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.

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 summarize the curative effect in treatment of Raynaud's syndrome with chemical thoracic sympathectomy(CTS) guided by X-ray since 2001.Methods: From March 2001 to August 2007,97 patients with Raynaud's syndrome(186 limbs) were treated by CTS.Guided by X-ray,a needle was punctured through the back skin to the second thoracic sympathetic ganglion beside the thoracic vertebrae and 2 mL of 5%(v/v) phenol was injected.Results: The first CTS treatment produced a good effect on 146 limbs with an effective rate of 78.5%(146/186).The same treatment was performed on the limbs with no effect 1-2 days after the first treatment and produced good effect on 13 limbs with an effective rate of 32.5%(13/40).The total effective rate of the patients who were hospitalized for the first time was 85.5%(159/186).Of the 97 patients,78 patients(80.4%) were followed up for 47 months on an average with an effective rate of 69.5%.And the rate of complications was 11.4% for pheumothorax,and 3.9% for hydrothorax.Hyperalgesia on axillary region and anterior chest wall;Horner syndrome and sinus bradycardia were rare.Conclusion: CTS is minimally invasive and effective in treatment of Raynaud's syndrome.

Objective To state and analyze collateral vessels in patients with cirrhosis and portal hypertension with multislice spiral CT (MSCT).Methods 203 cases of cirrhosis and portal hypertension were included in the study and undergone upper abdomen examination with MSCT.Results 612 collateral vessels were demonstrated in this group: lower esophageal varices in 175, paraesophageal varices in 49, including greatly dilated azygos or hemiazygos veins and showing mediastinal pseudotumors in 13, gastric fundic varices in 119, left gastricvarices in 105, gastrorenal shunts in 34, splenorenal shunts in 15, paravertebral varices in 16, reopened umbilical vein in 48, reopenedparaumbilical vein in 22, reopened umbilical vein and paraumbilical vein in 4, abdominal wall varices and caput medusa sigh in 12, portalvein cavernous transformation in 8, greatly dilated right posterior portal vein connecting the inferior vena cava in 4 and left gastric veindirectly connected with the left portal branch in 1. Conclusion MSCT can much more clearly demonstrate the collateral vessels in patients with cirrhosis and portal hypertension. An understanding of the varied appearances of acquired abnormalities of the portal venous system will allow more definitive diagnosis and help avoid false diagnosis of disease, and may play a significant role in making a clinical treatment plan.

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.

Objective To investigate whether intrathecal administration of corticotrophin releasing factor(CRF) has an efficacy on visceral hypersensitivity in irritable bowel syndrome model rat.Methods Thirty rats were randomly divided into three groups(n=10 ).After establishment of irritable bowel syndrome rat model were intrathecal injected with CRF or preemptive peritoneal injected with CP-154526,which is inhibitor of CRF-1 receptor,and the control group to give saline.After experiment all rat with the method of rectal balloon distention,the perception thresholds and the number of abdominal withdrawal reflexes (AWR) of different balloon volume were observed.Results The perception threshold of intrathecal administration of CRF group was(0.62±0.10)ml and higher than other two groups [(0.52±0.09)ml,(0.56±0.08)ml;F=3.25,P＜0.05].At the same time,the number of AWR to the lower balloon content (1.0 ml) was(9.10±1.97)in intrathecal administration of CRF group slightly lower than other two groups[(14.4±1.71),(15.6±2.32);F=29.4,P＜0.01],but no difference was found to the higher balloon content (1.5 ml and 2.0 ml).Besides,the areas and OD value of c-fos positive neurons in cornu posterius medullae spinalis in group with intrathecal administration of CRF were significantly lower than other two groups (P＜0.05).Conclusion Intrathecal administration of CRF can degrade the visceral hyperensitivity in irritable bowel syndrome model rat,and lower expression of c-fos in CNS is probably involved in the process.