There are cognitive differences between doctors and patients in the evaluation of doctor-patient relationship. Doctors place more emphasis on evaluation from a professional perspective, including the application of professional knowledge and skills, as well as the evaluation of patient treatment outcomes. While patients pay more attention to meeting their health needs, including the quality and effectiveness of medical services, and the experience of communication and care. This cognitive difference is influenced by factors such as culture, social background, education, information acquisition, etc. To alleviate this difference, it is necessary to strengthen doctor-patient communication and negotiation, strengthen doctor-patient education and interaction, and establish a fair and transparent medical system.

Establishing a targeted and suitable professional healthcare training model for pediatricians at primary level and exploring an effective, sustainable and innovative strategy for talent training are required in caring for children at large. The current study explored the methods and efficacy of " apprenticeship" mode originated from traditional Chinese medicine practice in primary pediatricians training. It is suggested that based on the framework of pediatric alliance, the " apprenticeship" mode could establish a fixed and precise one-to-one teaching mode in a short period, form a close, standard and persistent training system for talented pediatricians, thus effectively improving primary pediatric health care service.

Objective:To investigate the basic information and implementation of medical assistance for children of illness-caused poverty families.Methods:From March through September 2019, a customized questionnaire was used to collect by means of both field survey and on-site verification, the information of the sick children from such families registered on file from 17 counties in 6 provinces. These counties were the first to carry out the assistance pilot work under " Chinese Children Poverty Alleviation by Healthcare Program" . The data so acquired were subject to descriptive analysis.Results:A total of 312 questionnaires were recovered, and the median age of these child patients was 8.54 years. Diseases causing family poverty were mostly those in the circulatory system, nervous system, neoplastic disease of childhood and hematological disease, while unaffordability of medical bills ranked the top challenge when they seek medical services. Hierarchical diagnosis and treatment was made for 251 children: 193(76.89%)of them could be admitted to provincial or lower medical institutions, 43 children needed chronic disease management, and 15 children needed to be admitted by the National Children′s Medical Center for further diagnosis.Conclusions:The assistance for such families in poverty-stricken areas can be upgraded, by such means as disease prevention publicity and education, publicity of healthcare poverty alleviation policy awareness, improvement of medical competency of primary medical institutions and rational application of medical resources.

Objective To investigate the abnormal functional connectivity (FC) between the cores (including sublaterodorsal nucleus (SLD) and ventrolateral periaqueductal gray matter (vlPAG)) and the whole brain in rapid eye movement sleep behavior disorder (RBD) by resting state functional magnetic resonance imaging (rfMRI).Methods A total of 41 subjects recruited in the Department of Neurology,the People's Hospital of Zhengzhou University were enrolled in this study according to international diagnosis criteria,including 20 with idiopathic RBD (iRBD group) and 21 age,sex-matched normal controls (control group).All subjects were examined by Hoehn-Yahr Staging,cognitive tests and rfMRI.Resluts HoehnYahr staging score was 0(0,0) in the iRBD group,which showed no significant difference from that in the control group (0 (0,0),Z =-1.820,P =0.069).The scores of Rey Auditory Verbal Learning Test (AVLT) N1,AVLT N2,Symbol Digital Modalities Test,Rey-Osterrieth Complex Figure Test-Copy were 3.80 ± 1.67,5.10 ± 1.77,33.00(31.25,34.00) and 22.00(20.25,26.00) respectively in the iRBD group,which were significantly lower than that in the control group (4.95 ± 1.28,t =2.482,P =0.017;6.43±1.16,t =2.848,P=0.007;33.00(29.50,35.50),Z=-3.792,P=0.000;35.00(33.00,36.00),Z =-2.351,P =0.019) respectively.The scores of Trail Making Test 1 (86.5 (70.0,100.0))and Trail Making Test 2 (197.0(180.5,211.5)) in the iRBD group were significantly higher than that in the control group (66.0(49.0,91.5),112.0(99.5,173.0) respectively,Z=-2.373,P=0.018;Z =-3.105,P =0.002).Compared with the control group,the FC analysis showed reduced connections from the right SLD to the bilateral cingnlate gyrus (t =-4.173) and bilateral frontal gyrus (t =-2.965(left),-3.662(right)),from the vlPAG to the left precentral-postcentral gyrus(t =3.930),and from the vlPAG to the right frontal gyrus (t =4.141) in the iRBD.There was no statistically significant difference from the left SLD to the whole brain.Conclusion There were abnormal FCs from the SLD and vlPAG to cognitive and motor areas in RBD patients,perhaps leading to clinical RBD symptoms such as cognitive deterioration and movement disorder.

