By studying the physician-related factors in physicianpatient relationship,authors put forwards that excellent medical skill,good medical ethics,favorable communication ability,and adequate knowledge on relevant legal regulations are four key points to handle the physician-patient relationship harmoniously.This article will supply reference from the above aspects for the all-around quality-based education for medical students.

Objective To investigate the effect of music electroacupuncture on perifocal ferric ions and neuronal apoptosis and the brain water content in rats with acute cerebral hemorrhage and explore the mechanism of its action on acute cerebral hemorrhage.Methods One hundred and twenty-eight healthy adult male Wister rats were randomized to normal, model, electroacupuncture and music electroacupuncture groups. In each group, four time points of 6 hrs, 24 hrs, 3 days and 7 days were set up, eight rats each time point. A rat model of acute cerebral hemorrhage was made using collagenase. In the electroacupuncture and music electroacupuncture groups, point Baihui was connected to the anode and point Taiyang to the cathode, 2 voltage was used as a selection parameter and electroacupuncture lasted 30 min. Intracerebral perifocal ferric ions and neuronal apoptosis and the brain water content were measured at four time points of 6 hrs, 24 hrs, 3 days and 7 days after model making.Results Intracerebral ferric ion content was higher in the model, electroacupuncture and music electroacupuncture groups of rats than in the normal group at 6 hrsafter model making (P<0.05), lower in the electroacupuncture and music electroacupuncture groups than in the model group at 24 hrs, 3 and 7 days after model making (P<0.05) and lower in the music electroacupuncture group than in the electroacupuncture group at 3 and 7 days after model making (P<0.05). Intracerebral neuronal apoptosis was higher in the model, electroacupuncture and music electroacupuncture groups of rats than in the normal group at 6 hrs after model making (P<0.05) and lower in the music electroacupuncture group than in the electro- acupuncture group at 7 days after model making (P<0.05). The brain water content was higher in the model, electro- cupuncture and music electroacupuncture groups of rats than in the normal group at 6 and 24 hrs after model making (P<0.05), lower in the electroacupuncture and music electroacupuncture groups than in the model group at 3 days after model making (P<0.05) and lower in the music electroacupuncture group than in the electroacupuncture group at 7 days after model making (P<0.05).Conclusions Music electroacupuncture has a benign regulating effect on intracerebral perifocal ferric ions, inhibits neuronal apoptosis around hematoma in the early stage and reduces cerebral edema in rats with acute cerebral hemorrhage. Its therapeutic effect is superior to that of electroacupuncture.

Objective To synthesize 4 kinds of 111 In?TPP cations and evaluate their properties as tumor cationic radiotracers in vivo and in vitro. Methods DO3A?xy?TPP, DO3A?xy?mTPP, DO3A?xy?dmTPP and DO3A?xy?tmTPP were radiolabeled with 111 In;their lipid?water partition coefficients and in vivo and in vitro stability were evaluated. The binding affinities of 4 kinds of 111 In?radiotracers were determined in cell uptake and cell efflux assay using U87MG tumor cells. Biodistribution studies and γ imaging studies were performed using the athymic nude mice bearing U87MG human glioma xenografts to explore the biologi?cal properties of 4 kinds of 111 In?radiotracers. One?way analysis of variance was used. Results The labeling yields of 4 kinds of 111 In?radiotracers were all above 85%, and the radiochemical purity were all greater than 99% after purification. Binding assay in U87MG cells showed that 4 kinds of radiotracers had great binding affinity and cell retention ability, and 111In?DO3A?xy?mTPP had the best binding ratio (1?49%;F=177.8, P<0.05) . Gamma imaging and biodistribution results showed that the U87MG tumors could be clearly visualized by 111In?DO3A?xy?mTPP, 111In?DO3A?xy?dmTPP and 111In?DO3A?xy?tmTPP, and the liver uptake of the 3 tracers was lower than that of 111In?DO3A?xy?TPP. In particular, 111In?DO3A?xy?mTPP had the best tumor/liver ratio (0.13±0.05, 2 h postinjection;F=9.4, P<0?05). Conclusions The tumor?targeted ability of 111In?DO3A?xy?mTPP is better than those of 111In?DO3A?xy?dmTPP, 111In?DO3A?xy?tmTPP and 111In?DO3A?xy?TPP, suggesting that it has the potential to be a promising tumor cationic radiotracer.

