The attributes of hospital is one of important factors which affect the health service polices and medical practice.the current situation of doctor-patient relationship and frequent doctor-patient dispute was deviate from these attributes.The hospital attributes must return to its nature so as to lessen the contradiction of doctor-patient relationship and decrease the dispute,and use these theories as base to make scientific and rational health polices,and promote the development of our health service.

The high medical education must follow up the "talent doctor" view.In other words,virtue,erudite,high skill and far-reaching aspiration should be embodied in the training of talents.

Objective To investigate the clinical characteristics and prognosis of patients with different molecular subtypes of breast cancer.Methods A cohort of 716 breast cancer patients which had clear immunohistochemical detection were investiged.Their molecular subtypes were categorized as Luminal A,Luminal B,HER-2 over-expressing and basal-like subtypes,based on detection of ER,PR,HER-2 expression,and the clinical data including characteristics,relapse,prognosis and prognostic factors of the patients with different subtypes of breast cancer were analyzed retrospectively.Results There were no significant differences among different molecular subtypes at the age,menopausal status,production times,clinical stage,and radiation therapy(P ＞0.05).There were significant differences among different molecular subtypes at axillary lymph node starus (x2 =17.208,P =0.001),turner size (x2 =20.528,P =0.000) and operation method (x2 =24.242,P =0.000) and chemotherapy regimens (x2 =10.711,P =0.013).Univariate and multivariate analyses showed that clinical stage (x2 =17.005,P =0.002),axillary lymph node status (x2 =11.267,P =0.000) and molecular typing(x2 =125.634,P =0.000) were independent prognostic factors affecting long-term survisal rate.Conclusion Breast cancer patients in different subtypes have different long-term survival rate.The patients in basal-like subtype have the worst long-term survival rate.Molecular subtypes may provide important information to predict the prognosis of breast cancer.

Objective To investigate the relation among the results of thyroid fine needle aspiration cytology(FNAC),thyroid ultrasonography(US)and histopathologic diagnosis about the thyroid nodules detected by physical examination,meanwhile to analyze the etiopathogenesis of the nodtries and to evaluate the risk of thyroid cancer and the clinical diagnostic value of FNAC.Methods The data of thyroid FNAC results of the thyrroid nodules detected by physical examination in 271 cases were analyzed and compared with thyroid US and histopathologie diagnosis.Resuit (1)The FNAC results showed that the incidences of malignant and suspected mali-gnant lesions were 1.48%and 5.90%respectively.The rate of benign lesions was 78.60%and that of goiter was 29.15%,Hashimoto's thyroiditis 26.57%and thyroid adenoma 15.13%.Benign lesions were more common than malignant ones.(2)Comparison of the FNAC and US results of the thyroid nodules showed that of 96 cases with single nodule the rates of malignancy and suspected malignancy were 3.12%and 7.29%,but of 137 cases with multiple nodules the rates of the two lesions were 0.73%and 6.57%.In 108 cases with smaller nodules(≤1.5 cm)the rate of malignancy and suspected malignaney found with FNAC were 0.93%and 7.41%,while in 125 cases with greater nodules (＞1.5 cm)the rate of the two lesions were 2.40%and 6.42%.In 99 solid nodules the rates of malignancy and suspected malignancy were 2.02%and 12.12%,while in 85 cystic or mixed nodules the rates of the two lesions were 2.35%and 2.35%.In the above-mentioned three groups,only the suspected malignaney rate in solid nodules was higher than these in cystic or mixed ones with significant difference (P=0.013).(3)As compared with the cytological and histological diagnoses in 24 cases,the diagnostic accuracy of FNAC was 75.00%and the rates of false positive and false negative were 25.00%and 0,respectively.Conclusions The common causes of the thyroid nodules detected in physieal examination are goiter,Hashimoto's thyroiditis and thyroid adenoma.FNAC is a reliable method to define the benign or malignant nature of thyroid nodules with a high diagnostic accuracy.US features of the nodule alone,no matter it is single,solid or of greater size do not sufficiently increase the incidence of thyroid carcinoma.

Objective:To investigate efficacy of modified expander in the treatment of non-extraction patients with Angel Ⅰ maloccul-sion.Methods:1 4 Angel Ⅰcases aged 1 0 -1 4 years treated by non-extraction and fixed rapid expander.Jaw bones of the cases were laser scanned before(T1 )and after treatment(T2).The differences of arch width and length between T1 and T2 were analyzed.The In-dex of treatment complexity,outcome and need(ICON)was used to assess the pre-treatment and post-treatment study models.Data were statistically analysed with SPSS1 3.0 software.Results:The arch width increased significantly from T1 to T2.Good occlusal rela-tionship and soft tissue profiles were achieved in all cases.All cases were evaluated as greatly improved by ICON.Conclusion:AngelⅠ malocclusion can be treated successfully by increasing arch width with fixed rapid expander technique without tooth extraction.