OBJECTIVE:To establish the method for simultaneous determination of epiberberine,jateorhizine hydrochloride, coptisine,palmatine hydrochloride and berberine hydrochloride in Lianshen tonglin tablets. METHODS:HPLC method was adopt-ed. The determination was performed on Thermo Scientific Syncronis C18 column with mobile phase consisted of acetonitrile-0.1%phosphoric acid solution(pH adjusted to 3.0 with triethylamine)(30:70,V/V)at the flow rate of 0.3 mL/min. The detection wave-length was set at 345 nm,and column temperature was 25 ℃. The sample size was 2 μL. RESULTS:The linear ranges were 4.08-163 ng for epiberberine(r=0.9999),5.72-229 ng for jateorhizine hydrochloride(r=0.9998),5.67-227 ng for coptisine(r=0.9999),6.78-271 ng for palmatine hydrochloride(r=0.9996),13.2-526 ng for berberine hydrochloride(r=0.9999). RSDs of pre-cision,stability and reproducibility tests were lower than 2.0%. The recoveries were 96.83%-103.92%(RSD=2.2%,n=9), 97.62%-104.85%(RSD=2.9%,n=9),99.44%-104.18%(RSD=1.8%,n=9), 98.64%-104.42%(RSD=1.8%,n=9), 98.24%-102.40%(RSD=1.5%,n=9),respectively. CONCLUSIONS:The developed method is simple,sensitive,rapid and accu-rate. It is suitable for simultaneous determination of 5 coptis alkaloids in Lianshen tonglin tablets.

Objective:To describe the epidemiological characteristics of mental disorders in community resi-dents aged 18 years and over in the Chifeng City of Inner Mongolia Autonomous Region.Methods:Six thousand three hundred and seventy six individuals aged 18 years and over were sampled using stratified Probability-Propor-tional-to-Size Sampling in Chifeng City in 2010.All respondents were investigated by face-to-face interview.The Composite International Diagnostic Interview-3.0 Computer Assisted Personal Interview (CIDI-3.0-CAPI)was used to make diagnoses based on the definition and criteria of the Diagnostic and Statistical Manual of Mental Dis-orders,Fourth Edition (DMS-IV).Results:A total of 4528 subjects completed the CIDI-3.0-CAPI.Regarding anxi-ety disorder,mood disorder,substance use disorder,and impulse control disorder,the 30-day adjusted prevalence rates (95%CI)were 2.5%(2.08% -2.99%,0.9%(0.67% -1.23%),0.5%(0.34% -0.76%),and 0.6%(0.41% -0.86%)respectively,and the 12 -month prevalence rates were 4.5% (3.93% -5.15%),2.4%(2.0% -2.90%),1.1% (0.84% -1.45%),and 1.0% (0.74% -1.32%)respectively.The lifetime adjusted prevalence rates were 6.6% (5.92% -7.36%),6.5% (5.81% -7.24%),2.7% (2.26% -3.21%),and 1.4%(1.23% -1.95%)respectively.Conclusion:According to morbidity,anxiety disorders,mood disorder,substance use disorders and impulse control disorders are common in Chifeng City of Inner Mongolia Autonomous Region se-quencely,being a prominent public health problem.

