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 evaluate the possibility that CdCl2 induces autophagy and apoptosis in HEK293 cells,and the role of extracellular regulated protein kinases (ERK1/2) and AKT proteins in autophagy. METHODS Green fluorescence protein(GFP)-light chain 3B(LC3B)expression plasmid was transfected into HEK293 cells. After 24 h,HEK293 cells were induced with CdCl2 2,4,8 and 10μmol·L-1 for 12 h. The expression of GFP-LC3B was detected by fluorescent microscopy. HEK293 cells were induced with CdCl2 2,4,8 and 10μmol · L-1 without transfection of GFP-LC3B for 12 h while autophagic vacuoles were observed by transmission electron microscopy. The expression of LC3B-Ⅱ/Ⅰproteins and the phosphorylation levels of ERK1/2 and AKT were analyzed by Western blotting. Apoptosis was detected by flow cytometry microscopy. HEK293 cells were treated with 3-MA 20μmol · L-1+CdCl2 10 μmol · L-1 for 12 h before cleaved caspase 3 protein was detected by Western blotting. RESULTS When HEK293 cells were exposed to CdCl2(≤10μmol · L-1)for 12 h,cytoplasmic GFP-LC3B punctuates were observed under the fluorescence microscope,and autophagic vacuoles were observed under an electron microscope. The expression of LC3B-Ⅱ/Ⅰ,p-ERK1/2 and p-AKT proteins was significantly increased in CdCl2-induced cells(P<0.05,P<0.01). Moreover,apoptosis was observed. The addition of 3-MA 20μmol · L-1+CdCl2 10μmol · L-1 enhanced apoptosis. Cleaved capase 3 protein expression was significantly increased(P<0.01). CONCLUSION CdCl2(≤10μmol·L-1)can induce autophagy in HEK293 cells. ERK1/2 and AKT proteins might be associated with the activation of autophagy that is accompanied by apoptosis,suggesting that autophagy can inhibit apoptosis at certain concentrations of CdCl2.

Objective To observe the effect of three immunosuppressive agents on the function of human adult islets of langerhans in vitro, and explore the suitable immunosuppressive protocols for human islet transplantation.Methods In vitro, the isolated and purified islets were incubated with the immunosuppressive agents (mycophenolic acid, sirolimus, and FTY720) at different concentrations for 24 h, then stimulated by glucose at low ((2.8) mmol/L) and high ((16.7) mmol/L) levels. The (insulin) release after stimulations was detected using ELISA kit, and stimulation index was calculated.(Results) In control group (no agents exposure), the insulin release were ((7.37)?(1.74)) ng/ml at low (level) and ((15.15)?(5.39)) ng/ml at high level respectively, with stimulation index achieved to (2.06)?(0.46). Compared to control group, treatment with mycophenolic acid led to dramatic reduction of (insulin) release (P

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