In the course of medical activities, doctors and patients may form various kinds of social relationships. Of these, the one adjusted by health laws and regulations is termed the legal relationship between doctors and patients. A legal relationship is one involving certain rights and duties that are clear cut and must be observed and breaches will lead to corresponding legal responsibilities. From the legal perspective both doctors and patients, while enjoying their respective rights, must fulfull their legal obligations. Medical institutions and their workers ought to update concepts, cultivate the idea of a legal relationship between doctors and patients, and handle the doctor patient relationship on the basis of a legal relationship and legal reasoning so as to meet the actual needs of society.

The sex - change has been applied in clinic for about twently years. But there was no correlative law so far. It appeared law cases uninterrupted in recently years, which accompanied a simply on the legality, freedom for decision of the sex - change surgery and sexual testification after the surgery.

BACKGROUND: Junior medic is a special population, which has high speciality and great pressure in study. To investigate the characteristics of personality and mental health of this population can explore the reasons of mental problems in junior medics, which can provide theoretic gist for the establishment of the intervention to improve the mental health of this population.OBJECTIVE: To provide approaches and methods for customized development of mental health education through the comprehension of the status of personality and mental health characteristics of junior medics.DESIGN: A stratified randomized cluster sampling survey.PARTICIPANTS: Totally 550 students of grade 1 and grade 2 in Harbin Medical University were selected by stratified randomized cluster sampling in the September 2004.METHODS: Self-rating depressive scale (SCL-90) and Eysenck personality questionnaire (EPQ) were independently answered by 550 students and taken back on the spot.MAIN OUTCOME MEASURES: Key consequences: EPQ scores for extroversion(E), neuroticism(N), pschoticism(P), reliability(L) and the SCL-90 scores for somatization, compulsion, sensitive human relationship,depression, anxiety, hostility, phobia, crankiness and psychosis. Minor consequence: the statistical typical correlative analysis between total score and score of 9 items in SCL-90 and the scores of 4 scales in EPQ.RESULTS: Junior medics had significantly higher scores in compulsion (1.83 ±0.52), anxiety(1.47 ±0.43), psychosis(1.43 ±0.43), and crankiness(1.54 ± 0.55) than Chinese norm( t = 6. 57 -9.09, P ＜ 0. 05).The characteristics of personality were introversion, optimism, humility, and active. The shortcomings were anxiety, depression and emotional There was positive correlation between personality problem and the severity of mental problem in junior medics.CONCLUSION: The proportion of students with personality problems or mental health problems is relative high in junior medics. Effective interventions should be employed.

Objective To investigate the significance of levels of IL-8,TNF-α in serum of patients with aplastic anemia(AA).Methods Serum levels of IL-8 and TNF-α in 45 patients and 30 normal controls were measured by enzyme linked immunosorbent assay.Results The serum levels of IL-8,TNF-α increased significantly in AA and acute AA(AAA)group than in the control group(P＜0.05),there was no statistical significance between chronic AA(CAA)group and the control group(P＜0.05),and the levels in AAA group were much higher than in CAA group(P＜0.05).The serum level of IL-8 was positively related to TNF-αin AA group(r=0.682,P＜0.05).Conclusion There are immunological disorders in patients with AA and the overproduction of IL-8,TNF-α might be involved in the immunopathogenesis of AA,AAA.

Objective To analyze and compare of regional citrate anticoagulation (RCA),low molecular weight heparin and hep-arin-free in severe sepsis patients with thrombocytopenia CRRT treatment effect and complication of the situation.Methods Retro-spective analysis of 3 6 patients admitted to ICU CRRT therapy of severe sepsis in patients with thrombocytopenia was made.Nine patients were given RCA,1 4 patients were given low-molecular-weight heparin calcium and 1 3 patients were given no heparin anti-coagulation programme.And then observation of three groups of CRRT treatment of coagulation function in patients with platelet depletion,blood,bleeding conditions,filter effects,filter usage time,and 15-day,30-day mortality were made.Results In RCA group and heparin-free group,coagulation blood features was significantly superior to low-molecular liver pigment calcium group (P<0.05),there was no significant difference(P>0.05)between RCA group and heparin-free group coagulation in blood features. Bleeding rate and platelet consumption in RCA group were significantly lower than that in heparin-free group and low molecular liv-er pigment group(P<0.05).Filter usage life in RCA group and low molecular liver pigment group was obviously longer than that in heparin-free group(P<0.05).There was no significant difference in filter effect,15 days,30 day fatality rate among the three groups(P>0.05).Conclusion Severe sepsis in patients with thrombocytopenia in CRRT applications of regional citrate anticoagu-lation could reduce the risk of hemorrhage,reduced platelet consumption and longer filter usage time.

