大连医科大学内科学试题库

大连医科大学内科学试题库 1、获得性肺炎(CAP)的诊断 ?新出现或进展性肺部浸润性病变;?发热?38?;?新出现的咳嗽、咳痰、或原有的呼吸道疾病症状加重，并出现脓性痰;伴或不伴胸痛?肺实变体征或湿性罗音;?白细胞,10×109/L或<4×109/L伴或不伴核左移 以上?+?,?中任何一条并除外其他疾病 2、重症肺炎的诊断标准 ?主要标准:1.呼吸衰竭需要机械通气(MV);2.48小时内肺部浸润扩大?50%; 3.感染性休克或需要应用血管活性药物,4h; 4.急性肾功能衰竭尿量,80ml/4h或肌酐,2µg/dl ?次要标准:1.呼吸频率?30次/分;2.PaO2/FiO2(氧合指数),250 3.双侧或多叶炎症;4.收缩压,90mmHg; 5.舒张压,60mmHg 凡符合1条主要标准或2条次要标准可诊断 3、在肺炎治疗中，抗菌药物治疗后，多长时间应对病情进行评估，治疗有效的指标有哪些 48-72小时后进行病情评价; 治疗有效的指标:体温下降、症状改善、临床状态稳定、白细胞逐渐降低或恢复正常，而X线胸片病灶吸收较迟。 4、肺脓肿抗菌药物的疗程是多长,停药指征是什么, 疗程:8-12周 停药指征:临床症状完全消失.X线片显示脓腔及炎性病变完全消散，仅残留条索状纤维阴影。 5、结核病的分型 ?型 原发型肺结核;?型 血行播散型肺结核;?型 继发型肺结核(浸润性肺结核、空洞性肺结核、结核球、干酪样肺炎、纤维空洞性肺结核);?型 结核性胸膜炎;?型肺外结核 6、浸润性肺结核不同于细菌性肺炎的鉴别点有哪些, 浸润性肺结核病变多发生在肺尖和锁骨下，影像学表现为小片状或斑点状阴影，可融合形成空洞。细菌性肺炎可起病急、寒战、高热，咳嗽、咳痰明显，胸片表现密度较淡且较均匀的片状或斑片状阴影，抗菌治疗后体温迅速下降，1至2周左右阴影有明显吸收。 7、肺结核化学治疗(化疗)的原则 早期、联合、规则、适量和全程 8、试述COPD的病程分期和严重程度。 病程分期:1、急性加重期:疾病过程中，短期内症状加重。 2、稳定期:指患者咳嗽、咳痰、气促等症状稳定或较轻。 COPD严重程度分级 分级 分级标准 分级 分级标准 ?级:轻度 FEV1/FVC<70% ?级:重度 FEV1/FVC<70% FEV1>=80%预计值 30%<=FEV<50%预计值 有或无慢性咳嗽、咳痰症状 有或无慢性咳嗽、咳痰症状 ?级:中度 FEV1/FVC<70% ?级:极重度 FEV1/FVC<70% 50%<=FEV1<80%预计值 FEV1<30%预计值 有或无慢性咳嗽、咳痰症状 或FEV1<50%预计值，伴慢性呼吸衰竭 9、慢性支气管炎喘息型与支气管哮喘鉴别诊断要点有哪些? ?慢支喘息型多见于中老年病人,以咳嗽为主,常有感染表现;而支气管哮喘者多较年轻,可有过敏史,年幼起病. ?慢支喘息型病程迁延,肺气肿多明显,肺弥散功能障碍;而支气管哮喘病程较短,肺功能早期改变不太明显. 10、支气管哮喘的临床表现 典型:反复发作性喘息，大多有季节性，日轻夜重，常与吸入变应原有关，发作时两肺闻及弥漫性哮鸣音，以呼气为主;上述表现可自行缓解或解痉后缓解，缓解期如常人。 