As an important component of the social system, physician-patient relationship plays a guiding and fundamental role in creating a harmonious healthcare environment. However, due to certain social, ethical and moral factors, the current physician-patient relationship is not favorable, and various contradictions in physician-patient relationship are becoming barriers in building up a harmonious society. In order to enable medicine return to its "merciful" nature, restitute the respect for patients, the dignity of doctors, find the memorable warmth in the medical service world, hospitals must pay close attention to humanistic care in the management dimension in order to establish a harmonious relationship between doctors and patients.

Objective The differential diagnosis of female precocious puberty (PP) and premature breast development (PT) was made by ultrasound and related hormone levels,so as to provide the basis for clinical diagnosis.Methods In this study,from 2015 to 2016 due to early breast enlargement (age ＜ 8 years) to our hospital pediatric patients with children,according to the diagnostic criteria were divided into PP group and PT group.Ultrasonography was performed on all patients and graded according to the criteria.At the same time,the levels of clinical and hormones were compared between the two groups.ROC analysis was used to identify the significant differences.Results In this study,a total of 60 cases of female children,including PP and PT children were 30 cases.Ultrasonic breast grading was positively correlated with age,BA,BD,LH level,FSH level and E2 level,but there was no correlation between BA/CA.There was no statistical difference between the breast ultrasound and the breast diameter (P ＜ 0.05).The levels of LH and FSH,basal LH/ FSH,LF and FSH peak and LH/FSH peak in the PP group were significantly higher than those in the PT group (P ＜ 0.05).The ROC analysis found 100％ sensitivity and 85％ specificity for LH/FSH peak ＞0.25 for diagnosis of PP,with a 72％ sensitivity and a specificity of 65％ for basal LH ＞ 0.1 mIU/ml.The SHBG level was the only one that did not overlap [PP:80.6 (62.3-95.4) vs PT:114.5 (107.6-121.5)].There was no significant difference in kisspeptin,leptin and neurokinin B between the two groups (P ＞ 0.05).Conclusion Breast ultrasound by grading and measurement of breast buds can be effective in evaluating the development of female precocious puberty breast development,but can not identify PP and PT.The study found that SHBG concentration and peak ratio of LH/FSH can effectively identify PP and PT,but kisspeptin,neurokinin B and leptin is not enough to identify PP and PT.

OBJECTIVE:To discuss the economic effectiveness of different therapeutic schemes for the same disease.METH_ODS:104 cases of female's urogenital tract infections of gonococcus combining chlamydia were randomly divided into five gro_ups,which were given ofloxacin(A),levofloxacin hydrochloride(B),clarithromycin(C),azithromycin(D)and ceftriaxone+erythromycin(E)respectively.Using pharmacoeconomic cost-effectiveness analysis method,the five schemes were compared.RES_ULTS:The costs of the five schemes were RMB 351,390,474,633 and 666 yuans,respectively.The ratios between cost and effectiveness were 5.7,4.5,5.5,7.6 and 8.3 in term of curative rate and 4.9,4.1,5.2,7.1 and 7.8 in term of effective rate respectively.CONCLUSION: B and C schemes are the best ones.

normal morphology + cervicitis).

Objective To study the effect of estrogen on myocardial injury in hypothyroidism rats and to reveal the pathology of occurrence and development of the myocardial injury in hypothyroidism rats.Methods The model of hypothyroidism rats was established by feeding propylthiouracil.The pathology of the female group ( n =40 ) and male group ( n =40 ) was observed dynamicly.The presence of myocardial apoptosis cell was demonstrated by the method of terminal deoxynucleotidyl transferase mediated dTUP nick end labeling (TUNEL).And the immunohistochemistry was used to determine the expression of Caspase-3 and Bcl-2 in the myocardial cells.Results The myocardial cell apoptosis appeared in hypothyroidism rats.With the development of the disease,the apoptosis myocardial cell was increased progressively (Female rats group:the numbers of myocardial cell apoptosis at 3,6,8,10,and 12 weeks were 16.40 ± 2.62,29.50 ± 2.67,34.50 ± 3.34,42.70 ±3.24,and 56.00 ± 2.90 respectively,P ＜ 0.05 ; Male rats group:the numbers of myocardial cell apoptosis at 3,6,8,10,and 12 week were 21.60 ± 2.67,35.50 ± 2.94,41.70 ± 2.96,46.70 ± 3.11,and 60.70 ± 3.31respectively,P ＜ 0.05 ),which indicated that estrogen may be related to myocardial cell apoptosis.Conclusion The myocardial cell apoptosis is related with the myocardial injury in hypothyroidism rats.Myocardial cell apoptosis may result in the myocardial injury.The estrogen participates in regulating apoptosis,but its function gradually weakens with the development of the hypothyroidism.

