The core of the ethical and legal issues in the treatment and recovery of patients with mental disorders is the balance between public security and individual interests. In the treatment and recovery of patients with mental disorders, it is imperative to adhere to the principles of respecting basic hmnan rights and respecting the freedom, dignity, equality and rights of the individual, protect the privacy of the patient, stick to the combination of hospital recovery and community recovery, and strictly define the boundary between willing treatment and unwilling treatment. The aim is to promote the recovery and return of patients to society. At the same time, it is necessary to put issues of mental hygiene in China on the demestic legislative agenda and set up a specialized multi-level legal system of mental hygiene.

The authors first give a detailed account of the background against which humanistic medicine came into being and then expound the connotations of humanistic medicine. These include the following aspects. The first one is humanism and the humanistic spirit. The second one is humanistic medicine and the three implications it embodies. The authors argue that humanistic medicine, taken as the science of benevolence, ought to regard the patient as the unity of three aspects, physiological, psychological and social. The third one is medical humanity, viz. medical humanity is indispensable to the advancement from physiological medicine to humanistic medicine. As to what disciplines are involved in medical humanity, no final conclusion has yet been reached on this matter so far.

Objective To summarize the clinical characters,diagnosis and surgical treatment of primary hyperparathyoidism (PHPT).Methods The diagnosis,treatment and efficacy of 35 cases of PHPT were retrospectively reviewed.Results PHPT presented a variety of clinical manifestations,and occoured to different age groups without significant gender differences.All the 35 cases had elevated blood calcium and PTH.All patients underwent preoperative ultrasonography and 99Tcm-MIB imaging,and the positive rates were 68.6％ and 97.1％ respectively.34 patients received surgical treatment,among whom 30 cases had parathyroid adenoma,1 case had parathyroid hyperplasia and 3 cases had parathyroid carcinoma.Through operation,31 cases were cured,2 cases improved,and 1 case of parathyroid carcinoma suffered from lung metastasls.Conclusions PHPT can be diagnosed according to co-elevated serum calcium and PTH.Ultrasonography combined with 99Tcm-MIB imaging should be recommend for preoperative localization.The main cause of PHPT is solitary parathyroid adenoma.PTPT can be cured by surgery.Minimally invasive parathyroidectomy with accurate location is an efficient surgical strategy,and the prognosis is favorable.

Objective To systematically evaluate the short clinical effect of prone position ventilation (PPV) in patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Methods All relative literatures published in the past nine years were searched by computer and hands. Quality appraisal and review data extraction of searched literatures were completed and underwent Meta analysis. Results Eight studies including 184 patients with ALI/ARDS were brought into this Meta-analysis according to the inclusion and the exclusion criteria. Oxygen in artery(PaO2) 、oxygen index (PaO2/FiO2)、pulmonary compliance (C) increased during prone position ventilation, partial pressure of dioxide in artery (PaCO2)、central venous pressure (CVP) 、peak inspiratory pressure ( PIP)、airway resistance (Raw) showed no change, heart rate (HR) and mean artery pressure (MAP) both increased. Conclusions Pulmonary compliance and hypoxemia of patients with ALI/ARDS is improved markedly in PPV. While, due to some limitations of this Meta-analysis, high quality study on PPV is still needed to make clear the clinical effect, mechanism and scientific procedure of PPV and influence of PPV on hemodynamics of patients, so that we can improve the nursing level of patients with ALI/ARDS.

Objective To investigate and analyse the current situation and the factors impacting nursing soft skills in order to provide targeted advice to improve students′ nursing soft skills .Methods Totally 1 000 student nurses were investigated by the nursing soft skills scale and the self‐designed questionnaire .Results First ,there was no differences between the nursing soft skill of students and the national new nurses(P> 0 .05) .But the students′ organizational management and cognitive skills were lower than that of national new nurses(P< 0 .05) .Second ,class leader ,familiarity and fancy for nursing science were the main factors impac‐ting nursing soft skills(P< 0 .05) .Third ,the students′ organizational management and cognitive skills had an increasing trend fol‐lowing the extent of familiarity and fancy for nursing science(P< 0 .05) .Conclusion Education management institution and nursing schools should try to make some reform mearsure to improve students′ nursing soft skills .

