Objective:To define doctors professional risk connotation , the scientific judgment doctors profes-sional risk fact , seek medical professional risk guard against and dissolve the long -term mechanism , maintaining safety and legitimate rights and interests of the doctor′s body and mind .Methods:Using doctor -patient relation-ship as the research background , adopts the questionnaire survey , through the survey data analysis of the correla-tion between the doctor-patient relationship and the doctor professional risk , on the basis of the young workers , for example , the empirical research doctors professional risk existing conditions and the reality .Results:The doctor-patient relationship nervous career anxiety and unease , doctor of job burnout and the harm done by the profession itself, complicated medical environment cannot effectively solve the doctor occupational safety crisis , institutional arrangements and the prevention and control mechanism is not reasonable career crisis .Conclusion:The govern-ment should strengthen the professional risk management system design and the prevention and control institutions and hospitals to strengthen the construction of professional risk management and prevention and control system , the doctor should promote occupational consciousness of risk prevention and control and doctor -patient communication ability, the society should strengthen professional risk management and the prevention and control of environmental regulation .

?AIM:To compare the corrected vision and improvement of visual quality after wearing rigid gas permeable corneal lens ( RGPCL) or spectacles in aphakic patients.?METHODS: We selected 29 aphakic patients ( 29 eyes ) caused by different reasons wearing RGPCL and spectacle.The corrected vision, eye condition and visual quality were observed and all patients were followed up for 6mo.? RESULTS: RGPCL was better than spectacle on corrected vision (P<0.05).The patients who wore RGPCL for long had no corneal complications reported. The patients who wore RGPCL had better subjective visual quality than those wore spectacle.?CONCLUSION: RGPCL is a good choice for correcting high myopia and astigmatism for aphakic patients.The patients'compliance is good. Wearing RGPL long has high safety for patients'ocular surface.

Objective To summarize the experience of double layered anastomosis in thoracoscopic and laparoscopic esophagectomy,and to explore its impact on the postoperative anastomotic complications.Methods Patients with thoracoscopic and laparoscopic esophagectomy from September 2014 to Auguest 2015 were retrospectively included.The cervical anastomosis were conducted by hand-sewn double layered anastomosis on the posterior wall of the gastric remnant,with the anastomotic configuration of end-to-side.The patients' general information and postoperative complications were recorded and analyzed.Results 45 patients with esophageal squamous cell carcinoma were included.The major postoperative complications were gastric dilatation(6/45,13.3％),hoarseness(5/45,11.1％),anastomotic leak/gastric necrosis(2/45,4.4％),anastomotic stricture(0/45,0).All patients were discharged from hospital with no perioperative death.Conclusion Hand-sewn double layered anastomotic technique could be safely used in thoracoscopic and laparoscopic esophagectomy,which could assure the security of the anastomosis.The anastomotic complication rates for this technique are rare enough to be recommended,as compared with other anastomotic methods reported in the literatures.

Objective To explore the correlation between the epicaridal adipose tissue (EAT)volume and the SNYTAX score in patients with coronary artery diseases and to evaluate its clinical value.Methods Epicardial fat volume of 102 patients with coronary heart disease in our hospital were measured on dual-source CT angiography images,SNYTAX scores were calculated,and level of blood lipids,blood glucose (Glu),blood pressure,renal functional parameters and body mass index(BMI)were collected.Depending on SNYTAX scores,patients were divided into three groups (mild 0-22,moderate 23-32 and severe>33).The difference of EAT volume between groups and correlation with other indicators were analyzed.With indictors statistical significant in one-factor analysis,multi-ple regression equation was constructed to evaluate the risk factors of coronary artery diseases,particularly correlation between EAT volume and SNYTAX score.Results EAT,TC,TG,HDL,HbALc,GLu and BMI were significant different between three groups. Pearson regression showed that EAT,TC,GLu and BMI were independently risk factor in relation to the value of SNYTAX.Among them,standardized regressive coefficient of the EAT volume was the highest (β=0.52).Conclusion EAT volume is significantly positively correlated with the SNYTAX score in coronary heart disease,which can be as an effective predictor for its severity and prognosis.

