The essay mainly states and analyse some important cases,such as the physician-patient relationship,the clinical application of new medicine and new technology etc.Starting from the misleading caused by the disseminating,which is not scientific of medical health by the media,the author analyizes the reasons from the angle of the medium ethics and the medical ethics, and explores the ethical priciples which should be followed by the media while disseminating of the medical health information,in addition to some factors that should be considered by the media when disseminating information,if there aer conflicts among these primciples.

Through analyzing the data of Chinese Scientific and Technological Paper and Citation Database ( CSTPCD) , and studying the paper statistics of regional distribution, higher education institution distribution, medical institution as well as the situation of higher medical institution, the author holds that research strength influence rank of paper distribution most, and whether attach enough importance to paper publishing is an important factor.

Background Diabetic retinopathy (DR) has become the main cause of blindness in the world,But the etiology of DR is still not clear,and the results of the studies on the risk factors of DR are not completely consistent.Fully understanding the risk factors of DR has an important clinical value for the prevention and treatment of DR.Objective This study was to analyze the prevalence rate and risk factors of DR inpatients with type 2 diabetes and provide a basis for the establishment of ophthalmic intervention programs and measures for diabetic inpatients.Methods Cross sectional study was performed.Four hundred and seventy three patients with type 2 diabetes in the department of endocrinology,Dongguan People's Hospital from July 2011 to July 2012 were included.The patients were divided into DR group and non diabetic retinopathy (NDR) group.The DR group was subdivided into mild,moderate and severe non-proliferative DR (NPDR) group and proliferative DR (PDR) group.The sex and age of patients,course of diabetes,body mass index (BMI),systolic blood pressure,diastolic blood pressure,fasting blood glucose (FBG),2 hours postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1 c),fasting insulin,2 hours postprandial insulin,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A1 (APOA1),APOB,alpha lipoprotein,total cholesterol,three glycerol,urea nitrogen,creatinine,uric acid,percentage of neutrophil,24 hours urinary albumin total (ALBU-24 h) and ALBU were detected.Logistic regression was used to analyze the relationship between DR and various factors,and the risk factors of DR were screened out.Results The prevalence of DR inpatients with type 2 diabetes was 28.33％,the prevalence of mild,moderate and severe NPDR were 2.54％,16.28％ and 4.23％,respectively,the prevalence of PDR was 5.29％.The prevalence of DME was 10.36％ in the DR patients.The course of diabetes,the levels of serum lipoprotein,creatinine,ALBU-24 h and ALBU were statistically significant between DR group and NDR group (all at P＜0.05).By stepwise Logistic regression analysis,the course of disease,FBG were identified as the independent risk factors of DR (course of disease:odds ratio [OR] =1.155,95 ％ confidence interval [CI]:1.067-1.251;FBG:OR =1.313,95％ CI:1.071-1.610).Conclusions The course of diabetes,lipoprotein,creatinine,ALBU-24h,ALBU are closely related to the occurrence and development of DR.The course of diabetes and FBG are the independent risk factors of DR.

Objective To observe the prognostic factors of functional outcome of patients with cerebral infraction treated in stroke unit.Methods The data of patients with cerebral infractions treated in stroke unit in our hospital were prospectively collected from April 2004 to December 2005 continuously.All the patients They were fol lowed up either by their regular visits to our outpatient clinics or by phone interview.The modified Rankin scale(mRS)score was used as the index of primary outcome.The prognostic factors of the functional outcome were analyzed by monovariate and multivariate logistic regression.Results A total of 150 cases were collected,of whom 98 were with good outcome,52 cases with poor outcome.The multivariate logistic regression showed that the poor outcome was associated with aging,previous history of stroke,high NIHSS scores,complications,and time from onset of the disease to admission to stroke unit.Conclusion The results suggested that older age,having stroke history,higher NIHSS total scores,having complications and delayed hospitalized time were influence factors to functional outcome of cerebral infractions in stroke unit.