Objective: To explore the effect of electro-acupuncture and musk injection on recovery of injured sciatic nerve function in rats, so as to provide the experimental evidences for the promotion of peripheral nerve regeneration by electro-acupuncture and musk injection.Methods: Following establishing rat model of sciatic nerve injury by operation, the rats were randomly divided into electro-acupuncture group, musk injection group, electro-acupuncture plus musk injection group and model group, then sciatic functional index (SFI) and motor nerve conduction velocity (MNCV) were measured after 4 weeks of treatment, 8 weeks of treatment and 12 weeks of treatment respectively to evaluate recovery of nerve function. Results: SFI and MNCV in electro-acupuncture group, musk injection group and electro-acupuncture plus musk injection group were improved more obviously than that in model group, with significant differences(P＜0.01, P＜0.05). Conclusions: Both electro-acupuncture and musk injection could promote recovery of injured nerve function, and they had a certain synergetic effect and might be the effective methods in promoting recovery of injured peripheral nerve function.

AIM: To investigate the effect of IL-10 on IL-1?-induced prostaglandin E 2(PGE 2) release and cyclooxygenase-2(COX-2) expression in human mesangial cells and to examine whether IL-10 has effect on the biological function of IL-1?.METHODS: The PGE 2 concentration in supernatants of HMC was measured by radioimmunoassay. The COX-2 mRNA and protein were measured by RT-PCR and Western blot, respectively. RESULTS: PGE 2 and COX-2 were significantly increased after treatment with IL-1?( P0.05 , respectively), while it inhibited IL-1?-elicited PGE 2 production, as well as COX-2 mRNA and protein expression in a concentration-dependent fashion. CONCLUSIONS: These results indicated that IL-10 depressed the IL-1?-induced release of PGE 2 and expression of COX-2. These data suggested that IL-10 could exert anti-inflammatory actions at several levels, not only by inhibiting the production of pro-inflammatory cytokines but also by suppressing their biological function.

To meet the challenge of the clinical teaching,the"Regulations on the Management of Clinical Teaching Practice in Medical Education"has been made and implemented, which establish the definitude responsibilities,rights and profit relations among doctors,students and the patients. Related organizations and persons should fully realize its normative significance,implementation obstacles and deepen the study of clinical teaching research,thus facilitating the enhancement of the teaching effect,and building a harmonious triangular relationship among the concerned parties.

Objective To compare the outcomes of traumatic flail chest with multiple injuries treated by operative fixation versus conservative approach. Methods The clinical data of 60 patients with traumatic flail chest with multiple injuries were retrospectively analysed, and the outcomes between operation group (treated by operative fixation, n=32)and non-operation group (treated by conservative approach, n=28) were compared. Results The mean time of hospital stay, ICU stay and mechanical ventilation was significantly shorter, and the prevalences of chest wall deformity, pulmonary infection, pulmonary atelectasis and respiratory failure were significantly lower in operation group than those in non-operation group (P<0.05). Six months after discharge, the pulmonary function parameters such as inspiratory capacity, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, total lung capacity and maximal midexpiratory flow were significantly higher in operation group than those in non-operation group (P<0.05). Conclusion Traumatic flail chest with multiple injuries treated by operative fixation may lead to less flail chest associated complications. Operative fixation has short- and long-term benefits to flail chest.

Objective To investigate whether the clinical outcomes of HBV infection are associated with single nucleotide polymorphisms of Toll-like receptor (TLR) 9 gene promoter region.Methods The polymorphisms of three positions at TLR9 gene promoter region including A-1923C, T-1486C and T-1237C were detected using real-time fluorescence quantitative polymerase chain reaction in 96 patients with severe chronic hepatitis B, 156 patients with chronic hepatitis B and 151 cases of HBV spontaneous clearance, then the differences between the groups were analyzed.Analysis of variance was performed for measurement data,and χ2 test or Fisher exact probability test were used for enumeration data.Results The frequency of AC genotype at TLR9 gene A-1923C site in chronic hepatitis B group was 3.8%, which was significantly lower than that in HBV spontaneous clearance group (11.3%) (χ2=6.082, P ＜ 0.05), but no significant difference was found between severe chronic hepatitis B group (8.3%) and HBV spontaneous clearance group (χ2=0.552, P ＞0.05).No significant differences of genotype distribution were found between chronic severe hepatitis B group and HBV spontaneous clearance group , chronic hepatitis B group and HBV spontaneous clearance group at polymorphism sites of T-1486C and T-1237C (χ2=1.534 and 0.745, P ＞ 0.05).Conclusions Genotype AC at TLR9 gene A-1923C site is associated with HBV spontaneous clearance, but not correlated with chronic HBV infection and liver failure; there is no correlation of polymorphisms in T-1486C and T-1237C at TLR9 gene promoter region with the clinical outcomes of HBV infection.