This article deals with the relationships between doctors and patients in the ethical and legal perspective.It emphasizes that doctors should envisage,solve and settle new problems even conflicts with patients.Meanwhile,it points out that in China's tradition of ethical standard,the harmony between doctors and patients could not copy the legal system of the West.Adoption of ethics and laws as well as social responsibilities could result in good relationships between doctors and patients which could improve the service of hospitals.

Objective To investigate the effect of continuous positive airway pressure(CPAP) on nocturnal polyuria in patients with obstructive sleep apnea syndrome(OSAS). Methods The number of nocturia, the nocturia output, the osmotic pressure of nocturia and the nocturia excretion of Na＋ . Plasma levels of atrial natriuretic peptide (ANP) in night were measured in 8 patients. After treatment with CPAP, the patients were recorded or measured by those index again. Results The number of nocturia ， The nocturia output， The osmotic pressure of Na＋ ,and the plasma leels of NAP in night decreased significantly after tretment with CPAP.The osmotic pressure of nocturia rose significantly.The reduction of ANP corrected with the reduciton of the nocturia output,addition of the osmotic pressure of nocturia and the reduction of the nocturia exeretion of Na＋ .Conclusion CPAP can reduce the number of nocturia, the nocturia output and the nocturia excretion of Na＋ , increase the osmotic pressure of nocturia. The changes probably relate with the reduction of plasma level of ANP.

To introduction the biological function of vascular endothelial growth factor and to explore the role of vascular endothelial growth factor(VEGF)and in the pathogenesis of endotoxin,ischemia-reperfusion,hyperoxia,ventilator-induced lung injury(ALI)/acute respiratory distress(ARDS).

Objective To differentiate the sequences of Cyt b gene Agkistrodon from its adulterants sold in the market in order to provide molecular evidence for identification of Agkistrodon. Methods Cyt b gene was used to sequence and analyze Agkistrodon and its adulterants sold in the market. Results There was a mixed phenomenon in Agkistrodon species. The differences of Cyt b gene sequence between Agkistrodon and its adulterants sold in the market are significant: the difference rates among the species of Agkistrodon are 0%—0.91%, the difference rates between Agkistrodon and its adulterants are 18.57%—23.78%. Conclusion The characteristics of Cyt b gene sequence can be used as a better molecular marker for authenticating Agkistrodon from its adulterants.

The American Heart Association published a new guideline for cardiopulmonary resuscitation in Oct 2010.One of the most important recommendations is the sequence change of cardiopulmonary resuscitation from ABC to CAB.As pediatrician,we should understand the background of these changes,and give the most reasonable treatment to improve the success rate of resuscitation according to the different locations,different circumstances and different obiects.

Objective To explore prognostic factors associated with early and late recurrences after surgery for patients with gastric adenocarcinoma.Methods 214 patients who underwent curative resection for gastric adenocarcinoma were divided into 2 groups according to recurrence time:an early recurrence group included 143 patients who died within 2 years after surgery,and a late reeurrence group included 71 patients who died more than 2 years after surgery.Indexes such as age,sex,tumor site,tumor size,tumor pathology classification,Borrmann type,TNM staging,lymph node metastasis,operation type and postoperative adjuvant chemotherapy were compared.Results Single factor analysis showed that the tumor diameter,Borrmann type,TNM staging,lymph node metastasis,operation type,adjuvant chemotherapy were asoceiated with postoperative recurrence( test value were 8.32,16.21,24.90,5.22,17.23 and 3.61,respectively;all P ＜ 0.05 ).Multifactor analysis showed that tumor diameter and TNM staging is recurrent independent factors( relative risk were 5.642 and 6.211,respectively ;all P ＜ 0.05 ).Conclusion Tumor size and TNM staging are the most important factors for predicting the timing of recurrence after curative resection for gastric adenocarcinoma.Clinical practice should pay attention to follow up for patients with tumor diameter≥5cm,TNM Ⅲ-Ⅳ stage,especially within two years.

Objective　To study the effects of deliberated hypotension combined with acute simple hemodilution on blood loss,postoperative hemoglubin of the patients undergoing spinal side(back) protrude correction(SSP).Methods　Twenty four ASA grade Ⅰ to Ⅱ patients undergoing elective SSP were randomly divided into two groups:control group(n＝12) and hypotensive group(n＝12).The all patients received with general anesthesia.In the hypotensive group:acute simple hemodilution was accomplished with infusion of lactated Ringer's solution and Gelofusine of as three times as blood loss.Deliberated hypotensin was induced and maintained with 0.01% sodium nitroprusside 2～6μg/kg/min iv.Intraoperative blood loss,blood transfused volume during operation and postoperative hemoglobin were recorded and compared between both groups.Results　 Blood loss was about 51% lower in the deliberated hypotensive group than that in the control group at the end operation.The average volume of transfused blood during operation was(1200±140)ml in control group,blood transfusion was(400±128)ml in the hypotensive groups.Conclusion Deliberated hypotension combined with acute simple hemodilution can significantly decrease the intraoperative blood loss and the SSP operation can be better tolerated for the indicated patients.

Many studies show that excision repair cross-complementing gene 1 (ERCC1),ribonucleotide reductase subunit M1 (RRM1),p53,epidermal growth factor receptor (EGFR),and vascular endothelial growth factor (VEGF) are closely related to the curative effect and prognosis of non-small cell lung cancer (NSCLC).In recent years,many studies have investigated the association between polymorphisms of these factors and the curative effect and prognosis in patients with NSCLC.The polymorphisms of these factors may be potential biomarkers to predict the clinical outcome in patients with NSCLC.

Objective To study the expression of the imprinted gene H19 and IGF-Ⅱ in newborn placenta,and to discuss its influence on the birth body mass of the neonate. Methods The fresh placental tissues from full-term newborn (without trimester of pregnancy complica-tion and placenta and funic abnormality) with normal,high and low birth body mass (12,10 and 8 samples respectively)were collected. The expression of imprinted gene H19 and IGF-Ⅱ mRNA in the placenta were estimated by reakime fluorescence quantitative PCR Results The ex-pression of H19 mRNA in the placenta was negative correlation to the birth body mass (r =-0.403,P = 0.027).The expression of of IGF-H mRNA was positive correlated to the birth body mass (r = 0.444,P = 0.014). The H19 mRNA expression level in the high birth weight neonates (0.21 0.31) was significantly lower than that in the low birth body mass neonates (1.51 2.04)(P= 0.013). But the expression level of IGF-Ⅱ mRNA in the high birth body mass neonates (2.67±3.41) was significantly higher than that in the low birth body mass neonates (0.39±0.33)(P =0.013). Conclusion The expression of H19 and IGF-Ⅱ mRNA was significantly different in the placenta of normal,high and low birth body mass newboms. These two genes may be related to the birth body mass,and there may be some realation-ship between these two genes.

Juvenile idiopathic arthritis (JIA) is the most common chronic imnuro-rheumatic disease in children with different type of onset and varies clinical manifestation as well as poor prognosis.The research on the JIA have become the important subject of the connective disease.This paper has reviewed the different therapeutic methods of JIA.