Objective To evaluate the change of expression of estrogen receptor(ER) and progesterone receptor(PR) in endometrium of polycystic ovarian syndrome(PCOS) patients during induced ovulation and its clinical significance.Methods We recruited 108 PCOS patients as the disease group and 96 women with tubal infertility as the normal control group.Both groups were randomly divided into three groups with equal numbers (metaphase of generation group,metaphase of secretion group and ovulation group) and were tested the change of ER and PR levels in endometrium of PCOS patients at the fifth day after menstruation,ovulation period and the seventh day after ovulation with way of immunohistochemistry.Results There was marked change of ER and PR in the menstrual cycle of healthy controls.The levels of ER and PR were (0.89 ± 0.22) kU/L and (0.72 ±0.25) kU/L,and (1.65 ± 0.42) kU/L and (1.43 ± 0.42) kU/L respectively at metaphase of generation and (0.92 ± 0.29) kU/Land (0.87 ± 0.34) kU/L,and (1.68 ± 0.42) kU/L and (1.56 ± 0.30) kU/L respectively at metaphase of secretion.Positive gland decreased significantly during ovulation period (ER:(0.69 ± 0.35) kU/L and (0.55 ± 0.24) kU/L; PR:(0.97 ± 0.32) kU/L and (0.69 ± 0.30) kU/L).The levels of ER of stroma and positive gland in menstruation of PCOS patients were significantly higher than in menstruation of normal women during all the stages of menstrual cycle and did not have non-linear change (Metaphase of generation:(1.73 ± 0.22) kU/L and (1.89 ± 0.38) kU/L; Ovulation:(0.75 ± 0.32) kU/L and (0.63 ± 0.28) kU/L;Metaphase of secretion:(1.79 ± 0.31) kU/L and (1.90 ± 0.30) kU/L).The levels of PR in menstruation of PCOS patients were significantly lower than in menstruation of normal women during all stages of menstrual cycle (P ＜ 0.05).We did not observe trend of elevation of PR levels in PCOS patients (Metaphase of generation:(0.93 ±0.36) kU/L and (0.85 ± 0.56) kU/L; Ovulation:(0.77 ± 0.26) kU/L and (0.56 ± 0.41) kU/L) ;Metaphase of secretion:(0.98 ±0.36)kU/L and (0.88 ±0.47)kU/L).Conclusion The expressions of ER and PR in endometrium of PCOS patients are abnormal during all stages of induced ovulation.The endometrial receptivity of PCOS patients is worse than normal women.Improving the receptivity of ER and PR of PCOS patients is one of the ways to enhance pregnancy of PCOS patients.

Objective To investigate the effect of protamine(PS)coated polylactic acid(PLA)nanocapsule on the immune response of murine bone marrow-derived dendritic cells(BMDCs).Methods PLA nanocapsules were prepared by W1/O/W2 method.Protamine was used to modify the surface of PLA nanocapsule that encapsulated ovalbumin(OVA),a model anti-gen.The prepared OVA/PLA/PS nanocapsules were used to stimulate BMDCs.Flow cytometry was used to analyze the ex-pression of surface molecules CD80,CD83,CD86,MHCⅠ,and MHC Ⅱ,and the uptake of nanocapsule.The levels of IL-12 p70 secreted by BMDCs were detected by ELISA.Results OVA/PLA/PS nanocapsules could significantly up-regulate the expres-sion of CD80,CD83,MHCⅠ,and MHC Ⅱ in BMDCs,and increase the secretion of IL-12 p70 by BMDCs.Furthermore,OVA/PLA/PS nanocapsules could enhance the uptake efficiency of OVA by BMDCs.Conclusion OVA/PLA/PS nanocapsule can en-hance the immune response of BMDCs,and may become a good drug delivery carrier.

AIM: To investigate the correlation between the left ventricular filling type and geometry modality and functional change of the left ventricle in patients with hypertension. METHODS: Systolic function indexes (FS and EF) and diastolic function indexes (E, A, EAT, EDT, E/A,IVRT) in 120 patients with hypertension were measured by two dimensional ultrasonography (2-DUS) and M-mode and Doppler ultrasound. RESULTS: A rate of 83.5% in patients with hypertension appeared assured plump and configuration changes of left ventricle, and a rate of 84% in patients with hypertension appeared abnormal left ventricular filling function. The morphologic indexes were significantly different clearly in different left ventricular filling types, and the filling indexes were also significantly different in diferent left ventricular shapes. CONCLUSION: IVRT is a more important index than other factors to decide the left ventricular filling function. LVMI plays more important role than other factors in the left ventricular filling function.

Objective:To investigate the role of sanchi Saponin Rg1 in D-galactose -induced amnesic mice ,and its possible mechanism.Methods:D-galactose was injected by subcutaneous to establish the aging model, and with drug treatment group.The Y-maze tests was performed to evaluate the learning and memory function, spectrophotometry was used to measure abilities of anti-oxidation.ELISA was adopted to evaluate the level of IL-1? and IL-6. Then FCM was applied to assay the index of intracellular calcium and the percentage of neural cell apoptosis.Results:Compared with drug treatment group, the model mice reduced significantly activites of anti -oxidation , the overload of intracelluer calcium and the increase in apoptosis of neural cells as well as the inflammation factor.Conclusion:Sanchi Saponin Rg1 decreased in the content of inflammation factor , the index of intracellular calcium and the percentage of apoptosis in neural cells , possibly by enchancing the antioxidant function.

Extended-field and subtotal nodal radiation therapy (RT),developed in the 1960 s,was first reliably curative treatment for early-stage Hodgkin lymphoma (HL). However, the large volume of normal tissue irradiated resulted in significant delayed toxicity, including cardiac disease and second cancers (SC).The 30-year cumulative incidence of heart disease among adult survivors receiving 40-45 Gy of extended-field or mantle RT is approximately 30 ％; the incidence of SC is similar. How to improve disease control while reducing the toxicity of treatment has been a major objective of HL trials. Contemporary involved-field RT (IFRT) and involved-node RT (INRT) reduces irradiated volumes and produces significant reductions in normal tissue dose, and response-adapted therapy may be a means of identifying those patients most likely to benefit from treatment reduction or intensification, and enhanced screening will facilitate early intervention to reduce the clinical burden of late effects. There is a increasing interest in elucidating the genetic correlation of treatment toxicity.