To differentiate health responsibilities in different circumstances should judge correctly the principle and conditions of responsibility division .It is deemed that the controllability view of responsibility provides the mor-al basis for health responsibility , which claims that the controllable causality is necessary condition for the judgment of responsibility .The construction of health responsibility is a multi -party participation .In face of the current re-ality of China , must build a diversified responsibility principle system: the responsibility of the government as the leading factor , the family and social responsibility as the backbone , and individual responsibility as base .

Objective To study the relationship between the methylation of p16 promotor and the pathogenesis and progress of psoriasis. Method Methylation-specific PCR and DNA sequencing were used to detect the methylation of p16 promotor. Results The methylation of p16 promotor was found in 23.08% (6/26) of psoriatic lesions and 19.23% (5/26) of non-lesional areas in psoriatic patients, but none in normal controls. The frequency of methylation of p16 promotor was higher in psoriatic lesions than that in normal skin (P

Objective To observe the therapeutic effect of suspending-needle therapy combined with modified Zhengan Xifeng Decoction for the treatment of primary facial spasm,and to explore an effective traditional Chinese medicine therapy for primary facial spasm.Methods A total of 65 qualified patients were randomly divided into trial group (33 cases) and control group(32 cases),which was treated with suspending-needle therapy combined with modified Zhengan Xifeng Decoction,Carbamazepine tablets respectively.Twenty-eight days constituted one course of treatment.After treatment for one course,therapeutic efficacy of the two groups was evaluated,and the degree of facial spasm was assessed.Results (1) After one course of treatment,the markedly-effective rate of the trial group was 84.8％,and that of the control group was 62.5％,the difference being significant(P ＜ 0.05).(2) After treatment,the degree of facial spasm in the two groups was much improved as compared with that of the control group (P ＜ 0.05 or P ＜ 0.01),and the improvement in the trial group was superior to that in the control group (P ＜ 0.01).Conclusion Suspending-needle therapy combined with modified Zhengan Xifeng Decoction has better effect on relieving facial spasm of the primary facial spasm patients than Carbamazepine tablets.

OBJECTIVE To explore the rational application of aminoglycosides antibiotics.METHODS We randomly selected 520 patients' records of applying aminoglycosides antibiotics from Jan to Dec in 2007.Types of antibiotics,dosages,usage,ways of delivery and periods and combination of medicines were analyzed.RESULTS Out of the 520 cases,the oldest patient was 89 year and the youngest one was 7 years.The application rate of amikacin was the highest(35.6%),which was delivered mainly by iv,the combination of medicines accounted for 92.7%.CONCLUSIONS The application of aminoglycosides antibiotics in our hospital is basically rational.In some cases the improper antibiotics are used and the duration is a little longer,which should be supervised.

OBJECTIVE:To establish an ion-pair RP-HPLC method for determination of the concentration of netilmicin sulfate in human serum.METHODS:The determination was performed on Luna C18 column with column temperature set at 40℃;the mobile phase consisted of acetonitrile-water (15∶85,pH 2.0,containing 10 mmol?L-1 sodium heptanesulfonate) at a flow rate of 0.8 mL?min-1.The detection wavelength was set at 205 nm.RESULTS:The linear range of netilmicin was 2～20 mg?L-1(r=0.997 6) with a recovery rate of 93.66%～96.05%.The intra-day and inter-day RSD were both less than 10%,respectively.CONCLUSION:The method is sensitive and simple with accurate and reliable results,and it is able to satisfy the requirement for the determination of serum concentration of netilmicin.

OBJECTIVE:To observe clinical efficacy of acitretin combined with TGP in the treatment of psoriasis vulgaris. METHODS:81 patients were randomized into control group(n=40)and treatment group(n=41). Control group were treated with 0.5 mg?kg-1?d-1acitretin then the dose of acitretin was adjusted to 0.1～0.2 mg?kg-1?d-1after clinical symptom improved.Treat-treatment course. Blood and urine routine,liver and kidney function and the level of blood lipid of 2 groups were detected before and after 8 weeks treatment as well as ADR. RESULTS:The total response rate was 90.2% for treatment group and 62.5% for control group,there were significant difference(P

