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.

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 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.

Objective: To observe and analyze the efficacy and safety of naloxone in the treatment of patients with pulmonary encephalopathy. Methods:50 patients with pulmonary encephalopathy were randomly divided into the observation group and the con-trol group. All the patients were carried out continuous oxygen with non-invasive ventilator. The control group was treated with the con-ventional treatment, and the observation group was given naloxone on the basis of conventinal treatment. The treatment course was 7 days. The clinical efficacy, clinical indicators and adverse events of the two groups were observed. Results:The total effective rate of the observation group reached 92. 00%, which was higher than that of the control group without statistical significance (72. 00%, P>0. 05). The levels of pH, PaO2, PaCO2, angiotensinⅡand IL-8 were significantly improved in both groups after the treatment (P<0. 05), and the improvement in the observation group was much better than that in the control group (P<0. 05). The incidence of ad-verse reactions of the two groups after the treatment showed no significant difference (P>0. 05). Conclusion: Early application of naloxone in the treatment of pulmonary encephalopathy can improve the clinical indices significantly with low incidence of adverse reac-tions and high safety, which is worthy of promoted use in clinics.

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.

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 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.

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.