Legal relationship between doctors and patients is constructed by the three el-ements:the subject,the object and the contents.The subject is the medical side and patient side.The object is a medical act.The content of medical and legal relations is rights and obligations of both sides.

Objective To explore the effect of correcting astigmatism with corneal incision guided by the corneal topography preoperatively.Methods 97 patients(102 eyes) having undergone phacoemulsification and foldable introcular lens implanation,were divided into two groups according to the incision.Superior temple sclera tunnel incision was made on 51 eyes of the group A,and the clear cornea incision was made on the steepest meridian for the group B(51 eyes).The preexisting cornea astigmatism of all patients reneged from 0.25 D to 5.75 D.Corneal topography examination was made before the operation and one day,1 week,1 month and 3 months after surgery except for visual acuity,slit lamp and fundus examination.The value of surgical induced cornea astigmatism was observed.Results In the group A,the differences were not statistically significant between pre-operation and 1 day,1 week,1 and 3 months after surgery for the value of corneal astigmatism(P>0.05).In the group B,the value of corneal astigmatism in 1 day and 1 week after surgery were a little greater than that of pre-operation,but 1 month later,that was significant better than that pre-operation.The value of corneal astigmatism was reduced from 1.5 D before surgery to 0.52±0.14 D after surgery,from 1.5～2.5 D to 0.88±0.53 D and from over 2.5 D to 1.5±0.72 D respectively.Conclusion The incision guided by corneal topography can correct cornea astigmatism existed pre-operation and get the best visual outcome.

Objective To explore the characteristics of the reperfusion arrhythmia after acute myocardial infarction (AMI) pa-tients underwent emergency coronary interventional therapy ,in order to reduce the incidence of serious arrhythmia ,and improve the prognosis and quality of life .Methods Clinical data of 147 patients from January 2009 to May 2012 with acute myocardial infarction occurrence reperfusion arrhythmia after underwent emergency coronary interventional treatment were analyzed .Results In 147 ca-ses ,62 cases of reperfusion arrhythmia occurred .Infarct-related artery for the left anterior descending branch (LAD) 33 patients (LAD group ) ,left circumflex artery (LCX) 7 cases (LCX group ) after surgery ,the right coronary artery(RCA) 22 cases (RCA group) .The tachyarrhythmia in LAD group was higher than RCA group(P<0 .05);the bradyarrhythmia in RCA group was higher than LAD group (P<0 .05) .Opening of the infarct-related artery<6 h arrhythmia had 43 cases occurred ,and >6 h arrhythmia had 19 cases occurred ;Arrhythmia after acute myocardial infarction occurred mainly in infarct related artery opened earlier .Conclusion AMI occurrence reperfusion arrhythmia after underwent emergency coronary interventional treatment have high incidence ,there is a correlation between the arrhythmia type and infarct-related artery ,also has a correlation between incidence and reperfusion time .

Objective To examine the expression of cell cycle regulatory protiens in renal tubulointerstitial cells of human glomerulonephritis. Methods Immunohisochemieal studies were performed on 19 specimen from renal biopsy to detect cyclin Dl, cyclin A, p21 and proliferating nuclear antigen (PCNA) . Results Cyclin Dl, cyclin A and p21 were positive in some of tubulointerstitial cells, and showed significant correlations with positive PCNA cells. The numbers of tubular positive cells in both groupsofⅠand Ⅱ degree of histopathological change were more than those of other groups. The numbers of interstitialpositive cells showed significant correlations with the degree of tubulointerstitial histopathological change and the value of urine NAG. Conclusion Cell cycle regulatory proteins regulate the proliferation of tubular and interstitial cells, and correlate with the interstitial fibrosis.

PURPOSEObservation of clinical efficacy of idarubicin in the treatment of patients with both newly-diagnosed and relapsed/refractory acute leukemia. METHODS 34 patients of acute leukemia enrolled in this study are classified into 3 groups: newly-diagnosed, relapsed and refractory group. All patients are treated with combination chemotherapy composed of idarubicin and other agents. RESULTS The response rate for all patients is 70. 6% while the result in newly-diagnosed group is superior to both relapsed and refractory group (P

