The basic principles of dishonesty disciplinary mechanism are called into play tO probe into such issues as the necessity and key points of building such a mechanism in China's hospitals.The paper focused on ascertaining government leadership,designating key regulators of hospital dishonesty,formulating the regulations for hospital dishonesty recognition and accountability,penalty system for hospital dishonesty,information disclosure system for hospital dishonesty behavior.In addition,it covered such aspects as the incentives and education measures for hospital credit,and building supportive measures for hospitals dishonesty disciplinary mechanism.

Presentation of the importance to resolve medical treatment disputes via mediation,holding that mediation enjoys a promising perspective in this regard.At present,unsatisfactory use of mediation in resolving medical treatment disputes in China finds its root in the system itself.Reconstruction of the existing mechanism for disputes mediation and resolution is inevitable in caUing this mechanism into an active play.Mediation organizations and private institutions in the society should be mobilized to play a greater role in resolving disputes,in an effort to make mediation agreements binding,normalize mediation behavior.This way a new mechanism joining "private,administrative and judiciary" mediation with standardized behavior will be built.

Biotechnology is one of the important areas of life science, consequently the ethical problems were caused by its researches and applications. The article analyzed the ethical problems related to the development of biotechnology and put forwards some countermeasures in order to keep it developing constantly and steady.

Objective To investigate the clinical effect of compound Chinese medicine fumigation granules on surgical treatment of anorectal disease patients and the impact of postoperative complications and wound healing.Methods 78 cases of patients anorectal surgery from June 2013 to February 2016 in our hospital anorectal were admitted,and were randomly divided into observation group and control group,39 cases in each group,using anti-inflammatory and conventional dressing treatment after operation in both two groups,the observation group was treated with compound Chinese medicine fumigation granules,treatment for 10 days continuous.The changes of wound healing and related clinical symptoms were observed and compared between the two groups.Results Third,7,14 days after operation,VAS scores in observation group were lower than the control group,the differences were statistically significant(P<0.05).Tirst days after operation,there was no significant difference in perianal edema,anal bulge,anal dampness and bleeding symptom score between the observation group and the control group; third,7 days after surgery,the perianal edema,anal bulge,anal wet,bleeding symptom score in observation group were lower than the control group,the differences were statistically significant(P<0.05); fifth,14 days after operation,wound patients smoked wash reduction rate in observation group was higher than the control group,the differences were statistically significant(P<0.05); observation group average wound healing time was(16.3±2.8)days,the control group was(18.4±3.3)days,the differences were statistically significant(P<0.05).Conclusion After surgical treatment of anorectal disease,use the compound Chinese medicine fumigation particles for treatment can help relieve the clinical symptoms of patients,reduce pain,promote wound healing.

Based on introducing digital certificate related concepts, the paper compares the similarities and differences of digital sig-nature soft and hard certificates from the aspects of implementation process, implementation condition, convenience, security, law validi-ty, maintainability, etc.Combining with the actual status of information system, it analyzes the selection of digital signature.

ObjectiveTo explore the relationship between the different body mass index (BMI) ranges and all cause mortality in hemodialysis (HD) patients. MethodsEligible studies assessing the effects of BMI ranges on all-cause mortality(published from 1966 to 2012 )were searched, using hemodialysis/haemodialysis and obese/body mass index/overweight andmortality/surwival/reverse epidemiology/obesity paradox in PubMed,Embase,ScienceDirect,Wilcy,Scopus and Ovid. Inclusion criteria were that trials reported mortality in HD patients according to the traditional WHO/NIH BMI classification,and BMI levels were acceptable within 2 kg/m2.The quality of the trials was evaluated using the assessing risk of bias in studies included in Cochrane reviews.The mortality rate in HD patients was the primary endpoint of the study.ResultsWith no significant heterogeneity ( I2 =0％,P =0.45 ),a fixed-effects model was used for analysis.Four studies with a total of 81 423 patients met final inclusion criteria.Compared to individuals with non-elevated BMI levels,the elevated group (BMI ≥25 kg/m2) was associated with lower all-cause mortality ( OR 0.67,95％ CI 0.65-0.68 ). In a risk-adjusted sensitivity analysis,elevated BMI levels remained protective against mortality( adjusted HR 0.94,95％ CI 0.92-0.96 ).ConclusionsHigh BMI levels are associated with lower all-cause mortality rate in HD patients.More stable hemodynamic status,cytokine and neurohormonal alternations,and nutritional status maybe contribute to the protective effects of BMI on the mortality of HD patients.There is a need for more prospective studies to elucidate underlying mechanisms.

