3D STI was performed and analyzed using TomTec 4-D LV analysis 3.0 software in 37 DCM patients with CLBBB and 25 healthy volunteers.The global 3D,longitudinal,circumferential,radial strains were measured.LV dyssynchrony was evaluated by the standard deviation of time to peak from 3D strain of 16 segments related to the heart cycle(3D-SDI).ResultsIn control group,uniformity in the average value of 3D strain was observed between apical,mid-ventricular and basal levels (P ＞ 0.05).Global 3D,longitudinal,radial and circumferential strains had excellent correlations with LV ejection fraction ( r =- 0.92,- 0.84,- 0.78 and 0.81,respectively,P ＜0.01).Compared with control group,global 3D,longitudinal,radial and circumferential strains were significantly lower in DCM patients ( P ＜0.01 for all).3D-SDI in DCM patients with CLBBB was significantly longer than that of volunteers ( P ＜0.01).3D-SDI increased with worsening LV systolic function regardless of QRS duration (P ＜0.05).ConclusionsWhen image quality is optimal,3D STI represents a promising novel technique for assessment of global LV function and dyssynchrony.

Aim To investigate the effects of endogenous and exogenous hydrogen sulfide(H_2S)on the proliferation and apoptosis of human fetal lung fibroblasts.Methods Human fetal lung fibroblasts were cultured under 2% O2～93% N_2～5% CO_2 for 24 h to produce hypoxia.Cells were divided into 6 groups:(1)Hypoxia group(N_2);(2)N_2+600 μmol·L~(-1) NaHS group;(3)N_2+1 200 μmol·L~(-1) NaHS group;(4)N_2+6 400 μmol·L~(-1) NaHS group;(5)N_2+400 μmol·L~(-1) cysteine(Cys)group;(6)N_2+200 μmol·L~(-1) S-adenosyl-L-methionine(SAM)group.After they were cultured for 24 h, MTT assay was used to evaluate the cell proliferation, and flow cytometry was used to detect cell apoptosis.Results Compared with N_2 group, 600 and 1 200 μmol·L ~(-1) NaHS(H_2S donor)significantly reduced proliferation induced by hypoxia of human fetal lung fibroblasts(P <0.01)without effects on apoptotic rates of cells(P >0.05)and 6 400 μmol·L~(-1) NaHS increased apoptosis of human fetal lung fibroblasts during hypoxia significantly(P <0.05), although no effects were found on proliferation of cells(P >0.05).In addition, Cys, substrate of cystathionine β-synthetase(H2S synthase, CBS) or SAM(activator of CBS)did not affect proliferation of human fetal lung fibroblasts induced by hypoxia(P >0.05), whereas apoptotic rates were increased significantly compared with that of N_2 group(P <0.05).Conclusions Endogenous and exogenous hydrogen sulfide can inhibit proliferation induced by hypoxia and promote apoptosis of human fetal lung fibroblasts, suggesting endogenous hydrogen sulfide may play a protective role through lung fibroblasts by inhibiting the pulmonary vascular structural remodeling caused by hypoxia.