The relationship between medical practitioners and padtients always changes with time and this shift becomes quite striking nowadays.The characteristics and underlying reasons of this trend are expounded from such aspects as the changes in medical service system,the alteration in definitions of medical practitioners and patients, the advent of market economy.It is precondition and guarantee of handling the relationship properly to consummate relevant laws and codes,establish medical insurance institution,classify hospitals and set moral restraint for both medical practitioners and patients.

Technologies for the trans-institutional sharing of scientific data were studied with the sharing of nucleic acid sequence data as the study object , such as leaving a flexible space for implementation of the unified standards in working out the criteria for data sharing , implementing regular point to point data sharing and updating in agree-ment of institutional league , and providing multiple data services according to the unified working process by giving considerations to the local demands .The significance of trans-institutional sharing of scientific data under the insti-tutional league model was summarized for the reference in constructing the scientific datasharing platform.

Objectives To study a special pattern of electroencephalogram (EEG),regional attenuation without Delta in massive cerebral ischemic infraction and evaluate its clinical value.Methods All the 47 cases diagnosed as massive cerebral infraction were continuously observed and evaluated in the period of 2004 to 2006 for EEG,short-latency somatosensory evoked potential (SLSEP).Glasgow coma scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS) were also rated.EEG monitoring was performed every 1 to 3 day,but at least one time for patient with deteriorated condition.The outcome was evaluated with Glasgow outcome scale (GOS).Results 47 cases were performed 70 times of EEG all together,among whom 32 cases (68.1%) showed RAWOD in EEG.The positive rate of RAWOD was 76.9% within 24 hours of onset,but it was 28.6% in CT in the same time.The GCS and NIHSS of two groups had significant differences (P

Objective To study characteristics of clinical manifestation of patients with acute myocardial infarction (AMI).Methods From 1999 to 2002,the risk factors,symptoms,signs,and results of assistant check of 97 patients with AMI were analyzed.They were divided into thrombelytic group and control group.Results (1) The main risk factor are hypertention,smoking and diabetes.(2) There was no difference in complication of AMI between two groups.Thrombolytic group has higher curing rate.Conclusion AMI patients without contraindication should be treated by thrombolytion in time.

The paper focuses on precision medical initiatives of China,the United States and Britain.It outlines their main aims and tasks,and compares the implementation,data management and sharing of initiatives.Some enlightenment is summarized to provide references for China to carry out national key research,and development program of precision medical research.

Background Familial vitreous amyloidosis is a rare ocular regional amyloidosis,and it is a kind of autosomal dominant inheritance disease.Familial vitreous amyloidosis demonstrates a variable penetrance due to the mutation in the plasma thyroid hormone-binding protein transtheretin (TTR) gene.Many studies have reported over 100 types of TTR genetic mutation in Switzerland,Portugal and Japan,but rare in China.Objective This survey aimed to investigate the clinical and genetic mutation characteristics in familial vitreous amyloidosis.Methods Physical and eye examinations were performed on 52 family members of this vitreous amyloidosis family.Peripheral blood samples from 52 members were collected for TTR gene test by DNA extract,PCR amplification,clone,bolting and sequencing.Pars plana vitrectomy was firstly performed prior to the pathological examination of vitreous sample on 13 eyes of 8 members.Informed consent was obtained from each individual before any medical procedure.Results Seventeen members suffered from vitreous amyloidosis in this family without nervous system,heart,kidney and liver disease.Vitreous opacity was found in 34 eyes of the 17 members,and retinal vasculopathy was seen in 28 eyes of 15 members.In addition,cataract appeared in 16 eyes of 10 members.None of the members had glaucoma or ocular motility disorders.Congo red test of vitreous specimens showed a positive result in 13 eyes of 8 patients who received vitrectomy.Point mutation was verified on the 83th amine acid location of exon 3 (Gly83Arg) in TTR gene by gene sequencing.Conclusions Clinical characteristics of familial vitreous amyloidosis induced by TTR gene Arg-83 mutation is rate retinal vasculopathy without glaucoma,other ocular regional disease and systemic diseases.