Objective To explore the normal range of serum glycated albumin (GA) during the second trimester in non-gestational diabetes mellitus (GDM) population and the value of serum GA in the blood glucose monitoring during pregnancy.Methods The GA was measured in 101 healthy gravida during the second trimester and 80 gravida with GDM and diabetes mellitus who were in treatment at Peking University First Hospital between August 2011 and December 2011,in order to analyze the normal range of GA and the relationship between GA and the level of blood glucose.Results (1) The normal range of GA during the second trimester was 10.9％-15.3％,which was negatively correlated with body mass index (P＜0.01).(2) Significant correlations were observed between GA and the level of hemoglobin A1c (HbA1c),preprandial,postprandial and mean plasma glucose in gravida with GDM and diabetes mellitus (r:0.361,0.252,0.338,0.310 ; all P ＜ 0.05).(3) When the level of GA was 13.97％,the sensitivity and specificity index for glucose control were 78.0％ and 74.4％.Conclusions GA could evaluate the severity of disease in gravida with GDM and diabetes mellitus.10.9％-15.3％ could be suggested as normal range of GA for the gravida at the second trimester.

Objective To investigate the value of endoscopic submucosal dissection (ESD) and submucosal tunneling endoscopic resection (STER) for the diagnosis and therapy of gastric ectopic pancreas.Methods A total of 86 patients who were suspicion diagnose with gastric ectopic pancreas received ESD or STER in hospital,and the therapeutic effect and safety were followed-up.Results Fifty-four gastric ectopic pancreas patients were definitely diagnosed by postoperative pathology.Of the 54 patients,43 cases were located at the gastric antrum,7 cases were located at gastric fundus and gastric corpus juncture,4 cases were located at gastric corpus.Forty-five cases received ESD,9 cases received STER,rate of completely resection was 88.9％ (48/54),6 cases had a little tissue residual after resection.One case (1.9％,1/54) happened postoperative delay-bleeding,intraoperative and postoperative perforation was not found.During 1-32 months followed up,recurrence was not found.Conclusion ESD could excise the whole lesion to offer an accurate pathology diagnose,meanwhile good for treatment,ESD is an effective and relatively safe method for gastric ectopic pancreas,STER may be a new approach for gastric ectopic pancreas.

Objective To study the maternal and fetal outcome in pregnancy with overt diabetes. Methods Retrospective study was made on 88 pregnancies with overt diabetes from 1981 to 2001 in department of Obstetrics & Gynaecology, first teaching hospital, Beijing university to study the maternal and fetal outcome in pregnancy with overt diabetes and its relationship with the level of blood glucose. One case with artificial abortion and 2 cases with metaphase induced labor were rejeceted from the 88 cases, we devided the other 85 cases into two groups. Group A with well controlled glucose had 42 cases; group B without well controlled glucose had 43 cases. Results In this study, we found 5 cases of fetal death in group B, 3 of them were perinatal death. Nine cases of newborn malformation were all found in those people without well controlled glucose in early pregnancy, the incidence of newborn malformation was 10.2%. The rate of asphyxia of newborn in group B (24.4%) is significant higher than in group A (4.8%) ( P =0.011). The rate of pregnancy induced hypertension in group B (44.2%) is significantly higher than that in group A (21.4%) ( P = 0.026). The rate of premature labor in group B (30.2%) is significantly higher than that in group A (9.2%) ( P =0.017). Conclusions Maternal blood glucose with ideal control throughout pregnancy may reduce the maternal complications and perinatal morbidity and mortality in pregnancy with overt diabetes.

Objective Explore the risk factors and prevention of HAP after surgical excision of Esophageal carcinoma in elderly Patients.Methods Two hundred and eight elderly patients with HAP after Surgical excision of Esophageal carcinoma from 2009 to 2012 were analyzed.Logistic regression analysis was used to find the related risk factors.Results The incidence of HAP was 25.9％.In several factors Logistic regression analysis,smoking,low lung function,postoperative non-epidural analgesia,injure of recurrent laryngeal nerve and fistula of anastomotic were the risk factors.Conclusions The preoperative evaluation,Intensive monitoring during the postoperative period and reducing the complication after operation can decrease the incidence of HAP.