The basic principles of dishonesty disciplinary mechanism are called into play tO probe into such issues as the necessity and key points of building such a mechanism in China's hospitals.The paper focused on ascertaining government leadership,designating key regulators of hospital dishonesty,formulating the regulations for hospital dishonesty recognition and accountability,penalty system for hospital dishonesty,information disclosure system for hospital dishonesty behavior.In addition,it covered such aspects as the incentives and education measures for hospital credit,and building supportive measures for hospitals dishonesty disciplinary mechanism.

Presentation of the importance to resolve medical treatment disputes via mediation,holding that mediation enjoys a promising perspective in this regard.At present,unsatisfactory use of mediation in resolving medical treatment disputes in China finds its root in the system itself.Reconstruction of the existing mechanism for disputes mediation and resolution is inevitable in caUing this mechanism into an active play.Mediation organizations and private institutions in the society should be mobilized to play a greater role in resolving disputes,in an effort to make mediation agreements binding,normalize mediation behavior.This way a new mechanism joining "private,administrative and judiciary" mediation with standardized behavior will be built.

Biotechnology is one of the important areas of life science, consequently the ethical problems were caused by its researches and applications. The article analyzed the ethical problems related to the development of biotechnology and put forwards some countermeasures in order to keep it developing constantly and steady.

Objective To investigate the clinical effect of compound Chinese medicine fumigation granules on surgical treatment of anorectal disease patients and the impact of postoperative complications and wound healing.Methods 78 cases of patients anorectal surgery from June 2013 to February 2016 in our hospital anorectal were admitted,and were randomly divided into observation group and control group,39 cases in each group,using anti-inflammatory and conventional dressing treatment after operation in both two groups,the observation group was treated with compound Chinese medicine fumigation granules,treatment for 10 days continuous.The changes of wound healing and related clinical symptoms were observed and compared between the two groups.Results Third,7,14 days after operation,VAS scores in observation group were lower than the control group,the differences were statistically significant(P<0.05).Tirst days after operation,there was no significant difference in perianal edema,anal bulge,anal dampness and bleeding symptom score between the observation group and the control group; third,7 days after surgery,the perianal edema,anal bulge,anal wet,bleeding symptom score in observation group were lower than the control group,the differences were statistically significant(P<0.05); fifth,14 days after operation,wound patients smoked wash reduction rate in observation group was higher than the control group,the differences were statistically significant(P<0.05); observation group average wound healing time was(16.3±2.8)days,the control group was(18.4±3.3)days,the differences were statistically significant(P<0.05).Conclusion After surgical treatment of anorectal disease,use the compound Chinese medicine fumigation particles for treatment can help relieve the clinical symptoms of patients,reduce pain,promote wound healing.

Based on introducing digital certificate related concepts, the paper compares the similarities and differences of digital sig-nature soft and hard certificates from the aspects of implementation process, implementation condition, convenience, security, law validi-ty, maintainability, etc.Combining with the actual status of information system, it analyzes the selection of digital signature.

ObjectiveTo explore the relationship between the different body mass index (BMI) ranges and all cause mortality in hemodialysis (HD) patients. MethodsEligible studies assessing the effects of BMI ranges on all-cause mortality(published from 1966 to 2012 )were searched, using hemodialysis/haemodialysis and obese/body mass index/overweight andmortality/surwival/reverse epidemiology/obesity paradox in PubMed,Embase,ScienceDirect,Wilcy,Scopus and Ovid. Inclusion criteria were that trials reported mortality in HD patients according to the traditional WHO/NIH BMI classification,and BMI levels were acceptable within 2 kg/m2.The quality of the trials was evaluated using the assessing risk of bias in studies included in Cochrane reviews.The mortality rate in HD patients was the primary endpoint of the study.ResultsWith no significant heterogeneity ( I2 =0％,P =0.45 ),a fixed-effects model was used for analysis.Four studies with a total of 81 423 patients met final inclusion criteria.Compared to individuals with non-elevated BMI levels,the elevated group (BMI ≥25 kg/m2) was associated with lower all-cause mortality ( OR 0.67,95％ CI 0.65-0.68 ). In a risk-adjusted sensitivity analysis,elevated BMI levels remained protective against mortality( adjusted HR 0.94,95％ CI 0.92-0.96 ).ConclusionsHigh BMI levels are associated with lower all-cause mortality rate in HD patients.More stable hemodynamic status,cytokine and neurohormonal alternations,and nutritional status maybe contribute to the protective effects of BMI on the mortality of HD patients.There is a need for more prospective studies to elucidate underlying mechanisms.