Aim To investigate the effects of tamoxifen on the proliferation and DNA synthesis of cultured human pituitary adenoma cells and make a further investigation of the mechanism of the inhibitory effect of tamoxifen on the proliferation of pituitary adenoma cells. Methods The techniques of MTT colorimetry, 3H-TdR, flow cytometry, PKC activity detection and cAMP/ cGMP levels detection were used to detect or observe the effects of tamoxifen on proliferation, DNA synthesis, cell cycle, PKC activity and cAMP/ cGMP levels of cultured human pituitary adenoma cells, respectively.Results ①Tamoxifen (0.1,1 and 10 ?mol?L -1) inhibited the proliferation and DNA synthesis of cultured human pituitary adenoma cells in a dose-dependent manner.② tamoxifen (1,10 and 20 ?mol?L -1) increased the ratio of G_1 phase of pituitary adenoma cells, and decreased the ratio of S and G_2 phase markedly;②compared with control, PMA, a PKC activator, increased the activity of membrane and total PKC in human pituitary adenoma cells. However, after a 15-min treatment with tamoxifen (10 ?mol?L -1),a significant reduction of the activity of cytoplasm, membrane and total PKC in human pituitary adenoma cells was observed;③tamoxifen (1 and 10 ?mol?L -1) increased the amount of cAMP in the cytoplasm of human pituitary adenoma cells, but had no effect on that of cGMP. Conclusion These data provide an important clue to explore the molecular mechanisms of the inhibitory effect of tamoxifen on the proliferation of pituitary adenoma cells, and suggest that the modulating effect of tamoxifen on the proliferation of pituitary adenoma cells results from interactions of several cellular signaling pathways.

Objective To investigate the stress characteristics of atlanto-axial bony structure under conditions of anteflexion,posterior extension,lateral flexion,and rotation after artificial atlanto-odontoid joint arthroplasty using three-dimensional finite element method and to improve the orientation of artificial atlantoodontoid joint from perspective of stress.Methods A three-dimensional finite element model of prosthetic atlanto-odontoid joint arthroplasty was created from CT images of the artificial atlantoodontoid joint and cervical vertebrae using software Mimics,Freeform,and Ansys.Stress characteristics of the model dealt with proneness,posterior extension,lateral flexion,or rotation loads were observed.Biomechanical performance of the bony structure of the model was analyzed and the orientation in improving the prosthesis was discussed.Results Anteflexion loading produced a maximum stress of 0.138 ×l08 N/m2 at the junction of lateral mass and posterior arch of the atlas,and 0.201 × 108 N/m2 at axial nail hole,contact point of plates with the axis,and posterior arch of the axis.Posterior extension loading produced a maximum stress of 0.666 × 107 N/m2 at junction of lateral mass and posterior arch of the atlas and 0.254 × 108 N/m2 at arch of the axis.Besides,stress concentration occurred at atlantoaxis nail hole.Right bending produced a maximum stress of 0.124 × 108 N/m2 at nail hole of right mass of atlas and 0.178 × 108 N/m2 at right contact point of the axis with plates.Right rotation produced a maximum stress of 0.847 × 107 N/m2 at junction of lateral mass and posterior arch of the atlas and 0.170 × 109 N/m2 at contact point of the axis with plates.The finite element model comprised 28 620 nodes and 107 441 units and provided good defining of the structural properties of artificial atlanto-odontoid joint arthroplasty.Under different loading conditions,the stress was mainly distributed in contact point of the vertebral body with plates,nail holes,junction of lateral mass and posterior arch of the atlas,and axial pedicle.Conclusions Prosthetic atlanto-odontoid joint scatters a part of the stress and alters the stress distribution of the atlas and axis from the intact condition.Finite element method can obtain complete analysis of the stress distribution of the artificial atlanto-odontoid joint arthroplasty.

A competency dictionary of advanced health informatization application persons was compiled by inter-viewing 20 health information persons with behavior events interview , their competency characteristics were coded By Nvivo, the coding frequency and characteristics score in good performance group and ordinary group were ana-lyzed by variance analysis, which showed 8 characteristics of key competency and 12 characteristics of basic compe-tency in advanced health information application persons.

