In the complex interpersonal relationships,due to its specificities,the physician-patient relationship has drawn great attention from clinical doctors,patients and medical experts.The physician-patient communication is a skill.A harmonious physician-patient relationship can only be constructed by both the doctors and patients sharing their good faith and sincerity during their communication process.

Objective:To evaluate the present development and service offering of community health service(CHS) institutions in Chongqing City,to find the main problems at present,and provide the solving proposal.Methods:All the CHS institutions in 35 counties of Chongqing were surveyed;the CHS institutions of main city zone were investigated by stratified random sampling,and their principals were interviewed.Results:The new health service system of two levels have been established,but there are still several problems.The total number of CHS institutions is inadequate.Foundational construction of CHS station is not good.It's widespread that CHS institutions support their medicine sevice with drugs-income and their public heath sevice with medicine-income.The public health sevice is weakened.For the dual referral system,it's easy to refer up and hard to refer down.Conclusion:At present government should increse finance aid,improve management and monitor mechanism,strengthen the foundation construction,and further consummate the training system of personnel,and a GIS System should be built to help improve the Dual Referral System.

Gene chips have been widely applied for the study of lymphoma,involvement discovering tumor-associated genes,assisting classification and investigating cell origin.So far,studies about gene chips detection mainly focus on B-cell lymphomas and T-cell lymphomas.According to those studies,traditional classifications of some kinds of lymphomas have been suspected and cell origin of some kinds of lymphomas have been suggested,which lay the foundation for further study.However,there are still somethings unknown about extranodal NK/T-cell lymphoma,more gene chip detection should be performed for further understanding of the tumor.

In recent years, there were several extreme conflicts between doctors and patients in Otorhinolaryn-gology department. Medical field always contributes the disputes to medical system and patients′quality, however, the public blames the doctors′morality. This article analyzes these incidents in the perspective of ethics and social medicine, trying to find the causes. And it puts forward the countermeasures in terms of medical education, hospi-tal, and the medical personnel.

Objective To observe clinical effect of traumatic patellar dislocation treated with integrative traditional Chinese and western.Methods 103 patients with traumatic patellar dislocation were randomly divided into a treatment group and a control group.The treatment group was given the therapy of traditional Chinese medicine combined with western medicine,while the control group was treated only with western medicine.After 3 months'treatment,observed it's the clinical effect.Results Efficacy of the treatment group was obviously higher than the control group,with a significant difference (P＜0.05).Conclusion The integrative traditional Chinese and western medicine exerts a better effect than the sole therapy of western medicine.

Objective To explore the value of ambulatory electroencephalography (AEEG) monitoring in diagnosis and differential diagnosis of epilepsy.Methods 24-hour AEEG in 761 patients with epilepsy and 1327 patients with paroxysmal disorder was analyzed retrospectively.Results The positive finding of epileptiform discharge by AEEG was obviously higher than routine EEG (all P

Cell Differentiation ; Choristoma ; pathology ; Humans ; Soft Tissue Neoplasms ; pathology ; Thymoma ; pathology ; Thymus Neoplasms ; pathology

Objective To study the clinicopathologic features and immunophenotype of cutaneous NK/T cell lymphoma and the association with Esptein－ Barr virus (EBV) infection. Methods Five cases of cutaneous NK/T cell lymphoma were studied. Histologic sections of embedded tissues were immunohistochemically stained with CD45RO, CD3? , TIA－ 1, CD20, Ki－ B5, CD68 and LMP1 antibodies, and in situ hybridization for EBV－ encoded small nuclear RNAs－ EBER1/2 was also carried out. Results Cutaneous NK/T cell lymphoma accounted for 5.68％ in the cutaneous malignant lymphoma in the same period of observation. There were 4 male and 1 female patients, and the mean age was 34 years. The main clinical manifestations were asymptomatic nodules and masses, which were accompanied by ulcers in 2 cases. Histologically, the tumors were mainly located in the dermis and subcutaneous adipose tissue, the infiltrated lymphoid cells were pleomorphic, and angiocentricity and angiodestruction were found in almost all cases. Immunohistochemical stain showed that five cases were T cell phenotype and the expression rate of TIA－ 1 was 100％ (4/4). The EBV was present in three of four cases by in situ hybridization. Conclusions Cutaneous NK/T cell lymphoma presents with unique and diagnostic clinicopathologic features, and is strongly associated with EBV.

Objective To Investigate the disorder of colonic epithelium apoptosis and proliferation as well as its role of the epithelial barrier break down in ulcerative colitis(UC). Methods Fifty biopsy specimens were obtained endoscopically from 35 patients of UC and 15 controls respectively.The specimens were used for diagnosis of UC and investigation of epithelium proliferation an d apoptosis by IHC with markers of ki－ 67 and M30 respectively. Results Apopto sis index(marked by M30) and ratio of apoptosis to proliferation increased obvio usly in UC compared with the controls(P0.05);Disorder of epithelium apoptosis an d proliferation take place in UC.Apoptosis cells were found not only at luminal surface but also at the base of crypt;however,proliferation cells may extend to superior part of the crypt. Conclusion Unlimited and premature apoptosis as wel l as disorder of apoptosis to proliferation is maybe one of the causes which lea ding to breakdown of the epithelial barrier function i n UC.

Objective To introduce a new technique about reconstruction of anterior cruciate ligament(ACL) by transplantation of autogenous hamstring and fixation with a crossbar(Transfix Ⅱ) under arthroscopy and explore its effect on short term. Methods 72 patients with ACL injury were treated with ACL reconstruction by transplantation of autogenous semitendinous and gracilis tendon, fixed by a crossbar in femur end and a bio-absorbable interface screw in tibial tunnel. 2 cases of meniscus neoplasty, 31 partial meniscectomy, 8 large partial meniscectomy, 16 cartilage trimming, and 15 medial collateral ligament neoplasty, as well as 1 patellar tendon neoplasty were performed simultaneously. Pre- and post-operative knee joint function and stability as well as X-ray photograph were evaluated according to the Lysholm scoring scale system. The reliability of the fixation and its short-term effect were analyzed. Results 65 patients were available for follow-up with the duration from 8 to 36 months. The function of knee joint improved greatly. 8 cases had positive finding in physical examination. The average pre- and post-operative Lysholm score were 56?6.3 and 91?4.8, respectively(P