Setting up harmonious relations between doctors and patients is an important part of setting up the socialistic harmonious sociaty.But the tense relation between doctors and patients is still a very outstanding topic.This paper analyzes the reasons of the tense relation between doctors and patients from a new visual angle of the government.the social public and human right guarantee,and investigates the path of setting up harmonious relation between doctors and patients.It thinks the reasons of tense relation between doctors and patients lie in the clash of hospital public welfare and market survival way,the patients are easy to get harm but difficult to guarantee their rights.Therefore,setting up harmonious relations between doctors and patients not only depends on the medical service organization but also depends on the government undertaking the responsibility of the medical treatment guarantees,depends on the reform in the medical service system to make real medical service for common people,depends on the doctors' warm hearts and depends on establishing an organization of the patients who are in bad situation in order to contend with the medical service organization which is in good situation.

Objective To study the anatomic characteristics of the infraorbital ethmoid cells on muhislice CT(MSCT)and explore the relationship between the infraobital ethmoid cells and mueosal swelling of sinuses.Methods Two hundred sixty patients(520 sides) of consecutive axial scans by GE HisDeed VCT and the multiplunar reformation(MPR),virtual endoscopy(VE)reconstruction images by GE AW 4.2 workstation were reviewed retrospectively.The following CT features were assessed:(1)the anatomic characteristics of the infraobital ethmoid ceils,including the frequency of identification,origin,classification.(2)presence of mucosal swelling of sinuses,(3)the maximal transversal diameter of the inflraobital ethmoid cells in ostium of maxillary sinus(perpendicular to the uncinate process),and the diameter of the ostium of maxillary sinus,(4)presence of infraobital ethmoid ceils inflammatory findings and a contact between the mucosal surface of the ostium of maxillary sinus.The results were analyzed by using Chi-square test and logistic regression analysis with the statistical software SPSS 11.5.Results (1) UniLateral infraobital ethmoid cells were f10und in 68 patients(26.1%),and bilateral infraobital ethmoid cells were found in 81 patients(31.2%).Infraobital ethmoid ceHs were found in 230 sides on left Bide (120 sides)and right side(110 sides).(2)Infraobital ethmoid cells originated from the anterior ethmoid cells in 124 sides(53.9%)and from posterior ethmoidal cells in 62 sides(27%),originated from both the anterior ethmoidal cells and the posterior ethmoidal cells in 44 sides(19.1%).(3)The classification of the infraobital ethmoid cells included three types.Infraobital ethmoid cells with different origination differed significantly in theirtypes(x2=193.433,P<0.01).Most ofthe infraobital ethmoid cells originated from tlle anterior ethmoidal cells were type Ⅰ(160 sides),while the type Ⅱ(48 sides)and Ⅲ(45 sides) frequently originated from the posterior ethmoidal ceHs(4)The mueosal swelling of sinuses,were found in 165 sides in presence of infraobtial ethmoid cells and 192 sides in absence of infraobtial ethmoid cells.The presence of infraobtial ethmoid cells had no effect on mucosal swelling(X2=1.824,P>0.05).The maximal transversal diameter of the infraobital ethmoid cells in ostium of maxillary sinus did not differ significantly between the cases with or without mucosal swelling of sinuses(t=0.273,P>0.05).and the diameter of the ostium of maxillary sinus were not significantly related with mucosal swelling of sinuse8 (Wald=2.534,P>0.05).Presence of infraobital ethmoid cells inflammatory findings (Wald=10.817. P<0.01,OR=4.125)and a contact between the mucosal surface of the ostium of maxillary sinus (Wald= 6.640,P<0.01,OR=3.728)were significantly related to mucosal swelling of 8inuses. Conclusions (1)MSCT scan could clearly demonstrate the detailed information of infraobital ethmoid ceIIs.(2)The presence of infraobtial ethmoid cells Was not a risk factor for chronics sinusitis. When we assess inflraobtial ethmoid cells as a possible etiologic factor in chronics sinusitis we should observe presence of infraobital ethmoid cells inflammatory findings and a contact between the mucosal surface of the ostium of maxillary sinud.

Objective Portal hypertension and ischemia/reperfusion (I/R) have been implicated in small-for-size liver graft dysfunction. Matrix metalloproteinases-2 (MMP-2) and MMP-9 are critically involved in hepatic I/R injury. The goal of this study was to investigate the role of MMP-2 and MMP-9 in acute small-for-size graft injury. Methods 108 rats were divided into three groups:100 % (full-size), 50 % (half-size) and 25 % (quarter-size) liver transplantation groups. Blood and liver samples were collected to assess liver function, hepatic malondialdehyde (MDA) content, tissue myeloperoxidase (MPO) activity and histological changes. ELISA, real-time PCR, gelatin zymography, and immunohistochemistry were used to determine the expression pattern of MMP-2 and MMP-9 in liver grafts. Results The expression levels of MMP-9 were significantly higher in quarter-size and half-size grafts than those in full-size liver grafts 6, 12, and 24 h after reperfusioa And theelevated levels of MMP-9 were related to graft size inversely. However, MMP-2 was expressed and remained in all groups invariably. MMP-9 overexpression was accompanied by extensive liver I/R injury, as evidenced by significant increases in hepatic microscopic damage scores, MDA content,MPO activity and liver function levels. Furthermore, MMP-9 was found mainly to locate around periportal area. The presence of the active form of MMP-9 was significantly higher in small-for-size grafts, which was correlated with sinusoidal dilatation, congestion and hemorrhage. Conclusion These results support critical function of MMP-9 in acute small-for-size liver graft injury. Moreover,portal hypertension may be a crucial trigger for expression and activation of MMP-9.

