With health reform goes deeply,medical system becomes market economy gradually;some of medical workers are not fit with the market economy reform.By means of two years practice of defending the patient rights,the article sets forth that upholding the rights of the patient and defending the benefits of the hospital are identical.According to analysis to the patients present situation,it puts forward that there are some problems to ignore or infringe upon the patients informed rights,keep secret rights,private rights,autonomy rights,autonomg respect to the patients etc.According to the above problems,we set forth the discussion of corresponding countermeasure.The purpose is to recognize the patient rights,to participate competition positively,and realize the purpose--Uphold the Rights of the Patient and Defend the Bendfits of the Hospital.

Objective To explore the effect and application of the clinical teaching method of stage-separated to targeted management in the comprehensive ICU. Methods ICU rotation learning plans were developed for 113 probationers and rotating physicians,who were given the training of stage-separated to targeted teaching. The program was divided into three stages based on corresponding teaching objective and comprehensive examination and assessment with combination the dynamic and static evaluation were carried out to three parts. Results The probationers and rotating physicians had significant improvement in the familiarity and mastery of ICU specialist knowledge and skills through the systematic training. Conclusion Such training program can effectively improve the ICU specialized quality and comprehensive ability of the probationers and rotating physicians and bring about better clinical teaching effect.

Objective To ascertain the frequency distribution of CT examinations in children.Method A wide range of information was collected through the radiology information system (RIS),including ID,sex,birth date,examination time,the examined part of body and other relevant ones related to children who underwent CT examinations between Jan 1,2012 and Dec 31,2012.The SAS software was used for data processing and statistical analysis.Results A total of 1 542 children underwent 1 670 examinations,of which 67％ were male.Head CT examination was the most frequent,accounting for 71.9％ of all CT examinations,and followed by the abdomen/pelvis examinations.The number of examinations of children undergoing the repetitive examination accounted for 6.4％; 51.7％ of the examinations was for trauma.The positive rate of CT examination was 51％,dependent upon the age and examined body parts to some extent.The younger patients had lower positive rate,and the positive rate of head CT examination was lower than those in other parts.Conclusions To reduce the possible cancer risk to be induced by the ionizing radiation from CT,justification of CT examination should be considered for children.

Poria cocos,Cortex Poriae,Polyporusumbellatusand Alisma orientalisare common tra-ditionaI Chinese diuretic medicines. According to reported Iiterature,P.cocostriterpenes and poIysaccha-rides,steroids and tetracycIic triterpenes are the main chemicaI components of P.cocos,its epidermis, Pol.umbellatusand A.orientalis,respectiveIy. most of these diuretic drugs contain tetracycIic triterpenes and steroids,which have a simiIar structure to aIdosterone nucIeus structure. Therefore,this characteris-tic may reveaI their diuretic mechanisms. The tetracycIic triterpenes and steroids may exert diuretic effect through competitive inhibition of aIdosterone receptors in different parts of tubuIar reabsorption to increase urine output. The present articIe reviewed the chemicaI components of these diuretic Chinese medicines. Furthermore,their bioactive components and action mechanisms were aIso anaIyzed and discussed.

Objective To estimate the radiation dose and cancer risk of thyroid for children who underwent head CT or chest CT scans.Methods The parameters used in the CT scans were accessed from the DICOM files through PACS used DCMTK software, then the thyroid radiation dose was estimated with the CT-Expo(C) software and the cancer risk induced by CT scan was projected based on BEIR Ⅱ model combined with the Chinese cancer incidence and lifetime table in 2008.Results CT parameters used for different ages were roughly the same, the thyroid equivalent dose for head CT ranged from 1.2-2.0 mGy, the highest thyroid cancer risk occurs for newborn girls, about 9.6/100 thousand population;while for chest CT the thyroid equivalent dose ranged from 8.1 to 38.0 mGy, the highest thyroid cancer risk was also for newborn girls, about 244.7/100 thousand population.The radiation dose and cancer risk for thyroid decreased with the increased age.Conclusions The radiation dose for thyroid from chest CT was relatively higher than head CT, especially for newborn babies;therefore more protection should be given to the thyroid and other radio-sensitive organs during CT scanning.

