This article deals with the relationships between doctors and patients in the ethical and legal perspective.It emphasizes that doctors should envisage,solve and settle new problems even conflicts with patients.Meanwhile,it points out that in China's tradition of ethical standard,the harmony between doctors and patients could not copy the legal system of the West.Adoption of ethics and laws as well as social responsibilities could result in good relationships between doctors and patients which could improve the service of hospitals.

To introduction the biological function of vascular endothelial growth factor and to explore the role of vascular endothelial growth factor(VEGF)and in the pathogenesis of endotoxin,ischemia-reperfusion,hyperoxia,ventilator-induced lung injury(ALI)/acute respiratory distress(ARDS).

Objective To investigate the effect of continuous positive airway pressure(CPAP) on nocturnal polyuria in patients with obstructive sleep apnea syndrome(OSAS). Methods The number of nocturia, the nocturia output, the osmotic pressure of nocturia and the nocturia excretion of Na＋ . Plasma levels of atrial natriuretic peptide (ANP) in night were measured in 8 patients. After treatment with CPAP, the patients were recorded or measured by those index again. Results The number of nocturia ， The nocturia output， The osmotic pressure of Na＋ ,and the plasma leels of NAP in night decreased significantly after tretment with CPAP.The osmotic pressure of nocturia rose significantly.The reduction of ANP corrected with the reduciton of the nocturia output,addition of the osmotic pressure of nocturia and the reduction of the nocturia exeretion of Na＋ .Conclusion CPAP can reduce the number of nocturia, the nocturia output and the nocturia excretion of Na＋ , increase the osmotic pressure of nocturia. The changes probably relate with the reduction of plasma level of ANP.

Objective To differentiate the sequences of Cyt b gene Agkistrodon from its adulterants sold in the market in order to provide molecular evidence for identification of Agkistrodon. Methods Cyt b gene was used to sequence and analyze Agkistrodon and its adulterants sold in the market. Results There was a mixed phenomenon in Agkistrodon species. The differences of Cyt b gene sequence between Agkistrodon and its adulterants sold in the market are significant: the difference rates among the species of Agkistrodon are 0%—0.91%, the difference rates between Agkistrodon and its adulterants are 18.57%—23.78%. Conclusion The characteristics of Cyt b gene sequence can be used as a better molecular marker for authenticating Agkistrodon from its adulterants.

Objective To investigate the role of peroxynitrite in induction of apoptosis in non-heart-beating donor (NHBD) liver grafts. Methods Rat livers were harvested and perfused via the portal vein with 60 ml of cold 4℃ HTK solution from heart beating donors (HB) or 60 min after car-diac arrest from NHBD. A third group consisted of NHBD livers which were perfused with HTK con-taining 7500 IU of superoxide dismutase (SOD) (n=6, resp.). After cold storage for 24 h, the func-tional integrity of the liver was evaluated by isolated reperfusion with Krebs-Henseleit Buffer in a re-circulating system at 37℃ for 45 min. Results Compared to the NHBD livers, HB and SOD groups were characterized by a significantly reduced hepatic enzyme leakage(P<0. 05) as well as decreased portal venous pressure(P<0.01). Bile production upon reperfusion was increased significantly (P< 0.01). Prominent decreasing nitrite oxide(NO) (P<0.05), nitrotyrosine(P<0.01, P<0.05) and apoptosis(P<0.05) in effluent perfusate was encountered. Slight nitrotyrosine staining was concen-trated on the endothelial cells. Conclusion Peroxynitrite may play a fundamental role in the apoptosis caused by enhanced oxygen free radical production in NHBD livers.

Objective To study the different effects of hypertensive putamen hemorrhage with two different treatments of decompressive craniotomy and small bone window(keyhole) surgery. Methods Retrospective analysis of 120 cases of hypertensive putamen hemorrhage in patients with operation data was carried out. They were randomly divided into two groups according to the different surgical procedure, and then compared the incidence of postoperative complications, close and long-term effects and so on. Results There was no significant difference in early complication rate and postoperative GOS score after a week between two groups(P＞0.05). The difference was significant between two groups in close and long-term effects (P ＜ 0.05 ). Conclusion Small bone window (keyhole)surgery had characteristics such as surgical time-saving ,less damage and more rapid recovery with removal of hematoma, and made played a significant role in promoting the recovery of close and long-term effects with patients.