Objective:To explore the curative effect and safety of unilateral radical thyroidectomy via axillary approach endoscope without air insufflation.Methods:The clinical data of 80 patients with unilateral thyroid cancer in Huaibei People's Hospital in Anhui Province from June 2017 to June 2019 were retrospectively analyzed. The patients were divided into the control group (40 cases) and the observation group (40 cases) according to the surgical method. The observation group was treated with unilateral radical thyroidectomy via axillary approach endoscope without air insufflation, and the control group was treated with open surgery plan. The dissection number of lymph nodes in the central area, the time of flap separation and cavity establishment, the total operation time, the drainage volume and the days of hospital stay in patients of two groups were recorded, and the postoperative complications were evaluated and recorded. The neck and chest pain of patients were investigated with visual analogue scoring method (VAS) at 3 days, 1 month and 3 months after surgery. The white blood cell count (WBC), interleukin 6 (IL-6) and C-reactive protein (CRP) levels were measured before and 24 hours after treatment. The cosmetic satisfaction of the patients was investigated at 3 months after surgery.Results:The time of flap separation and cavity construction, total operation time, drainage volume and hospitalization days in the observation group were (34.27±4.38) min, (130.75±12.28) min, (143.49±15.48) ml, and (7.21±1.95) days, and they were (12.43±1.83) min, (90.38±8.65) min, (87.48±12.11) ml, and (5.48±1.32) days in the control group, and the differences between the two groups were statistically significant ( t values were 29.098, 17.002, 18.024, and 3.576, all P < 0.01). The VAS score of chest pain in the observation group was higher than that in the control group at 3 days after surgery ( P < 0.05); the CRP and WBC levels in the observation group were lower than those in the control group at 24 hours after treatment (both P < 0.05). The cosmetic satisfaction rating grade in the observation group was 6 cases of grade Ⅰ, 31 cases of grade Ⅱ, 2 cases of grade Ⅲ and 1 case of grade Ⅳ, and there were 1 case of grade Ⅰ, 10 cases of grade Ⅱ, 24 cases of grade Ⅲ and 5 cases of grade Ⅳ in the control group, the cosmetic satisfaction of the observation group was better than that of the control group ( P < 0.05). There was no significant difference in the incidence of postoperative wound infection, temporary recurrent laryngeal nerve paralysis and subcutaneous hematoma between the two groups (all P > 0.05). Conclusion:The radical thyroidectomy via axillary approach endoscope without air insufflation has good therapeutic and cosmetic effects, and it can effectively reduce the inflammatory response in patients.

The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored. The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug. 2007 to Nov. 2009 were retrospectively analyzed. In total 132 stents were implanted in the 111 patients. The mortality and rate of neural and non-neural complications were assessed perioperatively. Outcomes [including the frequency of transient ischemic attack (TIA), stroke, or death from vascular diseases) were assessed after operation. NIHSS rating was performed in all cases before and at first week, 6th month and 12th month after the operation. The PTAS success rate was 100%. The degree of stenosis was reduced after PTAS. The total complication rate during perioperative period was 15.3% (the rate of neural complications was 3.6%). Sixty-seven patients were followed up. Three patients (4.48%) developed cerebrovascular events within 1 month, containing one case of TIA, one case of ipsilateral mild stroke and one case of contralateral mild stroke. No severe stroke or death was observed. During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44%), including 2 cases of ipsilateral TIA (2.99%), 2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99%), one case of severe stroke (1.49%). In 13 patients receiving DSA re-examination one year after PTAS, 2 patients (15.38%) had in-stent restenosis. NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P<0.05). It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease. The success rate of PTAS was high, and the rate of complications was lower and the clinical outcomes were satisfactory. PTAS is a safe and effective therapeutic method, though the long-term outcomes need further study.

