Objective Identifying the factors of psychological pressure from medical disputes on clinical doctors and possible solutions. Methods Self-rating Anxiety Scale (SAS) and the Occupational Stress Indicator (OSI) were called into play, to study 52 clinical doctors in a tertiary hospital in a city, who had encountered medical disputes in recent two years. In parallel, 63 clinical doctors without such disputes and 50 non-clinical workers were randomly selected as the control group for questionnaires. Results Clinical doctors with such an experience were commonly found to be anxious, and their SAS score (58. 27±11.38)averaged higher than those in the control group. Doctor-patient relationship, legal liabilities and clinical positions were found to be positively correlated to psychological pressure of clinical doctors. Conclusions Medical disputes tend to add to psychological pressure of the doctors. Clinical doctors deserve psychological counseling and training and improvement of their working conditions.

Objective　To analyse the sensitivity of fineneedle aspiration cytology (FNAC) of breast masses.Methods　A series of 1035 FNAC of breast masses was reviewed.502 cases acccepted operation for histopathologic diagnosis.Results　The sensitivity of FNAC for breast malignant tumor was 98.9% and the specificity was 85.7%.Conclusions　The FNAC of breast masses has high accuracy.

Objective To observe clinical efficacy of recombinant human erythropoietin(rhu-EPO)in sepsis with anemia.Method From June 2005 to December 2006,sixty sepsis with anemia patients in the Second Affiliated Hospital of Tianjin Medical University were divided into control group(n=30)and theatment with rhu-EPO group(n=30).The exclusion criteria was:renal imufficiency patients needing blood purification,patients with hemorrhage of digestive tract,and patients who used rhu-EPO before.Patients in the rhu-EPO group were hypodermically injected with rhu-EPO at 48 hours after admission,6000 units par time,and continued every other day for two weeks.When the hemoglobin Was lower than 80 g/L,patients received red blood cell(RBC)transfusion or received other treatment decided by doctor.The data were expressed as(x±s),and were analyzed using Student's t test and Fisher's exact test with SPSS 11.5.A P valLie less than 0.05 indicated statistical significance.Results There Was no significant difference on hemoglobin between the two groups before treatment (P＞0.05).After treatment,the hemoglobin of patients in rhu-EPO group was higher than that in control group [(105.87±11.48)g/L vs.(91.23 ±19.89)g/L,P＜0.01].The units of RBC transfusions was less in patients of rhu-EPO group compared with control group[(2.0 ±0.47)U vs.(2.63±0.43)U,P＜0.01].There was no significant difference on mortality between two groups(P＞0.05).Conclusions In sepsis with anemia patients,administration of rhu-EPO every other day can increase red blood cell level and reduce RBC transfusion.

Objective To detect the expression of IL-6 in peripheral blood of patients with gastric cancer,as well as the expressions of IL-6,IL-6 receptor(IL-6R) and proliferating cell nuclear antigen(PCNA) in the neoplastic tissue in order to investigate the clinical significance of such expressions in looking for a convenient and effective way for the diagnosis and therapy of gastric cancer.Methods Enzyme-linked immunosorbent assay(ELISA) was employed for the parallel semi-determination of IL-6 levels in the peripheral blood of 30 patients with gastric cancer,as well as the levels of IL-6 and IL-6R in the neoplastic and adjacent tissues.The expression of PCNA in the neoplastic tissues was determined with immuno-histochemistry technique.Moreover,the correlation was comprehensively analyzed among IL-6,IL-6R,PCNA and the clinicopathologic findings of gastric cancers.Results The IL-6 levels in both peripheral blood and neoplastic tissues of 30 patients were significantly higher than those of the normal controls.The IL-6 levels in peripheral blood decreased significantly after operation;the IL-6 and IL-6R levels in cancer tissues were significantly higher than those in their adjacent tissues with a positive correlation between IL-6 and IL-6R levels.The expressions of IL-6,IL-6R and PCNA in both peripheral blood and neoplastic tissues of patients were positively related to the clinical manifestation of gastric cancer,including the differentiation degree of cancer cells,tumor size,infiltration extent and the metastasis of cancer cells.Conclusions IL-6,IL-6R and PCNA are the important factors which affect the degree of malignancy of the gastric cancer concerned,and they also,reflect the possibility of infiltration and metastasis of cancer cells.The IL-6 level in peripheral blood and the levels of IL-6,IL-6R and PCNA in tumor tissues of patients with gastric cancer are obviously high.The expression levels of all these factors are correlated with the clinicopathologic findings of gastric cancer.An adequate determination of IL-6 and PCNA is of benefit to the diagnosis and treatment of gastric cancer,and to the judgment of the course and prognosis of gastric cancer.