Objective To fit the functional relation between Percentage Depth Dose and depth by Newton Interpolation. Methods After analyzing the data of Percentage Depth Dose from different manufacturers' linear accelerators, the average of Percentage Depth Dose with same depth was calculated, and then the average data was determined. The interval was set and the interpolation node was selected for simulating the cubic polynomial with PDD and depth. Results Comparing the calculated values by the function with the measured ones, the error was less than 1%. Conclusion The function simulated with Newton Interpolation is applicable in routine clinical radiotherapy and research.

Objective To investigate the distribution of complications and the relationship with neurologic subtype and gross motor function in preterm infants with cerebral palsy (CP). Methods The type, grade of Gross Motor Function Classification System (GMFCS), intelligence,speech, ophthalmologic consultation, brainstem auditory evoked potential and electroencephalogram of 135 preterm infants with CP were reviewed. Results There were 284 complications in total, (2.10±1.33) per child, and was significantly different among various types of CP (F=5.50, P<0.001). The incidence of mental retardation and speech disorder was significant different among various types (P<0.05). The incidence of mental retardation, speech disorder, visual impairment and epilepsy increased significantly (P<0.05) in spastic quadriplegia infants,compared with those with diplegia and hemiplegia. The incidence of mental retardation, speech disorder, visual impairment and musculoskeletal disorder was significantly different (P<0.05) among various grades of GMFCS. The frequency of complications was more in children unable to walk (GMFCS Ⅳ~Ⅴ) than able to walk (GMFCS Ⅰ~Ⅲ) for children over 2 years old (t=70.05, P<0.001). Conclusion The incidence of mental retardation, speech disorder, visual and hearing impairment, secondary musculoskeletal disorder and the multiple disorders are related with neurologic subtype and/or the grade of GMFCS.

Objective A suspected Brucella strain, isolated from the first case of mink breeder in Hebei Province was identified and genetic characteristics were analyzed.Methods Blood sample of the patient with brucellosis was collected at brucellosis laboratory of Hebei Provincial Center for Disease Control and Prevention;anti-Brucella antibody was tested and Brucella was isolated by two phase culture bottles.Conventional methods were used to identify the isolated strain, the genetic characteristics were analyzed by multiple-locus variable-number tandem-repeat analysis (MLVA).Results Anti-Brucella antibody was tested positive.The isolated strain was identified as Brucella melitensis biovar 1 using the conventional methods.Using Pannel 1, the strain was genotype 42 clustering to the East Mediterranean Brucella Melitensis group.It was closely clustered with Brucella melitensis biovar 3, and difference of repeated numbers at variable-number tandem-repeat (VNTR) loci bruce19 was also displayed.Conclusion The case is the first brucellosis case of mink breeder in Hebei Province, the isolated strain from this patient is identified as Brucella melitensis biovar 1 and the genetic characteristics of the strain are closely related to those of Brucella melitensis biovar 3.

Objective To survey the incidence of cardiovascular damage in ankylosing spondylitis (AS) patients and explore the related risk factors.And to establish the risk prediction models for the future.Methods The electrocardiogram (ECG) and cardiac ultrasonography (UCG) of 122 AS patients (group A)in the department of rheumatology of Peking Union Medical College Hospital from 2001 to 2011 were analyzed.Fifty-nine AS patients with abnormal ECG and/or UCG findings consisted of the study group (group A1),the other 63 AS patients without cardiovascular damage were the control group (group A2).We selected 100healthy controls (group B).All healthy controls had ECG and UCG tests.The ECG and UCG findings of the group A1 were analyzed,the clinical manifestations and laboratory results were compared between group A1and A2.A univariate analysis and multivariate Logistic regression analysis were carried out to determine the risk factors related to cardiovascular damage in AS.Results The prevalence rate of cardiovascular damage in AS patients was 48.4％ (59/122).While the prevalence of ECG and or UCG abnormality in healthy controls was 12.0％ (12/100),the difference between the two groups was statistically significant (P＜0.05).In group A1,the main findings in ECG were abnormal sinus node function,high voltage in left ventricle and ST-T changes,other findings were atrioventricular block,branch bundle block and premature beats.In group A1,the main findings in UCG were valvular diseases and arterial root widening,other abnormal findings were pericardial effusion,left ventricular diastolic dysfunction and mild pulmonary hypertension.The level of ESR,CRP,RBC,HGB,blood glucose,the number of peripheral joint involvement,the severity of sacroiliac arthritis and the age were significantly different between group A1 and A2 (P＜0.05).Multivariate Logistic regression analysis showed that age and CRP were risk factors for cardiovascular damage in AS patients.Conclusion The prevalence of cardiovascular damage in ankylosing spondylitis is relatively high.Age and CRP are the risk factors contributing to cardiovascular damage in AS patients.