非典型:发作性胸闷、发作性顽固性咳嗽，称为咳嗽变异性哮喘(CVA) 严重哮喘可出现:心率增快、奇脉、胸腹反常运动、发绀 11、支气管扩张症痰液的分层特征 痰放置后分为四层:上层为泡沫;中为混浊粘液;下悬脓性成份;底层为坏死组织沉淀物 12、支气管哮喘的诊断标准 ?反复发作性喘息，呼吸困难，胸闷或咳嗽、多有接触变应原、感染、运动或刺激物诱因。 ?发作时双肺可闻及弥漫性、以呼气期为主的哮鸣音。 ?上述症状可经治疗缓解或自行缓解(可逆性。 ?排除可引起喘息或呼吸困难、咳嗽的其它疾病。 ?对症状不典型者应最少具备以下一项试验阳性 (1)支气管舒张试验阳性 (2)呼气流速峰值(PEF)日内变异率或昼夜波动率?20% (3)支气管激发试验(或运动激发试验)阳性。 符合?,?条或者?、?条者可以诊断为支气管哮喘 13、临床表现不典型的哮喘，应进行哪些项目检查帮助诊断 应最少具备以下一项试验阳性 ?支气管舒张试验阳性:(若基础FEV1(或PEF),80%正常值，吸入β2激动剂后FEV1(或PEF)增加12%以上。) ?呼气流速峰值(PEF)日内变异率或昼夜波动率?20% ?支气管激发试验(或运动激发试验)阳性。 14、支气管哮喘的药物治疗 ?缓解哮喘发作 (1)β2肾上腺素受体激动剂;(2)抗胆碱药;(3)茶碱类 ?控制或预防哮喘发作 LT调节剂;(3)其他:酮替酚 (1)糖皮质激素;(2) 15、重度哮喘处理原则 持续雾化吸入β2激动剂或合并抗胆碱能药，或静脉点滴沙丁胺醇或氨茶碱，加用LT拮抗剂，静脉点滴糖皮质激素，病情控制后改为口服用药，乃至吸入用药，注意维持水电平衡，纠正酸碱失衡，氧疗，有指征时进行机械辅助通气，发生下呼吸道感染时选用病原体对其敏感的抗菌药物 16、慢性肺源性心脏病肺动脉高压形成的原因 ?肺血管功能性改变:缺氧引起肺血管收缩，持续收缩导致肺血管病理改变。 1)体液因素:收缩血管物质增多，舒张血管物质减少。 2)神经因素:缺氧和高碳酸血症刺激颈动脉窦和主动脉体化学感受器，反射性的引起交感神经兴奋，儿茶酚胺分泌增加，使肺动脉收缩 3)缺氧对肺血管的直接作用:肺血管平滑肌膜对Ca2+的通透性增高， Ca2+内流增加，肌肉兴奋-收缩偶联效应增强，引起血管收缩 ?肺血管器质性改变:慢性缺氧还可以导致血管重构 ?血液粘稠度增加和血容量增多 1)长期缺氧，促红细胞生成素增加，继发性红细胞增多，血液粘滞性增高，肺血流阻力增高。 2)缺氧使醛固酮增加，水钠潴留;3)缺氧使肾小动脉收缩，肾血流减少，加重水钠潴留 17、慢性肺心病的并发症有哪些? 肺性脑病、酸碱平衡失调和电解质紊乱、休克、心律失常、消化道出血、弥散性血管内凝血 18、慢性肺心病的X线检查 ?原发病，肺动脉高压 ?肺动脉高压表现 (1)右下肺动脉横径?15mm，或右下肺动脉横径与气管横径比值?1.07， (2)肺动脉段突出?3mm, (3)肺动脉高压显著时，中心肺动脉扩张，周围动脉纤细，呈残根状。 ?心脏变化:心脏呈垂直位，心尖上翘。右心房增大。右心扩大，但在心力衰竭控制后，心脏可恢复。左心一般不大，偶见左心室增大 19、慢性肺心病急性加重期的治疗原则 ?积极控制感染;?通畅呼吸道，改善呼吸功能;?