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.

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.

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.

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.

Endometrial cancer (EC) is one of the most common gynecologic malignancy. Although the overall prognosis of EC patients is relatively good, patients with high-grade, recurrent, metastatic usually have a dismal prognosis. Lymph node status is one of the most important prognostic factors. However, for patients of early EC, whether lymphadenectomy must to be performed and its extent are still controversial. In this article, the indications of lymphadenectomy for early EC patients, the level of para-aortic lymph node dissection and the application of sentinel lymph node biopsy (SLNB) were reviewed respectively.

Translumbar amputation, also known as hemicorporectomy, is a life-saving procedure for patients with a life-threatening diagnosis but with a normal life expectancy. In the surgical procedure, the pelvis, pelvic contents, lower extremities and external genitalia are removed following transection of the lumbar spine. The operation makes the patient lose the ability of being upright. With the interdisciplinary cooperation of doctors, nurses, prosthetists, psychologists, vocational rehabilitation workers and social rehabilitation workers, the patient can realize most of independent activities of daily living through rehabilitation. The rehabilitation associated with the procedure is reviewed.

BACKGROUND:To control blood glucose, blood pressure, blood lipids and inhibit the rennin-angiotensin system is the main idea focused on the treatment of diabetic nephropathy, but the curative effect is unsatisfactory. Hemodialysis and kidney transplantation are suitable for serious cases, however, which is restricted because of the limited source of kidneys and high cost. Regenerative medicine research based on stem cells brings a new hope for treatment of diabetic nephropathy. OBJECTIVE:To comprehensively analyze the mechanism underlying different sources of stem cells for treatment of diabetic nephropathy and the clinical implications. METHODS:Papers addressing stem cells for the treatment of diabetic nephropathy were retrieved by computer in CNKI database and PubMed database from January 2005 to August 2013 with the key words“embryonic stem cells, bone marrow mesenchymal stem cells, induced pluripotent stem cells, diabetic nephropathyin Chinese and English. Papers published recently or in journals with high impact factor were selected. A total of 60 papers were included for review. RESULTS AND CONCLUSION:Embryonic stem cells, bone marrow mesenchymal stem cells, induced pluripotent stem cells have the potential to differentiate into renal histiocytes. A large numbers of experimental studies have shown that stem cells transplantation has a positive effect on recovery of injured kidney. Stem celltransplantation can provide a novel therapy for diabetic nephropathy.

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.