With health reform goes deeply,medical system becomes market economy gradually;some of medical workers are not fit with the market economy reform.By means of two years practice of defending the patient rights,the article sets forth that upholding the rights of the patient and defending the benefits of the hospital are identical.According to analysis to the patients present situation,it puts forward that there are some problems to ignore or infringe upon the patients informed rights,keep secret rights,private rights,autonomy rights,autonomg respect to the patients etc.According to the above problems,we set forth the discussion of corresponding countermeasure.The purpose is to recognize the patient rights,to participate competition positively,and realize the purpose--Uphold the Rights of the Patient and Defend the Bendfits of the Hospital.

Objective To study biologic effect of high radon exposure in non-uranium miners by measurements of serum levels of 1L-2, IL-6 and TNF-u and study on their gene polymorphism. Methods Serum levels of IL-2, IL-6 and TNF-αin the miners selected from a Yunnan-based copper mine were measured by ABC-ELISA. TNF-α (-308,G→A) genotypes were identified by RFLP-PCR, IL-2 (-330, T→G) genotypes by sequence analysis. Results Compared the miners with its control group, there were no statistical significance of the concentrations of serum IL-2 (F=0.71, P>0.05), IL-6 (F=1.09, P>0.05) and TNF-α(F=0.95,P>0.05). Frequencies of IL-2 (-330, T→G) genotypes (X2=0.02, P>0.05) and TNF-α(-308, G→A) genotype (x2= 2.21, P>0.05) were shown no statistical significance too. Conclusions Compared with the control group, concentrations of serum IL-2, IL-6 and TNF-n in miners working in the copper mine was lower, frequencies of genotypes of TNF-o (-308,A/A) was higher in the miners. But all the differences were not statistical significant.

Objective:To investigate the effect of the timing of intra-aortic balloon counterpulsation (IABP) treatment on the clinical efficacy of patients after severe cardiac surgery.Methods:A prospective study was conducted on 64 patients with IABP after cardiac surgery in Gaozhou People′s Hospital of Guangdong Province from March 2018 to March 2020.According to the time of IABP treatment, 33 patients were divided into early treatment group (severe cardiac surgery<6 h) and late 31 cases in treatment group (≥6 h after severe cardiac surgery): two groups of mean arterial pressure(MAP), left ventricular ejection fraction (LVEF), mechanical ventilation time, IABP indwelling time, ICU stay time, central venous oxygen saturation(ScvO2), N terminal pro B type natriuretic peptide(NT-proBNP), lactate clearance rate, complications and follow-up.Results:After 48 hours of IABP, MAP and LVEF in the early treatment group were (79.47±7.07) mmHg and (45.20±3.86)%, respectively, and those in the late treatment group were (71.38±6.26) mmHg and (41.66±4.49)%.There were significant differences between the two groups ( t value was 34.604, 29.375 respectively all P<0.01). The mechanical ventilation time (71.56±5.98) h, IABP indwelling time (68.31±10.10) h, ICU stay time (5.84±1.04) d in the early treatment group, and those in the late treatment group (82.79±4.96) h, (89.49±9.97) h, (6.82±1.07) d. There were significant differences between the two groups ( t value was 70.093, 72.855, 31.859 respectively, all P<0.01). The ScvO 2, NT-pro BNP and lactate clearance rate in the early treatment group were (71.66±5.45)%, (1 698.36±1 032.98) ng/L and (30.12±2.29)%, respectively at 48 hours after IABP, and those in the late treatment group (66.03±4.61)%, (2 898.43±1 383.29) ng/L and (20.47±1.92)%.There were significant differences between the two groups ( t value was 38.279, 34.379 respectively, all P<0.01). The incidence of complications were 18% (6/33) and 41.94%(13/31) in the early treatment group and the late treatment group.There was significant difference between the two groups( P=0.038). Conclusion:Early use of IABP treatment can improve the patients′ hemodynamic and serological indicators, reduce the patient′s mechanical ventilation time, IABP time, ICU monitoring time and complications.

Objective:To improve the accuracy of the coding of occupational radiation diseases in China, to provide standardized basis for the research on the management of such diseases as well as the informatization management of medical records and the formulation of relevant policies, and to improve the level of prevention and control.Methods:According to the nomenclature and disease characteristics of occupational radiation diseases in China, the diseases were coded by ICD-10 coding rules.Results:The system of occupational radiation diseases in China is the sum of all kinds of diseases caused by ionizing radiation, which is different from the common clinical symptom. The coding of such diseases must be based on the location, clinical manifestations, pathological changes, and other characteristics.Conclusions:The accuracy of occupational radiation diseases coding directly affects the accuracy of disease statistical data. Standardizing the coding of these diseases is a very necessary supplement to the system of occupational radiation diseases in China.

Objective: To establish a multiplexed immunoassay for detection of IgG antibodies against viral hemorrhagic fever epidemic in Africa. Methods: The recombinant antigens of hemorrhagic fever viruses (HFVs) epidemic in Africa were expressed and purified, and then coupled with the fluorescent microspheres. The coupling effects were evaluated by monoplexed detection of rabbit immune sera. Blood specimens were collected from people from Africa with fever, and multiplexed detection of IgG antibodies to HFVs was performed. Comparison of multiplexed assay and ELISA was performed by paired χ² test using SPSS software. Results: Both the purity and concentration of HFVs recombinant antigen met the standards for coupling and detection, and the antigens were successfully coupled with fluorescent microspheres. Seventy-eight sera samples of people from Africa with fever were multiplex detected. Among these, one was tested positive for LASV-specific IgG, one was tested positive for LUJV-specific IgG, 4 were tested positive for DENV-specific IgG and 6 tested positive for YFV-specific IgG. There was no statistically significant difference compared with ELISA, and the two method were highly correlated. Conclusions A multiplexed luminex-based immunoassay for detection of IgG antibodies to viral hemorrhagic fever epidemic in Africa was established, which laid the foundation for the differential diagnosis.

