The article analyses the avail relationship of doctor and paient from medical service nowadays. It contains expense and risk and care. It is essential for the setting questions that the both observe morality. It behaves law, credit, awareness, communication to reduce medical dissension, and avoid conflict for both avail to big and for happy cooperation relationship.

The bribe in the medical field is a persistent ailment. The phenomena can be contributed to various factors including the lack of allowance, unbalanced system and the cultural approval. To rectify it, the effective system is the key point while the healthy cultural morality is required.

Health is of moral significance from the comprehension of biopsychosocial adapting well-being.The morality is the essential featurse of health.Therefor,provation of personal moral accomplishment and social public welfare can promote health.

Objective To investigate the expression of S100A4 and hypoxia-induced factor 1α (HIF-1α) protein in type Ⅰ endometrial carcinoma,and to analyze their relationship.Methods The expressions of S100A4 and HIF-1α protein were detected in 65 cases of type Ⅰ endometrial carcinoma and 40 normal endometrial tissues.Results The positive rate of S100A4 in endometrial carcinoma was 47.7 ％ (31/65),the normal tissues was 0 (0/40),and there was significant difference (x2 =27.069,P =0.001).The positive rate of HIF-lα was significantly higher in endometrial carcinoma [63.1％ (41/65)] than that in the normal tissues [7.5 ％ (3/40)] (x2 =31.417,P =0.001).The expressions of S100A4 and HIF-1α were positively related with FIGO staging,pathological grades,myometrial invasion and lymphatic metastasis (all P ＜ 0.05).The expressions of S100A4 and HIF-1α were positively correlated in type Ⅰ endometrial carcinoma (r =0.348,P =0.005).Conclusion The expression levels of S100A4 and HIF-1α are closely related with the oncogenesis and progression of type Ⅰ endometrial carcinoma,and their co-detection may be useful in prognosis assessment.

0.8 mm) of carotid artery in patient group (42.3%) were more than those in control group (7.4%)((P45 yrs).Conclusion Cerebral infarction in young and middle-aged patients is closely related to atherosclerosis of carotid artery.

Objective To investigate the clinical efficacy of amoxicillin combined with pectin in the treatment of chronic atrophic gastritis. Methods According to the different treatment methods will be January 2015 to March 2017 patients with chronic atrophic gastritis in our hospital 80 cases groups:control group with clarithromycin+amoxicillin+bismuth pectin bismuth pectin treatment,observation group treatment;detailed records of two groups before and after treatment(pathological atrophy,intestinal metaplasia,dysplasia,chronic the inflammatory activity and the integral changes),the levels of inflammatory factors(IL-2/IL-6/CRP)incidence level changes and adverse reaction,the obtained related data for comparative analysis. Results Amoxicillin and bismuth pectin(observation group)in treatment of chronic atrophic gastritis is better than clarithromycin+bismuth pectin(control group)treatment,patients with pathological score decreased than the control group,the levels of inflammatory factors is better than the control group,the incidence rate of adverse reaction was lower than the control group,the difference was statistically significant(P<0.05). Conclusion Chronic atrophic gastritis patients choose amoxicillin and bismuth pectin treatment effect significantly,can greatly reduce the pathological integral,improve clinical symptoms,and can reduce the level of inflammatory factors in patients with a low incidence of adverse reactions,it is worthy of widely used to treat patients with chronic.

ObjectiveTo investigate the clinical efficiency of oral warfarin after cardiac valve replacement and the influence of vitamin K epoxide reductase complex subunit 1(VKORC1) gene polymorphisms on warfarin maintenance dose.MethodsOne hundred and fifty-nine patients who got cardiac valve replacement surgery were chosen and received anticoagulation therapy by oral warfarin.The prothrombin time (PT),international normalized ratio (INR) of patients were recorded and the safety ranges of PT and INR were calculated statistically.VKORC1 gene polymorphism of patients weredetected by PCR-PFLP technology by adjusting the dose of warfarin,and the results were compared.ResultsThe safety monitoring range of PT of oral warfarin after cardiac valve replacement surgery was 15.36 -24.82 s,safety monitoring range of INR was 1.33 - 2.62.The occurrence rate of bleeding during anticoagulation was 13.21％(21/159).The weekly dose of warfarin of VKORC1 gene type AA [(24.28 ± 10.79) mg] was significantly higher than that of VKORC1 gene type GA[ ( 16.64 ± 7.43 ) mg] and type GG[ ( 12.12 ± 7.17 ) mg](P＜ 0.05or ＜0.01 ).ConclusionsThe polymorphism of VKORC1 gene is the dominant factor of the differences of warfarin maintenance dose.The warfarin dose in patients with different gene type is different.The clinical safety monitoring ranges of PT and INR in patients with oral warfarin after cardiac valve replacement are lower than the recommended ranges of European and American countries.Therefore,the index of patients after surgery should be detected regularly.

