The writer discussed the features of modern relationship between hospitals & patients and the main factor which cause the irreconcilable relationship,and also points out the way of setting up normal relationship between hospitals & patients,furthering the medical reform,normalizing the medical performances,improving the medical service quality,ceteing up and perfecting the related laws and cstrenghening the cultivation and education for medical stndent etc.

OBJECTIVE: To investigate the characteristics and general pattern of the adverse drug reactions (ADR) occurred in our hospital. METHODS: A total of 113 ADR cases reported by our hospital in 2008 were analyzed statistically in respect of patients’age and sex, route of administration, dosage form, category of drug, organs and systems involved in ADR and clinical manifestations, etc. RESULTS: The ADR were mainly induced by venous administration (59.29%). Anti-infective drugs dominated the first place on the list of ADR incidence rate (46.90%) followed by TCM preparations (23.01%). The most common manifestation of the ADR was lesion of skin and its appendants(37.17%). CONCLUSION: Great importance should be attached to ADR monitoring to reduce or avoid the occurrence of ADR.

Through investigation that the “new network media” has become the partner of youth groups firstly , then this paper discussed the new trend of medical students in new network era , including:paying attention to so-cial trends , thinking of something but without deep thinking;main body values is good , but diversity values show obvious;mental strength weakening presents a variety of forms .In the final analysis how the ideological education in the new era of network breakthrough:to strengthen the construction of campus network , to lead healthy campus culture;establish a network ideological education platform;perfect the network psychological consultation platform , to strengthen medical students′psychological health education; strengthen the student party members and cadres network call .

Neuroendocrine carcinoma of the pancreas is uncommon in clinic,which has a low malignancy,maintains indolent patterns of growth,and has a good long-term prognosis.However,because of its atypical clinical manifestation,its delayed presentation often results in distant metastasis,in which the liver is the most common site.Currently,the treatment of pancreatic neuroendocrine liver metastasis is limited and requires a diverse and multidisciplinary combination of therapy.This manuscript will discuss the current status of treating pancreatic neuroendocrine carcinoma liver metastasis.

Objective To explore the differences of resistin level between Mongol and Han population in patients with metabolic syndrome and to analyze its related factors.Methods According to the diagnostic criterion of metabolic syndrome,30 patients with metabolic syndrome in Mongol population (group 1) and 28 patients with metabolic syndrome in Han population(group 2) were randomly selected from health examination population.Radioimmunoassay kit was used to examine the serum resistin level in patients with metabolic syndrome.At the same time,their weight,height,blood pressure,blood glucose,blood lipid [high density lipoprotein (HDL),low density lipoprotein (LDL),total cholesterol (TC),glycerin three greases (TG)],blood uric acid (UA),leptin,insulin were measured,and body mass index(BMI) and insulin resistance index(HOMA-IR) were counted and compared.Results There were significant differences in systolic pressure,leptin,resistin,blood insulin and HOMA-IR between the two groups(all P ＜ 0.05).There were no significant differences in age,diastolic pressure,BMI,HDL,LDL,TG,TC,UA and blood glucose between the two groups(all P ＞0.05).The increase of resistin level in group 1 was associated with UA,systolic pressure and HOMA-IR(r =0.357,0.427,0.582,all P ＜ 0.05).Conclusion The serum resistin level of patients with metabolic syndrome in Mongol population is correlated with UA,systolic pressure and insulin resistance index,and maybe play an important role in the development of metabolic syndrome.

Objective To explore the clinical efficacy of early breast cancer patients underwent breast-conserving surgery with postoperative chemotherapy and radiotherapy.Methods A retrospective analysis of 128 early breast cancer patients underwent routine breast-conserving surgery was conducted.The clinical effect and cosmetic results were analyzed by the follow-up results of 128 cases.Results (1) The 5-year follow-up rate was 100％,overall survival rate was 95.3％,1-year survival rate was 100％ (128/128) ;3-year survival rate was 98.4％ (126/128) ;5-year survival rate was 95.30％ (122/128).Postoperative follow-up 6 patients died,3 patients died of liver metastases,2 patients died of lung metastases,1 patient died of non-cancerous reasons.The local recurrence rate was 2.34％ (3/128),axillary lymph node recurrence rate was 1.56％ (2/128).The average recurrence time was three years and two months after operation,distant metastasis rate was 3.91％ (5/128).(2) Beauty evaluations of 128 patients with breast-conserving surgery were excellent in 71 cases (55.5％),good in 55 cases (43.0％),and poor'in 2 cases (1.6％).Good,acceptable as acceptance criteria,the acceptance rate was 98％.Conclusion Breast-conserving surgery is not only to a certain extent to solve the pursuit of female beauty,but also improve their quality of life.But only the complete elimination of residual lesions in order to truly ensure that no recurrence of tumor.Therefore,the appropilate survival rate of patients for radiotherapy and chemotherapy can be extended so that the patient's breast to maintain a good shape.Breast-conserving surgery combined with radiotherapy and chemotherapy is superior to the modified radical surgery,and popularization in the hospital.

