Doctor-patient relationship has attracted increasing attention.In the light of modern model to study the related theory,a preliminary study of the ancient Chinese doctor-patient relationship model has been done.The doctor-patient relationship in ancient society is the same complex and multi-level.Therefore,doctor-patient model could not be lumped together.According to the social status of patients and the extent of their demand for medical services,and the social status of doctors and their medical technique,the doctor-patient relationship could be divided into three typies-equality type,authority type,and principal and subordinate type.With a view of doctor-patient relationship of traditional Chinese medicine,there draws an acquisition value of the current complex patient relationship.

Objective To investigate the awareness and trainning needs of health management knowledge in primary healthcare professionals in Beijing.Methods Six hundred primary healthcare staff from Daxing,Fangshan,Miyun,Pinggu and Huairou District of Beijing were selected in 2012 through muhiphase random sampling method and required to complete a standardized questionnaire.The survey included the average awareness rates of health management(tobacco,body weight and alcohol consumption control and daily physical exercises),the rates of application and conception awareness of risk assessment tools of chronic diseases,the awareness rates of normal levels of blood pressure and serum glucose as well as training needs.Differences in different regions were analyzed.Chi-square test was used for data analysis.Results The average awareness rates of tobacco,body weight and alcohol consumption control and daily physical exercises were 94.1％ (513/545),95.3％ (522/548),94.0％ (515/548) and 85.9％ (470/547),respectively.However,the rates of application and conception awareness of risk assessment tools of chronic diseases were only 55.1％ (295/535) and 59.8％ (329/550),respectively.Those who knew the normal levels of blood pressure and serum glucose accounted for 85.4％ (475/556) and 92.4％ (514/556),respectively; although only 23.6％ (131/556) and 21.2％ (118/556) were completely familiar with the major risks of these conditions.About 57.4％ (308/537) or 56.7％ (305/538) participants reported urgent needs for health education on diabetes and hypertension management.Conclusion The awareness of health management of primary healthcare professionals in rural areas of Beijing remains lower and may need to be raised by education or training.

Objective To learn current status of health management provided by primary health professionals working in rural areas of Beijing.Methods Health professionals in township hospitals in Beijing were selected by multi-phase random sample method in 2012 and surveyed by a standardized questionnaire to gathering the data on various health management contents,including health checkup,chronic disease management et al,the action location,its collaborative persons and sectors.Statistics description and inference were conducted to describe and compare the distribution of health management implementation across rural areas by descriptive methods and test,respectively.Results Nearly 66.3％ (321/484) of subjects provided health check-up,and 19.1％ (92/481)involved in follow-up study of mental diseases.The main targets population of health management were chronic diseases and the elderly,with response rate of 44.7％ (214/479) and 38.0％ (182/479),respectively.Health check-up,health education and follow-up of chronic diseases were performed in 62.1％ (298/480),52.4％ (251/479) and 42.8％ (206/481) of the township health centers.About 66.1％ (292/442) township health centers had cooperation with general practitioners; however,cooperation with administrative personnels was only 10.6％ (47/443).More than 41.4％ (201/463) township health centers cooperated with community administrative sectors,and cooperation with the propaganda department was only 10.6％ (49/464).The statistical difference across regions shows in the following,including health management action (health checkup,chronic disease patients following-up,et al),the target population covered (youth,elder person,children,and chronic disease patients),health management location(health checkup,education and chronic disease patients following-up in township hospital and village clinic),cooperation with General Practitioner.Conclusions Our results suggest that the actual situation on health management service in Beijing rural areas and the standards of public health equalization of China are still disjoined,even difference exists across regions.In order to improve the health management service quality,we should strengthen the health management personnel training,increase the general practitioner in proportion,establish the performance evaluation mechanism,increase governmental finance to support those service.

Objective To explore true thoughts and experience about student-based nursing teaching rounds among vocational college nursing students in Pediatric during the initial stage of clinical practice.Methods Interview was conducted on 27 nursing students of seven focus groups with semi-structured interview.The data was transcribed based on the tape and were analyzed by Giorgi analysis.Results Nursing students held positive attitude to this mode.Three themes were extracted:stimulating nursing students' learning potential,enhancing the comprehensive ability of nursing students; some students had difficulties in case selection,disease analysis and physical examination; suggesting that detailed rounds guideline should be issued to students first,and teaching rounds should be held every two weeks.Conclusions We should strengthen training of the ability of nursing assessment in pediatrics for nursing students,play the role of facilitator and advocate self-directed learning methods.

