After the concept of risk of literature acquisition was described, its universal, objective, losing, controllable and social featureswere pointed out , followed by an analysis of the factors and related conditions for its occurrence , its consequences and possible losses, with measures proposed for its control.

Objective To explore the therapeutic efficacy for fractures around the knee with concurrent vascular and nerve injury.Methods The clinical data of 75 patients with fractures around the knee with concurrent vascular and nerve injury treated were retrospectively analyzed.And fracture reduction,vascular repair and nerve repair were given depending on degree of injure.Therapeutic efficacy of the treatments was recorded.Results 5 cases were amputation,while the others were alive,the rate of efficacy was 93.06％.27 of the 31 cases of contusion nerve were returned to normal,4 were returned to part of the sensory-motor,11 of 13 cases of completely torn nerve were recovering well,and 2 of which were 2 degree,and the rate of efficacy was 86.36％.Conclusion The appropriate measures and early treatment should be given,by which prognosis of limb could be improved comspicuously,and the order of vascular repair and fractures fixation is influential on surgery success.

According to the main problems existing in the rural patriotic hygiene work at present, this article analyses the causes of these problems from both the subjective and objective respects. According to the goal of building a well-off society in an all-round way and safeguarding the health interests of 900 million farmers, this article tries to discuss the guideline and principle of ethics on the rural patriotic hygiene work and put forward the code of ethics to do a good job in the rural patriotic hygiene work.

Aiming at the litigation to medical treatment dispute since new rule, there are different reply words and actions existing in medical service providers,according to the request of the new rule, the author analyzed doctor-patient relationship and medical treatment dispute,medical service and reform,'proof'consciousness and work circumstance of doctors,bring upped the request that the medical treatment organization and its members should reply to the new rule from thought consciousness,doctor-patient relationship,rules in medical service practice, proof system,etc.

Objective To understand the prevalence of erectile dysfunction (ED) in elderly male and to provide the basis for clinical diagnosis and treatment of ED. Methods The questionnaire about sexual history was used, and related past history, medication and life-style were reviewed. Results Total prevalence of ED was 89.7% in the 272 elderly male persons. The prevalence of 60-years group, 70-years group and 80-88 years group was 75.9%, 78.6% and 100%, respectively. Among ED patients, 95.1% of them suffered from hypertension. Conclusions Prevalence of ED in elderly male persons is associated with the ageing and the hypertension.

The medical teaching assistant terrace has been established and finished in the digital libraries.It has increased library function,satisfied medical teaching innovating demand and advanced library value and position.It has also provided the chance and established the direction of the development for library and its workers.

It is required by objective reality to discuss the teaching conception and mode of evidence-based medicine,based on its nature and from the fundamental differences between it and traditional medicine.

Objective To observe the clinical effect of mifepristone combined with intramuscular injection of methotrexate in the treatment of cesarean scar pregnancy.Methods Fifty-six patients with uterine scar pregnancy after cesarean section were divided into observation group and control group by random number method.The control group was intramuscularly injected methotrexate,the observation group was given methotrexate combined with mifepristone therapy.The therapeutic effect,blood β human chorionic gonadotropin(β-HCG) decreased to normal time,vaginal bleeding time,mass size were observed.Results After treatment,the serum β-HCG decreased to normal time[(15.96±3.71)d] and vaginal bleeding time[(5.12±2.08)d] of the observation group were significantly shorter than those of the control group [(25.42±4.02)d,(7.39±3.37)d],the mass size of the observation group [(1.88±0.15)cm] was also significantly smaller than (2.14±0.33) cm of the control group,and there were significant differences between the two groups(t=4.3142,3.0331,3.7954,all P＜0.05).Conclusion Mifepristone combined with intramuscular injection of methotrexate has significant effect on uterine scar pregnancy after cesarean section.

Objective To investigate the application of Vein Infrared Imaging instrument in the treatment of medical patients with difficulty of vein-detaining needle. Methods A total of 116 cases of patients with difficulty of vein-detaining needle were admitted to Peking Union Medical College Hospital International Medical Service Department from June 2015 to May 2016. These participants were divided into vein imaging and conventional puncture group by the punctures method, 58 cases in each group. Vein imaging group applied vein imaging device in the whole process of venous indwelling needle, including vascular assessment before operation, real-time imaging and confirmation, the control group used conventional technology in peripheral venous catheter. The success rate of vein-detaining needle, operation time, puncture tube material cost, the incidence rate of venous indwelling needle complications were compared between two groups of patients. Results One-time success rate of vein imaging group reached 72.4% (42/58), puncture success rate reached 93.1% (54/58), higher than in conventional puncture group, which was 48.3% (28/58), 67.2% (39/58),the difference between the two groups had statistical significance(χ2=7.061, 10.629,P<0.05). Conventional puncture group 's operation time was (8.4±4.2) min,and puncture tube material cost was(123.37±62.20)yuan;vein imaging group respectively were (3.5±1.2) min, (67.50±24.82) yuan, the difference between the two groups had statistical significance (t=5.410, 4.057, P<0.05). Conventional puncture group's rate of complications was 41.4%(24/58), and vein imaging group was 17.2%(10/58), the difference between the two groups had statistical significance (χ2=8.155,P=0.004). Conclusions Application of vein infrared imaging instrument is a practical, safe and rapid method of vein-detaining needle, which can improve the work efficiency of nurses, and have more advantages in the treatment of patients with difficulty of vein-detaining needle.

Renal medullary cystic diseases are a large class of heterogeneous diseases,and they are common in clinic,most of them often progress to end-stage renal disease.With recent advances in genetics,increasing number of genes and genetic mutations has been identified with the etiology of renal medullary cystic diseases.Although genetic testing can provide mass data for diagnosis,clinical manifestation are even more important for clinical diagnosis,differentiation and genetic counseling for the patients.In this review,the classification,renal presentations,extra-renal presentations,and genetic analysis of renal medullary cystic diseases will be discussed.