Objective: To explore the dual relationships and associated factors among Chinese counselors and psychotherapists.Methods: 1000 participants were investigated by a self-made questionnaire composed of ethical problems in psychotherapy and counseling.Results: The main dual relationships between counselors/psychotherapists and clients were the association of friends.Thirty-two percent of participants provided counseling or psychotherapy to their friends.To the item of "providing counseling or psychotherapy for their friends,students,supervisee,employees",the judges of ethical beliefs of participants were inconsistent,and forty-one percent of them thought that such behaviors were ethical.These items were the main associated factors,such as gender,the duration time of professional experience,the title of a technical post,the different experience of training,prescription,and medicine.Conclusion: The present state of nonsexual dual relationships between counselors/psychotherapists and clients are not rare,and the ethical beliefs of some participants in dual relationships were blurring.It is necessary to intensify the professional education,unify the ethical code,and accept the help of psychotherapy and supervision,in order to improve the current states of Chinese counselors and psychotherapists.

Objective To study the distribution characteristics of intraperitoneal free gas and the location value of the site of gastrointestinal perforation using multi-slice CT (MSCT).Methods 60 cases of gastrointestinal perforation were retrospectively collected.The distribution of the intraperitoneal free gas in CT image was analyzed and observed.The digestive tract were divided to the upper digestive tract and the lower digestive tract by Treitz ligament.The distribution of the intraperitoneal free gas was analyzed using χ2 test.The distribution of the intraperitoneal free gas between each different perforational site was analyzed.Results 38 cases of the site of gastrointestinal perforation located in upper gastrointestinal tract and 22 cases located in lower gastrointestinal tract,there was statistically significant difference between the upper digestive tract and the lower digestive tract about the distribution of the intraperitoneal free gas(χ2=22.33,P<0.001).In the cases of upper gastrointestinal tract perforation,13 cases of the site located in stomach and 25 cases located in doudenum,there was no statistically significant difference between stomach and duodenum(χ2=1.97,P>0.05).In the cases of lower gastrointestinal tract perforation,11 cases of the site located in bowel and 11 cases located in colon,there was statistically significant difference between bowel and colon(χ2=8.98,P<0.05).Conclusion The MSCT distribution of the intraperitoneal free gas has important value in localization diagnosis of gastrointestinal perforation.

Objective: To summarize surgery experience and efficiency of laparoscopic excision of choledochal cyst and reconstruction of biliary tract and to analyze the treatments administered during intra and post-operation of the biliary reconstruction. Methods: We enrolled 48 cases of video-guided laparoscopic intraoperative cholangiography, cholecystectomy, choledochocele resection, Roux-en-Y hepaticojejunostomy with an anti-reflux valve from August, 2001 to October, 2003.Their operative procedures and aims were retrospectively analyzed. Results: Forty-four out of 48 patients successfully underwent laparoscopy and recovered soon. Only 4 cases were transformed to open operation. The post-operation complications were found in 4 cases. Conclusion: Video-guided laparoscopic excision of choledochal cyst, biliary tract reconstruction and Roux-en-Y hepaticojejunostomy are an effective method of treatment with advantages of minimal injury, less bleeding, and sooner recovery.

Objective:To explore the clients' assessment for the ethical behavior of the counselors and psychotherapists.Methods:The main method used in this evaluation was questionnaire,and the self-made questionnaire of the ethical problems in psychotherapy and counseling(for the clients)were used as evaluation tools.Totally 1100 clients,from 12 cities in China,were investigated with 807 questionnaires returned.Results:84.5% of the clients were confident in the treatments,and 89.2% of them gave positive assessment for the ability of their counselors and psychotherapists.15.9% of clients said the counselors and psychotherapists showed impatience or talked to them about their stress sometimes.Besides,59.1% knew about the characters,names and charge of the psychotherapies and counseling,and 53.4% knew the background of the counselors and psychotherapists.91.3% of clients thought the privacy and treatment could be kept secret.7% of clients had intimate relationship with their counselors or psychotherapists,1.5% had sexual relations,and 18.3% made friends in lives.79% of clients could receive timely psychotherapies and counseling.Conclusion:From the assessment of the clients,the vast majorities of the counselors and psychotherapists do well in work ability,confidentiality and time-setting,but not so well in informed-consent and dual relations,which need to be paid attention to and improved.

Objective To assess the epidemiological characteristics of hypertension and its attributing factors in Heilongjiang province and establish a comprehensive basis for the prevention and control of hypertension in this region. Methods Using the stratified chunk method, a survey lasting 50 years was conducted on a sample of 299 677 (including i 58 782 males and 140 895 females) patients, aged 15 and above, residing in both rural and urban areas of Heilongjiang province from 1958 to 2007. Both blood pressure measurement and analysis on attributing factors of hypertension were carried out in 1958, 1979, 1991, 1999 and 2007. Results The prevalence of hypertension was significantly higher in Heilongjiang than in other provinces. It elevated annually, reaching a 3-fold increase in 50 years with an accelerating pace ( 17.06% to 25. 69% ) in the recent 8 years. Among the people examined, the prevalence of hypertension increased with aging. Furthermore, the prevalence of hypertension varied among different professions. Office workers had the highest prevalence (41.67%). Compared with female population, male participants had a much higher prevalence before the age of 55 (P < 0.0001 ). Body mass index, gender, hypertriglyceridemia, age, low-high density lipoprotein cholesterol and family history were identified as major risk factors for the development of hypertension in Heilongjiang province. However, the awareness (48. 90% ), treatment (25.33%) and control (4. 32% ) rates of hypertension in this region were relatively low. Conclusion The results of the present study identified Heilongjiang province as a high-risk region for hypertension. It also suggests the necessity to plan and implement actions for the effective prevention and treatment of hypertension in this region.