Objective To explore the relationship between field cognitive style and self-handicapping of medical students.Methods 124 medical students were measured by embedded figure test (EFT) and self-handicapping questionnaire (SHS).Results ①The scores of self-handicapping questionnaire were significantly different in whether they like their major or not(33.61±5.21,35.94±5.16,t=-0.218,P=0.031).Differences were also found in whether they could obtain the scholarships (33.20±6.19,35.12±4.12,t=-0.247,P=0.043),and in whether they were in a relationship(35.35±5.48,33.39±5.01,t=2.063,P=0.041).②Compared with field-independent cognitive style students,Field-dependent cognitive style students ' self-handicapping score was higher (35.69±3.91,32.63±6.08,t=3.303,P=0.001).③Field-dependent cognitive style,dislike their major and be in a relationship were the significant predictors of self-handicapping.Conclusion Correlation exists between field cognitive style and self-handicapping of the medical students.Students who belong to field-dependent cognitive style are more prone to self-handicapping than field-independent cognitive style students.

Objective:To investigate the efficacy and safety of different doses of tirofiban combined with coronary artery intervention in treatment of Non ST-segment elevation acute coronary syndromes (NST-ASC).Methods:110 cases with NST-ACS from October 2014 to January 2016 in our hospital were chosen and divided into the all dose group and half dose group.The TIMI blood grade before and after treatment,cardiac function before and after treatment for 30 d,major adverse cardiac events and bleeding events,hospitalization expenses and hospitalization days were recorded and compared between two groups.Results:Compared with before treatment,the TIMI 2 grade and 3 grade were obvious decreased,and the left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV) after treatment for 30 d were all obvious decreased,while the left ventricular ejection fraction (LVEF) were significant increased,P＜0.05.And the TIMI blood flow grading,LVEDV,LVESV and LVEF before and after treatment in two groups had no significant difference (P＞0.05),and the major adverse cardiac events and hospitalization days of two groups had no significant difference,P＞0.05.While the bleeding events and hospitalization expense of all dose group was obvious higher than those of half dose group,P＜0.05.Conclusions:The half dose group of tirofiban combined with coronary artery intervention in treatment NST-ACS has obvious efficacy,it can decrease the bleeding events and hospitalization expense.

Objective To investigate the sleep habit of children with cerebral palsy. Methods The parents of 81 children 4~12 years old ere interviewed with Children's Sleep Habits Questionnaire (CSHQ). Results The prevalence rate of sleep disorder (the score of CSHQ≥ 9) was 51.9%, and increased with the age of the children (P=0.001). The total score, bedtime resistance, and sleep anxiety of CSHQ was igher in 4~5-year-old group than in 6~7-year-old group and 8~12-year-old group (P<0.05). Female (OR=3.222 , P=0.032), young (OR= .702, P=0.022), and accepted rehabilitation later (OR=1.029, P=0.048) children were in risk for poor sleeping. Conclusion Sleep disorders re severe among children with cerebral palsy. Early rehabilitation may improve their sleep.

