The study and discussion of the establishment,continuance,and termination of physician-patient relationship from a legal point of view is of great significance for establishing a harmonious physician-patient relationship,standardizing the rights and duties on both sides,and regulating doctors' clinical practice.The physician-patient relationship is a special type of contractual relationship,whose establishment needs the patients' requirement,doctors' commitment,and the consistence and acknowledgement expressed or implied by both sides.But the patients with acute diseases or dangerously ill or the patients with Class A infectious diseases are exceptions.In the physician-patient relationship,patients enjoy more rights and doctors assume more duties.In the continuance of physician-patient relationship,principles of the bilateral equality and negotiated consensus should be followed.The physician-patient relationship should be terminated when the doctors have fulfilled their duties or the occurrence of statutory causes.

Objective To investigate therapeutic effects of CT-guided percutaneous minimally invasive treatment by using Herbert screws for wrist scaphoid fracture . Methods From September 2010 to October 2012, 21 patients with scaphoid fracture were treated by internal fixation by using Herbert screws under the guidance of CT .The results of the procedure were assessed in terms of osseous union , pain extent , grip strength , and active motion of the wrist .Postoperative outcomes were evaluated by wrist standard scores based on patients’ perception of functions. Results The operation time was 25 -55 min (mean, 35.3 min).The intraoperative blood loss was 8-40 ml (mean, 18.6 ml).Fracture fragments were cured with bone union , with an average healing time of 10.4 weeks (range, 8-17 weeks).All the 21 cases were followed up for 8 -13 months (mean, 9.8 months).The VAS scores at the last follow-up was (1.2 ±0.8) points, which was significantly lower than that before the operation (5.3 ±1.4) points (t=11.785, P=0.000).The grip strength was (39.6 ±3.5) kg, which was significantly higher than that preoperatively [(19.4 ± 2.4) kg, t=-21.624, P =0.000].The Angle of wrist flexion and extension was 115.2°±7.4°, significantly higher than preoperative measure (89.8°±10.4°, t =-9.103, P =0.000).The wrist ulnar radial deflection angle was 53.7°±5.5°, significantly higher than preoperative one (39.4°±3.4°, t =-10.116, P=0.000).At the last follow-up assessment of wrist functions, excellent result was recorded in 18 cases, and good in 3 cases, with a good-or-excellent rate of 100%. Conclusion Treatment of scaphoid fracture with Herbert screws under the guidance of CT is a minimally invasive method , bearing advantages of little incision, simple operation performance , and good effects .

2(38.2 vs 34.4 months, P=0.214).The 1, 2 and 3-year local control rates were 84.0%, 72.9% and 56.7%, respectively.Conclusion:When given a sufficient combination of modality treatment for selected elderly patients with esophageal carcinoma, the tolerance and therapeutic efficacy were not significantly worse than those of younger patients.Therefore, combined chemoradiotherapy for elderly patients is worthy of further study.

The major developments in SPR technology are reviewed.The principle,parameters and configurations of SPR sensors are also introduced.Then the applications and future prospects of SPR sensor technology in biomedical engineering area are discussed.It is pointed out that the development of this technology tends to further improve the detection sensitivity and resolution,multi-channel detection,the array of micro-devices,etc.

Objective To investigate the effect of cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma. Methods 124 cases with primary liver carcinoma were randomly divided into two groups:60 cases were treated by TACE and cryotherapy; the other 64 cases were simply done by TACE as control. In general, TACE was undertaken once a month and altogether three times for a course. Cryotherapy was undergone 1-3 times for a course. Results The total effective rates (CR+PR) were 45.3% for the control group and 68.3% for the combined therapy group, with an obvious difference between the two groups, 0.5,1,1.5 years survival rate were 81.3%,62.5%,43.8% respectively in the control group;93.3%,83.3%,63.3% respectively for the combined group. There was an obvious difference between the two groups of 1,1.5 years of survival rates. Conclusions Cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma is feasible with raising the effective rate and prolonging survival time.

