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 study the impact of gender,gender role and gender traits on depression in adolescents.Methods A sample of 1330 middle school students from seven provinces in China completed Beck Depression Inventory (BDI) and Gender Traits Inventory.Results 27.1 percents of participants displayed the symptoms of depression.The mean score of males of BDI was 10.04 ± 8.38 while that of females was 10.33 ± 8.37,indicating that there was no sex differences in depression of adolescents(P=0.535).The participants could be classified into 4 sex role types:masculine,feminine,androgynous and undifferentiated,and the BDI mean score of each type was 9.51 ± 7.66,12.30 ± 8.81,9.14 ± 8.10,10.72 ± 8.66,and significant differences were found among adolescents with different gender roles (P =0.000).BDI scores of the feminine adolescents were the highest among the four gender roles,which were significantly higher than scores of the masculine and androgynous adolescents (P =0.000).Regression analysis indicated that adolescents with more positive masculine traits tended to be less depressive (t =-4.966,P ＜ 0.01) while adolescents with more negative masculine (t =2.574,P ＜ 0.01) or feminine (t =10.566,P ＜ 0.01)traits tended to be more depressive.Conclusion Gender role rather than gender has greater impacts on adolescent depression,and specifically,positive masculine traits represent protective factors for depression.

Objective:To investigate the role of sanchi Saponin Rg1 in D-galactose -induced amnesic mice ,and its possible mechanism.Methods:D-galactose was injected by subcutaneous to establish the aging model, and with drug treatment group.The Y-maze tests was performed to evaluate the learning and memory function, spectrophotometry was used to measure abilities of anti-oxidation.ELISA was adopted to evaluate the level of IL-1? and IL-6. Then FCM was applied to assay the index of intracellular calcium and the percentage of neural cell apoptosis.Results:Compared with drug treatment group, the model mice reduced significantly activites of anti -oxidation , the overload of intracelluer calcium and the increase in apoptosis of neural cells as well as the inflammation factor.Conclusion:Sanchi Saponin Rg1 decreased in the content of inflammation factor , the index of intracellular calcium and the percentage of apoptosis in neural cells , possibly by enchancing the antioxidant function.

AIM: To investigate the correlation between the left ventricular filling type and geometry modality and functional change of the left ventricle in patients with hypertension. METHODS: Systolic function indexes (FS and EF) and diastolic function indexes (E, A, EAT, EDT, E/A,IVRT) in 120 patients with hypertension were measured by two dimensional ultrasonography (2-DUS) and M-mode and Doppler ultrasound. RESULTS: A rate of 83.5% in patients with hypertension appeared assured plump and configuration changes of left ventricle, and a rate of 84% in patients with hypertension appeared abnormal left ventricular filling function. The morphologic indexes were significantly different clearly in different left ventricular filling types, and the filling indexes were also significantly different in diferent left ventricular shapes. CONCLUSION: IVRT is a more important index than other factors to decide the left ventricular filling function. LVMI plays more important role than other factors in the left ventricular filling function.

Objective: To investigate the relationship between Oxfordshire community stroke project (OCSP) classification (and each subtype) and the risk factors for stroke. Methods: Nine hundred thirty-two consecutive patients with ischemic stroke from the symptom onset to admission < 2 weeks were registered. The patients were divided into 4 groups according to the OCSP classification criteria: total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), lacunar infarction (LACI), and posterior circulation infarction (POCI). The gender, age, nationality of the patients as well as the history of hypertension, diabetes, hyperlipidemia, smoking, and alcohol consumption were recorded. The effects of different risk factors on each subtypes of stroke were analyzed. Results: Circled digit oneAmong the 932 patients, there were 463 patients (49.7%) in the LACI group, 326 (35.0%) in the PACI group, 78(8.4%) in POCI group, and 65 (7.0%) in the TACI group. Circled digit twoThere were no significant differences in age, hypertension, diabetes, hyperlipidemia, cerebral hemorrhage, and history of smoking among all subtype groups. The proportion of male was the highest (75. 6%) in the OCSP group; the proportions of Muslim (21.5%), ischemic stroke (36. 9%), atrial fibrillation (20.0%), and TIA (21.5%) patients were the highest in the TACI group (21.5%); the proportion of alcoholic drinkers was the highest in the LACI group (50.3%). Circled digit threeThere were no significant differences on the relative risk of the occurrence of POCI in patients with history of diabetes, hypertension, hyperlipidemia, smoking, alcohol consumption, ischemic stroke, TIA, cerebral hemorrhage, and atrial fibrillation. There were no significant differences on the relative risks of the occurrence of all types of stroke in patients with history of diabetes, hypertension, hyperlipidemia, and smoking. The history of alcohol consumption and TIA increased the risk of LACI (OR, 1.488, 95% CI 1.148-1.928; OR, 1.686, 95% CI 1.155-2.462); the history of ischemic stroke increased the risks of PACI and TACI (OR, 1.466, 95% CI 1.058-2.032; OR, 2.472, 95% CI 1.453-4.205); the history of intracerebral hemorrhage increased the risk of TACI (OR, 2.570, 95% CI 1.036-6.379); atrial fibrillation increased the risk of TACI (OR, 4.266, 95% CI 2.174-8.368). Conclusion: The incidence of the LACI subtype was the highest among all the OCSP subtypes. The different risk factors may increase the risks of different subtypes of OCSP.

Objective To perform statistical analysis of low frequency electromagnetic comprehensive therapy apparatus for adverse events,and the characteristics of the adverse events,and investigate the risk factors,thus to provide effective information for the safe of the medical device.Methods Using database software from national MDR monitoring center,preliminary study on safety of low frequency electromagnetic comprehensive therapy apparatus was performed.Results The manifestations of adverse events was 50.0%,mainly included skin allergy and scald,burn, stabbing pain,25.0% included treatment without feeling,parts damaged,other manifestations accounted for 25.0%. Conclusion Monitoring should be strengthened in order to reduce or avoid the vaginal dilator adverse events.