11? Hydroxysterold dehydrogenases (11?-HSDs )catalyse the interconversion of active glucocorticoids(cortisol,corticosterone )and their inert 11?-keto derivatives(cortisone,11-dehydrocorticosterone)They play an important role in regulating the local glucocorticoids activities.Glucoeorticoids can induce insulin resistance.The alteration of 11?-HSD activities in tissues such as liver ,adipose tissue, is closely relevant to some common disorders,including obesity and type 2diabetes mellitus.

AIM: To observe the effect of sibutramine in the treatment of obesity with different body weight. METHODS: Forty overweight subjects were divided into three groups according to their BMI: Group 1 (n=10), the early stage of obesity; Group 2 (n=11), obesity in degree Ⅰ; and Group 3 (n=19), obesity in degree Ⅱ. The patients conformed to the same standards of diet, sports and life style, and then took sibutramine 10 mg a day for 12 weeks. RESULTS: After taking the medicine for two weeks, the efficacy rate was 45.5 % (5) in Group 2 and 94.7 % (18) in Group 3 (P

Aim To establish a simple reverse dot blot m ethod (RDB) for detecting the genotype of NAT2 in Chinese people. Methods PCR was performed to obtain a biotin labeled DNA fragment. Allele specific oligonucleotide probes were spotted onto a nylon membrane. The DNA fragment hybridized with the membrane under stringent conditions. Finally, a nonradioactive colorimetric reaction was used to detect five mutants of NAT2. NAT2 genotypes of 48 patients with pulmonary tuberculosis were detected with RDB.Results The results obtained from RDB were in consistent with those from allele specific amplification. The NAT2 allele frequencies of *5, *6, *7 were 1.04%, 22.9% and 15.6%, respectively.Homozygous wildtype,heterozygous mutant and homozygous mutant subjects were 33.3%, 54.2% and 12.5%, respectively.Conclusion RDB method was proved to be accurate and convenient, it can be u sed in rational drug therapy.

ABSTRACT:Objective To investigate the clinical value and application indications of the second biopsy-cervical conization in the diagnosis and treatment of cervical lesions.Methods We selected 413 patients from Department of Gynecology and Obstetrics,General Hospital of Jinan Military Command,who received cervical multi-point biopsy pathology IA for cervical cancer and cervical conization (LEEP knife)of the second biopsy between January 2012 and October 2015.Their data were retrospectively analyzed.Results Compared with cervical multi-point biopsy, the second biopsy-cervical conization after operation had pathological upgrade in 10.65% (44/413),agreement in 73.37% (303/413),and reverse (pathological levels drop and overcast)in 15.98%(66/413).Cervical multi-point biopsy and the second biopsy-cervical conization significantly differed in the diagnosis of cervical low-level intraepithelial lesion,high-grade intraepithelial lesions,and early invasive cancer (IA)(T=21.740,v=3-1=2,P<0.05).Before conization high-risk type HPV infection positive rate was 71.91%(297/413);after operation it was 86.36% (38/44)in upgrade pathology and 70.20% (259/369)in non-upgrade one.And thin prep cytologic test (TCT)showed that the positive rate (ASC-US and above)was about 87.89% (363/413), of which about 11.85% (43/363)was pathological upgrade after conization.The positive rates of high-risk type HPV infection and TCT result (ASC-US and above)in cervical lesions differed significantly between pathological upgrade and non-upgrade after conization (χ2=5.092,P<0.05,χ2=4.476,P<0.05).Conclusion The second biopsy-cervical conization technique as a means of reevaluation of cervical pathological changes in diagnosis and treatment of cervical biopsy under colposcopy can significantly improve diagnosis rate,reduce misdiagnosis and occult cervical cancer,but its clinical application has some indications.

Population pharmacokinetics(PPK),which is based on the principle of statistics,can be used to estimate various inter- and intra-individual factors which affect pharmacokinetics.By using Bayesian estimator,PPK can predict individual pharmacokinetic parameters accurately.PPK is widely used in the immunosuppressive therapy with cyclosporine,tacrolimus,mycophenolic acid and sirolimus.

The larval and adult schistosomes can effectively establish the stable parasitic relationship with their final hosts and then maintain the parasitism for a long time,due to the successful adaptation to their parasitic lifestyle. This paper reviews the progress of research on parasitic adaptability of schistosomes in several respects,and demonstrates the application value of schisto-somal genes related to parasitic adaptability in schistosomiasis control and exploitation of natural active molecules.