Objective A suspected strain of Brucella canis isolated in Hebei Province in 2015 was identified and its genetic characteristics were analyzed.Methods After conventional identification of the bacteria strain,multiplex polymerase chain reaction (M-PCR) and multiple-locus variable-number tandem-repeat analysis (MLVA) were conducted to determine its species and genetic characteristics.Results The strain was identified as Brucella canis by conventional subtyping and M-PCR.Using Panel 1,the strain was genotype 3,using Panel 2A,the strain was genotype 28.It was closely clustered with Brucella canis,and differences of repeated numbers at variablenumber tandem-repeat (VNTR) loci Bruce04,Bruce07,Bruce09 and Bruce16 were also displayed.Conclusions The conventional subtyping and molecular methods can improve the stability and accuracy of the identification.Genetic characteristics of the strain is closely related to that of Brucella canis.

OBJECTIVE: To investigate the effects of compound preparation of Cordyceps sinensis and Tripterygium hypoglaucum (CSTHC) on survival time of grafted pigskin after allogeneic transplantation and its mechanism. METHODS: The pigskin was treated with CSTHC solution before allogeneic transplantation, and CSTHC ointment was applied for external use on the grafted pigskin after skin transplantation. Cyclosporine A (CsA) and normal saline were served as control. The survival time, the appearance and the histomorphological changes of the grafted pigskin were observed. The histomorphological changes of testicles in pigs were also examined. The CD4 and CD8 expressions in the grafted pigskins were measured by immunohistochemical method. The white blood cell count in peripheral blood and the liver and renal functions were also examined. RESULTS: The survival time of the grafted pigskin in the CSTHC-treated group was (28.50+/-3.26)d, which was much longer as compared with (10.60+/-1.52)d in the untreated group (P<0.01). The survival time of the grafted pigskin in the CsA-treated group was (28.33+/-3.50)d, and there was no remarkable difference in the survival time of the grafted pigskin between the CsA-treated group and the CSTHC-treated group. The expressions of CD4 and CD8 were lower in the CSTHC-treated group than those in the untreated group on the 7th and 14th day after skin graft (P<0.05), while there was no significant difference in the indices between the CSTHC-treated group and the CsA-treated group. The WBC count was higher in the untreated group than that in the CSTHC-treated group or CsA-treated group on the 7th day after skin graft (P<0.05). CONCLUSION: CSTHC can prolong the survival time of allogeneic grafted pigskin. Its mechanism of inhibiting the immunological rejection may relate to decreasing the expressions of CD4(+) and CD8(+) in the grafted pigskin and reducing the local inflammatory reaction.

OBJECTIVETo investigate the application of osteotomy template manufactured via 3D printing technique in bilateral sagittal split osteotomy (BSSO).

METHODSThe patient group consisted of 32 patients (17 males and 15 females) with mandibular hypoplasia who underwent a BSSO setback (Hunsuck modification; 64 splits). The mean age at the time of surgery was 23.5 years (range 1.9-35 years). All patients were scanned using cone beam computed tomography (CBCT) to create a 3D model of the mandibular, and the osteotomy template of the inner horizontal ramus of mandible bone incision was manufactured via 3D printing technique. All splits underwent operation with or without the osteotomy template by either a young doctor (attending doctor) or a doctor with extensive orthognathic surgery experience (chief doctor). The time it took to perform the mandible bone incision of the inner horizontal ramus of each group was recorded. Postoperative CBCT scan was performed, and the lingual split scale was used to assess the effect of the operation.

RESULTSPrimary healing of incisions was observed in all patients, and no serious complications occurred. The time it took to perform the mandible bone incision of the inner horizontal ramus was significantly different in the four groups (F=30.059, P<0.05), and it was longer in the group of the attending doctor without osteotomy template than in the other three groups (P<0.05). No significant difference was observed in the other groups (P>0.05). Although all splits (n=64) were performed according to the standardized protocol, only 59.38% (38/64) of the fracture lines run according to the Hunsuck's description. By contrast, only 21.88% (14/64) run through the mandibular canal and 18.75% (12/64) was split. The database was analyzed using crosstabs and via Fisher exact test. The split pattern was influenced by the application of an osteotomy template (P<0.05).

CONCLUSIONThe application of osteotomy template manufactured via 3D printing technique in BSSO was effective, which enabled the young doctor to complete the operation faster and with good results.