In the course of medical activities, doctors and patients may form various kinds of social relationships. Of these, the one adjusted by health laws and regulations is termed the legal relationship between doctors and patients. A legal relationship is one involving certain rights and duties that are clear cut and must be observed and breaches will lead to corresponding legal responsibilities. From the legal perspective both doctors and patients, while enjoying their respective rights, must fulfull their legal obligations. Medical institutions and their workers ought to update concepts, cultivate the idea of a legal relationship between doctors and patients, and handle the doctor patient relationship on the basis of a legal relationship and legal reasoning so as to meet the actual needs of society.

The sex - change has been applied in clinic for about twently years. But there was no correlative law so far. It appeared law cases uninterrupted in recently years, which accompanied a simply on the legality, freedom for decision of the sex - change surgery and sexual testification after the surgery.

BACKGROUND: Junior medic is a special population, which has high speciality and great pressure in study. To investigate the characteristics of personality and mental health of this population can explore the reasons of mental problems in junior medics, which can provide theoretic gist for the establishment of the intervention to improve the mental health of this population.OBJECTIVE: To provide approaches and methods for customized development of mental health education through the comprehension of the status of personality and mental health characteristics of junior medics.DESIGN: A stratified randomized cluster sampling survey.PARTICIPANTS: Totally 550 students of grade 1 and grade 2 in Harbin Medical University were selected by stratified randomized cluster sampling in the September 2004.METHODS: Self-rating depressive scale (SCL-90) and Eysenck personality questionnaire (EPQ) were independently answered by 550 students and taken back on the spot.MAIN OUTCOME MEASURES: Key consequences: EPQ scores for extroversion(E), neuroticism(N), pschoticism(P), reliability(L) and the SCL-90 scores for somatization, compulsion, sensitive human relationship,depression, anxiety, hostility, phobia, crankiness and psychosis. Minor consequence: the statistical typical correlative analysis between total score and score of 9 items in SCL-90 and the scores of 4 scales in EPQ.RESULTS: Junior medics had significantly higher scores in compulsion (1.83 ±0.52), anxiety(1.47 ±0.43), psychosis(1.43 ±0.43), and crankiness(1.54 ± 0.55) than Chinese norm( t = 6. 57 -9.09, P ＜ 0. 05).The characteristics of personality were introversion, optimism, humility, and active. The shortcomings were anxiety, depression and emotional There was positive correlation between personality problem and the severity of mental problem in junior medics.CONCLUSION: The proportion of students with personality problems or mental health problems is relative high in junior medics. Effective interventions should be employed.

Objective To analyze and compare of regional citrate anticoagulation (RCA),low molecular weight heparin and hep-arin-free in severe sepsis patients with thrombocytopenia CRRT treatment effect and complication of the situation.Methods Retro-spective analysis of 3 6 patients admitted to ICU CRRT therapy of severe sepsis in patients with thrombocytopenia was made.Nine patients were given RCA,1 4 patients were given low-molecular-weight heparin calcium and 1 3 patients were given no heparin anti-coagulation programme.And then observation of three groups of CRRT treatment of coagulation function in patients with platelet depletion,blood,bleeding conditions,filter effects,filter usage time,and 15-day,30-day mortality were made.Results In RCA group and heparin-free group,coagulation blood features was significantly superior to low-molecular liver pigment calcium group (P<0.05),there was no significant difference(P>0.05)between RCA group and heparin-free group coagulation in blood features. Bleeding rate and platelet consumption in RCA group were significantly lower than that in heparin-free group and low molecular liv-er pigment group(P<0.05).Filter usage life in RCA group and low molecular liver pigment group was obviously longer than that in heparin-free group(P<0.05).There was no significant difference in filter effect,15 days,30 day fatality rate among the three groups(P>0.05).Conclusion Severe sepsis in patients with thrombocytopenia in CRRT applications of regional citrate anticoagu-lation could reduce the risk of hemorrhage,reduced platelet consumption and longer filter usage time.

Objective To investigate the significance of levels of IL-8,TNF-α in serum of patients with aplastic anemia(AA).Methods Serum levels of IL-8 and TNF-α in 45 patients and 30 normal controls were measured by enzyme linked immunosorbent assay.Results The serum levels of IL-8,TNF-α increased significantly in AA and acute AA(AAA)group than in the control group(P＜0.05),there was no statistical significance between chronic AA(CAA)group and the control group(P＜0.05),and the levels in AAA group were much higher than in CAA group(P＜0.05).The serum level of IL-8 was positively related to TNF-αin AA group(r=0.682,P＜0.05).Conclusion There are immunological disorders in patients with AA and the overproduction of IL-8,TNF-α might be involved in the immunopathogenesis of AA,AAA.