ObjectiveTo investigate the diagnostic value and prognostic significance of plasma soluble triggering receptor-1 on myeloid cells ( sTREM-1 ) in patients with sepsis in the early stage.MethodsA total of 56 patients with systemic inflammatory response syndrome (SIRS) were enrolled for prospective and control study from May 2009 through July 2010. According to the criteria of sepsis set by SCCN/ESICM/ACCP/ATS/SIS in 2001, patients were divided into sepsis group ( n = 32), SIRS group (n = 24) . Meanwhile, 25 non-SIRS patients were enrolled in the control group. The sepsis group was further divided into two subgroups, namely survival subgroup and non-survival subgroup according to 28-day outcomes. The sTREM-1, procalcitonin (PCT), C-reactive protein (CRP), white blood cell count and neutrophil percentage count (NPC) were measured and APACHE Ⅱ scores were determined within 24 hours after admission. The correlation between sTREM-1 and APACHE Ⅱ score was analyzed. Quantitative data were analyzed by using F-test or Kruskal-Wallis test. ResultsThe plasma level of sTREM-1 in patients of sepsis group was significantly higher than that in SIRS group and control group [215. 1 (157.9 ～397.3) ng/L vs 103.6 (89.4 ～ 176.2) ng/L vs 33.6 (26.2 ～ 43.0) ng/L, P＜0. 05]. The plasma level of sTREM-1 in non-survival group was significantly higher than that in survival group[360.5 (262.2～434.5) ng/L vs 204. 1 (175.0～269.6) ng/L, P=0.002]. In sepsis group, the plasma level of sTREM-1 was positively correlated with APACHE Ⅱ score ( r, = 0. 426, P = 0. 032 ) The area under the ROC curve of sTREM-1 was 0. 935, larger than that of PCT and CRP. Conclusions Plasma sTREM-1 is a useful marker in diagnosis of sepsis at early stage. The increase in the level of sTREM-1 during the first 24 hours might be correlated with poor outcome of patients with sepsis.

OBJECTIVE:To investigate the relationship between the variation of bacterial-resistant and the consumption of antibacterial drugs. METHODS:The DDDs and its sequence of antibacterial drugs in 70 hospitals in Shanxi province over 3 years and the synchronic annual resistant rates of some pathogenic bacteria were analyzed statistically and the correlation between the variation of bacterial-resistant and the drug consumption was analyzed. RESULTS:In terms of variety,there was no obvious change for the top twenty antibacterial drugs. The antibacterial drugs with high DDDs thus ranked the lead were those kinds that with high bacterial drug resistance. At a value of over 50%,the bacterial drug resistance rate would not decrease obviously with the variation of the drug consumption. The drug resistance rate increased greatly with the increase of the consumption of the forth generation of cephalosporins cefepime. The consumption of vancomycin increased,but its resistance rate decreased. The antibacterial compound preparation showed satisfactory antibacterial activity even if its consumption had a marked increase. CONCLUSION:There is a direct relation between the consumption of antibacterials in large quantity and the variation of drug resistance. It is necessary to strengthen clinical management on antibacterials to raise rational drug use level.

Objective To evaluate the change situation of cognitive function in the patients with chronic renal failure (CRF) complicating obstructive sleep apnea syndrome(OSAS) .Methods Sixty‐two inpatients with non‐dialysis CRF in our hospital from September 2013 to January 2015 were selected and divided into the group O (complicating OSAS ,31 cases) and group N(without complicating OSAS ,31 cases) ,and contemporaneous 33 individuals undergoing the physical examination were taken as the control group(group C) .The cognitive function was evaluated by the Montreal cognitive assessment (MoCA) .The apnea hypopnea index (AHI) and lowest pulse oxygen saturation(LSpO2 ) at night were measured with a portable sleep monitor .The comparative analysis was performed .Results In the group O ,there was 14 cases of patients(45 .16% ) whose MoCA total score was less than 26 points , while there was only 3 cases(9 .68% ) in the group N ,the difference was statistically significant (P<0 .05) .The MoCA total score , scores of visuospatial and executive function ,attention ,delayed recall and orientation in the group O and N were lower than those in the group C ,while the MoCA total score ,attention and delayed recall in he group O were lower than those in the group N ,the score of language was lower than that in the group N and C ,the differences were statistically significant (P< 0 .05) .The MoCA total score was negatively correlated with serum creatinine and AHI (r= -0 .374 ,r= -0 .408 ,P<0 .05) ,and positively correlated with the GFR level and night LSpO2 (r=0 .382 ,r=0 .519 ,P<0 .05) .Conclusion The patients with CRF complicating OSAS increase the risk of cognitive impairment .