Objective To assess epidemiological characteristics of metabolic syndrome(MS)and its attributing factors in a resident sample aged over 35 living in both rural and urban areas of Harbin in Heilongjiang province.Methods A cross-over sectional and cluster sampling was carried out in 5 984 residents aged over 35 years living in the rural and urban areas of Harbin.Height,body mass,waist circumference,blood pressure,fasting blood glucose,triglyeeride,and high density lipoprotein cholesterol were determined.In this survey,the prevalence of MS and its attributing factors were analyzed by logistic regression model according to the diagnostic criteria of international diabetes federation in 2005.Results The prevalence of MS in this sample was 24.60%(male 22.49%,female 26.29%),and the standardized prevalence rate was 23.31%(male 22.12%,female 25.19%).Compared to female population,male participants showed a much lower prevalence;and compared to urban area population,rural participants showed a much lower prevalence(26.70% vs 20.05%,P<0.05).The prevalence of MS rose progressively with age in females.The individuals with MS presented increased body mass index,hyperglycemia,and hypertriglyceridemia.Gender,age,employment,education,smoking or drinking habit,and family history of hypertension were identified as maior risk factors of MS.Conclusion The prevalence of MS in a sample of residents aged over 35 in Harbin Was 24.60%.It becomes an public health problem requiring urgent attention for prevention and treatment.

Objective To study the diagnosis and treatment of Currarino triad Methods A retrospective study was made on clinical features, diagnosis; treatment and prognosis of 7 cases with Currarino triad Results In 6 patients definite diagnosis was made only intraoperatively including reoperation in 3 cases All the 7 cases were cured Postoperative urinary retention and infection developed in one each Conclusion Correct preoperative diagnosis of Currarino triad has great influence on the treatment Total excision of presacral mass should be emphasized

Objective To explore the application and effect of case-based learning(CBL)in vas-cular surgery clinical teaching. Methods Totally 37 resident doctors were randomly divided into 2 groups respectively: CBL teaching group (n=21)and traditional teaching group (n=16). CBL teaching was con-ducted through the following procedures:selecting typical cases-establishing and applying typical case library-autonomous learning-holding regular seminars. Traditional teaching was conducted through the following procedures: basic theory studying-participating in clinical practice-participating in case discus-sion. Evaluation was conducted based on test socre (written test and clinical operational skill test)and res-idents' feedback of teaching effect. Data were statistically described and independent sample t test was performed. Results Theoretical exam score and clinical skill test score were high in CBL group than in traditional group ((thoretical score:(85.53 ±1.75) vs. (79.94 ±2.29);clinical skill test score:(85.10±1.64)vs.(80.31±1.82)). CBL teaching group had advantages in improving learning efficiency, cultivat-ing clinical thinking,promoting mastery and application of knowledge,broadening knowledge, promoting communication and expression ability and improving study enthusiasm ,et al . Conclusion CBL teaching can effectively improve the teaching quality and obtain higher evaluation. Typical case li-brary should be constantly improved and education of vascular surgical basic theory should be strength-ened to promote CBL.

A facial allotransplanted patient presented hyperglycemia with blood glucose ranged 14. 3 -33. 3 mmol/L after receiving immunosuppressive drugs and glucocorticoids. To control the blood glucose level, the patient was treated with two subcutaneous doses of 10 U human neutral protamine hagedorn (NPH) insulin, and the fasting glucose level came down to 3. 6 - 9. 4 mmol/L. Then the continuous subcutaneous infusion of insulin aspart ( Novo Industri) was administrated (from 96 to 21 U/d) , and the fasting blood glucose levels were 3. 9 -4. 6 mmol/L. With oral administration of Metformin and Repaglinide, the fasting blood glucose was maintained to 4. 3 -5.9 mmol/L. With these medications, the blood glucose level of the patient was under good control and the acute and chronic complications of hyperglycemia were effectively prevented.

OBJECTIVETo study the chemical changes of salvianolic acid B and lithospermic acid of Salvia miltiorrhiza under the conditions of high temperature and high pressure and explore the reaction mechanism.

METHODS. miltiorrhiza extracts, salvianolic acid B and lithospermic acid were put in the reactor under the conditions of high temperature and high pressure (120 degrees C, 0.2 MPa), and the chemical changes and stability was studied.

RESULTSalvianolic acid A was the primary product in salvianolic acid B and lithospermic acid's conversion process, and lithospermic acid was an intermediate in the conversion process of salvianolic acid B. Compared with salvianolic acid B, lithospermic acid could convert into more salvianolic acid A and fewer other products in the same conditions. Salvianolic acid A was not stable under the conditions of high temperature and high pressure, and could sequentially convert into other small molecules.

CONCLUSIONReferring to the chemical conversion of salvianolic acid B and lithospermic acid, a method of large-scale preparation of salvianolic acid A can be developed.

Benzofurans ; analysis ; Caffeic Acids ; analysis ; Depsides ; analysis ; Hot Temperature ; Lactates ; analysis ; Pressure ; Salvia miltiorrhiza ; chemistry