Objective To construct replication deficient adenovirus vector AdCMV lacZ Methods Recombinant adenovirus shuttle plasmid pAdCMVlacZ was first constructed and then lacZ cDNA cloned into Hind Ⅲ and Eco R Ⅴ of adenovirus shuttle plasmid pAdCMV by conventional methods Results The restriction enzymatic map of pAdCMVlacZ accorded with theoretic analyses and pAdCMVlacZ showed blue bacterium groups under the existence of revulsant and X gal Conclusion The adenovirus shuttle plasmid pAdCMVlacZ has been constructed successfully

This study was aimed to investigate the effect of Rheum tanguticum on expression of serum endothelial nitric oxide synthase (eNOS), endothelin (ET) and 6-keto-prostaglandin F1α (6-Keto-PGF1α) in uric acid nephropathy rat model. After 3 weeks of treatment with different extractions of Rheum tanguticum on uric acid nephropathy rat model, levels of serum BUN, Cr and UA were measured by biochemical analyzer. ELISA method was used to measure the expression of serum eNOS, ET and 6-Keto-PGF1α. Meanwhile, pathological changes of renal tissues were observed by light microscope. The results showed that compared with the normal control group, the levels of serum BUN, Cr, UA and renal index were higher in the model group (P< 0.05). Compared with the model group, the concentration of eNOS in the model group was obviously higher in the rhubarb ethanol extraction group, rhubarb water extraction group, and allopurinol group (P< 0.05). Concentration of ET was obviously reduced in the rhubarb water extraction group and allopurinol group (P< 0.05). There was no statistical difference with the rhubarb ethanol extraction group. There was no significant difference in the concentration of 6-Keto-PGF1α among groups. Lots of inflammatory cells and uratic crystallization were observed by light microscope in renal tissues among rats in the model group. Damages of renal tissues in medication groups were alleviated than the model group. It was concluded that Rheum tanguticumcan alleviate the damage of uratic crystallization and inflammatory cell infiltration, increase the concentration of serum eNOS, and decrease the concentration of serum ET. Thus, it can reduce the damage of renal endothelial cells and protect renal functions. The effect of rhubarb ethanol extraction on reducing ET expression was less than the water extraction.

BACKGROUND:To control blood glucose, blood pressure, blood lipids and inhibit the rennin-angiotensin system is the main idea focused on the treatment of diabetic nephropathy, but the curative effect is unsatisfactory. Hemodialysis and kidney transplantation are suitable for serious cases, however, which is restricted because of the limited source of kidneys and high cost. Regenerative medicine research based on stem cells brings a new hope for treatment of diabetic nephropathy. OBJECTIVE:To comprehensively analyze the mechanism underlying different sources of stem cells for treatment of diabetic nephropathy and the clinical implications. METHODS:Papers addressing stem cells for the treatment of diabetic nephropathy were retrieved by computer in CNKI database and PubMed database from January 2005 to August 2013 with the key words“embryonic stem cells, bone marrow mesenchymal stem cells, induced pluripotent stem cells, diabetic nephropathyin Chinese and English. Papers published recently or in journals with high impact factor were selected. A total of 60 papers were included for review. RESULTS AND CONCLUSION:Embryonic stem cells, bone marrow mesenchymal stem cells, induced pluripotent stem cells have the potential to differentiate into renal histiocytes. A large numbers of experimental studies have shown that stem cells transplantation has a positive effect on recovery of injured kidney. Stem celltransplantation can provide a novel therapy for diabetic nephropathy.

Systems biology is a new science of the 21st century, which resembles traditional Chinese medicine (TCM) in many aspects such as study method and design. Adoption of systems biology approach would do much help for exploring the scientific connotation of TCM syndrome and the modernization of Chinese herbal medicine. Its technological platforms, such as genomics, proteomics and metabonomics, provide powerful tools for the study of the essence of TCM syndrome and the function of herbal compound recipe. Compared with other molecular biological methods, such as genomics and proteomics, metabonomics method is more direct and more concise, especially for providing an effective method for the study of TCM therapy in preventing and treating kidney diseases.

AIM: To investigate the correlation between the left ventricular filling type and geometry modality and functional change of the left ventricle in patients with hypertension. METHODS: Systolic function indexes (FS and EF) and diastolic function indexes (E, A, EAT, EDT, E/A,IVRT) in 120 patients with hypertension were measured by two dimensional ultrasonography (2-DUS) and M-mode and Doppler ultrasound. RESULTS: A rate of 83.5% in patients with hypertension appeared assured plump and configuration changes of left ventricle, and a rate of 84% in patients with hypertension appeared abnormal left ventricular filling function. The morphologic indexes were significantly different clearly in different left ventricular filling types, and the filling indexes were also significantly different in diferent left ventricular shapes. CONCLUSION: IVRT is a more important index than other factors to decide the left ventricular filling function. LVMI plays more important role than other factors in the left ventricular filling function.