Objective To investigate the changes of immune function,serum procalcitonin (PCT) and C-reactive protein (CRP) in children with mycoplasma pneumoniae pneumonia (MPP),and to provide clinical evidence for immunotherapy in children with MPP.Methods A total of 126 children with MPP during their hospitalization were enrolled into lobar pneumonia group (n =42) and bronchopneumonia group (n =84),and 28 healthy children were enrolled into normal control group.The immunoglobulin(Ig),CD4+T,CD8+T,PCT and CRP of all children were determined.Results The levels of IgG,IgM and IgE of children in lobar pneumonia group and bronchopneumonia group were significantly higher than that of the normal control group (P ＜0.05),but there were no significant differences in the level of IgA between three groups (P ＞ 0.05).The levels of IgG in lobar pneumonia group were significantly higher than that of bronchopneumonia group (P ＜ 0.05),but there were no significant differences in the levels of IgM,IgE,IgA between the two groups(P ＞0.05).The ratios of CD4+T and CD4+T/CD8+T in lobar pneumonia group and bronchopneumonia group were significantly lower than that of the normal control group(P ＜ 0.05).The levels of PCT and CRP in lobar pneumonia group and bronchopneumonia group were significantly higher than that of the normal control group (P ＜ 0.05).Conclusion Humoral immunity and cellular immune dysfunction plays an important role in pathogenesis of MPP.They are important for PCT and CRP in evaluating clinical condition and immunotherapy.

Objective To study the effect of obesity and overweight on the hospital stays and total course of common pneumonia in children and the possible reasons.Methods A total of 455 children with common pneumonia aged from 2 to 7 years were enrolled in this study,including 147 obese children,141 overweight children and 167 normal weight children.Then all the children were divided into 2 groups based on age:≥ 2-4 years group and ≥ 4-7 years group.The information of the patients was collected from the medical records management system of our hospital,and including gender,age,weight,height,hospital stays,total course,peripheral blood cell counts (white blood cell,neutrophil,monocyte and lymphocyte),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),IgG,IgA,CD4 + T,CD8 +T and the history of recurrent pneumonia.Results In ≥ 2-4 years group,the average length of the hospital stays of common pneumonia in obese and overweight children was longer than that in the normal weight children(P =0.037,0.009),and the total course of common pneumonia in obese children was longer than that in the normal weight children (P =0.014).In ≥ 4-7 years group,the average length of the hospital stays and total course of common pneumonia in obese and overweight children were longer than those in the normal weight children (the hospital stay:P =0.002,0.000,the total course:P =0.004,0.001).In ≥2-4 years group,the peripheral blood cell counts(white blood cell,neutrophil,monocyte and lymphocyte),CRP,ESR,IgG,IgA,CD4 + T,CD8 + T,CD4 + T/CD8 + T and the history of recurrent pneumonia were of no significant difference among obese,overweight and normal weight children (all P ＞0.05).In ≥4-7 years group,the peripheral blood cell counts(white blood cell,neutrophil,monocyte and lymphocyte),and ESR were of no significant difference among obese,overweight and normal weight children (all P ＞ 0.05),but the levels of IgG,CD4 + T and CD4 + T/CD8 + T in obese and overweight children were lower than those in the normal weight children,and the obese children were more notable in this aspect (P ＜ 0.05).And obese and overweight children were more likely to suffer from recurrent pneumonia.Conclusions Obese and overweight children with common pneumonia aged from 2 to 7 years may need longer hospital stay and total course than normal weight children.Impaired immunity may be the main reason for the ≥4-7 years group,but in the ≥2-4 years old group,it may be attribute to some non-immune factors.

This study compared two techniques of artery anastomoses,renal artery to the ex- ternal iliac artery (ESA) and to the internal iliacartery (EEA) in renal transplantation.The operation time and the incidence of anastomotic stenosis was cut down significantely in ESA group.The blood flow in grafts has no difference in two groups with normal renal function.The utilization rate of grafts with multiple arteries was higher (94.4%) in ESA group.Back bench surgery for artery repain,cold ischemia time and renal damage were reduced in ESA group.