Continual strengthening medical worker's service consciousness in the first condition th eliminate the disputes; serous cultivating dedication spirit is an essential way to avoid the disputes; raising moral state is a crucial factor to avert disputes.

In order to prosecute and implement the regulation how to deal with unskillful and faulty medical treatment and the hospitals must put to the proof concerning no faulty,the author considers the hospital should pay attention to build new doctor-patient relationship.Moreover, the author puts forward some rationalization proposal, such as medical staff should realize that doctors are the main side in the doctor-patient tradiction;medical staff should strengthen the legal consciousness,etc.

Objective To understand the nurse-patient communication before and after nurse-patient communication training. Methods Using self-made questionnaire to investigate patients who were admitted from June to December 2010 and hospital stay longer than 3 days. Results After training, problems between nurses and patients communication significantly reduced; nurses could use verbal communication and non-verbal communication properly; the harmonious rate between nurses and patients increased from 38.6% to 57.0%; patients satisfaction degree increased from 80.2% to 93.8%. Conclusions The nurse-patient communication and targeted training have an important significance for dermatology nurses to improve communication skills.

Objective To investigate the effect of batroxobin on the blood-retinal barrier (BRB) and vascular endothelial growth factors (VEGF) in diabetic rats. Methods Sixty Sprague-Dawley rats were used to establish diabetic models by intraperitoneal injecting with streptozotocin (60 mg/kg), and were divided into 3 groups: diabetic group (n=20), batroxobin (40 mg/kg) group (n=20) and batroxobin (20 mg/kg) group (n=20). Twenty-five else rats were in control group. All of the rats were executed 7 days later. The function of BRB was observed by Evans blue method. Results concentration of VEGF protein was detected by enzyme-linked immunoabsorbert assay (ELISA). The results of each group were compared. Results The content of BRB leaked into retina was obvious lower in the control group than which in the other 3 diabetic groups(P0.05). The content of Evans blue was lower in the 2 diabetic groups with different dosage of batroxobin than which in the control group (P

Objective To investigate the clinical effect of L -glutamine gung shimron acid sodium in combi-nation with esomeprazole in the treatment of pediatric peptic ulcer and its effects on immunological function and intes-tinal flora.Methods 120 patients of pediatric peptic ulcer meeting the inclusion criteria were randomly divided into two groups equally.Besides conventional treatments,the control group was treated with esomeprazole,and the observa-tion group was treated with L -glutamine gung shimron acid sodium in combination with esomeprazole.After the course of treatment,the curative efficacy was compared after the eight -week follow -up.Before and after the treat-ment,T lymphocyte subpopulation (CD +4 ,CD +8 ,CD +4 /CD +8 )reflecting cellular immune function,intestinal flora and adverse reactions were compared.Results After the eight -week follow -up,the total effective rate of the observa-tion group was 96.7%,which was significantly higher than 86.7% of the control group (χ2 =3.93,P <0.05).After treatment,levels of CD +4 [(43.5 ±6.6)% vs (40.9 ±6.2)%],CD +4 /CD +8 [(1.72 ±0.38)vs (1.38 ±0.45)] were statistically higher and level of CD +8 [(26.2 ±3.7)% vs (30.1 ±5.0)%]was statistically lower in the obser-vation group in comparison with the control group (t =2.22,P <0.05;t =4.47,t =4.86,P <0.01).As to intestinal flora,the observation group had statistically higher concentration of lactobacillus [(7.5 ±1.3 )LonN /g feces vs (5.8 ±1.2)LonN /g feces],bifidobacterium[(8.3 ±1.1)LonN /g feces vs (6.6 ±1.4)LonN /g feces]in the feces in comparison with the control group after treatment (t =7.44,t =7.40,both P <0.05).During the treatment,there were no severe adverse reactions.Conclusion L -glutamine gung shimron acid sodium in combination with esome-prazole is effective for pediatric peptic ulcer,which can significantly increase curative efficacy,enhance cellular immune function and effectively regulate intestinal flora with minor adverse reactions.

Objective To investigate the change of blood lactate level in children with severe sepsis,and its relationship with clinical prognosis.Methods 90 children with severe sepsis who treated in our hospital from February 201 3 to May 201 4 were selected as the study subjects.According to the prognosis of children,they were divided into survival group and death group,45 cases in each group.The blood lactate levels at different time points, blood lactate clearance rates between the two groups at different time points as well as fibrin,oxygenation index and D -dimer levels were compared after admission.Results After treatment,the fibrin,oxygenation index and D -dimer levels in the two groups were improved.The fibrin and D -dimer levels in the survival group[(2.71 ±0.31 )ng/mL, (0.89 ±0.1 0)mg/L)]were lower than those in the death group[(2.89 ±0.21 )ng/mL,(1 .26 ±0.1 8)mg/L)],the differences were significant(t =3.224,P =0.001 ;t =1 2.053,P =0.000).The oxygenation index of the survival group[(1 96.23 ±1 4.69)mmHg)]was higher than that of the death group [(1 80.23 ±21 .03 )mmHg)],the difference was significant(t =4.1 84,P =0.000).The EGOT compliance rate,APACHE Ⅱscore and MODS incidence rate of survival group were significantly lower than those of the death group,the differences were significant(t =7.200,P =0.007;t =9.1 49,P =0.000;t =29.298,P =0.000).The blood lactate levels at each time points in the survival group were significantly lower than the death group,the differences were statistically significant(t =50.543, P =0.000;t =33.932,P =0.000;t =1 7.91 5,P =0.000;t =28.703,P =0.000).The 6 h,24 h blood lactate clearance rates≥1 0% of the survival group (73.33%,80.00%)were significantly higher than those of the death group(37.78%,44.44%),the differences were significant(χ2 =1 1 .520,P =0.000;χ2 =1 2.1 00,P =0.000). Conclusion Lactate level in children with sepsis is an important indicator of prognosis in children with severe sepsis,with guidance for the treatment of children with sepsis.