50% was in 72.1% of patients and

The de novo transcription of hTERT gene represents a rate-limiting step in the activation of human telomerase.The expression of hTERT is strictly regulated with several oncogene products and tumor suppressor gene products in normal cells.The construction of a reverse-transcriptional virus vector that contains the promoter of hTERT without losing its specificity can dramatically augment the expressions of anticancer genes in telomerase-positive cancer cells,which prompts the use of an hTERT promoter for anticancer gene therapies.Firstly,we briefly introduce the structure and regulation of hTERT gene,and then we also review the present knowledge of its biological function in cancer progression.

Objective To investigate the effects of hepatic pedicle exclusion and low central venous pressure (LCVP) on blood loss in right lobe tumor resection and evaluate its influence on hepatic and renal function. Methods Forty-eight patients with right lobe tumor admitted from December 2006 to June 2008 were randomly allocated to the LCVP group (23 cases) and routine hepatectomy, (control group 25 cases). During the parenchymal transection phase of surgery, CVP < 5 mm Hg ( 1 mm Hg = 0.133 kPa) and SBP ≥90 mm Hg were maintained in the LCVP group by drugs. However, no special management of CVP and SBP was done in control group. The parenchymal transection blood loss, postoperative hospital stay, postoperative hepatic and renal function changes between two groups were compared, and the incidence of comphcation was also observed. Results There were no significant difference in type of hepatectomy, time of vascular clamping, period of operation, postoperative complication rate, postoperative hepatic and renal functions between two groups. Parenchymal transection blood loss in the LCVP group was significantly lower than that in the control group (326.67 ± 109.13 ) ml vs (538.33 ± 177.07 ) ml, (P < 0.01 ). Postoperative hospital stay in the LCVP group was significantly shorter than that in the control group (8.52 ± 1.78) d vs (9.40±1.68) d, (P < 0.05). Conclusions Hepatic pedicle exclusion and LCVP during hepatectomy is safe. It can reduced blood loss during parenchymal transection and decrease postoperative hospital stay. It is no detrimental effect to hepatic or renal function.

Twenty cases of clinically diagnosed dilatation cardiomyopathy (DCM) were examined with the Model XJY-6 ultrasound instrument to determine the anatomical changes of their hearts and the changes of their left ventricular diastolic function (LVDF) . Twenty healthy individuals were also examined as control. The following results were observed.Most patients exhibited dilatation of all the chambers and the increase of the left ventricular weight, however, dilatation was the main manifestation. Cardiac dilatation and hypertrophy present the similar pictures on radiograph or ECG, differentiation of the two conditions can hardly be made with either of the above methods, but must depend on ultrasound especially in cases complicated with left atrial dilatation and fibrillation.The changes of LVDF of DCM patients revealed by ultrasoundfwere the abnormalities of the amplitude and rate of the posterior wall movement and of the dias-tolic filling volume and filling rate of the left ventricle. It was found that the PWE, DPWV, RFF, RER/ESV of the patients were much lower than those of the control (P

The left ventricular function of 103 normal subjects in the age range of 17 to 48 were examined with three echocardiographic methods, the Pombo's method (Method I), Fortuin's method (Method II) and Lalani's method (Method III), in order to evaluate their relative efficiency. The results were as following:( 1 ) The value of left ventricular end diastolic volume determined with Method II was larger than that determined with Method 1(123. 9?22.6vsl05. 43?26.0 ml, P0. 05).( 2 ) The values of stroke volume, stroke index, cardiac output, and cardiac index were the largest as determined with Method II, the second with Method I and the smallest with Method III. For instance, the value of cardiac index was 4.66 ?1.21 /m2/min wita Method 11,3.81?1.0 with Method I, and 2.96?0.8 with Method III(P0. 05).( 4 ) All the parameters obtained from Methods I and II were correlated with each other closely (r = 0.72 - 0.96, P0.05).( 5 ) Methods I and II are simple to operate and easy to reproduce and there have been a lot of parameters obtained with these two methodds. However the systolic mitral closure slope of Method III is rather difficult to determine and the parameters obtained with Method III are comparatively less in number.It is concluded that Methods I and I of the echocardiographic technique are the methods of choice in determining the left ventricular function of a normals-sized or nearly normal-sized heart since they are simple, effective and accurate.