In view of the origin of doctor-patient relations,the rights and obligations of the parties,and their corresponding legal responsibilities,doctor-patient relations may be divided into three categories,namely,medical contract relationship,undefined medical management relationship,and forced medical relationship.Of these three,the first two are civil relationships while the last an administrative one.This paper deals in depth with the legal nature and character of three types of doctor-patient relations,based on principles of civil and administrative laws.

OBJECTIVE:To provide reference for upgrading emergency management of pharmaceutical affairs and enhancing the safety and effectiveness of clinical medication.METHODS:The guiding effect of evidence-based parmacy(EBP)on emergency management of pharmaceutical affair security especially on the choice of drugs in clinical medication were discussed by elaborating the example of seeking sovereign remedy for tetramine acute poisoning.RESULTS & CONCLUSIONS:Emplying the principle of EBP to guide clinical medication can help to choose more effective and safe drugs and to find the best emergency treatment scheme.

In 2010,studies found that achievement of sustained virologic response after treatment in patients with chronic HCV infection meant cure;the overall cure rate of interferon combined with ribavirin around the world was about 60％,and the result of real-world study in China was 71.1％.In 2013,the US took the lead in launching the direct-acting antiviral agents (DAAs) for HCV,and the cure rate was increased to almost 100％.However,recent studies have found that the incidence of hepatocellular carcinoma (HCC) tends to increase after the application of DAAs,and there are still controversies over whether DAAs are the major cause of this phenomenon.In our opinion,this phenomenon is caused by the fact that the indications for DAAs cover more end-stage hepatitis C patients who are intrinsically the high-risk population of HCC;however,it cannot be excluded that DAAs may lead to the change in the body's antitumor immune status.Studies are needed in the future to examine this issue at the molecular level.

OBJECTIVE:To provide reference for reducing the occurrence of ADR and disposing ADR correctly. METHODS:Using the Excel statistics and manual screening,528 ADR reports were collected from a third grade class A hospital in Chongqing during Oct. 2005 to Dec. 2015. Those ADR cases were analyzed statistically in respects of general information of ADR patients, routes of administration and occurence time,types of ADR-inducing drugs,organs/systems involved in ADR and clinical manifesta-tions,disposal and outcomes,etc. RESULTS:A total of 285 cases(53.98%)of ADR occurred in elderly patients aged more than 65. Most of original diseases were respiratory system disease(144 cases,27.27%). 124 ADR cases occurred in people who had al-lergic history(23.48%). Most of ADR cases were induced by intravenous administration(428 cases,81.06%). ADR frequently oc-curred within 1 h after medication(385 cases,72.92%). Anti-infective agents(211 cases,39.96%)and TCM preparations(67 cas-es,12.69%) were the top 2 involved drug types. The most common ADR occurred in skin and its appendants (175 cases, 33.14%),followed by general reaction(148 cases,28.03%)and administration sites(63 cases,11.93%). The treatment of ADR mainly involved drug withdrawal and symptomatic treatment (285 cases,53.98%). ADR mainly were cured and recovered (509 cases,96.40%). CONCLUSIONS:The characteristics and regularity of ADR disposal should be analyzed to formulate clinical path-way for ADR diagnosis,suspected cases observation,examination,disposal and rescue. When the patient has general reaction or re-spiratory system and circulatory system problems,treatments should be more actively processed.

Legal relationship between doctors and patients is constructed by the three el-ements:the subject,the object and the contents.The subject is the medical side and patient side.The object is a medical act.The content of medical and legal relations is rights and obligations of both sides.