纠正缺氧和二氧化碳潴留; ?控制呼吸和心力衰竭;?积极处理并发症 20、慢性肺心病治疗中，应用利尿剂要注意哪些副作用 低钾、低氯性碱中毒;痰液黏稠不易排痰;血液浓缩 21、胸腔积液常见的病因和发病机制 胸膜毛细血管内静水压增高;胸膜通透性增加;胸膜毛细血管内胶体渗透压降低;壁层胸膜淋巴引流障碍;损伤;医源性 22、气胸的临床类型:闭合性(单纯性)、交通性(开放性)、张力性(高压性) 23、原发性支气管肺癌的临床表现 ?原发肿瘤引起的症状和体征:1)咳嗽:刺激性呛咳，无痰或少痰，肺泡细胞癌可有大量粘液痰;2)咯血:痰中带血或间断性血痰;3)喘鸣:肿瘤引起支气管狭窄，产生局限性哮鸣音;4)气急5)发热:阻塞性肺炎或肺不张，肿瘤坏死产生癌性发热;6)体重下降、厌食、乏力 ?肿瘤局部扩展引起的症状和体征:胸痛;呼吸困难;吞咽困难;声音嘶哑;上腔静脉阻塞综合征;Horner综合征;臂丛神经压迫症 ?肿瘤远处转移引起的症状和体征:转移至脑、中枢神经系统;转移至骨骼;转移至腹部;转移淋巴结 ?肺外表现-副癌综合征:肥大性肺性骨关节病(杵状指趾);异位促性腺激素;异位ACTH综合征;抗利尿激素分泌异常综合征(SIADH);神经肌肉综合征;高钙血症;类癌综合征 24、40岁以上男性长期重度吸烟者，出现下列情况之一应及时检查 ?无明显诱因的刺激性咳嗽持续2,3周，治疗无效;?原有慢性呼吸道疾病，咳嗽性质改变;?近2-3个月持续或反复痰中带血或者咯血，且无其它原因可以解释;?反复发作的同一部位肺炎，特别是肺段性肺炎;?原因不明的肺脓肿，无中毒症状，无大量脓痰，无异物吸入史，抗炎治疗效果不显著;?原因不明的四肢关节疼痛及杵状指(趾)?影像学提示局限性肺气肿或段、叶性肺不张;?孤立性圆形病灶和单侧性的肺门阴影增大;?原有肺结核病灶已稳定，而形态或性质发生改变;?无中毒症状的胸腔积液，尤其是血性、进行性增加者。 25、呼吸衰竭及其血气诊断标准 呼吸衰竭:指各种原因引起的肺通气和(或)换气功能严重障碍，以致在静息状态下亦不能维持足够的气体交换，导致低氧血症伴(或不伴)高碳酸血症 诊断标准:在海平面大气压下，静息条件呼吸室内空气，排除心内分流或心排出量降低因素 后，动脉血氧分压(PaO2),60mmHg伴或不伴二氧化碳分压(PaCO2),50mmHg。 ……慢性呼衰治疗时主要采取哪几方面措施? ?保持呼吸道通畅 ?氧疗 ?增加通气量 ?控制感染 ?纠正水电酸碱失衡 ?加强营养支持治疗 26、男性，20岁，淋雨后出现寒战，高热，右上腹痛4天，伴恶心呕吐，咳少量黄痰1天，请问诊断最可能是什么,应与哪些疾病相鉴别(列出4种疾病) 诊断:肺炎链球菌肺炎 鉴别诊断:肺结核、肺癌、急性肺脓肿、肺血栓栓塞症、非感染性肺部浸润 27、男，28岁，平素健康，3天前淋雨，2天前突然高热39度，伴寒战，咳铁锈色痰伴呼吸困难，胸片右下肺大片状密度均匀的实变影，口唇周围疱疹。本病最可能诊断,诊断依据，治疗及鉴别诊断(2种以上) 诊断:肺炎链球菌肺炎 诊断依据:?男，28岁，平素健康;?3天前淋雨，2天前突然高热39度，伴寒战，咳铁锈色痰伴呼吸困难;?口唇周围疱疹;?