Objective To explore the clinical value of colposcopy directed biopsy in diagnosis of vaginal intraepitheal neoplasia (VaIN).Methods The clinical data of 106 VaIN patients diagnosed by colposcopy directed biopsy were reviewed and analyzed retrospectively.In the past medical history of 106 patients,46 patients had cervical cancer history,43 patients had cervical intraepithehal neoplasia history,13 patients had previous hysterectomy because of benign disease and 4 patients had uncertain past medical history.Results Among 106 patients,97 patients(91.51％,97/106) had abnormal pap smears of vagina,9 patients (8.49％,9/106) had abnormal pap smears of cervix.Histological analysis revealed that 69 patients were VaIN Ⅰ,24 patients were VaIN Ⅱ,13 patients were VaIN Ⅲ.The high-risk human papilloma virus (HPV) test at diagnosis were positive in 98 patients (92.45％,98/106),negative in 8 patients (7.55％,8/106).Eighty-seven patients VaIN were localized in the upper one third of the vagina,19 patients VaIN were localized in other parts of vaginal wall.Ninety-eight patients VaIN affected to the multifocal vaginal wall,8 patients VaIN affected to the focal vaginal wall.Conclusions It has highly therapeutic value of colposcopy directed biopsy in diagnosis of VaIN.But should closely correlated to past medical history,colposcopy should performed on the whole vagina wall and multiple punch biopsy to elevated positive rate.

Objective To analyze the clinical characteristics and prognostic factors of endometrial carcinoma in senile women, explore the optimized therapeutic modality. Method The clinic pathological characteristics and survival outcome of 268 patients of endometrial carcinoma in senile women were reviewed retrospectively, and prognostic factors affected the survival of endometrial carcinoma were evaluated. Results According to univariate analysis, therapeutic modality, surgical-pathological classification and pathological grade were closely correlated with prognosis of endometrial carcinoma in senile women(P < 0.01 ). According to COX multivariate analysis,surgical-pathological and pathological grade were independent prognostic associated-factor (P = 0.002,0.000). Conclusions There are closely correlations between prognosis and surgical-pathological classification,therapeutic modality and pathological grade,surgical-pathological classification and pathological grade are independent prognostic associated-factor. The therapy on endometrial carcinoma in senile women should connect with high risk factors and adopt integrating and individual therapeutic modality.

尿路感染是脊髓损伤患者最常见的并发症。反复泌尿系感染所致的肾功能衰竭是后期脊髓损伤的主要死因。我院建院以来对156名脊髓损伤患者的尿路管理采用间歇性无菌导尿术21624人次，取得了较好的效果。为使这种方法能顺利实施，就需要对护理技术和患者进行有效的管理。

Objective:To understand the present situation of the grass-roots hospital patient satisfaction and influence factors after the implementation of new health care reform, and to put forward the rationalization proposals of improving degree of satisfaction. Methods:Conducted a questionnaire survey to 310 Grassroots hospital patients in Shandong province, and make data statistics and analysis. Results:After the implementation of new health care reform, satisfaction degree of medical services is relatively high in the mass, but there are also some problems. Through the investigation and analysis, the factors influencing patients satisfaction mainly include medical treatment cost, The doctor's technical level, the doctor's service attitude, diagnosis and treatment effect, The cost perform-ance of paying the medical costs and getting medical service price, The situation of meeting the work -up with medical equipment. Conclusion:From the perspective of new health care reform, the ascension of hospital patient satisfaction need to improve the level of basic hospital's medical technology, improve the medical service attitude, strengthen the management and control of medical expenses, and strengthen the government's financial investment.

Preeminent Doctors Education and Training Plan has put forward an urgent request to reform the five-year clinical undergraduate medical talent training mode and strengthen the professional spirit cultivation for medical students. As a pilot project, our college continuously explored the professional spirit cultivation mode for medical students in preeminent physician class and has almost established the three-dimensional mode of whole process, joint participation, multi approach and stressing practice.

Medical ethics courses play a main channel role in the cultivation of applicable medical profession-als, who have both virtue and professional competence. To adapt to clinical medical education comprehensive re-form on the need for educating and training outstanding doctor and strengthen medical students′professional ethics and ethical practice ability, we must further optimize the medical ethics teaching reform:optimizing medical ethics education philosophy that to enhance the students′ability of ethical practice as the goal;optimizing implementation of the interactive case teaching that to strengthen the students′ethical thinking and decision-making skills as the basis;optimizing the channels and methods of research that to strengthen the students′ability of scientific research ethics as the promotion;optimizing evaluation method of medical ethics that to strengthen the formative assessment methods as the sudden breaking.

Objective:To understand the present situation of the grassroots medical personnel satisfaction during the implementation of new health care reform , and compared with the survey of 2011 , to further analysis the main factors of affecting the job satisfaction .Methods:Conducted a questionnaire survey to 326 employees of basic medi-cal institutions of Weifang city , Dongying city and Yantai city in Shandong Province , and study with the method of qualitative analysis and quantitative analysis .Results:The number of satisfied with the current basic medical work only is 5.2%, and the overall satisfaction rate is 38.04%.The overall satisfaction to compensation rate is 31.3%. The overall satisfaction to the relationship between doctors and patients is 36 .19%.The overall satisfaction to the hospital management system and performance appraisal is respectively 44 .17%and 40 .79%.Conclusions:Com-pared with the investigation results in 2011 , the overall satisfaction of the grassroots medical personnel has im-proved, but the overall satisfaction is not high .It puts forward constructive countermeasures: strengthen grass -roots hospital ability and talent building;strengthen the policy stability;improve the grassroots personnel′s reasona-ble salary;improve the occupation environment;protect the doctors′interests.

Objective To explore the effect of individual rehabilitation nursing guidance on the initiative of rehabilitation therapy of spinalcord injury patients. Methods 50 spinal cord injured patients were divided into conventional group (group A) and individualized group(group B). Group A was given conventional rehabilitation nursing guidance. Group B was given special rehabilitation nursing guidance consideringthe patients' and their families' requirement. Initiative of rehabilitation therapy was assessed between group A and group B beforeand 2 months after intervention. Results Group A had no significant increasing of initiative assessment score (P<0.05) 2 months, while theinitiative assessment score of group B increased significantly (P<0.01), even group B was better than group A (P<0.05) after the intervention.Conclusion Individual rehabilitation nursing guidance may facilitate to improve the initiative of SCI patients.