Among several intraoral distalizing devices,the pendulum appliance is one of the most commonly used noncompliance appli-ances.It is widely used to correct Class Ⅱ molar relationship.More healthy teeth can be preserved with the using of pendulum appliance in the tooth extraction of borderline cases.The pendulum appliance was modified and used in clinic.Long-term observasion showed that the modified pendulum appliace is effective in orthodontic treatment.

OBJECTIVE: To observe the effects of Jianpi Yishen Recipe (JPYSR), a compound Chinese herbal medicine, on recurrence, metastasis and life span of mice transplanted with proventriculus squamous carcinoma cells after tumorectomy. METHODS: JPYSR was orally administered to 615 mice transplanted with proventriculus squamous carcinoma cells in the palma of left hind limb after tumorectomy. The local tumor recurrence, lung metastasis and life span of the mice were evaluated and compared with those of the 5-FU-treated mice and untreated mice. RESULTS: The pulmonary metastasis rate was 94.4% and the recurrence rate was 94.44% in untreated group. The pulmonary metastasis rate was 68.4%, the inhibition rate of pulmonary metastasis was 27.5%, the recurrence rate was 78.95%, and the inhibition rate of tumor recurrence was 65.35% in JPYSR-treated group. The average and median life spans were obviously prolonged in JPYSR-treated group, as compared with those in untreated group. The life-prolonging rate was 100%. CONCLUSION: JPYSR can effectively inhibit the local recurrence and pulmonary metastasis of the transplanted proventriculus squamous carcinoma in mice after tumorectomy, and prolong the life span.

An old male patient visited the hospital due to shortness of breath and palpitation for 6 h, with fever 3 days before and pump failure at admission. Having no risk factor of coronary diseases such as hypertension, diabetes mellitus and obesity, with ST-T changes and abnormal Q wave on ECC, the signs were compatible with those of acute anterior wall myocardial infarction, while the characteristics of cardiac biomarkers ( significant increase in Troponin I and creatine kinase's isoform, and normal creatine kinase) were not in accordance with those of acute myocardial infarction. Emergency angiography was performed, which indicated normal coronary artery, normal pulmonary artery and global systolic dysfunction of left ventricle. The diagnosis of acute severe myocarditis was established, and intra-aortic balloon pump (IABP) was employed to provide hemodynamic support. Severe myocarditis mimicking acute myocardial infarction may be fatal, and can be easily misdiagnosed. Careful analysis of clinical manifestations, early diagnostic angiography and possible IABP placement are important for the successful treatment.

Objective To understand the incidence of subclinical thyroid dysfunction in adult population of Beijing.Methods Serum levels of thyroid-stimulating hormone(TSH),T3,T4 and thyroid peroxidase antibody(TPOAb)were measured for 1966 persons living in Beijing by physical examinations in 2002,and 1646 of them(83.72%)were followed-up in 2004.Results Overall incidence of subclinical hypothyroidism and subclinical hyperthyroidism were 1.72 percent and 0.25 percent,respectively.Incidence of subclinical hypothyroidism in females aged ＞40 years was significantly higher than that in those ≤40 years(χ2=10.869,P＜0.01),but no significant difference between those ＞40 and ≤40 years in males was found.Incidence of subclinical hypothyroidism in females was significantly higher than that in males ＞40 years of age(χ2=24.122,P＜0.01),but no significant difference between females and males ≤40 years was found.No significant difference in incidence of subclinical hypothyroidism was noticed between varied age groups and between males and females.Incidence of subclinical hypothyroidism was significantly higher in those with history of subclinical hypothyroidism than that in those without it(χ2= 6.898,P＜0.01).No significant difference in incidence of subclinical hypothyroidism between those with family history of thyroid disease and those without it was found.Incidence of subclinical hypothyroidism was significantly higher in those with positive TPOAb than that in those with negative one(χ2=14.084,P＜0.01),but no significant difference in incidence of subclinical hyperthyroidism between those with positive and negative TPOAb was found.Conclusion Incidence of subclinical hypothyroidism was a little bit higher in population of Beijing area by physical examinations,particularly in females,elder age and positive TPOAb.

Organic chemistry is an important foundation course for medicine, chemistry and other majors in universities and colleges. In this study, combined with the characteristics of pharmacy students in local colleges and universities, teachers introduced case teaching, enhanced curriculum connotation, and explored the integration of green chemistry concepts into the teaching process of organic chemistry, so as to cultivate pharmaceutical professionals with environmental protection concept and safety awareness. The practice shows that this teaching model not only improves students' attention to organic chemistry and learning efficiency, but also improves students' comprehensive quality.