This article deals with the relationships between doctors and patients in the ethical and legal perspective.It emphasizes that doctors should envisage,solve and settle new problems even conflicts with patients.Meanwhile,it points out that in China's tradition of ethical standard,the harmony between doctors and patients could not copy the legal system of the West.Adoption of ethics and laws as well as social responsibilities could result in good relationships between doctors and patients which could improve the service of hospitals.

Objective To investigate the effect of continuous positive airway pressure(CPAP) on nocturnal polyuria in patients with obstructive sleep apnea syndrome(OSAS). Methods The number of nocturia, the nocturia output, the osmotic pressure of nocturia and the nocturia excretion of Na＋ . Plasma levels of atrial natriuretic peptide (ANP) in night were measured in 8 patients. After treatment with CPAP, the patients were recorded or measured by those index again. Results The number of nocturia ， The nocturia output， The osmotic pressure of Na＋ ,and the plasma leels of NAP in night decreased significantly after tretment with CPAP.The osmotic pressure of nocturia rose significantly.The reduction of ANP corrected with the reduciton of the nocturia output,addition of the osmotic pressure of nocturia and the reduction of the nocturia exeretion of Na＋ .Conclusion CPAP can reduce the number of nocturia, the nocturia output and the nocturia excretion of Na＋ , increase the osmotic pressure of nocturia. The changes probably relate with the reduction of plasma level of ANP.

To introduction the biological function of vascular endothelial growth factor and to explore the role of vascular endothelial growth factor(VEGF)and in the pathogenesis of endotoxin,ischemia-reperfusion,hyperoxia,ventilator-induced lung injury(ALI)/acute respiratory distress(ARDS).

Objective To differentiate the sequences of Cyt b gene Agkistrodon from its adulterants sold in the market in order to provide molecular evidence for identification of Agkistrodon. Methods Cyt b gene was used to sequence and analyze Agkistrodon and its adulterants sold in the market. Results There was a mixed phenomenon in Agkistrodon species. The differences of Cyt b gene sequence between Agkistrodon and its adulterants sold in the market are significant: the difference rates among the species of Agkistrodon are 0%—0.91%, the difference rates between Agkistrodon and its adulterants are 18.57%—23.78%. Conclusion The characteristics of Cyt b gene sequence can be used as a better molecular marker for authenticating Agkistrodon from its adulterants.

The American Heart Association published a new guideline for cardiopulmonary resuscitation in Oct 2010.One of the most important recommendations is the sequence change of cardiopulmonary resuscitation from ABC to CAB.As pediatrician,we should understand the background of these changes,and give the most reasonable treatment to improve the success rate of resuscitation according to the different locations,different circumstances and different obiects.

Objective To explore prognostic factors associated with early and late recurrences after surgery for patients with gastric adenocarcinoma.Methods 214 patients who underwent curative resection for gastric adenocarcinoma were divided into 2 groups according to recurrence time:an early recurrence group included 143 patients who died within 2 years after surgery,and a late reeurrence group included 71 patients who died more than 2 years after surgery.Indexes such as age,sex,tumor site,tumor size,tumor pathology classification,Borrmann type,TNM staging,lymph node metastasis,operation type and postoperative adjuvant chemotherapy were compared.Results Single factor analysis showed that the tumor diameter,Borrmann type,TNM staging,lymph node metastasis,operation type,adjuvant chemotherapy were asoceiated with postoperative recurrence( test value were 8.32,16.21,24.90,5.22,17.23 and 3.61,respectively;all P ＜ 0.05 ).Multifactor analysis showed that tumor diameter and TNM staging is recurrent independent factors( relative risk were 5.642 and 6.211,respectively ;all P ＜ 0.05 ).Conclusion Tumor size and TNM staging are the most important factors for predicting the timing of recurrence after curative resection for gastric adenocarcinoma.Clinical practice should pay attention to follow up for patients with tumor diameter≥5cm,TNM Ⅲ-Ⅳ stage,especially within two years.

Asthma is a chronic inflammation of airway.The prevalence of children's asthma is becoming higher and higher in the past few decades for many reasons,such as environmental changes,the life style modification and so on.Risk factors,such as C-section,artificial feeding,pet touch and so on,were described.And the measures for the prevention of asthma were also prospected,for example,avoiding maternal vaginal infection,unnecessary C-section,improving the living surrondings,reducing the use of broad-spectrum antibiotics,avoiding the abnormal weight increase,preventing and treating the urticaria and allergic rhinitis and vaccinating the bacillus Calmette-Guérin.

Objective　To study the effects of deliberated hypotension combined with acute simple hemodilution on blood loss,postoperative hemoglubin of the patients undergoing spinal side(back) protrude correction(SSP).Methods　Twenty four ASA grade Ⅰ to Ⅱ patients undergoing elective SSP were randomly divided into two groups:control group(n＝12) and hypotensive group(n＝12).The all patients received with general anesthesia.In the hypotensive group:acute simple hemodilution was accomplished with infusion of lactated Ringer's solution and Gelofusine of as three times as blood loss.Deliberated hypotensin was induced and maintained with 0.01% sodium nitroprusside 2～6μg/kg/min iv.Intraoperative blood loss,blood transfused volume during operation and postoperative hemoglobin were recorded and compared between both groups.Results　 Blood loss was about 51% lower in the deliberated hypotensive group than that in the control group at the end operation.The average volume of transfused blood during operation was(1200±140)ml in control group,blood transfusion was(400±128)ml in the hypotensive groups.Conclusion Deliberated hypotension combined with acute simple hemodilution can significantly decrease the intraoperative blood loss and the SSP operation can be better tolerated for the indicated patients.

Objective To investigate the role of peroxynitrite in induction of apoptosis in non-heart-beating donor (NHBD) liver grafts. Methods Rat livers were harvested and perfused via the portal vein with 60 ml of cold 4℃ HTK solution from heart beating donors (HB) or 60 min after car-diac arrest from NHBD. A third group consisted of NHBD livers which were perfused with HTK con-taining 7500 IU of superoxide dismutase (SOD) (n=6, resp.). After cold storage for 24 h, the func-tional integrity of the liver was evaluated by isolated reperfusion with Krebs-Henseleit Buffer in a re-circulating system at 37℃ for 45 min. Results Compared to the NHBD livers, HB and SOD groups were characterized by a significantly reduced hepatic enzyme leakage(P<0. 05) as well as decreased portal venous pressure(P<0.01). Bile production upon reperfusion was increased significantly (P< 0.01). Prominent decreasing nitrite oxide(NO) (P<0.05), nitrotyrosine(P<0.01, P<0.05) and apoptosis(P<0.05) in effluent perfusate was encountered. Slight nitrotyrosine staining was concen-trated on the endothelial cells. Conclusion Peroxynitrite may play a fundamental role in the apoptosis caused by enhanced oxygen free radical production in NHBD livers.

Aspirin is a primary and secondary preventive medication for ischemic cerebrovascular diseases .Artery thrombotic events are still possible to occur after taking aspirin for a long time,and this indicates aspirin resistance(AR).At present, there is still lack of gold standard for the diagnosis of AR. It is usually interpreted as the loss of the biological effect of aspirin's antiplatelet aggregation and the role of preventing cerebral thrombosis events. Once AR occurs, other safe and effective altematives to antiplatelet agents should he used timely. This article reviews the concept, epidemiology, mechanisms, laboratory methods for detection and clinical intervention of AR.