Objective To investigate the clinical features, treatments and prognostic factors of rhabdomyosarcoma (RMS) in the female genital tract. Methods A retrospective analysis was performed on 13 cases of RMS in the female genital tract. Clinical characteristics, treatments and prognosis were compared and analyzed statistically. Results The median age was 21.0 years (range, 6 to 54 years). There were 6 cases vaginal RMS and 7 cases cervical RMS, included 11 cases of embryonal RMS (ERMS) and 2 cases of alveolar RMS (ARMS). According to the Federation International of Gynecology and Obstetrics (FIGO)staging system,there were 6 cases of stageⅠ, 3 cases of stageⅡ, 1 case of stageⅢand 3 cases of stage Ⅳ, the median survival time were respectively 112.5, 153.0, 9.0 and 3.5 months. According to the Intergroup Rhabdomyosarcom Study Group (IRSG) staging system, there were 10 cases of stageⅠ and 3 cases of the stage Ⅳ, and their median survival time were respectively 112.5 and 3.5 months. Nine patients received surgery and the median survival time was 108.0 months (range, 9 to 228 months), 6 of them received chemotherapy after surgery and the median survival time was 152.0 months (range, 9 to 228 months), the other 3 cases did not receive any therapy after surgery and the median survival time was 25.0 months (range, 9 to 108 months). Four patients did not receive surgery and the median survival time was 6.3 months (range, 1 to 117 months). There were 2 cases received combined treatment included radiotherapy and the survival time were respectively 4 and 198 months. There were 8 cases who was survival without disease and 5 cases died of cancer. The median survival time in 13 patients was 25.0 months (range, 1 to 228 months) and the 5-year overall survival rate was 58.6%. Conclusions The prognosis of early stage of RMS in the female genital tract is good. While, the prognosis of advanced stage is poor. The standard treatment strategy is combination of surgery and chemotherapy,whether radiotherapy could improve the prognosis still need further study.

Objective:To explore the surgical techniques in posterolateral mini-incision total hip arthroplasty and clinical effcacy.
Methods:A total of 94 patients (98 hips) had posterolateral mini-incision total hip arthroplasty, from December 2006 to December 2008, and were randomly divided into a posterolateral mini-incision total hip arthroplasty group (Group A) and a conventional group of posterolateral incision for total hip arthroplasty (Group B). Forty-nine patients (50 hips) in Group A had posterolateral small incision total hip arthroplasty [26 males, 23 females, between 37.0 and 95.0 years (average 68.9 years), body mass index (BMI) between 20.3 and 29.7 (average BMI 25.4)]. Forty-ifve patients (48 hips) in Group B had the conventional posterolateral incision [27 males, 18 females, between 45.0 and 92.0 years (average 69.7 years), BMI between 18.7 and 34.1 (average BMI 26.9)]. The incision length, blood loss, drainage, operation time, and postoperative Harris scores were compared between the 2 groups.
Results:The incision length was 6.0~10.5 (average length 7.4) cm, average blood loss was 387.6 (140.0~1000.0) mL, average drainage was 143.1 (63.0~375.0) mL, average blood transfusion was 77.6 (0~400.0) mL, average operation time was 84.6 (63.0~130.0) min, and vitalock abduction angle imaging after the operation was 41.6° (averagely 38.0°~57.0°) in Group A. The incision length was 15.0~23.0 (average length 20.0) cm, average blood loss was 513.1 (210.0~1350.0) mL, average drainage was 152.3 (70.0~520.0) mL, average blood transfusion was 142.2 (0~800.0) mL, average operation time was 84.0 (71.0~115.0) min, and postoperative radiographic acetabular cup abduction angle was 42.3° (37.0°~54.0°) in Group B. The follow-up showed that the prosthesis of the 2 groups was in a good position, Harris score was significantly improved with no complications after total hip arthroplasty in the 2 groups.
Conclusion:With the correct selection of indications and adept operation skills and other circumstances, posterolateral mini-incision total hip arthroplasty may do little damage to the soft tissue with a small scar on the skin. The imaging evaluation after the operation and the Harris score show no difference between the 2 groups. Patients are satisfied with their joint function and postoperative recovery.

OBJECTIVE To compare the difference of testing cleaning effectiveness in the operation instrument between the eye measurement and hemoglobin enzyme test.METHODS Five batches of instrument after cleaning were tested by two methods.RESULTS By eye inspection,all tested samples were qualified.However there were only 76 percent of samples qualified according to enzyme test.CONCLUSIONS Compared with eye inspection,enzyme test is a more sensitive method.Enzyme test can better assess the cleaning effectiveness than others.