Objective To investigate the risk factors for early neurological deterioration (END) in patients with ischemic stroke. Methods The consecutive patients with new acute ischemic stroke within 24 h were enrol ed. They were divided into either an END or a non-END group. Their relevant medical history, baseline clinical data, imaging examinations and laboratory test results in both groups were compared. Results A total of 95 patients with acute ischemic stroke were enrol ed, including 32 in the END group and 63 in the non-END group. There were significant differences in the proportion of patients in diabetes mel itus (χ2 =6. 081, P=0. 014), baseline National Institutes of Health Stroke Scale (NIHSS) score >15 (χ2 =9. 851, P=0. 002), baseline infarct volume >30 cm3 (χ2 =10. 815, P=0. 001), and fever (χ2 =6. 642, P=0. 010), as wel as the fasting glucose (t=2. 632, P=0. 010), homocysteine (t =2. 997, P=0. 003), C-reactive protein (t=2. 349, P=0. 021), baseline NIHSS (Z=497. 5, P=0. 001), and baseline infarct volume (Z=544. 5, P<0. 001) between the 2 groups. Furthermore, there were significant differences in the proportions of patients in large artery atherosclerotic stroke (χ2 =24. 539, P<0. 001 ) and smal arterial occlusive stroke (χ2 = 27. 913, P< 0. 001 ) in the TOAST classification, as wel as the total anterior circulation stroke (χ2 =7. 578, P<0. 006) and partial anterior circulation stroke (χ2 =4. 818, P<0. 028) in the OSCP classification. Multivariate logistic regression analysis showed that fasting glucose >6. 0 mmol/L (odds ratio [OR] 6. 951, 95%confidence interval [CI] 2. 159-22. 348; P=0. 001), homocysteine >15 μmol/L (OR 3. 301, 95% CI 1. 028-10. 595; P=0. 045), NIHSS score >15 (OR 4. 174, 95% CI 1. 772-14. 870;P=0. 028), infarct volume >30 cm3 (OR 4. 996, 95% CI 1. 334-18. 717; P=0. 017), and fever (OR 4. 528, 95% CI 1. 334-15. 372;P=0. 015) were the independent risk factors for occurring END in patients with acute ischemic stroke. Conclusions The baseline glucose, NIHSS score, infarct volume, homocysteine, and increased body temperature are the independent risk factors for occurring EDN in patients with acute ischemic stroke.

Objective To analyze the cause of platelet aggregation in blood specimens ,so as to provide basis for reducing platelet aggregation ,and avoiding false positive of platelet count ,false report ,misdiagnosis and mistreatment .Methods The blood speci-mens which platelet was below 80 × 109 /L ,below 125 × 109 /L with histogram hinted platelet aggregation ,were smeared ,stained with Wright-Giemsa ,and observed by microscope for platelet morphological changes .The data between each groups were calculated and analyzed by statistical software SPSS version 18 .0 .Results A total of 184 cases of ethylenediaminetetraacetic acid dependent pseudothrombocytopenia(EDTA-PTCP) were found ,accounted for 0 .444 ‰ totally ,including 0 .244 ‰ of out-patients (101 cases) , 0 .159 ‰ of hospitalized patients (66 cases) ,and 0 .041 ‰ of health examination personnel (17 cases) .3 cases of multi-dependent pseudothrombocytopenia and 25 cases of pseudo platelet aggregation were found ,and accounted for 0 .007 ‰ and 0 .060 ‰ respec-tively .Conclusion The discovery of platelet aggregation which caused mainly by EDTA-PTCP ,still relies on microscopy ,and pseu-do platelet aggregation comes mainly from sampling ,so it needs to strengthen the skills training .

Objective To evaluate the real-time genotyping and quantitative PCR(RT-GQ-PCR)method by comparing it with direct sequence analysis and the multiplex-PCR method.Methods RT-GQ-PCR,direct sequence analysis and the multiplex-PCR method were used to detect HBV genotypes of 113 patient samples with HBV-DNA positive.ResultsThe detection rate of RT-GQ-PCR and direct sequence analysis was 100%,and the multiplex-PCR is 94.69%.The concordance between RT-GQ-PCR and the multiplex-PCR is perfect(Kappa value =0.915),and the consistency of RT-GQ-PCR and direct sequence analysis is pretty good(Kappa value = 0.742),specially at detecting single genotype.Twenty-eight samples with genotypes B and C dual infections were detected by RT-GQ-PCR,but only 19 samples by the multiplexPCR and 13 samples by direct sequence analysis.Conclusion The RT-GQ-PCR is convenient,rapid and accurate in HBV genotyping,especially more sensitive than direct sequence analysis and the multiplex-PCR for detecting dual genotypes.The method is applicable for large-scale epidemiological study.