Doctor-patient relationship is a special relationship between people in special circumstances during a special peri -od, which is directly related to the harmony and stability of society as well as people's quality of life.Values are the fundamental views of people, including the understanding of the nature , composition and standards of values .Doctors and patients are consistent in goals , interests and ideals , having the same objectives to overcome diseases , promote health , and prolong lives .They are essentially unified in values.However, there are some inharmonious phenomena in the relationship between doctors and patients .Efforts should be made to improve the present doctor-patient relationship by the whole society besides doctors and patients , aiming to establish a harmonious doctor-patient relationship of mutual respect , mutual trust , mutual tolerance and mutual cooperation on the basis of common values .

Objective:To explore the normative procedures for the hospital in introducing the new- into the hospital.Methods: To fill in the application form about the introduction of new-type medical materials into the hospital and to demonstrate them according to the procedures. The evaluation of management effect in normalizing the introduction procedures.Results: Standardize the introduction of new- type medical material flow, a long-term mechanism to establish open and transparent management, perfect the procurement model of hospital. Conclusion: Normalizing the introduction process of new-type medical materials, can make the hospital technological innovation and competitiveness.

This paper introduces the working flow of the installation and the check & acceptance of the medical equipment.The maior working flow includes the following item.(1)the time of accepting contract.(2)Auditing contract.(3)confirming the arrival time of the equipment.(4)preparing fabricating yard for the equipment installation.(5)the actual time of the equipment arriving.(6)unpacking and inspecting.(7)checking accessories of the equipment.(81collecting the manual of the equipment.(9)the procedure information of the importing equipment.(10)checking the eligibility of the equipment.(11)the operation and the training of the maintenance.(12)the measuring and auditing of the equipment.(13)the maintenance of equipment time.The working flow contributes a lot to our equipment checking & acceptance.In this article,we summarize the experience of the checking &acceptance of the medical equipment.

Medical model is the product of medical practice and crystallization of the essence of medicine and insights of life based on human being's fights against diseases for ages.Medical practice and medical model change fundamentally with the changing needs of human.being for health,having undergone for example from biomedical model to biopsychosocial(BPS)model.Thanks to perspectives of Epistemology and practice theory,the medical model is nourishing itself with BPS theories and methodologies for sustainable development,helping human being to better understand health and life multi-dimensionally.In such a model,individual hospitals will shift from focusing on disease care to provision of wholesome and sustained health services,while hospital systems will shift from coordination to resources reallocation and vertical integration.Thus the hospitals will gain new perspectives and broader horizon for development in the future.

BACKGROUND:Artificial valve replacement for valvular disease has good biocompatibility and hemodynamic characteristics, but there are stil many factors that affect its therapeutic effects. OBJECTIVE:To detect the level of serum Apelin-12 in the perioperative period of valve replacement in valvular disease patients with atrial fibrilation. METHODS: Sixty-two patients with valvular heart disease scheduled for artificial valve replacement were selected, including 30 patients with persistent atrial fibrilation (atrial fibrilation group) and 32 patients with sinus rhythm (sinus rhythm group). There were 33 males and 29 females, with a mean age of (55±11) years. Levels of serum Apelin-12 and makers related to inflammation and oxidative stress were detected in two groups at admission. Furthermore, the sinus rhythm group was sub-divided into postoperative atrial fibrilation (POAF) group (n=8) and non-POAF group (n=24) after valve replacement, and the above-mentioned indicators were detected and compared between these two subgroups. RESULTS AND CONCLUSION:Compared with the sinus rhythm group, the serum level of Apelin-12 was significantly lower in the atrial fibrilation group, while the levels of high-sensitivity C-reactive protein and interleukin-6 and total antioxidant capacity were significantly higher in the atrial fibrilation group (P <0.05). Correlation analysis showed that the serum level of Apelin-12 was negatively correlated with high-sensitivity C-reactive protein level and total antioxidant capacity (r=-0.265,P=0.045;r=-0.960,P <0.001), but not correlated with the interleukin-6 level (r=-0.155,P=0.230). Compared with the non-POAF group, the serum level of Apelin-12 was significantly lower in the POAF group (P< 0.05), but the left atrial diameter, high-sensitivity C-reactive protein level were higher in the POAF group (P < 0.05). Apelin-12 may take part in the occurrence and maintenance of atrial fibrilation through the regulation of inflammations and oxidative stresses. The testing of serum Apelin-12 has a certain value in predicting the occurrence of postoperative atrial fibrilation.

Rat brain development is a complicated process.There are significant changes of histology, cytology and molecular biology in the process of fetal and postnatal brain development.The basic structure of brain has formed in the prenatal period.While the formation of connections between different parts and the improvement of the function of the brain occur after birth, during which many of the variations are bases of the nervous system diseases, so the postnatal brain development is still very important.Although the concept of brain microenvironment has been proposed more than 150 years ago, the research about the changing extracellular space ( ECS ) during the postnatal brain development has yet to gain significant progress.The author reviewed the anatomical and physiological characteristics of ECS in the process of postnatal development of the rat, stating the important role of ECS in the individual development, which is expected to provide reliable evidences for the explore of mechanisms and effective treatment approaches of pediatric development related nervous system diseases.

