In the course of medical activities, doctors and patients may form various kinds of social relationships. Of these, the one adjusted by health laws and regulations is termed the legal relationship between doctors and patients. A legal relationship is one involving certain rights and duties that are clear cut and must be observed and breaches will lead to corresponding legal responsibilities. From the legal perspective both doctors and patients, while enjoying their respective rights, must fulfull their legal obligations. Medical institutions and their workers ought to update concepts, cultivate the idea of a legal relationship between doctors and patients, and handle the doctor patient relationship on the basis of a legal relationship and legal reasoning so as to meet the actual needs of society.

The sex - change has been applied in clinic for about twently years. But there was no correlative law so far. It appeared law cases uninterrupted in recently years, which accompanied a simply on the legality, freedom for decision of the sex - change surgery and sexual testification after the surgery.

BACKGROUND: Junior medic is a special population, which has high speciality and great pressure in study. To investigate the characteristics of personality and mental health of this population can explore the reasons of mental problems in junior medics, which can provide theoretic gist for the establishment of the intervention to improve the mental health of this population.OBJECTIVE: To provide approaches and methods for customized development of mental health education through the comprehension of the status of personality and mental health characteristics of junior medics.DESIGN: A stratified randomized cluster sampling survey.PARTICIPANTS: Totally 550 students of grade 1 and grade 2 in Harbin Medical University were selected by stratified randomized cluster sampling in the September 2004.METHODS: Self-rating depressive scale (SCL-90) and Eysenck personality questionnaire (EPQ) were independently answered by 550 students and taken back on the spot.MAIN OUTCOME MEASURES: Key consequences: EPQ scores for extroversion(E), neuroticism(N), pschoticism(P), reliability(L) and the SCL-90 scores for somatization, compulsion, sensitive human relationship,depression, anxiety, hostility, phobia, crankiness and psychosis. Minor consequence: the statistical typical correlative analysis between total score and score of 9 items in SCL-90 and the scores of 4 scales in EPQ.RESULTS: Junior medics had significantly higher scores in compulsion (1.83 ±0.52), anxiety(1.47 ±0.43), psychosis(1.43 ±0.43), and crankiness(1.54 ± 0.55) than Chinese norm( t = 6. 57 -9.09, P ＜ 0. 05).The characteristics of personality were introversion, optimism, humility, and active. The shortcomings were anxiety, depression and emotional There was positive correlation between personality problem and the severity of mental problem in junior medics.CONCLUSION: The proportion of students with personality problems or mental health problems is relative high in junior medics. Effective interventions should be employed.

Objective To investigate the significance of levels of IL-8,TNF-α in serum of patients with aplastic anemia(AA).Methods Serum levels of IL-8 and TNF-α in 45 patients and 30 normal controls were measured by enzyme linked immunosorbent assay.Results The serum levels of IL-8,TNF-α increased significantly in AA and acute AA(AAA)group than in the control group(P＜0.05),there was no statistical significance between chronic AA(CAA)group and the control group(P＜0.05),and the levels in AAA group were much higher than in CAA group(P＜0.05).The serum level of IL-8 was positively related to TNF-αin AA group(r=0.682,P＜0.05).Conclusion There are immunological disorders in patients with AA and the overproduction of IL-8,TNF-α might be involved in the immunopathogenesis of AA,AAA.

Objective To analyze and compare of regional citrate anticoagulation (RCA),low molecular weight heparin and hep-arin-free in severe sepsis patients with thrombocytopenia CRRT treatment effect and complication of the situation.Methods Retro-spective analysis of 3 6 patients admitted to ICU CRRT therapy of severe sepsis in patients with thrombocytopenia was made.Nine patients were given RCA,1 4 patients were given low-molecular-weight heparin calcium and 1 3 patients were given no heparin anti-coagulation programme.And then observation of three groups of CRRT treatment of coagulation function in patients with platelet depletion,blood,bleeding conditions,filter effects,filter usage time,and 15-day,30-day mortality were made.Results In RCA group and heparin-free group,coagulation blood features was significantly superior to low-molecular liver pigment calcium group (P<0.05),there was no significant difference(P>0.05)between RCA group and heparin-free group coagulation in blood features. Bleeding rate and platelet consumption in RCA group were significantly lower than that in heparin-free group and low molecular liv-er pigment group(P<0.05).Filter usage life in RCA group and low molecular liver pigment group was obviously longer than that in heparin-free group(P<0.05).There was no significant difference in filter effect,15 days,30 day fatality rate among the three groups(P>0.05).Conclusion Severe sepsis in patients with thrombocytopenia in CRRT applications of regional citrate anticoagu-lation could reduce the risk of hemorrhage,reduced platelet consumption and longer filter usage time.