Objective To analyze the distribution status of soil-transmitted nematodes infection for prevention and treatment.Methods The inquiry field test and grade random sampling were emplyed on a group of people naturally selected in Shanxi Province.The people were examined through pathogen test and statistical diagnosis.Results A total of 7 726 people were investigated.Soil-transmitted nematodes infection rate was 18.86%.Ascaris,enterobius,trichuris,and hookworm was 15.87%,11.46%,0.82%,and 0.04% respectively.The intensity of ascaris infection was 97.74%,1.60%,and 0.66% respectively in light,moderate,and serious conditions,and that of trichuris infection was 88.89%,7.41%,and 3.70% respectively in light,moderate,and serious conditions.Conclusions Soil-transmitted nematodes infection rate is lower than that in 1992.Its cases are mainly distributed in rural areas and schools,closely related to education level.Improving water-drinking conditions and personal hygiene is still key to the prevention and control of the infections.

ve value and 68.0% total coincidence rate. Conclusion The PCR developed in this study is found to be a rapid and reliable method for the detection of adenoviruses in infant diarrheal stools samples.

Objective To integrate the self-developed Web-based early warning management system into EMR system to decrease average medical fee as well as the occurrences of cost overrun,arrearage for self-paid fee and etc.Methods The method mapped into image for users' browse based on using the user-defined URL extension characteristic of EMR system,combining the advantages of Web platform in handling Http request,applying Java as well as SQL technology to obtain source data,integrating statistical analysis for multi-dimensional comparative analysis as well as visualization technology.Results This system changed the behavior pattern of early warning and supervision in course,relieved work burden of medical staffs,and helped hospital achieve high economic management benefit.Conclusion The application of crossplatform system realizes high effect and provides approaches for expanding other functions.

Objective To investigate the changes of thrombomodulin and matrix metalloproteinase-9 in sepsis and determine their significance in the early diagnosis and prognosis of multiple organ dysfunction syndrome. Methods The plasma levels of thrombomodulin and matrix metalloproteinase-9 in 32 ICU patients with sepsis were measured by immunofluorescence. Results Compared with control group,the levels of TM and MMP-9 were significantly higher on the day of the diagnosis of sepsis(P

Objective To investigate the sequences of the 3' end of genomes from enterovirus 71 isolated from pediatric patients with different symptoms in Beijing during 2008-2009.Methods Clinical specimens were collected from pediatric patients suffering from hand,foot and mouth disease(HFMD)and/or with neurological complications who visited the affiliated Children's Hospital during the epidemic seasons of 2008 and 2009 in Beijing.The samples were inoculated into the Vero cell line,and the virus isolates were further identified by nested reverse transcription-nested PCR(RT-nPCR)assay using universal enterovirus primers,type specific primers for EV71 and CA16.The 3' end of genomes(including 3D and 3' UTR regions)from 10 EV71 strains derived from various clinical presentations were amplified and sequenced.Results Analysis of the nucleotide sequences of the amplified fragments showed that the 3' end of genomes of 10 EV71 isolates include the 3D region of 1386 nucleotides(nt)encoding the 3D polymerase(3Dpol,462 amino acids),the terminator codon TGA and 3' UTR of 81 nt.Nucleotide sequence identities among 3D regions from these 10 EV71 isolates were in the range of 95.8%-99.6%,while the nucleotide sequence identities for 3' UTR were 96.3%-100%.The majority of nucleotide changes were located at the third codon positions which caused silent mutations,thus the amino acid sequence changes of 3Dpol among those 10 EV71isolates were scanty.The residues 140 and 263 which were R and 1 were substituted by K and V,respectively in 3 of 4 neurovirulent strains,whereas only 1 of 6 strains from mild cases had these 2 amino acid changes.The sequences of the 3D and 3' UTR regions of 10 EV71 isolates were compared to the representative strains of known genotypes from the GenBank.The nucleotide and amino acid sequences of 10 EV71 isolates in the 3D region exhibited highest homology to the subgenotype C4 of EV71(92.7%-94.2%and 96.8%-97.6%.respectively).However,3' UTR of 10 EV71 isolates shared the highest nucleotide identity with CA16/G10(88.9%-91.4%).The phylogenetic analysis based on the 3D regions demonstrated that 10 EV71 isolates had the closest genetic relationship with the representative isolate of CA sub-genotype of EV71 and shared more homology with CA16/G10 than other known genotypes of EV71.Conclusion Genetic analysis of the 3' end of genomes from 10 EV71 strains indicated that the 3' end of genome may play a role in the evolution of EV71.