Objective To understand clinical characteristics of primary pulmonary cryptococcosis (PPC),so as to provide reference for clinical diagnosis and treatment.Methods Clinical data of 32 patients who were confirmed PPC by pathological diagnosis in a hospital from January 2008 to June 2014 were analyzed retrospectively. Results All 32 cases were community-acquired infection ,26 male and 6 female (age between 17 and 62 years old, the average age was (35.53 ± 11 .29).Among 32 patients,8 had underlying diseases,2 were parturients,4 were carpenters,5 were pigeon keepers,3 were seafood transport drivers,and 10 lived in humid environment.Imaging findings:Solitary or multiple nodules and cluster shape(n=21),lobar consolidation(n=2),diffuse patchy shadow on bilateral lung (n=5),pulmonary cavity(n=3),and diffuse and mixed lesions (n=1).Pathological confirmation:di-agnosis through percutaneous lung biopsy(n=23),thoracoscopic surgery(n=7),and thoracotomy(n=2).Progno-sis:30 were cured,and 2 had marked effect.Conclusion PPC is commonly occurs in young and middle-aged immu-nocompetent persons,the onset is occult,clinical manifestations and imaging features lack specificity,can be easily misdiagnosed or omitted diagnosis,diagnosis is difficult,lack rapid diagnostic method in clinical practice,invasive pathological biopsy can be used as the basis of diagnosis;there is a controversy on therapy,adverse reaction of flu-conazol is mild,and has good therapeutic effect.

Objective To observe the efficacy of melbine combined with clomifene citrate in treatment of patients with polycystic ovarian syndrome ( PCOS) .Methods 60 patients aged 20 to 39 with PCOS were randomly divided into observation group and control group, 30 patients in each group.In the menstrual cycle of 3~7 d, the control group received clomifene citrate orally (50 mg per time, qd), and the observation group received melbine (2.5 mg per time, qd)combined with clomifene citrate (50 mg per time, qd), with a course of 5 days.Results The number of mature follicles and score of cervical mucus in obsercation group was significant higher than that in control group, respectively(P<0.05).The rate of follicular development and ovulation rate of single follicle in obsercation group was significant higher than that in control group, respectively(P<0.05), but there were no significant differences of pregnancy rate, first trimester abortion rate and periodic ovulation rate between two groups.The rate of endometrial thickness<7 mm patients in observation group was significantly lower and positive rate of three line was higher than that in control group, respectively ( P<0.05).The follicle stimulating hormone level in observation group was significantly lower than that in control group(P<0.05), but there was no significant difference of luteinizing hormone between two groups.Conclusion Melbine combined with clomifene citrate has a good effect on mature follicles number and endometrial thickness in anovulatory infertility women caused by polycystic ovary syndrome.

Objective To discuss the application of cephalocervical CT angiography (CTA) and ABCD2 score in evaluating arterial characteristics and interventional curative effect for patients with transient ischemic attack (TIA). Methods During the period from Jan. 2010 to Jan. 2012, a total of 64 patients with clinically-diagnosed TIA were admitted to authors’ hospital. ABCD2 score evaluation and cephalocervical CTA examination were performed in all patients. The correlation of stenotic degree and distribution of the cephalocervical arteries with the ABCD2 score was analyzed. According to the stenotic degree of the cephalocervical arteries, the patients were divided into low-risk group and mid-to-high-risk group. Twenty-two patients in mid-to-high-risk group received stenting angioplasty treatment. Follow-up was made at 3, 6 and 12 months after the treatment. Results Of 64 TIA patients, cephalocervical artery stenosis was found in 52(81.25%) A total of 149 arterial segments were involved, including intracranial segment (n=81, 54.36%) and extracranial segment (n = 68, 45.64%). Patients in low-risk group mainly suffered slight or moderate arterial stenosis, while patients in mid-to-high-risk group had moderate or serious arterial stenosis (χ2 =10.126, P=0.018). The preoperative ABCD2 score was (6.41 ± 0.50). The ABCD2 scores determined at 3, 6 and 12 months after the treatment decreased to(2.88 ± 0.69), (2.82 ± 0.63) and(3.00 ± 0.71), respectively. The differences were statistically significant (F = 86.657, P < 0.05). Conclusion Cephalocervical CT angiography and ABCD2 score can reliably evaluate the arterial stenosis and interventional curative results in TIA patients.

Objective To evaluate the influence of anus-preserved procedures on life quality of patients with low rectal carcinoma.Methods One hundred and forth cases with low rectal carcinoma who underwent double stapling technique(DST) (n =64) or support binding procedure(SBP) (n =50) were selected as our subjects.Patients in both group were undergone total mesorectal excision (TME) to sever mesorectum.Anal Function was assessed by Xu Zhongfa Anal-Function's criterion after operation.All patients were performed a 5 years follow-up.Results The 5-years survival rate and local recurrence rate were 65.63％ (37/64),20.03％ (13/64) respectively in DST group,and 76.0％ (38/50),6.0％ (3/50) in SBP group.The differences were significant (P =0.049,0.032).The postoperative general occurrence rate of dysuria,dysporia and sexual disorder in the DST group were 31.25％ (20/64),17.19％ (11/64) and 45.31％ (29/64) respectively,higher than those of SBP group(14.00％ (7/50),4.00％ (2/50) and 26.00％ (13/50) ;P =0.037,0.045,0.034).Conclusion Both DST and SBP therapy are proved to be effective in terms of anus-preserved treatment for low rectal cacinoma.5-year survival rate is similar in the two groups,while the survival quality is better in SBP group than in DST group.