Objective To explore the clinical efficacy,adverse reactions and serum levels of IL -10 and TNF-αin children with peptic ulcer undergoing sequential therapy.Methods 68 children with peptic ulcer were selected and randomly divided into two groups,34 cases in each group.The control group received quadruple therapy, namely omeprazole,amoxicillin,clarithromycin and bismuch treatment for seven days.The treatment group underwent sequential therapy:the first 5 d of oral omeprazole,amoxicillin treatment,and the next 5 d omeprazole,amoxicillin and inidazole treatment.The clinical efficacy,adverse reactions,IL-10 and TNF-αlevels of the two groups were com-pared.Results The total effective rates after treatment of the control group and treatment group were 88.24% and 91.18% respectively,there was no statistically significant difference between the two groups(χ2 =1.21,P>0.05). After treatment,the levels of IL-10 and TNF-αin the control group were (24.93 ±6.29)pg/mL and (37.93 ± 8.28)pg/mL,which were significantly decreased (t=5.52,P<0.05,t=8.51,P<0.01).And the levels of IL-10 and TNF-αin the treatment group were (21.36 ±6.31)pg/mL and (29.67 ±6.38)pg/mL,which were significantly decreased(t=11.15,12.29,all P<0.01).The levels of IL-10 and TNF -αof the treatment group were much significant than those of the control group after the sequential therapy (t=3.32,P<0.05,t=8.71,P<0.01). Conclusion Sequential therapy for the treatment of children with peptic ulcer has better effect than the quadruple therapy,and can reduce serum IL-10 and TNF-αlevels,it is worthy of promoting.

Objective To compare the clinical effect of intraosseous versus traditional infusion in critical pediatric patients under resuscitation.Methods 56 critical pediatric patients under resuscitation,who were difficult to establish a venous access,were divided into two groups:intraosseous infusion group (IOI group)and traditional group.The clinical characteristics,lab tests,clinical efficacy and complications of all patients were recorded in detail. Results The general characteristics of two groups were comparable.The mean operation time to establish an emergency infusion access in the IOI group was (1.01 ±0.53)min,which was significantly shorter than (8.97 ±2.36)min of the traditional group(t =4.856,P <0.01).The IOI group had a greater efficacy over the traditional group (50.0% vs 36.7%),in the IOI group,the patients showed obvious positive effect and less patients had no efficacy(χ2 =18.476, P <0.05 ).In addition,lower complication rate and mortality were observed in the IOI group.Conclusion For critical pediatric patients under resuscitation whose intravascular access cannot be achieved through peripheral venous,intraosseous infusion is prior to traditional infusion.

Objective To explore an accurate,objective and simple method for barrel distortion correction and lesion area measurement by assistance of computer.Methods The software of Panaroma tool was employed to correct barrel distortion of endoscopy and Image J to measure lesion size and manage the relative measurement error.Computed measurement in vitro of lesion area was established,firstly,by identification of correction factor of Panorama tool to minimize measurement error; then by determination of influence of object distance change between the lens and the image.This measurement was used on patients with gastric ulcer for focal area.Results were compared with those of traditional method.Results Number of 0.1was determined to be the correction factor for barrel distortion of endoscopy.Prior to the correction of the barrel distortion,the relative error of measurement gradually increased with the increasing distance between endoscopy and the image.However,different object distances did not exert influence on the relative measurement error when barrel distortion was corrected by Panaroma tool ( P =0.141 ).A total of 50 foci of gastric ulcer were measured,results from combinational treatment of Panorama tool and Image J showed the areas (35.0 ± 5.0) mm2 were significantly larger than those determined by traditional method [ ( 29.1 ± 4.1 ) mm2,P =0.000 ],with a correlation coefficient of 0.988.Conclusion Computed endoscopic lesion measurement is a relatively accurate,objective and simple method to determine the area of gastric lesions.

Objective To investigate the effect of the asymmetric of masticatory force on the remodeling of bilateral mandibular condylar cartilage of SD rats. Methods The animal models were established respectively by excising the unilateral temporalis, and injecting botulinum toxin A into the unilateral masseter. Dividing three batch processing 3 weeks, 6 weeks, and 9 weeks after the animal modeling, six rats were killed in each group. The expression of CTGF in condylar cartilage was observed by immunohistochemical staining. Results CTGF expressed in proliferative layer,chondroblast layer and hypertrophic layer of the condylar cartilage. The expression of CTGF in the experimental groups was increased than control groups (<0.05) . There was no significant difference between the left and right side in the experimental groups ( >0.05), the expression of CTGF after 6 weeks of operation was stronger than the group after 3 weeks of operation, the expression of CTGF after 9 weeks of operation was the strongest than all of other groups ( <0.05) . Conclusions The asymmetric of masticatory force can up-regulate the expression of CTGF mRNA in rat mandibular condylar chondrocytes. CTGF induces the effect of stress-mediated on the mandibular condylar cartilage remodeling.