Building up a harmonious type of physician-patient relationship in hospitals is an important contents in the construction of harmonious society.Major factors that jeopardize the physician-patient relationship include insufficiency of mutual communication,lack of human sympathy in medical treatment service,neglect of patients' right of informed consent.This article also puts forward some measures to solve these contradictions,such as reinforcing ethical training,improving physician-patient relationship,respecting patients' right of informed consent,and setting a psychological department for concerned issues,etc.

Objective To study the relationship between the exposure time of puncture needle of infusion bottle stopper and microbial contamination during clinical intravenous transfusion. Methods A total of 600 cases from November 1, 2014 to January 31, 2015 who have received the clinical intravenous transfusion for investigation were selected.When replacing the infusion bottle (bag), inserting the puncture needle slowly across the bottle stopper and making the needle tip be canted to the transfusion bottle mouth (bag) of the rubber plug, gently squeezing the Murphy's tube until solution was not dripping, recording down the exposure time in the air of the needle tip from medicine droplet to the end. To dip the lower part with sterile swabs and culture the swabs in nutrient broth medium. Meanwhile, to replace the next bottle of medicine and get the remaining 2 ml of liquids into the culture broth medium, after 48 h, both of which medium were switched to blood plate culture cultivation for observing the general situation of the bacteria growth. Results Among the 600 cases of clinical transfusion, 24 cases were positive for sterile swabs microorganisms culture, positive rate was 4.0%, among which microorganisms, 15 cases were gram-positive coccus, 3 cases were gram-negative bacillus, 3 cases were gram-positive bacillus and 3 cases were fungi. Correspondingly, 3 cases were positive for liquid broth culture, positive rate was 0.5%as the gram-positive coccus. The exposure time and broth microbial culture result was statistically significant, while the exposure time and medicinal broth microorganisms culture result possesses had no statistical significance. Conclusions Inserting the puncture needle across the bottle stopper could successfully reduce the liquid drug residues in the infusion bottle (bag), however, which might also cause time-dependent microbial contamination during the exposure process in the air.

Objective To study the sonographic features of fetal lung in normal and preeclampic pregnancies,with follow-up on the occurrence of neonatal respiratory distress syndrome (NRDS),as well as,examine the effects of preeclampsia (PE) on fetal lung maturity (FLM).Methods We collected data from 140 cases during the early pregnancy period (29 to ＜34 weeks),100 cases during the late pregnancy period (34 to 39 weeks),as well as 240 cases of normal pregnancies with the same gestational ages for the contwl group.Data included the parameters of fetal lung maturity measured by ultrasound and the incidence of NRDS postpartum.We analyzed the effects of PE on fetal lung maturity.Results The right fetal lung from the early onset PE group was significantly smaller than that of the normal group.There was no difference in the right lung area between the PE group and the normal group of the same gestational age.Compared with the normal group of the same gestational age,the LHR group had no difference in the early and late PE groups.The acceleration time/ejection time of the main pulmonary artery in the early and late PE group was significantly higher than that of the normal group.There was no difference in the incidence of NRDS among all the groups of the same gestational age.Conclusion PE has no significant effect on fetal lung function or maturation of the pulmonary tissues.Lung maturation may precede the same gestational age without PE.

Objective　To observe the effects of residual perfluorocarbon liquid(PFCL) droplets in the anterior chamber in patients after vitreoretinal(VR) surgery for complicated retinal detachments.Methods　The study group consisted of nine patients(nine eyes)aged 16～64 in whom droplets of perfluorodeclin liquid(PFDL) appeared in the anterior chamber subsequent to VR surgery for complicated retinal detachments involving scleral bucking, vitrectomy and/or lensectomy, the peeling of pre-retinal membrane, perfluorodecalin injection, and perfluorodeclin liquid-silicone oil or fluid-air exchange. Mean follow-up was 10.3 months.Results　Three to 30 droplets of perfluorodeclin liquid were found in the anterior chambers in 9 eyes. There was no corneal complication or inflammatory reactions or blood vessel invasion into the corneal stroma or increased intraocular pressure.Conclusion　Residual perfluorodeclin liquid droplets in the anterior chamber are well tolerated and do not induce corneal damage or ocular inflammation.