Objective To understand the effects of reform on clinical teaching taking patient's symptoms as the starting point and to investigate students' recognition degree towards this reform and their information feedback.Methods Totally 42 clinical students of the second clinical medical college (the second class) of China Three Gorges University were enrolled in the study and clinical teaching taking patient's symptoms as the starting point was conducted.Thirty-nine clinical students of the second clinical medical college (the fourth class) were enrolled as control group and traditional method was conducted.Effects of clinical teaching were evaluated by examination score and students' recognition degree towards this reform was investigated by self-made questionnaire and information feedback.Data were processed using SPSS 13.0 statistical software; t tests were used to compare students' scores of theoretical test and skill test; P ＜ 0.05 signifies that the difference is statistically significant.Results There was no statistical difference in theoretical test score between experiment group and control group (P ＞ 0.05).Skill test scores were higher in experiment group than in control group (P＜0.01).Students highly admitted this teaching mode and they thought that this mode can improve their self-study ability,clinical practice skill and clinical thinking ability without influencing their theoretical learning.Conclusions Practice of clinical teaching taking patient's symptoms as the starting point is feasible,which can increase scores of skill test significantly without influencing scores of theoretical test.

Objective To explore the effects of modified long-term low concentration caudal blocking in medium-term drug induced odinopoeia.Methods According to the digital table,63 patients received drug induced odinopoeia were divided randomly into the control group(without analgesis)and treatment group(analgesis).The control group were treated with caudal blocking with mifepristone,premelle and ethacridine lactate.The treatment group received additional treatments of 0.75％ bupivacaine hydrochloride + 2％ lidocaine hydrochloride + morphine sulfate injection based on treatment of the control group.The duration of labor,bleeding volume and severity of pain were recorded and compared between the two groups.Results The duration of labor of the treatment group was (5.33 ±3.77) h,which was significantly shorter than that of the control group [(7.88 ± 2.62) h] (t =8.01,P ＜ 0.05).The severity of pain of the treatment group were all better than those of the control group(all P ＜0.05).There was no significantly statistificant difference in bleeding volume between the two groups (t =4.63,P ＞ 0.05).Conclusion Application of modified long-term low concentration caudal blocking in medium-term drug induced odinopoeia has confirmed analgesis effects,and can shorten duration of labor without increasing bleeding volume.

Objective To investigate the differences of leptin (LEP) between Mongol and Han population with metabolic syndrome (MS) and its related factors.Methods According to the diagnostic criterion of MS,291 people with MS were selected as subjects,of which,146 were Han nationality(A group) and 145 were Mongol(B group).Radioimmunoassay kit was used to measure the serum leptin level.At the same time,the indices including weight,height,blood pressure,blood glucose,blood lipid,Serum uric acid (sUA),insulin (Fins),body mass index (BMI) and insulin resistance index (HOMA-IR) were measured.Results The following indices in B group including fasting plasma glucose (FPG),Low-density lipoprotein cholesterol (LDL-C),leptin,blood insulin,insulin resistance index were (6.2 ± 1.5) mmol/L,(3.1 ± 0.8) mmol/L,(4.3 ± 2.0) μg/L,(22.4-± 16.0) mU/L and (6.5 ± 0.5) respectively,significantly differed from that of A group ((6.7 ±1.7) mmol/L,(2.7 ±0.7) mmol/L,(3.4 ± 1.5) μg/L,(18.8 ±14.0) mU/L,(4.7 ±3.6)respectively;t =2.04,2.84,3.47,2.18,4.82 ;P ＜ 0.01 or P ＜ 0.05).There was no significant difference in terms of age((46.9 ±9.8) vs.(46.3 ± 8.4)),systolic blood pressure (SBP) ((146.8 ± 17.0) mm Hg vs.(149.1 ±19.2) mm Hg),diastolic blood pressure (DBP) ((90.5 ± 11.6) mm Hg vs.(92.5 ± 13.1) mm Hg),BMI ((27.4 ± 2.9) kg/m2 vs.(27.9 ± 3.2) kg/m2),total cholesterol (TC) ((5.5 ± 1.0) mmol/L vs.(5.5 ±0.9) mmol/L),triacylglycerol (TG) ((2.3 ± 1.4) mmol/L vs.(2.3 ± 1.4) mmol/L),high density lipid cholesterol (HDL-C) ((1.3 ±0.3) mmol/L vs.(1.2 ±0.4) mmol/L),and sUA (((320.7 ±93.6)μmol/L) vs.(308.7 ±86.9) μmol/L) between the patients with metabolic syndrome in Mongol population and in Han population(t =0.47,0.90,1.15,1.15,0,0,1.00,0.94 respectively,P ＞ 0.05).The increase of leptin level in the patients with metabolic syndrome in B group was associated with blood glucose,blood insulin and insulin resistance index (r =0.108,0.146,0.183 ; P ＜ 0.05).BMI,blood insulin and insulin resistance index may be the factors due to the higher of serum leptin levels.Conclusion The serum leptin of patients with metabolic syndrome in Mongol population are correlated with blood glucose,blood insulin and insulin resistance index,which plays an important role in the development of metabolic syndrome.

Artemisinin and its derivatives,which are known as traditional antimalarial drugs,have anticancer activities by inhibiting cell proliferation,inducing apoptosis of tumor cells,and resisting angiogenesis,etc.The activity of inducing apoptosis has become high-light for studies recently.Most scholars believed this activity was obtained by increasing apoptosis-inducing genes(Bax),decreasing anti-apoptosis genes(Survivin,Bcl-2),and regulating two-ways controlling genes,and finally led to the distinctive morphological changes.