Description of a multi-perspective view of harmonious doctor-patient relationship holds that medical social workers as a key tie for building such a relationship.It proposed the medical social work strategies for such workers in the face of patients and their families,hospital staff,and hospital management.

This paper described 8 patients in whom a spontaneeus renal subeapsular hematoma devel-oped.Two cases with systemic hypertension by the mechanism described by Page were observed.The diagnosis was confirmed by CT and ultrasound,and the patients were treated by means of the hematoma aspiration guided by uttrasound,8 cases were cured.The blood presure in 2 patients with Page's kidney was dropped to normal.No relapse was dernon,vtrated by follLw-up.Author reconlmend this treatment in such cases based on uhrasound and CT finding that rule OUt underlying pathological changes.

Objective To observe the efficacy of oxcarbazepine monotherapy on adult patients with temporal lobe epilepsy (TLE). Methods Eighty-nine patients with TLE who were admitted to hospital from July 2011 to December 2014 were enrolled in this study. They had underwent surgery. Depending on the postoperative treatment they were divided into oxcarbazepine group (46 patients) and carbamazepine group (43 patients) group. They were treated by oxcarbazepine and carbamazepine after operation. The efficacy and complication were compared. Results The patients in two groups were followed up for 1.5 years. According to Engel grade, the number ofⅠ, Ⅱ, Ⅲand Ⅳ grade in oxcarbazepine group was 29, 10, 5 and 2 patients, in carbamazepine group was 26, 9, 5 and 3 patients, and there was no significant difference (P>0.05). The rate of adverse effect in oxcarbazepine group was 6.5%(3/46), in carbamazepine group was 20.9%(9/43), and there was significant difference (P<0.05). At the end of follow-up, the scores of generic quality of life inventory (GQOLI-74) in oxcarbazepine group was (74.6 ± 2.9) scores, in carbamazepine group was (65.1 ± 3.2) scores, and there was significant difference (t=9.838, P=0.000). Conclusions The efficacy of oxcarbazepine and carbamazepine shows no significant difference in adult TLE.But oxcarbazepine monotherapy has fewer adverse effects and more security.

The emergence of drug resistance mutations in human immunodeficiency virus (HIV) genome is the major reason for antiviral treatments failure.To investigate the drug-resistance viral quasispecies in HIV-infected individuals and to find out the new drug resistance mutations have significant effects on directing effective clinical treatment and developing novel antiviral drugs.HIV drug resistance tests mainly include genotypic drug susceptibility assay and phenotypic drug susceptibility assay.We reviewed in this article some novel development in the field.

Objective To explore the clinical value of serum tumor markers including CEA,AFP,CA199,CA125,CK19,CA242 and CA724 in diagnosis of pancreatic adenocarcinoma in the elderly.Methods Totally 158 elderly and 102 middle-aged patients with pancreatic adenocarcinoma were selected.Pancreatic adenocarcinoma in all patients were confirmed by pathological examination,cytological examination and CT.100 elderly and 100 middle-aged patients with benign diseases were selected as control groups.The levels of serum tumor markers were detected and their sensitivities and specificities were calculated and compared between groups.Results The levels of serum CEA,CA199,CA125,CK19,CA242 and CA724 were higher in elderly patients with pancreatic adenocarcinoma than in the elderly control group [(70.9±11.4) g/L vs.(1.6±0.4) g/L,(158.9±19.1)U/mlvs.(12.6±3.2)U/ml,(53.9±15.4)U/mlvs.(11.6±1.1)U/ml,(70.2±16.3)U/ml vs.(1.4±0.2)U/ml,(96.4±18.5)U/ml vs.(7.9±2.2)U/ml,(57.6±13.6)U/ml vs.(4.4± 0.6)U/ml,t=26.13,31.63,17.57,19.03,20.95,15.59,respectively,all P＜0.05].The sensitivities of serum CEA,AFP,CA199,CA125,and CA242 were higher in the elderly patients than in the middle aged patients (61.72％ vs.48.69％,19.56％ vs.4.13％,80.31％ vs.69.55％,70.21％ vs.46.77％,75.24％ vs.59.44％,x2=4.28,12.63,3.94,14.32,7.23,respectively,all P＜0.05).The specificities of serum CEA,AFP,CA199,CA125,and CA242 had no significant differences between the elderly and middle aged patients (all P＞0.05).Conclusions Serum tumor markers may provide effective reference for the clinical diagnosis of pancreatic adenocarcinoma in the elderly,which has important value for pancreatic adenocarcinoma control and reversal.

Many datas show that thrombosis related events during chemotherapy in patients with cancer increase obviously.Thromboprophylaxis in patients receiving chemotherapy has been shown to not only improve the hypercoagulable states and effectively prevent thrombosis,but also have the potential antitumor effect and prolong the patients over survival.

