In order to perfect the course-setting and enhance the teaching effect,we questioned our students' knowledge about the position and quality of medical law and the style of teaching, examining method etc. It proves that there are some differences between the fact and students'expectation on these questions.Furthermore, the author put forward some concrete advice on them in this article.

Coincidence exists in the value selection,main form of human communication and imbalance between teacher-student relationship and doctor-patient relationship.Therefore,teacher-student relationship today will directhy have an impact on the future of doctor-patient relationship.Teachers should cultivate medical students'equality consciousness and communicating ability between doctors and patients by establishing equal relationship and good communication between teachers and stdents.

As a patient's right,informed consent has been acknowledged universally.Both hospital and patients attach great importance to normal informed consent during clinic.But the subjects' right in clinical trial didn't draw enough attention,which leads to encroachment of the subjects' right and even the clinical disputes.The law and rule,based on the ethics principle,can enhance the protection of the subject's right of informed consent.In this article,the problem on the legal protection against the infringement of the subject's right and the corresponding counter-measures are discussed.

OBJECTIVE To study the state of mixed infection of sexually transmitted diseases(STDs) pathogens isolated from female genitourinary tract and analyze the clinical meaning.METHODS Gram staining and test under microscope,DIGFA,cultivation and enzyme linked immunosorbent assay were adoptmaed to detect five pathogens such as Neisseria gonorrhoeae,Chlamydia trachomatis,Ureaplasma urealyticum,Mycoplas hominis and herpes simplex virus.RESULTS Among 2 188 female patients,we got 175 mixed infection cases,accounted for 8.0%.77.7% Patients were 21 to 40 years.CONCLUSIONS We should pay attention to monitoring STDs and control work.

OBJECTIVE To investigate the nosocomial status and drug resistance of imipenem-resistant Pseudomonas aeruginosa(IRPA) to provide the reference for doctor′s use of the antibiotics.METHODS Totally 178 strains of imipenem-resistant P.aeruginosa were identified by the routine methods.And drug sensitivity was determined by Kirby-Bauer method.RESULTS All strains of IRPA were mainly from departments of respiratory diseases,tumor and geriatrics,most of them were isolated from sputum(62.4%).The susceptibility test showed that 100.0% IRPA were resistant to imipenem.Drug resistance rates to piperacillin,cefotaxim,gentamicin,ciprofloxacin and SMZ-TMP were all over 50.0%.CONCLUSIONS The status of nosocomial infection caused by IRPA is very serious.To detect and control the infection is very important.

Objective To evaluate the influence of Motivational Interview on function restore and life quality after artificial unilateral total hip replacement surgery. Methods A convenient sampling method was used for collecting 103 patients underwent artificial unilateral total hip replacement surgery for the study. Lottery method was used to divide these patients in to treatment group 53 cases and control group 50 cases. Intervention of both joint exercise and motivational interview was used for the treatment group, and routine health education was used for the control group in a large general hospital in Hangzhou. Results 1 month later, patients′joint function assessed with Harris score of the intervention group and control group were 62.40 ± 8.95 and 54.06 ± 9.61; 3 months later, intervention group was 82.25 ± 7.09 while control group was 74.60 ± 9.97, the difference was statistically significant (t=-4.559 and-4.451, P=0.000). Patients′life quality after 1 month was 485.54 ± 86.85 in intervention group and 400.69 ± 72.36 in control group;3 months later, the scores were 601.54 ± 73.49 and 543.08 ± 81.77, the difference was statistically significant (t=-5.370 and-3.821, P=0.000). Conclusions Motivational Interview was capable of improving joint function restore and quality of life through changing patients′ motivation, helping patients establishing and adhering to joint exercise.

Medical Ethics Committee founded in medical orgnizations,universities,academic periodicals and hygiene institutes is an international regulation in the filed of medicine.Although we have done a large amount of work to be in line with international standards,there are still some problems such as no systemic roles,function deficiencies etc.Therefore,we should study its establishing background and main function and strengthen its construction.

OBJECTIVE To discover diversity of X gene sequences of hepatitis B virus isolates in hepatitis B induced liver cirrhosis patients and HBV carriers.METHODS DNA fragment including X gene sequences of hepatitis B virus was amplified,sequencing PCR products was preformed.The PCR products of three liver cirrhosis patients and three HBV symptomless carriers were cloned into pGEMT Easy vectors.Positive clones with target sequences were selected out for sequencing.Sequence comparison was made to find the identity.RESULTS A comparison of T1762/A1764,G1719T,T1727G/A,G1730C and T1753C mutations in a core promoter between the liver cirrhosis patients and the HBV carriers showed that the HBV isolates from the former had higher frequencies of mutation than the latter.The X promoter region of the HBV isolates from the liver cirrhosis patients showed higher frequencies of mutation than the isolates from the HBV carriers.Additionally,the homology between clones of X gene from one individual with liver cirrhosis averages 91.3-99.7%,that of HBV carriers averages 96-100%.CONCLUSIONS The core and X promoter region of the HBV isolates from the liver cirrhosis patients show the higher frequencies of mutation than the isolates from the HBV carriers.There are HBV quasispecies which possess great variation in the liver cirrhosis patients.

OBJECTIVE To investigate drug resistance status of the pathogens of nosocomial pulmonary infection in stroke patients and to provide the scientific reference for clinical prevention of nosocomial infections and reasonable use of antibiotics.METHODS By the methods combining prospective monitoring and retrospective review,patients′ clinical data were analyzed statistically.Referring to National Rules of Procedures in Clincal Laboratory,the strains were identified.The antibiotic susceptibility test was performed by K-B method and the results were read according to CLSI 2006.RESULTS The main pathogens of nosocomial pulmonary infection in stroke patients were Klebsiella Pneumoniae(22.0%),Pseudomonas aeruginosa(18.4%),Acinetobacter baumannii(12.7%),Staphylococcus aureus(12.3%) and Escherichia coli(11.4%).The detection rate of extensive-spectrum beta-lactamase(ESBLs) producing E.coli and K.pneumoniae was 43.2%.Meticillin-resistant S.aureus(MRSA) accounted for 39.0%.Pan-drug resistant strains were found in A.baumannii.CONCLUSIONS Drug resistance status of pathogens of nosocomial pulmonary infection in stroke patients is very serious.We should take intervention measures to prevent and control the onest and prevalence of resistant strains.

Objective To explore the association between the signal transducer and activator of transcription 4 (STAT4) gene polymorphism and Chinese Han systemic lupus erythematosus patients. Methods Pyrosequencing technique was used to genotype the 3 single nucleotide polymorphisms (SNP) in the samples of patients and normal individuals. Results Not only these 3 SNPs, but also the haplotypes composed by them showed significant difference between the SLE patients and normal individuals[rs11889341:P=0.012 02, OR (95%CI)=1.22( 1.044～1.424); rs7574865:P=0.003 454, 0R(95%CI)=1.25(1.076～1.451 ); rs8179673: P=0.004 275, OR (95%CI)=1.274 (1.079～1.505)]. Conclusion rs11889341, rs7574865 and rs8179673 of STAT4 are associated with the pathogenesis of Chinese Han SLE, and the STAT4 gene is a susceptibile gene for SLE in a few racial cohorts.