The patient doctor relationship,as the essential part of medical relationship, is inevitably influenced by the medical views and develops with the evolvement of medical modes. Understanding the inner logical relationships between the medical mode and the patient-doctor relationship can facilitate the further research on the patient-doctor relationship. Currently, we should choose the mode of the patient-doctor relationship on the basis of respecting patient, emphasizing the obligation, motivating the activity of patients, and constructing an honesty-trust relationship between patient and doctor, which will make it easy to understand the ethical request of the constructing of patient-doctor relationship and make the definition of the patient doctor relationship clearer.

Objective To study the determining method of trace amounts of Pb?Cd in nature water body. Methods Pb, Cd in nature water body were concentrated by on-line chelate resin, and concentration was determined by concentration-AAS. Results The Pb and Cd detection limit of the present method were 0.500,0.02 ?g/L respectively, RSD were 2.3%,1.7% respectively and the rates of recovery were 94%-104.4%. Conclusion Using on-line chelate resin concentration technic and atom absorption,the sensitivity will increase two order of magnitudes compared to concentration FAAS,the precision will be better than that of GAAS. The present method can be used for quick determination of trace Pb?Cd in nature water body.

Objective:To observe the recent effects and toxicity of thermochemotherapy on malignant hydrothorax or hydroperitoneum,to evaluate the changes of the immunological functions,and to investigate the mechanism of thermochemotherapy.Methods:Fifty-two patients were treated with weekly intracavitary chemotherapy,and then combined with local endogenetic thermotherapy twice a week.As the control,another 50 patients received weekly intracavitary chemotherapy.The treatment lasted for two weeks and was followed by one-week rest,and then the recent effects and toxicity were observed.The T cell subset,NK cells and VEGF levels in serum,hydrothorax or hydroperitoneum were tested.Results:Overall response rates of the malignant hydrothorax were 86.9% vs 60.0%(P

Objective:Position emission tomography/computed tomography(PET/CT) is a new bio-imaging system which is combined metabolic with anatomic imaging.This study was to compare the accuracy of conventional staging methods(including computed tomography,ultrasound,magnetic resonance imaging,and detection of bone marrow) with that of PET/CT for lymphoma staging and re-staging. Methods:A total of 42 patients with lymphoma diagnosed by operation or biopsy,received conventional and PET/CT staging.The accuracy of these two methods and their impact on lymphoma staging were compared.Results:The accuracy of PET/CT scan was 95.2%(40/42),and that of conventional staging was 78.6%(33/42).The detection rates of internal lymph node were 97.1%(66/68) and 88.2%(60/68),respectively.The detection rates of outer lymph node were 91.7%(22/24) and 58.3%(14/24),respectively.Compared with conventional staging methods,7 cases were up-staged and 2 cases were down-staged by PET/CT,which led to the change of therapy in 8 cases.Conclusion:PET/CT scan is more sensitive and accurate than conventional staging methods in staging and restaging of lymphoma.

Objective To investigate the interference of thyroglobulin antibodies ( TgAb ) on the measurement of thyroglobulin ( Tg) by 2 chemiluminescence immunoassays ( CLIAs) .Methods Data of 199 315 individuals with determined TgAb and Tg , including physical checkup subjects , differentiated thyroid carcinoma ( DTC) patients and patients with other diseases , were retrospectively collected in Peking Union Medical College Hospital from November 2012 to April 2015.The correlation between serum Tg level and serum TgAb concentration was analyzed and the positive rate of TgAb in physical checkup subjects was calculated.Furthermore, 290 serum samples with different TgAb concentration were applied in the recovery test by adding in confirmed serum Tg .The correlation between the recovery of confirmed serum Tg and TgAb concentrations was evaluated using Pearson correlation analysis .Results The serum Tg was all decreased with the elevated TgAb concentration in each group of subjects .The positive rate of TgAb was 10.84%(8 416/77 634) in physical checkup subjects .It was higher in females than in males and was increased with age.Recovery test showed that the average recoveries of confirmed serum Tg in TgAb-negative serum were 107.28%(86.30%-117.60%) and 107.94% (85.60%-124.10%) respectively in Roche and Beckman systems.But in TgAb-positive serum samples , the average recoveries in Roche and Beckman systems were 88.59% (35.85% -141.53%) and 95.77% (36.48% -131.78%) respectively, and 12.63%(24/190) and 13.68%(26/190) samples displayed a recovery less than 80%.The recovery rate of confirmed serum Tg showed a significantly negative correlation with elevated TgAb concentration , with r=-0.239 (P=0.001) in Roche and r=-0.251 (P<0.001) in Beckman.Conclusions TgAb-positive serum, especially with high concentration of TgAb , significantly interfered the measurement of Tg .Thus, serum TgAb should be determined together with serum Tg to explore whether there was an interference .To avoid misdiagnosis and inappropriate therapy , clinician should be informed once serum TgAb displayed positive.

Background: Thyroid diseases are highly prevalent worldwide, but their diagnosis remains a challenge. We established reference intervals (RIs) for thyroid-associated hormones and evaluated the prevalence of thyroid diseases in China. Methods: After excluding outliers based on the results of ultrasound screening, thyroid antibody tests, and the Tukey method, the medical records of 20,303 euthyroid adults, who visited the Department of Health Care at Peking Union Medical College Hospital from January 2014 to December 2018, were analyzed. Thyroid-associated hormones were measured by the Siemens Advia Centaur XP analyzer. The RIs for thyroid-associated hormones were calculated according to the CLSI C28-A3 guidelines, and were compared with the RIs provided by Siemens. The prevalence of thyroid diseases over the five years was evaluated and compared using the chi-square test. Results: The RIs for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were 0.71–4.92 mIU/L, 12.2–20.1 pmol/L, 3.9–6.0 pmol/L, 65.6–135.1 nmol/L, and 1.2–2.2 nmol/L, respectively. The RIs of all hormones except TT4 differed significantly between males and females. The RIs of TSH increased with increasing age. The prevalence of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was 0.5% and 0.8%, 0.2% and 0.6%, 3.8% and 6.1%, and 3.3% and 4.7% in males and females, respectively, which differed from those provided by Siemens. Conclusions Sex-specific RIs were established for thyroid-associated hormones, and the prevalence of thyroid diseases was determined in the Chinese population.