Humans ; Isotope Labeling ; Nuclear Magnetic Resonance, Biomolecular ; Protein Domains ; src-Family Kinases ; chemistry

Objective To analyze the clinical characteristics and survival prognosis of patients with AIDS-related malignant tumor. Methods We retrospectively analyzed the data of 354 patients with AIDS-related malignant tumor. Univariate analysis was conducted by Log rank test and multivariate analysis was conducted by Cox proportional risk regression model. Results The average age of the patients was 54.10±12.96 years old. The ratio of male to female patients was 2.1:1. The number of patients with AIDS complicated with lymphoma was the most, accounting for 28.25%. The 1-, 3- and 5-year survival rates were 78.48%, 62.13% and 55.31%, respectively. Univariate analysis showed that there were statistical differences in prognosis of patients with different types of malignant tumor, age, gender, medical insurance type, number of admissions after diagnosis of AIDS, average length of stay, radiotherapy or not, leaving hospital according to medical advice. Multivariate analysis showed that gender, number of admissions after diagnosis of AIDS, average length of stay, proportion of out-of-pocket and leaving hospital according to medical advice were independent risk factors affecting the survival and prognosis of patients. Conclusion AIDS is easily complicated with lymphoma, lung cancer and cervical cancer. The patients received insufficient anti-tumor courses in hospital.

Objective To explore the development and validation of a prediction model for severe communi-ty-acquired pneumonia in adults based on peripheral blood inflammatory indicators.Methods Venous blood samples of 204 community-acquired pneumonia in adults patients admitted to 7 hospitals in Chongqing area from April 2021 to August 2022 were collected to detect C-reactive protein(CRP),peripheral white blood cell count(WBC),neutrophil to lymphocyte ratio(NLR),cytokines,lymphocyte subgroups and neutrophil CD64 index.All of patients were divided into a training group and a validation group according to the time of admis-sion.Univariate and multivariate Logistic regression were used to analyze the data of the training group,the characteristic factors of severe progression for pneumonia were selected to construct the nomogram model,and the data of the validation group was used to verify the model.The receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)were used to evaluate the prediction ability of the model for severe community-acquired pneumonia in adults.Results Logistic regression analysis showed that age,CRP,WBC,interleukin(IL)-4/interferon gamma ratio and IL-6/IL-10 ratio were independent risk factors for severe community-acquired pneumonia in adults.The area under the ROC curve of the nomogram model in the training group and the validation group was 0.893 and 0.880,respectively.The calibration curve and DCA results shown that the model had a good prediction effect for severe community-acquired pneumonia in adults.Conclusion The inflammatory indicators included in this model are simple and easy to obtain clinically.This model with good differentiation and accuracy,it can be used as a practical tool to predict severe community-ac-quired pneumonia in adults,and has certain clinical application value.

The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored.The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug.2007 to Nov.2009 were retrospectively analyzed.In total 132 stents were implanted in the 111 patients.The mortality and rate of neural and non-neural complications were assessed perioperatively.Outcomes [including the frequency of transient ischemic attack (TIA),stroke,or death from vascular diseases) were assessed after operation.NIHSS rating was performed in all cases before and at first week,6th month and 12th month after the operation.The PTAS success rate was 100％.The degree of stenosis was reduced after PTAS.The total complication rate during perioperative period was 15.3％ (the rate of neural complications was 3.6％).Sixty-seven patients were followed up.Three patients (4.48％) developed cerebrovascular events within 1 month,containing one case of TIA,one case of ipsilateral mild stroke and one case of contralateral mild stroke.No severe stroke or death was observed.During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44％),including 2 cases of ipsilateral TIA (2.99％),2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99％),one case of severe stroke (1.49％).In 13 patients receiving DSA re-examination one year after PTAS,2 patients (15.38％) had in-stent restenosis.NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P＜0.05).It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease.The success rate of PTAS was high,and the rate of complications was lower and the clinical outcomes were satisfactory.PTAS is a safe and effective therapeutic method,though the long-term outcomes need further study.