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 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 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 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.

Objective To discuss the value of double tunnel separation technique in the application of laparoscopic radical resection for rectal carcinoma. Methods A retrospective analysis of clinical data of 67 cases of laparoscopic radical resection for rectal carcinoma from September 2010 to July 2014 was made.There were 37 cases of Miles operation and 30 cases of Dixon operation, with laparoscopic double tunnel separation technique which refered to under the sigmoid colon mesentery space and under the mesorectum space. Results All cases of laparoscopic radical resection were completed.The duration of operation was 100-240 min, with an average of 158 min.The intraoperative blood loss was 50-200 ml, with an average of 110 ml.The hospitalization time was 8-15 d, with an average of 10 d.Complications included postoperative anastomotic leakage in 1 case, small intestinal obstruction induced by intestine pelvic adhesion in 1 case, and lower extremity deep venous thrombosis in 1 case, all of which were cured with conservative treatment. Conclusions Double tunnel separation technique in laparoscopic radical resection is helpful to application of total mesorectal excision, thus effectively protects blood vessels, nerves, and ureters.Meanwhile, the lymph nodes and extranodal tumor deposits can be cleaned to the greatest degree.

Objective To analyse the role of haptoglobin in the immunomodulatory in patients with premature coronary heart disease.Methods Clinical data of 60 premature coronary heart disease patients and 40 healthy people was analysed.The general information and serume haptoglobin,hs-CRP and IL-6 were compared.Results There were no statistically difference between the two groups of the general information such as sex,years,BMI,hypertension and diabetes (P>0.05),excepts the smoking history(27/33 vs 9/31,χ2=3.324,P<0.05).Hp,hs-CRP and IL-6 levels in the observer group were signifi-cantly higher than the control group,the difference was statistically significant (97.76±23.08 mg/L vs 65.81±19.42 mg/L,10.43±3.81 mg/L vs 3.05±0.94 mg/L,16.43±4.59 pg/L vs 4.62±1.83 pg/L,P<0.001).Correlation analysis showed that in the observer group Hp and hs-CRP showed a significant positive correlation (r=0.518,P<0.001),and the same results was found between IL-6 and Hp (r= 0.291,P=0.024).Conclusion Haptoglobin level was significantly in-creased in patients with coronary heart disease,which suggested that haptoglobin played a role in the development of coro-nary heart disease,and its level was correlated with IL-6.

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.

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.