Objective To evaluate the change of expression of estrogen receptor(ER) and progesterone receptor(PR) in endometrium of polycystic ovarian syndrome(PCOS) patients during induced ovulation and its clinical significance.Methods We recruited 108 PCOS patients as the disease group and 96 women with tubal infertility as the normal control group.Both groups were randomly divided into three groups with equal numbers (metaphase of generation group,metaphase of secretion group and ovulation group) and were tested the change of ER and PR levels in endometrium of PCOS patients at the fifth day after menstruation,ovulation period and the seventh day after ovulation with way of immunohistochemistry.Results There was marked change of ER and PR in the menstrual cycle of healthy controls.The levels of ER and PR were (0.89 ± 0.22) kU/L and (0.72 ±0.25) kU/L,and (1.65 ± 0.42) kU/L and (1.43 ± 0.42) kU/L respectively at metaphase of generation and (0.92 ± 0.29) kU/Land (0.87 ± 0.34) kU/L,and (1.68 ± 0.42) kU/L and (1.56 ± 0.30) kU/L respectively at metaphase of secretion.Positive gland decreased significantly during ovulation period (ER:(0.69 ± 0.35) kU/L and (0.55 ± 0.24) kU/L; PR:(0.97 ± 0.32) kU/L and (0.69 ± 0.30) kU/L).The levels of ER of stroma and positive gland in menstruation of PCOS patients were significantly higher than in menstruation of normal women during all the stages of menstrual cycle and did not have non-linear change (Metaphase of generation:(1.73 ± 0.22) kU/L and (1.89 ± 0.38) kU/L; Ovulation:(0.75 ± 0.32) kU/L and (0.63 ± 0.28) kU/L;Metaphase of secretion:(1.79 ± 0.31) kU/L and (1.90 ± 0.30) kU/L).The levels of PR in menstruation of PCOS patients were significantly lower than in menstruation of normal women during all stages of menstrual cycle (P ＜ 0.05).We did not observe trend of elevation of PR levels in PCOS patients (Metaphase of generation:(0.93 ±0.36) kU/L and (0.85 ± 0.56) kU/L; Ovulation:(0.77 ± 0.26) kU/L and (0.56 ± 0.41) kU/L) ;Metaphase of secretion:(0.98 ±0.36)kU/L and (0.88 ±0.47)kU/L).Conclusion The expressions of ER and PR in endometrium of PCOS patients are abnormal during all stages of induced ovulation.The endometrial receptivity of PCOS patients is worse than normal women.Improving the receptivity of ER and PR of PCOS patients is one of the ways to enhance pregnancy of PCOS patients.

Objective To investigate the effect of protamine(PS)coated polylactic acid(PLA)nanocapsule on the immune response of murine bone marrow-derived dendritic cells(BMDCs).Methods PLA nanocapsules were prepared by W1/O/W2 method.Protamine was used to modify the surface of PLA nanocapsule that encapsulated ovalbumin(OVA),a model anti-gen.The prepared OVA/PLA/PS nanocapsules were used to stimulate BMDCs.Flow cytometry was used to analyze the ex-pression of surface molecules CD80,CD83,CD86,MHCⅠ,and MHC Ⅱ,and the uptake of nanocapsule.The levels of IL-12 p70 secreted by BMDCs were detected by ELISA.Results OVA/PLA/PS nanocapsules could significantly up-regulate the expres-sion of CD80,CD83,MHCⅠ,and MHC Ⅱ in BMDCs,and increase the secretion of IL-12 p70 by BMDCs.Furthermore,OVA/PLA/PS nanocapsules could enhance the uptake efficiency of OVA by BMDCs.Conclusion OVA/PLA/PS nanocapsule can en-hance the immune response of BMDCs,and may become a good drug delivery carrier.

Objective To investigate the effect and mechanism of quercetin in LPS-induced acute lung injury. Methods The PaO2, PaCO2, RR and pH, the expression of IL-6、 IL-1β、 TNF-α、 JAK2、 STAT3、 p-JAK2、 p-STAT3, the pathological change and Dry/Wet of Lung tissues were evaluated in rats. Results Quercetin can significantly decrease the pathological change of Lung tissues, the PaCO2, RR and the expression of IL-6、IL-1β、 TNF-α、 p-JAK2 and p-STAT3 with increasing the PaO2, pH and D/W. Therefore, with on influence on the expression of JAK2. Conclusion Quercetin pretreatment decreased LPS-induced acute lung injury by suppressing JAK2/STATA3 signallingto improve exchange ability though reducing inflammation.

The foot overpronation is termed as pronation persisting more than 25%of stance phase in a walking cycle, which may re-sult from some antenatal or postnatal conditions. Overpronation would lead to abnormal alignment of ankle, knee, pelvis and spine, and re-sult in a set of syndromes of chronic pain. The Navicular Drop Test and the Foot Posture Index are often used as the assessment tools, how-ever, there are several empirical ways for clinic. Foot orthoses, special shoes, taping and training of muscle strength are effective on overpro-nation as well as chronic pain.

Circadian clock governs 24-hour rhythms in body temperature, blood pressure, circulating hormones, metabolism, and oth-er physiological parameters in humans and most mammals. The circadian clock is regulated by circadian clock genes. For instance, peri-od (PER) is a core circadian clock gene. Human PER includes PER1, PER2, and PER3, which play a role in cancer suppression. Abnormal PER expression not only causes cancer but also changes cellular sensitivity to radiation and chemotherapeutic drugs. Thus, this theory has provided a new direction for cancer radiotherapy and chemotherapy. This paper presents the research progress on PER in tumors.