Objective To investigate the self-management behaviors in patients with liver cirrhosis and analyze its influencing factors. Methods Totally 103 liver cirrhosis patients were recruited by convenience sampling method. They were investigated by using Self- management Questionnaire for Chinese patients with liver cirrhosis. Results The total score of self-management behaviors was 63.69 ± 13.60. All subscales scoring from high to low in turn were medication, diet management, condition monitoring and daily management. Conclusions The self-management level in patients with liver cirrhosis of decompensation period need to be improved, nursing staff should pay attention to effect evaluation during the hospital health education, to ensure that patients can master disease self-management knowledge, to improve the self-management behavior of patients with liver cirrhosis.

Objective To investigate the current situation of healthcare-associated infection(HAI)management in secondary and above medical institutions in Shaanxi Province,analyze development trend,and put forward sugges-tions for improvement.Methods In May-June,2016,170 secondary and above hospitals in 10 cities were selected for surveying through stratified random sampling method.Survey content included basic situation of hospitals,HAI management,HAI monitoring,and so on.Results Available questionnaires were obtained from 165 hospitals (43 tertiary hospitals,and 122 secondary hospitals).Of 165 hospitals,more than 90% have established HAI manage-ment organizations and regulations,but hospital risk management should be paid more attention,only 63.03% of hospitals perfected the risk management system and 66.06% conducted risk assessment.99.09% of hospitals im-plement training on HAI to all staff regularly and 88.41% conducted effective feedback.In the aspect of staff alloca-tion,88.48% of the hospitals assigned enough professionals for HAI management,but only 34.55% have specific training programme for these personnel.Only 33.94% of hospitals have special funds for HAI control;in the aspect of monitoring on HAI,21.21% of hospital installed and used HAI monitoring software;In the aspect of implemen-tation of monitoring programme,about 90% of hospitals developed monitoring on HAI cases and environmental hy-giene,but only 34.55% and 23.64% of hospitals conducted targeted monitoring on intensive care unit and neonatal intensive care unit respectively.Conclusion Organizational structure of HAI management in Shaanxi Province is perfect,relevant rules and regulations are basically established,basic monitoring projects are universal,but the awareness of risk management needs to be strengthened,professional allocation and professional quality develop-ment are both imbalance,informational monitoring is inadequate.

Objective The medical code of biology-psychology-societyplays a vital role in modern treatment .The arti-cle aimed to investigate the clinical value of He-Ne laser combined with psychological intervention in the treatment of acute herpes and zoster. Methods Retrospective analysis was made on the clinical data of 81 patients with acute herpes and zoster in our hospital from Jan 2015 to Jan 2016 .The patients were divided into 3 groups randomly .Patients in group A were treated with antiviral and neu-rotrophic medication , psychological intervention and analgesic drugs . Patients in group B were treated with antiviral and neurotrophic medi-cation, psychological intervention and He-Ne laser.Patients in group C were treated with antiviral and neurotrophic medication , psychologi-cal intervention, analgesic drugs and He-Ne laser.Visual analogue scale ( VAS) was evaluated before treatment in hospital on the 3rd day, the 5th day of treatment, and telephone follow -up after 4 weeks of treatment.VAS and average length of stay were analyzed . Results No difference was found as to VAS before treatment in hospital among three groups (8.1 ±1.1, 8.1 ±0.9 vs 7.9 ±1.0, P<0.05).VAS was decreased in all groups after nursing propaganda , psychological intervention and placebo (P<0.05).Compared with the VAS before treatment, VAS in three groups decreased significantly on the 3rd day and the 5th day of treatment.From the re-sults on the 5th day and telephone follow -up after 4 weeks of treatment , VAS was still at a low level in group A and group B , on the contrary, VAS was decreased continuously in group C . Conclusion Combined treatment of antiviral , neurotrophic, analgesic drugs and He-Ne laser can relieve pain , decrease VAS and shorten the average length of stay for patients with acute herpes and zoster .

