On the basis of principal-agent theory,this paper analyzed the reasons of doctor-patient problems from the perspective of patients and hospitals,hospitals and physicians,and patients and physicians.It included asymmetric medical information,ethical risks of physicians,incomplete contracts between physicians and patients,and uncertainty of medical results.Aimed at these problems,this paper put forward relevant suggestions.In the view of recognition,patients are supposed to get a rational idea in the process of selecting hospitals and try making a contract with general practitioners.In the view of improvement,the pattern of performance assessment to physicians should be developed.In the view of system,the corresponding management measures of health service should be improved so as to better serve patients.

Objective To explore the factors affecting the duration of secondary prophylaxis for penicilliosis marneffei in patients with acquired immunodeflciency syndrome (AIDS).Methods A retrospective analysis was conducted.The study included 92 adult patients with AIDS and penicilliosis mameffei which were confirmed at the Guangxi Centers for Disease Control and Prevention/Medecins Sans Frontieres clinic.The patients were divided into two groups based on the counts of CD4+ T cells at the time of discontinuation of secondary prophylaxis with itraconazole.The patients with a CD4+ lymphocyte count ＞ or =200 × 106 cells/L at the discontinuation of secondary prophylaxis were assigned to Group Ⅰ,and those with a CD4+ lymphocyte count ranging from 100 × 106 to 200 × 106 cells/L to Group Ⅱ.The treatment duration and clinical outcome were compared between the two groups,and factors which might affect the duration of secondary prophylaxis,including organ involvement,complications,antifungal regimen,antiviral treatment timing,and so on,were assessed.The SPSS 13.0 ~ftware package was used for statistical analysis.Results All the 92 patients received highly active antiretroviral therapy (HAART).No significant difference was observed in the sex ratio,age,follow up duration,number of organs involved,occurrence of complications,composition and duration of antifungal treatment regimens between the two groups (all P ＞ 0.05).The duration of secondary prophylaxis was significantly shorter in Group Ⅱ than in Group Ⅰ (8.13 ± 5.13 vs.12.44 ± 9.51 months,P＜0.05).The commencement of HAART after the treatment of penicilliosis,coinfection with other pathogens or mycobacterium tuberculosis were associated with a longer duration of secondary prophylaxis,and the influence degree of these factors decreased in order,whereas the commencement of HAART before the treatment of penicilliosis was associated with a shorter secondary prophylaxis (P ＜ 0.05).Conclusions For AIDS/PSM patients receiving HAART,secondary prophylaxis could be discontinued 3 to 6 months after the CD4 +lymphocyte count restores to 100 × 106 cells/L or more.The duration of secondary prophylaxis may be extended by the commencement of HAART after the treatment of penicilliosis,coinfection with other pathogens or mycobacterium tuberculosis,but shortened by the commencement of HAART before the treatment of penicilliosis.

Objective To investigate the relationship of Helicobacter pylori(Hp) and gastric cancer in animal.Methods Ninety of two-grade Wistar male rats were randomly divided into experimental group and control group.In 12 weeks after the rats of experimental group were infected with SS1 Hp strain,animal in two groups were then randomly subdivided into blank ,MNNG subgroup and MNNG+NaCl subgroup,15 rats in each subgroup.Animals in the MNNG and MNNG+NaCl subgroups received 100?g/ml of MNNG in the drinking water,and in the MNNG+NaCl still received 10% NaCl 1 5ml,two times a week for ten months.The blank received water plus libitum.All animals were sacrificed in two months after the above treatment.Histopathological features of the glandular stomach were assessed by HE stainning.Results By the end of the study ,87 rats were survival,3 rats died from the mistakes of perfusion of NaCl.Hp was detected in all infected rats.Adenocarcinoma had developed in the antrum of one experimental rat in the MNNG+NaCl subgroup. Adenomatous hyperplasia were observed in two groups,but its incidence in the MNNG and MNNG+NaCl subgroups of the experiment were 40% and 57 14% respectively,higher than that of the control(6 67% and 15 38%)(P0 05).Conclusions We demonstrated that long-term Hp infection could induce the chronic active and atrophic gastritis in animal model,increase the sensitivity of glandular gastric mucosa to carcinogen,and promote the incidence of pre-carcinomatous lesion.

0.05) for penetrating blood vessel, 46% and 18%( P

The reflective behaviors of teachers are a primary factor affecting teaching quality.However,the reflective behaviors of teachers can be propelled only by enhancing stimulus to teaching work,completing training system of continuing education on teaching theory and techniques to increase the teaching theory of teachers and performing teaching summarization of courses and assessment system.Only in this way can the teaching level and teaching quality of teachers be enhanced.