BACKGROUND:Under different induction conditions,bone marrow mesenchymal stem cells can differentiate into the mesodermal tissues such as osteoblasts,chondroblasts,muscle cells,adipocytes and so on.OBJECTIVE:To verify the effect on repairing the rabbit articular cartilage injury using bone marrow mesenchymal stern cells (MSCs)induced by tissue engineering method.DESIGN,TIME AND SETTING:Randomized controlled animal experiment was performed in the Clinical Center Laboratory of Shenyang Medical College between May 2005 and December 2007.MATERIALS:Twenty health New Zealand rabbits,irrespective of genders,aged 2-3 months,were used.METHODS:①Rabbit bone marrow MSCs were cultured in vitro,experiment group was cultured for one week withdexamethasone,basic fibroblast growth factor and vitamin C,then for additional 3 weeks with transforming growth factor-β instead of basic fibroblast growth factor;calls without inductors served as controls;②Twenty rabbits were used to establish knee articular cartilage defect models,which were then divided into three groups at random. Experiment group (n=5) was transplanted with the induced bone marrow MSCs;control group with the non-induced cells;blank control group with saline. At 2,4,6,8 weeks postoperation,two rabbits in the experiment group were killed,while one animal in control group and blank control group was killed for the index determination.MAIN OUTCOME MEASURES:①Cell morphology. ②Alkaline phosphatase activities.③General observation. ④X-ray observation.⑤Histological observation.RESULTS:①The morphology of the induced bone marrow MSCs was changed,from long fusiform to polygon,which was similar to cartilage calls-like morphology.②After the bone marrow MSCs were induced for 4 weeks,the alkaline phosphatase activities were obviously enhanced(P＜0.05).③Eight weeks after transplantation,the specimens in the experiment group exhibited smooth surface and unclear outlines with surrounding cartilage;X-ray results showed joint space broadened,subchondral bone sack was improved;histological slices observation revealed similarity with normal chondrocytes.CONCLUSION:Autologous MSCs transplantation can repair articular cartilage injury.

Objective To investigate the difference of MT4 G-201A of Metallothionein (metallotionein, MT) family gene locus single nucleotide polymorphisms (SNPs) in type 2 diabetes and essential hypertension. Mothods We selected 324 cases of patients with type 2 diabetes, 301 cases of patients with essential hypertension, 301 case of normal physical examination population. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis technology was used to detect MT4 G-201A polymorphism. Results (1) The genotype GG, GA and AA frequency of MT4 G-201A in 324 cases of patients with type 2 diabetes,301 cases of patients with essential hypertension, 301 case of normal physical examination population were 39.5%, 46.6%, 13.9%;42.2%, 48.5%, 9.3%;and 42.5%, 51.5%, 6.0%, respectively. The genotypes in all the distribution were in Hardy-Weinberg equilibrium (P>0.05) . (2) MT4 G-201A polymorphism:Three groups of genotype and allele frequency distribution (G and A) had differences (P<0.05) ; there was no difference between essential hypertension group and normal group (P>0.05);there was a difference between type 2 diabetes group and the normal group (P<0.05);there was no significant difference in genotype and allele frequency distribution (P>0.05) . (3) MT4 G-201A polymorphism in Men:Three groups of genotype and allele frequency distribution had differences (P<0.05) . In essential hypertension and type 2 diabetes group, there was no significant difference in genotype and allele frequency distribution (P>0.05) .MT4 G-201A polymorphism between women:Three groups of genotype and allele frequency distribution had differences (P<0.05), there was a difference between type 2 diabetes and normal group genotypes (P<0.05) . Conclusions (1) There is correlation of MT gene G-210A polymorphism and type 2 diabetes, no association with essential hypertension. (2) There is a difference of MT gene G-210A polymorphism in type 2 diabetes in women, no difference in men.

Objective To investigate the correlation between developmental function and pathological behavior in children with autism. Methods A total of 154 children with autism were tested with Revised Chinese Version Psycho-Educational Profile (C-PEP) during 2011 to 2014. Results The scores of fine movement, hand-eye coordination, and oral language of developmental function were lower in the girls than in the boys (t>2.120, P<0.05). Among the children with autism aged 2-7 years, the developmental function was better in the older group than in the younger group (P<0.05);however, it was not better in the children aged 8-10 years and>10 years than in those aged 6-7 years. There was no difference in the scores of pathological behavior between the girls and the boys (P>0.05). Some pathological behaviors were milder in the older group than in the younger group (P<0.05). The scores ofP(pass) in developmental function were positively correlated with the scores ofA(absence) in pathological behavior (P<0.01), and negatively correlated with the scores ofS(severe) in pathological behavior (P<0.01). The scores ofF(fail) in developmental function were negatively correlated with the scores ofA(absence) in patho-logical behavior (P<0.01), and positively correlated with the scores ofS(severe) in pathological behavior (P<0.01). Conclusion Develop-mental function of children with autism is highly correlated with pathological behavior, and the rehabilitation and education of children with autism aged above 7 years should be concerned.