Objective:To construct a system for evaluating the professional capability of provincial radiological health institutions.Methods:Based on the Donabedian model and the main professional responsibilities of provincial radiological health institutions, the logical framework and indicator database of the capability evaluation system were initially constructed, the Delphi expert consultation method and analytic hierarchy process were further used to determine each indicator and its weight. The self-assessment test was carried out throughout the provincial radiological health institutions by using the system established in this study.Results:The evaluation system included 3 primary-class indicators, 11 second-class indicators, 30 third-class indicators and 76 fourth-class indicators. Taking 100 points as the full score, the self-assessment scores of the 29 provincial institutions ranged from 28.7 to 97.7 with an average of 78.7, and the scores conform to the normal distribution.Conclusions:The system established in this study are scientific, comprehensive and operable, which can be used as an effective tool to evaluate the professional capability of provincial radiological health institutions.

Objective: To establish a method for detection of chikungunya virus(CHIKV) antigen. Methods: CHIKV virus like particle(VLP), that contains all structural proteins, was prepared by baculovirus expression system. Mice and rabbits were immunized with the VLP to develop antibodies against CHIKV. A double antibody sandwich ELISA was established for detection of CHIKV antigens. The concentrations of the antibodies used and the reaction conditions were optimized. The detection limit and repeatability of the ELISA was evaluated. Results: The sensitivity and specificity was estimated by 10 mimicking CHIKV sera, 90 health person sera, 40 other virus infected sera. It was show that the specificity of DAS-ELISA was 100%, the detection limit was 10 TCID₅₀, the coefficients of variation (CV) within plate was <5%, the CV of different plates was <10%. Conclusions The double antibody sandwich ELISA established in this study can be used to detect the CHIKV antigen in acute phase serum of patient and provide a method for detection of CHIKV.

Objective:To evaluate the radiation shielding performance for a novel self-shielded ZAP-X radiotherapy system used for intra-cranial and neck treatments. The present evaluation was performed according to the relevant Chinese national standards and the clinical placement of the radiotherapy system in an unshielded treatment room.Methods:The radiation source of the ZAP-X was a 3 MV linear accelerator. A total of 33 detection sites were selected surrounding the self-shielded system at 1.3, 2.3 and 3.3 m away from the periphery of the equipment. The maximum ambient dose equivalent rate in each irradiation condition was measured accordingly. A commonly used clinical treatment plan was selected to simulate the treatment process. During the delivery of this treatment plan, the cumulative doses of these 33 sites were measured, separately. The applicable current radiation protection standard for radiotherapy in China was chosen to evaluate the radiation shielding performance of the system.Results:According to the measurement result of the ambient dose equivalent rates along the aforementioned perimeter lines, a suggestion was put forward to redefine the existing 1 m controlled area by determining the distance at which the instantaneous dose rate of 10 μSv/h will not be exceeded. This is to meet the requirements of the Chinese standard GBZ 121-2020.Conclusions:According to the existing Chinese national radiation protection standards, the self-shielded radiotherapy system in the unshielded treatment room has the clinical applicability in China. But for such a novel self-shielded system, the corresponding performance testing and radiation protection standards shall be formulated.

In order to accurately master and understand the national occupational health standard Diagnosis for Occupational Radiation Thyroid Disease(GBZ 101-2020), the significance of the publication of this standard, the relevant background, the basic principles of the revision, the main basis for technical content revision, and the application of the standard are described. To provide guidance for t the physcians for occupational disease diagnosiss to understand the diagnostic principles, make correct diagnosis and avoid confusion in using the standard, so as to better protect the occupational health rights of radiation workers.

Objective: To establish a method for the simultaneous identification of Zika, Chikungunya and Mayaro viruses. Methods: The complete genome sequences of Zika, Chikungunya and Mayaro virus were retrieved from Global Shared Database for comparative analysis, estimate its conservative region and determine the target gene location, specific primers and probes were designed, then a triplex real-time RT-PCR assay was developed. The specificity, sensitivity and repeatability of the assay were assessed by viral nucleic acid of Zika virus, Chikungunya virus a, in vitro transcriptional RNA of Mayaro virus, normal human serum and related virus simulation sample. Results: The result showed that the established method could detect Zika virus, Chikungunya virus, as well as simulated Mayaro virus samples, the limit of detection (LOD) of Zika and Chikungunya virus was 16.22 Copy/PCR and 12.02 Copy/PCR, respectively, the LOD for simulated Mayaro virus RNA was 2.82 Copy/PCR, no significant difference was detected between the triplex and monoplex assays. No cross reaction was found in the detection of dengue virus, Hantavirus, severe fever with thrombocytopenia syndrome (SFTS) virus, yellow fever virus and influenza virus, and 100 healthy adults blood samples, the specificity of the method was 100%. The repeatability result showed that the standard deviation of all three detections were blow 0.5 and the coefficient of variation was less than 2% by selecting viral nucleic acids or transcribed RNA with high, medium and low concentration gradients. Conclusions A triplex real-time RT-PCR assay for detection of Zika, Chikungunya and Mayaro virus has been established with an acceptable specificity, sensitivity and repeatability.