Objective To investigate the changes of β-adrenergic receptor (βAR) in peripheral lymphocytes and β2AR mRNA levels at different stages of bronchial asthma. Methods β2AR density and β2AR mRNA level in peripheral lymphocytes, cAMP and cGMP levels in blood plasma were estimated by radioligand binding assay, radioimmunoassay and RT-PCR.Results (1) Maximum bound volume (Bmax) and equilibrium dissociation constant (Kd) of β2AR of lymphocyte in asthma patients at remission stage were markedly higher than that in normal subjects, while cAMP levels in blood plasma showed no difference. Bmax of β2AR and cAMP levels in asthma patients at acute exacerbation stage were significantly lower than that in normal subjects, and Kds between these two groups were not much different. (2) Expression of β2ARmRNA in peripheral lymphocytes of asthmatics at remission stage was not significantly different compared with that in normals. Conclusions Amount and function of βAR and β2ARmRNA levels are related to asthmatic conditions. Changes of βAR and β2ARmRNA in asthma might rather be a pathological change accompanied by the course of the disease than a primary defect.

The purpose of the present study was to investigate the anti-proliferative and apoptotic effects of tetramethypyrazine(TMP)on HepG2 and to elucidate the underlying mechanisms. CCK-8 was introduced to analyze the HepG2 cells proliferation. Cell apoptosis, mitochondrial membrane potential(ΔΨm)and cytochrome C were measured by high content screening(HCS). Cleaved-caspases protein expression was detected by Western blot. CCK-8 assay indicated that TMP significantly inhibited HepG2 cells proliferation in dose-dependent manner compared with the control group. Moreover, it was found that TMP could also induce HepG2 cell apoptosis, directly increase the release of cytochrome C, decrease ΔΨm and increase cleaved-caspase-3 and cleaved-caspase-9 protein expression. TMP may inhibit cell proliferation and induce cell apoptosis by stimulating the mitochondrial pathway apoptosis in HepG2 cells.

Objective To establish a suitable model for predicting the success of trial of labor after cesarean section (TOLAC) during the pregnancy at term.Methods Data for all deliveries at term with one cesarean delivery history in Shenzhen Maternity and Child healthcare hospital during 1 January 2012 to 31 December 2014 were reviewed.Variables associated with VBAC were identified and used to build a model to predict the outcome of TOLAC with multivariable logistic regression.Godness of fit and accuracy of the model were evaluated by ROC.Results A total of 531 women met inclusion criteria and underwent TOLAC.Of the women who underwent trial of labor, 448 (84.4％) had a successful VBAC, 83 failed, and 2 (0.38％) had uterine rupture.Multivariable logistic regression analysis showed that previous cesarean section (CS) time interval, neonatal birth weight (BW) and premature rupture of membranes (PROM) were independent factors affecting TOLAC outcome, and their Odds Ratios were 2.79, 1.002 and 0.244, respectively.The Logistic regression model was expressed as follows:P =1/[1 + exp (2.4 × neonatal BW + 1.03 × previous CS time interval-1.41 × PROM-10.24)].The Hosmer-lemeshow test showed that the model fitted well (x2 =123.45, P =0.996), and the prediction accuracy of the model was 86.77％.The model performed well with an AUC of 0.794 (P =0.000).Conclusions A predictive model, which contains three variables (previous CS time interval, neonatal BW and PROM), has been developed and its prediction efficiency and accuracy are satisfactory.The larger birth weight, the longer time interval from previous CS, and the absence of PROM are more likely to be failed in TOLAC.

Pregnancy with autoimmune diseases is a challenging area that involves multidisciplinary management of immunology, rheumatology, and obstetrics. During pregnancy, the maternal immune system dynamically regulates the balance between maintaining immune tolerance to the fetus and autoimmune. However, for women with common systemic autoimmune diseases such as systemic lupus erythematosus, antiphospholipid syndrome, and rheumatoid arthritis, this balance can be upset, leading to exacerbation or recurrence of the disease and significantly increasing the risk of pregnancy complications. This paper describes the adaptive changes of the immune system during pregnancy and the effects of systemic autoimmune diseases on pregnancy outcomes, proposes multidisciplinary management strategies and challenges in perinatal pregnancy, and aims to provide references for optimizing clinical practice and improving pregnancy outcomes.