Objective To evaluate the feasibility and utility of three different assays on early diagnosis and monitoring of neonatal congenital cytomegalovirus infection. Methods Ninety-eight neonates whose mother was CMV-IgM positive during pregnancy were examined on the 14th days after birth for CMV antigen in blood and PCR-CMV-DNA in the saliva. Three different methods were applied including CMV antigenemia assay, PCR for CMV-DNA and ELISA for serum CMV-IgM. Neonates were followed up for six months. Results (1) Forty-eight of the 98 neonates were diagnosed as congenital CMV infection including 7 symptomatic infection and 41 asymptomatic. None of the 98 subjects was CMV-IgM positive. Among the 7 symptomatic cases, the positive rates of CMV antigen and PCR-CMV-DNA were 100%(7), 71.4%(5), and 70.7%(29/41), 46.3%(19/41) in the asymptomatic group, respectively. The sensitivity of CMV antigenemia assay and PCR was 75.0% and 54.2%, respectively. The CMV antigenemia index of the symptomatic cases was significantly higher than that of asymptomatic ones [(16-52)/50 000 vs (3-31)/50 000 white blood cells, P

Objective To explore influencing factors of postoperation fast-track recovery in patients with thoracoscopic lobectomy and provide support for the concept of fast track surgery in clinically application. Methods A total of 129 patients who underwent thoracoscopic lobectomy were selected and questionnaire were adopted for survey between January 2015 and September 2015. Univariate analysis and multivariable logistic regression analysis were used to screen influencing factors of postoperation fast-track recovery. Results Univariate analysis showed that the influnecing factors of postoperation fast-track recovery in patients with thoracoscopic lobectomy were closely related to the age, combined basic disease or not,smoking index,preoperative smoking cessation time,preoperative pulmonary function training or not,systematic health education or not,postoperative wound pain,early postoperative ambulation or not,postoperative chest exercises in time or not (t=2.880,χ2=0.219-33.224, P<0.01 or 0.05). Multivariable logistic regression analysis showed that systematic health education or not, postoperative wound pain,preoperative pulmonary function training or not,postoperative chest exercises in time or not,combined basic disease or not,smoking index,and quit smoking more than two weeks or not were the independent risk factors. Conclusions For the patients with thoracoscopic lobectomy, preoperative condition and postoperative condition in the early should be assessed in time. Controlling the pain effectively,giving reasonable guidance of preoperative pulmonary function exercise,strengthening the respiratory tract management,systematic health education,improving the ward environment,high quality of social support and other diversified services could accelerate the recovery of the postoperative patients.

Objective To explore the effect of spa with free position on parturition of primipara.Methods One hundred and thirty-eight primiparas were equally randomized into control group and observation group. The control group conducted Doula delivery,which means a delivery at recumbent or semi-recumbent position when mouth of the uterus opened by 3 cm and the primiparas in the observation group took free position with spa based on Doula delivery. The two groups were compared in terms of the durations of each labor and total labor, postpartum bleeding 2 h after delivery and neonatal Apgar score,delivery way,pains,anxiety and feeling of control at delivery.Results The postpartum bleeding in the observation group was significantly lower than that in the control group(P<0.05). The durations of first labor, second labor and total labor in the observation group were all significantly shorter than those of the control. The degrees of pain and anxiety were lower than those of the control group,while the control sense at delivery was better than that of the control group(P<0.05,for all). There were no differences in the rate of spontaneous delivery,the rate of uterine-incision delivery,the rate of episiotomy and scores on 1 min Apgar scales(P>0.05).Conclusion Aided delivery by spa with free position can reduce labor pain and anxiety levels,improve the birth control and comfort and ultimately enhance the sense of delivery control and comfort.

Colorectal cancer is a kind of malignancies with high incidence in the worldwide, that is seriously harmed human health. So far the pathogenesis of the disease is not fully understood, this causing many difficulties to the diagnosis and treatment of the disease, and resulting in the cure rates of disease is not ideal. With the development of molecular genetics and molecular biology, many oncogenes and tumor suppressor genes have been found to be associated with the disease, and this made it is possible to reveal the pathogenesis of colorectal cancer at the molecular level. However, it is a complex and multi-step process from normal colorectal epithelial cells transformed to colorectal cancer cells, and it is the results of polygenic and multifactorial interactions. Now it is thought that the Wnt, TGF-beta, PI3K/Akt, MAPK and p53 signaling pathways are closely associated with pathogenesis of colorectal cancer. Based on the five kinds of signaling pathways as the main line, this article reviewed the roles of different signaling pathways and their related genes in the pathogenesis of colorectal cancer.