Objective To investigate the effect of stage 1 acute kidney injury (AKI) on the prognosis of patients underwent cardiopulmonary bypass (CPB) cardiac operation. Methods A retrospective analysis was conducted. All patients aged ≥ 18 years who underwent cardiac operation with CPB admitted to Beijing Anzhen Hospital from July 1st, 2013 to December 31st, 2015 were enrolled. According to the standard of serum creatinice (SCr) of Kidney Disease Improving Global Outcomes (KDIGO) criteria, the AKI patients with stage 1 and non-AKI patients were served as the research objects. Perioperative clinical data of two groups were collected, and the prognosis was recorded during follow up to draw the Kaplan-Meier survival curve. Cox regression model was used to analyze the risk factors of prognosis in patients with stage 1 AKI experienced CPB during cardiac operation. Results A total of 5 823 patients were enrolled, of which 1 285 patients with AKI, and those in stage 1 was 998, accounting for 77.67% of total AKI patients; and 4 538 in non-AKI group. The mean follow-up period among survivors was (23.13±12.28) months. Compared with non-AKI patients, 30-day mortality of patients with stage 1 AKI was significantly increased [4.00% (40/998) vs. 0.40% (18/4 538), P < 0.01]. It was showed by Kaplan-Meier survival analysis that the cumulative survival rate of patients with stage 1 AKI was significantly lower than that of non-AKI patients (log-rank = 51.989, P < 0.001). It was showed by further subgroup analysis that the cumulative survival rate of patients with stage 1 AKI without serum creatinine (SCr) recovery was significantly lower than that of patients with SCr recovery from stage 1 AKI (log-rank = 43.580, P = 0.000). It was showed by Cox multivariate analysis that stage 1 AKI [hazard ratio (HR) = 2.725, 95% confidence interval (95%CI) = 1.810-4.230, P = 0.000] and prolonged CPB in patients undergoing cardiac operation (HR = 1.013, 95%CI = 1.001-1.017, P = 0.000), combined with coronary heart disease (HR = 1.046, 95%CI = 1.010-1.063, P = 0.005) and diabetes mellitus (HR = 1.060, 95%CI = 1.010-1.090, P = 0.002) were independent risk factors of death in patients undergoing CPB during cardiac operation. Conclusion Stage 1 AKI is the main stage of AKI and it is independently related to all-cause mortality in patients underwent cardiovascular operation using CPB.

Objective To investigate the clinical and renal pathologic features of isolated hematuria in children and the relationship between them. Methods A retrospective review of 251 cases of isolated hematuria undergone renal biopsy from 1995 to 2008 in our hospital were conducted to analyze their clinical manifestations and renal pathologic features. Results Among the pathologic changes, minor abnormalities was found in 93 cases (37.05%), normal biopsies in 62 cases (24.70%), IgA nephropathy (IgAN) in 52 cases (20.72%), thin basement membrane nephropathy (TBMN) in 17 cases(6.77%), mesangial proliferative giomerulonephritis(MsPGN) in 16 cases (6.37%), focal segmental glomerulosclerosis (FSGS) in 5 cases (1.99%), focal proliferative glomerulonephritis (FPGN) in 5 cases (1.99%), capillary proliferative glomerulonephritis (EnPGN) in 1 case (0.40%). IgAN was more popular in gross hematuria group than that in microscopic hematuria group (31.88% vs 16.48%, P＜0.05). zcording to Haas classification, the ratio of class Ⅲ in two groups had no statistical significance (microscopic vs gross: 16.67% vs 4.55%, P＞0.05). In the 35 cases (102 cases were detected) with elevated urinary microalbuminuria, the proportion of IgAN Ⅲ was significantly higher than those cases without urinary microalbuminuria (14.28% vs 0%, P＜0.01). There were more FSGS and FPGN (total 20.00%) and less minor abnormalities (28.57%) in these cases as compared to the normal albuminuria cases (1.49% and 58.21%, all P＜0.01). Conclusion The main pathologic changes of isolated hematuria in children are minor abnormalities, normal and IgAN. IgAN is more popular in the cases with gross hematuria. Elevated urinary microalbuminuria may be an indicator of more serious pathologic changes in children with isolated hematuria.

Adult ; Cranial Nerve Neoplasms ; Female ; Humans ; Hypoglossal Nerve ; Paraganglioma

A thiosulfate-oxidizing bacterium TX was isolated from polysulfide wastewater treatment system.It was preliminarily identified as Halothiobacillus sp.according to its morphological,physiological proper-ties and similarity analysis of 16S rRNA gene sequence(GenBank accession No.EU871645).This bacte-rium was an obligate chemolithoautotrophic sulfur-oxidizing bacterium since it could utilize thiosulfate,elemental sulfur,tetrathionate,sulfide or sulfite as sole energy source but did not show growth on the me-dium with glucose,sucrose,fructose,lactose,mannose or yeast extract as sole carbon source.The optimal growth condition for thiosulfate oxidation was 30?C~35?C and pH 3.0~5.0 respectively.Significant reduc-tion in medium pH from 4.0 to 1.2 was observed due to oxidation of thiosulfate to sulfate during the batch culture incubation period.During the course of thiosulfate oxidation accumulation of tetrathionate was ob-served either in synthetic medium or in the mixed liquor from aeration tank of the polysulfide wastewater treatment system.This indicates that the "S4 intermediate(S4I)" pathway was responsible for thiosulfate oxidation in this bacterium.