Objective　To study the effects of deliberated hypotension combined with acute simple hemodilution on blood loss,postoperative hemoglubin of the patients undergoing spinal side(back) protrude correction(SSP).Methods　Twenty four ASA grade Ⅰ to Ⅱ patients undergoing elective SSP were randomly divided into two groups:control group(n＝12) and hypotensive group(n＝12).The all patients received with general anesthesia.In the hypotensive group:acute simple hemodilution was accomplished with infusion of lactated Ringer's solution and Gelofusine of as three times as blood loss.Deliberated hypotensin was induced and maintained with 0.01% sodium nitroprusside 2～6μg/kg/min iv.Intraoperative blood loss,blood transfused volume during operation and postoperative hemoglobin were recorded and compared between both groups.Results　 Blood loss was about 51% lower in the deliberated hypotensive group than that in the control group at the end operation.The average volume of transfused blood during operation was(1200±140)ml in control group,blood transfusion was(400±128)ml in the hypotensive groups.Conclusion Deliberated hypotension combined with acute simple hemodilution can significantly decrease the intraoperative blood loss and the SSP operation can be better tolerated for the indicated patients.

Asthma is a chronic inflammation of airway.The prevalence of children's asthma is becoming higher and higher in the past few decades for many reasons,such as environmental changes,the life style modification and so on.Risk factors,such as C-section,artificial feeding,pet touch and so on,were described.And the measures for the prevention of asthma were also prospected,for example,avoiding maternal vaginal infection,unnecessary C-section,improving the living surrondings,reducing the use of broad-spectrum antibiotics,avoiding the abnormal weight increase,preventing and treating the urticaria and allergic rhinitis and vaccinating the bacillus Calmette-Guérin.

Objective To explore the nutritional condition of primary liver cancer inpatients by means of nutrition risk screening 2002 (NRS2002) and mini nutritional assessment,and compare their feasibility.Methods A total of 80 cases of liver cancer patients hospitalized in Tianjin Third Central Hospital from August 2012 to March 2013 were collected.We investigated the incidence of malnutrition with the scales of NRS2002 and MNA.Comparative analysis of the relationship between the two methods and the traditional single index,liver function was conducted in order to find the more appropriate one for nutritional evaluation.Results NRS2002 got a 33.7％ nutrition risk incidence and MNA showed a 45.0％ risk rate.NRS2002 showed better correlation with traditional individual indicators than MNA.Conclusions Compared with MNA,NRS2002 is more reliable for nutritional assessment in primary liver cancer inpatients.

The overall 5-year survival rate for patients with metastatic colorectal cancer(CRC) is less than 10%.Median survival with 5-fluorouracil(5-FU)/leucovorin(LV) therapy is approximately 12 months.Recent additions to the chemotherapy armamentarium for this disease have begun to prolong median survival times.In trials in which patients are exposed to all three approved chemotherapy agents,oxaliplatin,irinotecan,and 5-FU/LV,or capecitabine during the course of their disease,median survival has reached 20 months. The addition of oxaliplatin and irinotecan to 5-FU/LV regimens has also led to the maintenance of quality of life for longer intervals than were traditionally observed with 5-FU/LV alone.Current standard first-line regimens for metastatic CRC are FOLFOX(infusional 5-FU/LV with oxaliplatin) and FOLFIRI(infusional 5-FU/LV with irinotecan).Ongoing investigations will identify a place for molecular targeted combination chemotherapy on metastatic colorectal cancer(CRC) and some trials achieved better efficiency.In this review,we discuss the current advances in combined management of metastatic colorectal cancer of 5-Fu,chemotherapy,Molecular targeted therapy.