Objective To study the maternal and fetal outcome in pregnancy with overt diabetes. Methods Retrospective study was made on 88 pregnancies with overt diabetes from 1981 to 2001 in department of Obstetrics & Gynaecology, first teaching hospital, Beijing university to study the maternal and fetal outcome in pregnancy with overt diabetes and its relationship with the level of blood glucose. One case with artificial abortion and 2 cases with metaphase induced labor were rejeceted from the 88 cases, we devided the other 85 cases into two groups. Group A with well controlled glucose had 42 cases; group B without well controlled glucose had 43 cases. Results In this study, we found 5 cases of fetal death in group B, 3 of them were perinatal death. Nine cases of newborn malformation were all found in those people without well controlled glucose in early pregnancy, the incidence of newborn malformation was 10.2%. The rate of asphyxia of newborn in group B (24.4%) is significant higher than in group A (4.8%) ( P =0.011). The rate of pregnancy induced hypertension in group B (44.2%) is significantly higher than that in group A (21.4%) ( P = 0.026). The rate of premature labor in group B (30.2%) is significantly higher than that in group A (9.2%) ( P =0.017). Conclusions Maternal blood glucose with ideal control throughout pregnancy may reduce the maternal complications and perinatal morbidity and mortality in pregnancy with overt diabetes.

Objective To investigate the effect and hematopoietic reconstitution as well as survival of diffierent kinds of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in the treatment of leukemia.Methods allo-HSCT was used to treat 20 cases of leukemia from March 2003 to July 2006 in my hospital.Twelve of them received allo-PBSCT from HLA matched sibling donors.Four of them received HLA-mismatched unrelated umbilical cord blood transplantation.Three of them received allo-PBSCT from unrelated donors.One of them received bone marrow transplantion from unrelated donors.Results Totally 19 recipients acheived hematopoietic reconstitution.The median time of hematopoietic reconstitution after UCBT was longer than that of HLA matched sibling PBSCT.Seven patients received aGVHD after allo-HSCT,and 4 among them were Ⅰ~Ⅱ degree and 3 cases Ⅲ~Ⅳ degree.Two patients died of relapse,and 3 patients died of GVHD.One patient was puzzled by cGVHD.The others are disease-free survival now.The median time of survival is 30(1~41)months.Conclusion allo-HSCT is effective for the cure of patients with leukemia.UCBT with enough cells and 1~2 mismatched loci is safe and effective for the patients who have no HLA matched sibling donors.

Objective Explore the risk factors and prevention of HAP after surgical excision of Esophageal carcinoma in elderly Patients.Methods Two hundred and eight elderly patients with HAP after Surgical excision of Esophageal carcinoma from 2009 to 2012 were analyzed.Logistic regression analysis was used to find the related risk factors.Results The incidence of HAP was 25.9％.In several factors Logistic regression analysis,smoking,low lung function,postoperative non-epidural analgesia,injure of recurrent laryngeal nerve and fistula of anastomotic were the risk factors.Conclusions The preoperative evaluation,Intensive monitoring during the postoperative period and reducing the complication after operation can decrease the incidence of HAP.

Objective To explore the pathogenesis of renal damage induced by melamine and the characteristics of kidney damage in rats.Methods Twenty Wister rats were randomly divided into one control group fed with normal pet food and one exposure group fed with animal food mixed with melamine at 25 mg(/kg?d).After 4 weeks,biochemical indexes of blood were determined,histopathological examination was performed,and kidney/body weight was measured among rats.The kidney slices were observed using light microscopy of animal anatomy.Renal tissues from affected rats were analyzed using high-performance liquid chromatography and mass spectrometry.Kidney X-ray diffraction were performed to determine the existence of crystals Results After 4 weeks of melamine exposure,the rats showed polyuria,less activity,weight loss,increasing levels of serum creatinine,urea nitrogen,triglyceride.The appearance of kidney significantly changed.The diffuse distribution of the point and the flake crystal shadow were observed in kidney slices.Histopathological examination showed the existence of a large number of crystals in renal tubular,renal tubular epithelial damage.The analysis of high-performance liquid chromatography and mass spectrometry revealed that crystals were composed of melamine and cyanuric acid.Kidney X-ray diffraction revealed that crystals could be found in kidneys of rats.Conclusion Melamine can enter the body through the digestive tract and generate partially cyanuric acid through hydrolysis.Then cyanuric acid and melamine formed cocrystals in renal tubules leading to progressive tubular blockage,renal tubular epithelial damage,tubular reabsorption dysfunction,eventually renal failure.