OBJECTIVETo evaluate the effects of thermal and mechanical cycling on the metal-ceramic bond strength of machine-milled Ti2448 alloy and commercial pure titanium (cp Ti).

METHODSCeramic-cp Ti (n = 30) specimens and ceramic-Ti2448 combinations (n = 30) were prepared in accordance with ISO 9693. The specimens from each metal-ceramic combination were randomly divided into three subgroups. In group A or the control group, the specimens were only stored in distilled water for 24 h at 37 °C; in groups B and C, the specimens were subjected to 3,000 cycles of thermal cycling between 5 and 55 °C for a dwell time of 60 s and to mechanical cycling of 20,000 or 40,000 cycles with 50 N load and 4 Hz in distilled water at 37 °C. A crack initiation test was performed using a universal testing machine in accordance with ISO 9693. Failure types at the metal-ceramic interface and the morphological and elemental composition of this interface were analyzed using a scanning electron microscope and an energy dispersive spectrometer. Statistical analysis was performed via two-way ANOVA and Tukey's adjustment test (α = 0.05).

RESULTSThe bond strength of the ceramic-Ti2448 combination was significantly higher than that of the ceramic-cp Ti combination regardless of fatigue conditions (44.86 MPa ± 1.75 MPa and 29.21 MPa ± 2.20 MPa for Ti2448 and cp Ti, respectively; P < 0.01). The mean bond strengths of ceramic-cp Ti and ceramic-Ti2448 combinations in group C were significantly lower than that of group A (P < 0.01). Although ceramic-cp Ti combination failed adhesively at the metal-ceramic interface without the ceramic on the substrate surface, Ti2448 frameworks exhibited cohesive failure; as a result, large amounts of residual porcelain were retained on the specimens.

CONCLUSIONThe metal-ceramic bond strength of cp Ti and Ti2448 is decreased by thermal and mechanical cycling.

The measurement of renaI volume by ultrasound was carried out in 488 women with sigleton pregnahey.Sixty-eight women had infants with the intrauterine Browth retardation(IUGR).The average of renal volume in nofmal pregnant females and females with IUGR increased 57.2% and 8.4% respectively during trimester.Hence,the neonatal weight outcomes were cortelated with the renal volume in their mothers.The specficity of measurement was 96%,and the sensitivity was 65%.The sensitivety was influenced by type of IUGR and individual difference of renal vohme.The positive predictive vaIue was 74%.

Objective To explore the role of new emergency mode "Green track" in treatment on traffic injuries. Methods The data of 2 947 patients with traffic injuries rescued by prehospital emergency "green track" and inhospital emergency treatment from March 1998 to January 2009 were retrospectively studied in aspects of prehospital and inhospital treatment methods and their results. Results Of all patients, 2 089 patients were treated surgically and 858 patients treated conservatively, in which 2 736 patients (92.8%) were cured but 211 (7.2%) died, with mortality rate of 7.2%. Head, face and limbs were the main injury parts. Of all, 1 874 patients (63.6% ) were admitted into the hospital within one hour after injury. Conclusions The new emergency mode "Green track" , either prehospital or inhospital, can markedly improve success rate of treatment for traffic injuries, increase survival rate and is of importance to be clinically applied.

Objective:To compare the therapeutic effects between the Governor Vessel-regulating, liver-soothing and mind-calming needling and the routine acupuncture therapy for insomnia due to liver fire disturbing the heart.
Methods:A total of50 cases with insomnia were randomly divided by the random numberl table into the two groups, 25 cases in each group. The observation group was treated with the Governor Vessel-regulating, liver-soothing and mind-calming needling, while the control group was treated with the routine acupuncture therapy. The two groups were treated for five sessions per week, ten sessions as a course. After 3-course treatment, the therapeutic effects and the improvement of Pittsburgh sleep quality index (PSQI) were observed.
Results:After treatment for three courses, the total effective rate was 100% in the treatment group and 92% in the control group. The difference in the therapeutic effect between the two groups was statistically significant (P<0.05). After the treatment, thesleep latency, sleep duration, habitual sleep efficiency, subjective sleep quality, sleeping disturbances, daytime dysfunction, and total PSQI scores in the patients of the two groups were obviously improved in comparing those before treatment, with significant differences (allP<0.01). After treatment, the inter-group differences in the sleep latency, sleep duration, habitual sleep efficiency, subjective sleep quality, and total PSQI scores were statistically significant (all P<0.01); the differences in the scores of sleeping disturbances and daytime dysfunction is not statistical significant (all P>0.05).
Conclusion:Thetherapeutic effect of Governor Vessel-regulating, liver-soothing and mind-calming needling is better for insomnia due to liver fire disturbing the heart than the routine acupuncture therapy.