Objective:To explore the multiple meditation effects of emotional intelligence and self-esteem between interpersonal initiative personality and social positive adaption in left-behind junior high school students.Methods:Totally 331 left-behind junior high school students [165 boys,160 girls,average age of (14.5 ± 1.2) years] were selected.They were assessed with the Interpersonal Self-Support Scale for Middle School Students (ISSS-MSS),Emotional Intelligence Questionnaire (EIQ),Rosenberg Self-Esteem Scale (RSES) and Social Adjustment Scale (SAS-YB).Results:The scores of social positive adaption were positively correlated with the scores of interpersonal initiative personality,EIQ and RSES (r ＝ 0.47-0.67,Ps ＜ 0.001).Path analysis showed that interpersonal initiative personality had direct effects on social positive adaption (β ＝ 0.47,P ＜0.001).Mediation modeling showed that interpersonal initiative personality could exert effects on social positive adaption indirectly through the mediating effect of not only emotional intelligence,but also self-esteem (x2/df＝ 3.03,TLI ＝ 0.87,CFI ＝ 0.89,RMSEA ＝ 0.08).Conclusion:The present study indicates that parallel multiple mediation model of emotional intelligence and self-esteem could explain the mechanism of influence of interpersonal initiative personality on social positive adaption appropriately.

OBJECTIVE To study the sites of nosocomial infection in the Traditional Chinese Medical Hospital and the pathogen distribution and drug resistance;to provide basis against nosocomial infection. METHODS Retrospective analysis was performed for 851 strains of bacteria isolated from those tested specimens sent by the inpatient department from 2005 to 2007. RESULTS The main sites of nosocomial infection was respiratory tract,followed urinary tract and wounds,the main responsible bacteria was Gram-negative bacilli,their rate was 52%.While the rate of Gram-positive cocci was 36%,the rate of fungi was 12%.The common bacteria in nosocomial infection our hospital were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,Staphylococcus and Candadi albicans,whose rate of drug resistance was similar to that in the comprehensive hospital. CONCLUSIONS In nosocomial infection the proportion of Gram-positive cocci and fungi is increasing,so is their rate of drug resistance.It mustn′t be neglected in clinic.

Objective To observe the therapeutic effect of Jin's three-needle manipulation combined with rehabilitation training on spastic cerebral palsy children,and to explore its therapeutic mechanism.Methods One hundred and thirty-five spastic cerebral palsy children were equally randomized into three groups: the treatment group was given Jin's three-needle manipulation combined with rehabilitation training,control group 1 given Jin's three-needle manipulation,and the control group 2 given rehabilitation training.The improvement of symptoms,activities of daily living(ADL) and event-related potentials(ERP) P300 were observed in the three groups.Results ADL score was increased in the three groups after treatment(P

It is a clinically tough problem to repair compound tissue d efects of limbs. Application of microsurgical technique with autologous pedicel or free tissue grafts has saved numerous invalid limbs with tissue defects, and is still an essential method to restore compound tissue defects of limbs and res love effectively many difficult problems, such as larger solf tissue defects,seg mental bone defects, bone-skin compound defect, and etc. Microsurgical repair i n emergency has special value in treating compound tissue defects of hand. Altho ugh the resource of autologous tissue graft as donator is limited, tissue engine ering and gene technology hold the promise of revolutionary advances in repairin g compound tissue defects of limbs. Because of the achievements made in the fiel ds of trauma repair and tissue regeneration, both structure and function will be hopefully restored.

A pepsin modified poly (glycidyl methacrylate-ethyleneglycol dimethacrylate)(poly (GMA-EDMA)) capillary monolith (32 cm ×75 μm,22cm effective lenth)was applied in exploring the interaction between nefo-pam enantiomers and bovine serum albumin (BSA),mode of frontal analysis was selected to measure the binding constant,number of binding sites and the location of binding sites of BSA to both nefopam enantiomers.The opti-mal CEC conditions obtained were a running buffer consisted of 15 mmol /L ammonium acetate at pH 5.5,separa-tion voltage 5.0 kV,detection wavelength 215 nm,injection 10 kV ×6 s,solvent of samples consisted of 50 mmol/L ammonium acetate at pH 7.4.The results indicated that the monolith could provide a satisfactory resolution between the two enantiomers plateaus,BSA in the binding system didn′t disturb the separation or determination of nefopam enantiomers in electrochromatography.The frontal analysis demonstrated that BSA has only one binding site with both enantiomers,the binding constants (K)were 443 L/mol and 527 L/mol,respectively,and the dis-placement experiments indicated that binding site of both isomers to BSA molecule was the Sudlow siteⅡ.