Objective To research the effects of establishing core system key risk index in reducing adverse events. Methods Analyzed the causes of the 147 adverse events in 2014. Including the core system implementation of the reasons for the end of the adverse events caused, the data of fundamental reasons in adverse events and the high risk link that because nurses don′t practice the core system. In 2015, randomly checked the 29 nursing units, including 27 wards and emergency outpatient transfusion room, ICU. Contains the implement rates of the core system in transfusion treatment, day and night shifts, doctors′ advice and patients′ identification. In order to quarterly analysis the index and pertinently improve the results, assessors of quality administration council, head nurse in endemic area and attendant watch keeper are chosen to gather index data. Results After one year of management, the key aspects of the core system execution qualified rate has reached 95%, the check of the implementation of the system, the total pass rate compared with before had increased 6.94%, orders execution system implementation of a qualified rate had increased 9.33%, patient identification system implementation of qualified rate had increased 4.29%, the qualified rate of change of comparison the differences were statistically significant (P<0.05). After the establishment of the core system key risk index management, the adverse events had decreased 11.06%(P < 0.05). Conclusion The establishment of the core system key risk index management can effectively improve the implement rates and reduce the nurse adverse events.

OBJECTIVE:To compare the clinical efficacy and safety of Jianpi shengxue tablets and Iron polysaccharide complex capsules in the treatment of nondialysis renal anemia. METHODS:A total of 60 nondialysis renal anemia patients in our hospital during Mar. 2016 to Mar. 2017 were divided into control group(30 cases)and observation group(30 cases)with random allocation concealment method according to random number and admission order. Both groups received routine treatment as rhEPO injection,Folic acid tablets,Vitamin B12 tablets. Based on it,control group was given Iron polysaccharide complex capsules 0.15 g orally,once a day;observation group was given Jianpi shengxue tablets 1.8 g orally,3 times a day. Both groups were treated for 12 weeks. Clinical efficacies were compared between 2 groups. The levels of Hb,RBC,HCT and Ret％ were observed before treatment and 2,4,8,12 weeks after treatment;the levels of SI,SF and TS were also observed before treatment and 8,12 weeks after treatment. The occurrence of ADR was recorded. RESULTS:Both groups completed the treatment. The total effective rate of observation group(86.67％)was significantly higher than control group(63.33％),with statistical significance(P<0.05). Before treatment,there was no statistical significance in the levels of Hb,RBC,HCT,Ret％,SI,SF or TS between 2 groups (P<0.05). After treatment,the levels of above indexes in 2 groups were significantly higher than before treatment,and observation group was significantly higher than control group(except for Ret％ at 8th week),with statistical significance(P<0.05). The case number of black stool and rust colored stool in observation group were significantly lower than control group,while the incidence of black-dyed teeth in observation group was significantly higher than control group, with statistical significance (P<0.05). CONCLUSIONS:Therapeutic efficacy of Jianpi shengxue tablets are significantly better than Polysaccharide iron complex capsules in the treatment of nondialysis renal anemia,and can significantly improve iron reserve and anaemia. But Jianpi shengxue tablets causes high incidence of black-dyed teeth.

Objective: To understand the prevalence of school bullying and depressive symptoms among the Han, Yi, and Tibetan adolescents in western China, and to explore the relationships between bullying roles, bullying frequency and depression symptoms. Methods: A combination method of typical sampling and cluster sampling was used to recruit 3 115 participants from six primary and middle schools in Cangxi County and Ganluo County in Sichuan Province, and Lhasa City in Tibet Autonomous Region from April to November 2020. All participants completed self filled questionnaires. Multiple Logistic regression was used to analyze the association between school bullying and depression symptoms. Results: A total of 881 participants (28.3%) had experienced school bullying in the past 6 months, and 892 participants(28.6%) were detected with depressive symptoms. The rates of school bullying in the Han, Yi, and Tibetan adolescents were 20.5%, 46.4% and 23.8%, respectively. Among them, the rates of victims were 15.3%, 25.0% and 11.8%, respectively; the rates of bully were 2.3%, 5.7% and 6.7%, respectively; the rates of bully victims were 2.9%, 5.7% and 5.4%, respectively. The prevalence of depressive symptoms in the Han, Yi, and Tibetan adolescents were 20.4%, 37.9% and 36.5%, respectively. After adjusting for age, grade, ethnicity, smoking, and drinking, the odds for depressive symptoms among victims ( AOR=1.98, 95%CI =1.61- 2.45 ), bully ( AOR=2.63, 95%CI =1.81-3.82), and bully victims ( AOR=3.33, 95%CI =2.44-4.54) were significantly higher than those without school bullying experience( P <0.01). And the risks increased with the increasing bullying frequency. Conclusion School bullying and depressive symptoms of the Yi and the Tibetan adolescents in western China were higher than those of the Han adolescents. Meanwhile, participation in school bullying and the high frequency of bullying were closely related to depressive symptoms. Future interventions should pay attention to various bullying roles and minority adolescents.