Objective Through the introduction and implementation of the tutor system to explore nursing practice of cultivating and management methods in operating room. Methods The theoretical knowledge,operation ability,comprehensive ability,and quality of work and so on before and after the implementation of tutor system for new nurse training were compared. Results Tutor system has obviously im-proved the comprehensive quality of new nurses,such as the interpersonal and communication skills and the ability to analyze and solve prob-lem independently. Conclusion The tutor system is beneficial to the interaction between teachers and students,thus enhancing the profes-sional identity of the operating room nurses,reducing the loss of the specialized nursing talents,improving the quality of nursing and setting up a new adapted teacher-and-students mode for teaching and training in the operating room. So it is worthy of extending application.

Objective To evaluate the efficacy and safety of tacrolimus 0.03％ ointment for the treatment of 2-year-old patients with moderate to severe AD.Methods An open-labeled,non-comparative,multi-center study was carried out,which included 59 2-year-old children with moderate to severe AD.All the patients were given topical tacrolimus 0.03％ ointment twice daily for 3 weeks.The evaluation of patients was scheduled at the baseline,1,2,and 3 weeks after the start of treatment.Clinical outcome parameters included the total response rate,eczema area and severity index score (EASI score),the percentage of body surface area (BSA％) affected,physician's global evaluation (PGE),children's dermatology life quality index (CDLQI),visual analog scale (VAS) pruritus score.Safety was assessed based on adverse events reported by patients or observed by the physicians.Results At the end of the treatment,the total response rate was 65.85％ with an EASI score of 4.18,and BSA％ of 16.41％.Of these patients,85.10％ achieved a satisfactory outcome,2.13％ achieved a complete cure,and all achieved an improvement,with no exacerbation observed.The 3-week treatment also resulted in a significant decrease in VAS pruritus score (from 6.80 to 3.21) and CDLQI (frown 7.06 to 2.91).Side effects mainly manifested as temporary burning sensation at the application site,and no severe adverse events associated with tacrolimus were observed.Conclusion Tacrolimus 0.03％ ointment seems safe and effective for the treatment of 2-year-old patients with moderate to severe AD.

Objective The aim of this study is to investigate STAT3 expression and the relationship between protein levels of STAT3 and clinicopathological parameters together with preoperative chemotherapy in human breast cancer. Methods Samples were obtained from 51 patients with breast carcinoma in which 7 patients had received preoperative chemotherapy. Western blot was used to measure the protein expression in tissue and SK-BR-3 cell line. MTT method was used to evaluate the proliferation. Cell-cycle and apoptosis were quantified by flow cytometry. Results STAT3 protein levels increased in breast cancer tissues compared with adjacent normal tissues(t=5.540,P

Objective The inhibitory effects of avastin on new blood vessels in nonproliferation diabetic retinopathy, age-related macular degeneration and neovascular glaucoma have been demonstrated. But only seldom report of avastin on corneal neovascularization(CNV) was seen. Present study was to evaluate the effect of topical bevacizumab (avastin) on experimental corneal neovascularization in mice. Methods Thirty eyes of 30 Balb/c mice were chemically cauterized by applying a 2 mm-diameter filter paper soaked 1 mol/L NaOH solution at the central cornea for 40 s. All animals were randomly assigned to five groups, including 1 mg/mL, 3 mg/mL and 5 mg/mL bevacizumab eye drops group respectively, 1 mg/mL dexamethasone sodium phosphate eye drops group (positive control) and normal saline solution group (negative control) . The drug was topically utilized twice per day. CNV was examined under the slim lamp on the 3rd, 7th and 14th day after alkali burn. Animals were killed on the 14th day after alkali burn. Area of CNV was calculated in terms of pixels on digital photographs. The use of animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results No significant difference was found in the grade of corneal injury among five groups (F = 0. 201, P = 0. 935). The area of neovascularization at the cornea surface was (37.11 ±3.17)% in 1 mg/mL bevacizumab group, (29.75 ±3.56)% in 3 mg/mL bevacizumab group, (18. 76 ± 2. 55) % in 5 mg/mL bevacizumab group, (20. 91 ± 2. 75) % in dexamethasone group and (41. 65 ±2. 11)% in normal saline group, showing a significant difference among groups(F = 71. 687, P =0. 000) with the further comparative decline in 5 mg/mL bevacizumab group compared with other groups (P ＜ 0. 01) . Conclusion The topical use of bevacizumab (avastin) inhibits alkali burn-induced CNV in mice.

This paper performs some explorations of the objective of talent-cultivation in 8-year-system medical education,and gives some advices of the objective of talent-cultivation in 8-year-system of Southern Medical University.