A supportive appraisal system is needed in medical ethics construction to guarantee its persistent effect.This paper carries forward the realization of a harmonious physician-patient relationship as the final goal of medical ethics construction,and repelling medical corruption as its sub-target,so as to enhance the quality of medical service.By analyzing medical corruption with real case demonstration and ethical theories,the internal correlation of medical ethics and medical corruption is clarified,and the idea that " construction of medical ethics appraisal system calls for to carry forward medical professionalism,repel medical corruption,and construct a harmonious physician-patient relationship".

The expxprience of 8 thousand cases using contrast medium in abdomen CT scanning were reported.The results showed that it was more suitable for selecting 76% Urografin.The best oral concentration was 1.5%.In abdomen scanning intramuscular injection 654-2 conventionally could improve the image quality.The rectum and sigmoid region scanning should use tee contraast medium through the anus.Vein injection rapidly(bolus)was a best vein contrast method.When visualing badly after bolus or needing observe vessels of contin- uous several sections,continuous bolus method was used.while delay scanning was often used in defining nature of angioma.

Objective To analyze the clinical efficacy of diacerein plus methotrexate and leflunomide in the treatment of rheumatoid arthritis in elderly patients.Methods Eighty elderly patients with rheumatoid arthritis seeking treatment at our hospital from September 2010 to December 2012 were divided into the treatment group (n =40) and the control group (n =40).Patients with osteoarthritis were excluded from enrollment.The treatment group was given diacerein,in addition to methotrexate and leflunomide,whereas the control group received methotrexate and leflunomide.Results Compared with the control group,the treatment group showed a lower swollen joint count [(0.93±0.21) vs.(3.43±0.69),t=10.728,P=0.013],a lower tender joint count [(1.15±0.46)vs.(3.6110.83),t=11.443,P=0.008],shorter morning stiffness (1.6±2.2 min vs.13.5±4.2min,t=11.164,P=0.011),and greater hand grip strength [7.97±1.53) kPa vs.(5.68±2.07)kPa,t=10.562,P=0.014].When measured by health assessment questionnaire (HAQ),visual analogue scale (VAS) and DAS28 scores,the treatment group also performed better than the control group.Additionally,the treatment group displayed a more favorable laboratory profile,which included the erythrocyte sedimentation rate (ESR) (9.51±4.32 mm/h vs.26.47±6.32 mm/h,t=9.892,P=0.028),C-reactive protein (CRP) [(2.34±0.57) mg/L vs.(8.13±2.14) mg/L,t=9.427,P=0.031],and rheumatoid factors (RF) [(231.3±45.5) kU/L vs.(283.3±68.4) kU/L,t=10.023,P=0.018].Furthermore,the adverse reaction rate was significantly lower in the treatment group than in the control group (15.0％ vs.37.5％,x2 =5.230,P=0.020).Conclusions Diacerein in combination with methotrexate and leflunomide has shown clearly positive outcomes in the treatment of rheumatoid arthritis in elderly patients and should be recommended in clinical treatment.

No abstract available.
Delivery of Health Care* ; Korea*

About 30％ ～ 40％ of small cell lung cancer (SCLC) patients belong to limited disease (LD).In the setting of limited-disease small cell lung cancer (LD-SCLC),the combination of thoracic radiotherapy (TRT) with chemotherapy is the standard treatment for LD-SCLC with improved survival and local control.It is proven that prophylactic cranial irradiation can improve the prognosis of patients with SCLC.Radiotherapy should join in the early chemotherapy and individualized formulate appropriate target volume.Radiation schemes of conventional fractionation or hyperfractionation way are recommended.

BACKGROUND:To evaluate the psychological characteristics of the patients waiting for renal transplantation in order to analyze coping style, thus perform the corresponding personalized clinical psychological intervention which is conductive for patients to face reality and disease. OBJECTIVE:To investigate the psychological characteristics of the patients waiting for renal transplantation and to analyze the effect of different social factors on the coping style of patients and to explore the corresponding clinical mental intervention method METHODS:Fifty-eight patients waiting for renal transplantation and 60 patients without renal transplantation were randomly selected from Second Department of Urology, Organ transplantation Center, the 309th Hospital of PLA between February 2009 and August 2010, the patients were required to fil in a psychological questionnaire form using the currently general used medical response. The effect of social factors on the coping style and psychological stress status was analyzed with multi-factor Logistic regression analysis. RESULTS AND CONCLUSION:From the questionnaire survey, the evasive and yielding value scores of the patients waiting for renal transplantation were significantly higher than those of the patients without renal transplantation (P<0.05), but there was no significant difference of confrontation score between the patients (P>0.05). It indicated that the psychological pressure of the patients waiting for renal transplantation was bigger that of the patients with out renal transplantation, which may related with course of the disease, cost and the rejection after transplantation for the patients has to endured. Multi-factor Logistic regression analysis showed that sex, education, income, payment methods and age of the patients were al related with the confrontation, evasive and yielding scores, as those with technical secondary school education or better got the best confrontation score while those with annual income less than 60 000 yuan got the highest score in evasive and yielding styles. The results show that income and education level of patients are the main factors that affect the coping style and psychological stress status of the patients waiting for renal transplantation, treating the patients with reasonable renal clinical care interventions can help the patients face to the disease positively and can reduce the damage of transplantation to the psychology of the patients.

Bacterial infection is frequently seen in patients with liver cirrhosis,and the most common type of bacterial infection is spontaneous bacterial peritonitis (SBP).In clinical practice,antibacterial agents are widely used in the treatment of SBP.In addition,antibacterial agents can reduce rebleeding and mortality rates in patients with upper gastrointestinal bleeding.However,in order to avoid bacterial resistance,the appropriate use of antibacterial agents is very important.This article reviews the indications and resistance of antibacterial agents in patients with liver cirrhosis.

Objective To analyse CT appearances of fibroma and fibrosarcoma and to provide evidences for clinical diagnosis and treatment.Methods 8 cases with surgically-and pathologically-proved hard fibroma(nasal cavity,maxillary sinus and soft palate each and all 2 cases)and fibrosarcoma(nasal cavity and maxillary sinus each and all 1 case)were studied with retrospectively analysis.The scanning parameters were 5 mm thickness and interval for axial scanning.Results CT appearances of fibroma were single circular,semicircular or elliptical soft tissue masses which usually had homogeneous density,clear margin,thin and full envelope,wide base or a pedicel and slight or middle enhancement after contrast.The tumors grew distensibly,bones near the mass were constricted and thinned or absorbed but never destroried and the structures nearby were deviated but not involved.Fibrosarcoma showed such common CT manifestations as other malignant tumors in the same locations.Conclusion CT appearances of fibroma has some features,they are different from more common benign lesions.Fibrosarcoma can not be differeciated from other maglinant tumors,thier diagnosis must depend on pathology.

Objective To explore CT features and clues to diagnosis of rhabdmyosarcoma(RMS) in head and neck .Methods 14 cases of rhabdmyosarcoma scanned by CT were co llected retrospectively during 1992～2001 and comparatively studied by the age o f patients and the pathologic types. Results Children and adolecence were mainly involved in R MS in head and neck which pathologic types were embryonal type and adeno-vesicle type ,and the former was the main type .CT features of rhabdomyosarcoma include d round and oval masses which had a homogeneous high density and close relation to muscles ,obvious enhancement after injection of contrast media ,often complic ated with the wide destruction of bone and other adjacent tissues,the collecting lymph node enlargment.Conclusion CT findings of rhabdomyosarcoma in head and ne ck had some features and combined with the age of patients can be made the diagn osis of RMS.