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.

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.

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.

HLA (human leukocyte antigen) is critical molecule relevant to immunoresponse, which is always involved in antigen presentation and determining killing activity of immune cells against tumor. The abnormal expression of HLA in lung cancer is believed to be a common phenomena of tumor biology. It has been demonstrated that HLA expression varies in various types of lung cancer, even in differential stages of one type of lung cancer. HLA expression is highly associated with genre, progression and prognosis of lung cancer. The thorough investigations of the relationship between HLA and lung cancer and of mechanism of HLA abnormality will provide useful information for studying of development of lung cancer and tumor immunotherapy.

Objective To evaluate the therapeutic effect and safety of insulin lispro mix 50/50 combined with mefformin in newly diagnosed overweight/obese type 2 diabetic mellitus patients.Methods Sixty-two patients with newly diagnosed overweight/obsess type 2 diabetic mellitus were randomly divided into observation group (32 cases) and control group (30 cases) by systematic sampling method.The observation group received insulin lispro mix 50/50 combined with metformin,and the control group received recombinant human insulin and insulin glargine.The therapeutic effect and safety were compared between the 2 groups.Results There were no statistical differences in the blood glucose before eating,before retiring and at mane primo 3:00 between the 2 groups (P ＞ 0.05).There were no statistical differences in the time of blood glucose standard and rate of hypoglycaemia between the 2 groups (P ＞ 0.05).Daily insulin dosage and costs in the observation group were lower than those in the control group [(0.6 ± 0.1) U/kg vs.(0.8 ± 0.1) U/kg and (15.8 ±2.1) yuan/d vs.(21.3 ±2.6) yuan/d],and there were statistical differences (P ＜0.05).Conclusion Insulin lispro mix 50/50 combined with mefformin provides a convenient,effective and safe therapy for newly diagnosed overweight/obese type 2 diabetic mellitus patients and high cost performance.

Objective To find out the iodine nutritional status of school-age children in Yichang city,and to provide a scientific basis for prevention and control of iodine deficiency disorders.Methods In 2009,children aged 8 to 10 in each county(city,region) in Yichang city Hubei province were selected as study subjects.In each county (town,district),a township(town,street) was selected according to their orientation of east,west,south,north and center in the county.A village primary school was selected from each township(town,street).Twenty children aged 8 to 10 from each school were selected.Real-lime urine samples were collected to test iodine level.Results A total of 1300 urine samples of school children were collected and tested.The median urinary iodine was 277.4 μg/L.Therein,there were 11 children whose urinary iodine level was less than 20 μg/L,accounting for 0.8％ ; there were 28 children whose urinary iodine level was between 20 μg/L to 50 μg/L,accounting for 2.2％ ;there were 84 children whose urinary iodine level was between 50 μg/L to 100 μg/L,accounting for 6.5％; there were 606 children whose urinary iodine level was between 100 μg/L to 300 μg/L,accounting for 46.6％; there were 571 children whose urinary iodine level was more than 300 μg/L,accounting for 43.9％.There were 648 males,their median urinary iodine was 263.1 μg/L.There were 652 females,their nedian urinary iodinc was 277.5 μg/L.A total of 388 eight-year-old children's median urinary iodine was 277.5 μg/L.A total of 458 nine-year-old children whose median urinary iodine was 259.4 μg/L.A total of 454 ten-year-old children whose median urinary iodine was 295.8 μg/L.Conclusions The iodine nutrition of school-age children in Yichang city is in good condition,and complies with the national standard of eliminating iodine deficiency disorders.But the urine iodine content is higher than the appropriate level,so there is a need to strengthen the prevention work.

This study was aimed to investigate the effect of Rheum tanguticum on expression of serum endothelial nitric oxide synthase (eNOS), endothelin (ET) and 6-keto-prostaglandin F1α (6-Keto-PGF1α) in uric acid nephropathy rat model. After 3 weeks of treatment with different extractions of Rheum tanguticum on uric acid nephropathy rat model, levels of serum BUN, Cr and UA were measured by biochemical analyzer. ELISA method was used to measure the expression of serum eNOS, ET and 6-Keto-PGF1α. Meanwhile, pathological changes of renal tissues were observed by light microscope. The results showed that compared with the normal control group, the levels of serum BUN, Cr, UA and renal index were higher in the model group (P< 0.05). Compared with the model group, the concentration of eNOS in the model group was obviously higher in the rhubarb ethanol extraction group, rhubarb water extraction group, and allopurinol group (P< 0.05). Concentration of ET was obviously reduced in the rhubarb water extraction group and allopurinol group (P< 0.05). There was no statistical difference with the rhubarb ethanol extraction group. There was no significant difference in the concentration of 6-Keto-PGF1α among groups. Lots of inflammatory cells and uratic crystallization were observed by light microscope in renal tissues among rats in the model group. Damages of renal tissues in medication groups were alleviated than the model group. It was concluded that Rheum tanguticumcan alleviate the damage of uratic crystallization and inflammatory cell infiltration, increase the concentration of serum eNOS, and decrease the concentration of serum ET. Thus, it can reduce the damage of renal endothelial cells and protect renal functions. The effect of rhubarb ethanol extraction on reducing ET expression was less than the water extraction.

Oxycodone sustained-release tablet is a new formulation of potent opioids, which are characterized by their exact anal-gesic effect, high safety for oral administration, and slight adverse drug reaction. Oxycodone improves the quality of life of patients with cancer pains and is among the selected drugs used for controlling moderate and severe cancer pains. Relief from prolonged pain is achieved by adjusting the dose of Oxycontin (oxycodone hydrochloride) sustained-release tablet according to its pharmacological char-acteristics. The details are reviewed in this article.