Objective To compare the operative and conservative treatments for senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ using Meta-analysis.Methods A literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,Wanfang Data and CNKI for studies on senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ from the earliest records through June 2016.The relative studies identified were screened by 2 independent authors.The quality of these articles was evaluated using modified Newcastle-Ottawa scale,and the meta-analysis was conducted using Review Manager 5.3.Results A total of 22 articles were brought into this Meta-analysis.The union rate was significantly higher in the operative group than in the conservative group[OR =0.30,95％ CI(0.20,0.44),P ＜ 0.001];the mortality in the operative group was significantly lower than in the conservative group[OR =0.61,95％ CI (0.39,0.96),P=0.03];the complication rate was similar in both groups[OR=1.09,95％ CI(0.76,1.57),P ＜ 0.46].The heterogeneity of all the 3 indexes was low.In the subgroup analysis,the union rate was significantly higher in posterior operations than in anterior operations or conservative treatments (P ＜ 0.05).Conclusion For the elderly patients with dens fracture of type Ⅱ or Ⅲ who can tolerate surgery,operative treatment may be more suitable because it can lead to much better prognosis.

Objective To analyze the characteristics and risk factors of preoperative deep vein thrombosis in patients with hip fracture,and provide a theoretical basis for clinical treatment and intervention.Methods 470 patients with hip fracture were chosen as the objects of study.The clinical data of the patients were retrospectively analyzed,including age,gender,injury,combined with other systemic diseases,fracture type (whether old fractures),two D-dimer level.All the patients with deep venous thrombosis of lower extremity were divided into DVT group and nonDVT group.There were 83 cases in DVT group,387 cases in non-DVT group.The factors like aboves as independent variables,presence of deep vein thrombosis as dependent variable,,preoperative deep venous thrombosis of the characteristics and risk factors were analyzed.Results 83 patients had DVT,the incidence rate was 17.7％.There were significant difference in age (40/83 vs 268/387),combined with other system diseases (57/83 vs 283/387),prevention measures (58/83 vs 196/387),D-thrombosis two dimer level (16/83 vs 122/387) of the two groups (x2 =13.712,14.836,9.876,5.313,all P ＜ 0.05).3 age ≥ 40 years,with other system diseases and injury,did not take to prevent the formation of thrombus measures were independent risk factors influencing the occurrence of DVT.Conclusion Age ≥40 years,combined with other system diseases and injury,don't take to prevent the formation of thrombus measures are independent risk factors influencing the occurrence of DVT.

Objective To investigate the incidence and risk factors for surgical site infection (SSI)in clean wound orthopedics surgery.Methods SSI among patients receiving clean wound orthopedic surgery from April 1 to Sep-tember 30 in 2014 were monitored,risk factors for SSI were analyzed.Results A total of 665 patients were moni-tored,14 cases(2.11 %)of SSI occurred.Univariate analysis showed that types of skin,skin preparation modes, and ASA score were risk factors for SSI in clean wound orthopedic surgery (all P <0.05 ).Multivariate logistic analysis revealed that conventional skin preparation,ASA score ≥ grade Ⅱ,and duration of operation ≥90 minutes were independent risk factors for SSI in patients receiving clean wound orthopedic surgery (OR [95%CI ],3.96 [1 .07-14.70],6.45[1 .97-21 .11],and 4.08[1 .35 -12.30]respectively).Conclusion The improved method of skin preparation,grade I ASA score,and shortening duration of operation can reduce the incidence of SSI in clean wound orthopedic surgery,on the basis of improving the autoimmunization of patients,strengthening prevention and control of healthcare-associated infection can reduce the incidence of SSI in clean wound orthopedic surgery.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Neuromyelitis Optica ; therapy