胸片右下肺大片状密度均匀的实变影 主要治疗:?抗菌药物治疗，首选青霉素G;?青霉素过敏者或多重耐药菌株感染，可选用喹诺酮类，头孢噻肟或头孢孢曲松; 鉴别诊断:肺结核、肺癌、急性肺脓肿、肺血栓栓塞症、非感染性肺部浸润 28、奇脉: 为吸气时动脉收缩压下降1.3kpa(10mmHg)或更多,伴有脉搏减弱或消失. 29、按血压水平，高血压分几级,如何分级, 分类 收缩压(mmHg) 舒张压(mmHg) 正常血压 ,120 ,80 正常高值 130-139 85-89 高血压 ?140 ?90 1级高血压(轻度) 140-159 90-99 2级高血压(中度) 160-179 100-109 3级高血压(重度) ?180 ?110 单纯收缩期高血压 ?140 ,90 30、继发性高血压常见的主要病因 肾实质性高血压;肾血管性高血压;原发性醛固酮增多症;嗜铬细胞瘤;皮质醇增多症;主动脉缩窄 31、举例说明降压药的分类 ?利尿剂——氢氯噻嗪、氯噻酮;?ACEI——卡托普利;?ARB——氯沙坦 ?钙拮抗剂——硝苯地平;?β受体阻断剂——普萘洛尔 32、试述典型心绞痛的临床表现 1、稳定型心绞痛临床特点为: 症状:阵发性的前胸压榨性疼痛或憋闷感觉，主要位于胸骨后部，可放射至心前区和左上肢尺侧，常发生于劳力负荷增加时，持续数分钟，休息或用硝酸酯制剂后消失。 体征:发作时心率增快、血压升高、表情焦虑、皮肤冷或出汗、有时出现第四或第三心音奔马律，可伴暂时性心尖收缩期杂音。 2、不稳定型心绞痛的临床特点为:部位、性质与稳定型心绞痛相似，但具有以下特点之一:?原为稳定性心绞痛，在1个月内疼痛发作频率增加，程度加重，时限延长，诱发因素变化，硝酸类药物缓解作用减弱。?1个月之内新发生的心绞痛，并因较轻负荷所诱发。?休息状态下或较轻微活动即可诱发。 33、详述AMI的心电图动态性改变 ?有Q波心肌梗死者 超急性期: 起病数小时内，无/高大T波 病理性Q波， 急性期: 数小时至2天内ST段抬高，单相曲线 亚急性期: 数日至2周左右ST段逐渐回到基线，T波平坦或倒置 慢性期: 数周至数月“冠状T”形成 ?无Q波心肌梗死者:ST段普遍性压低 T波倒置，但始终不出现Q波ST-T改变持续 存在1,2天以上 34、简述急性心梗时的并发症 乳头肌功能失调或断裂;心脏破裂;心包填塞;室间隔缺损;栓塞;心室壁瘤;心肌梗死后 综合征 35、试述心绞痛与急性心梗的鉴别诊断要点 鉴别诊断项目 心绞痛 急性心肌梗死 疼痛特点 1.部位 胸骨中,上段之后 相同,但可在较低位置或上腹部 2.性质 压榨性或窒息性 相似,但更剧烈 3.诱因 劳累,情绪激动,受寒,饱食等 不常有 4.时限 短,1,5分钟或15分钟以内 长,数小时或1-2 天 5.频率 频繁发作 不频繁 6.硝酸甘油疗效 显著缓解 作用较差 气喘或肺水肿 极少 常有 血压 升高或无显著改变 常降低,甚至发生休克 心包摩擦音 无 可有 坏死物质吸收的表现: 1.发热 无 常有 2.WBC增多 无 常有 3.ESR增快 无 常有 4.血清心肌酶增高 无 有 心电图变化 无变化或暂时性S-T段和 T波变化 有特征性和动态性变化 36、试述溶栓治疗判断冠脉再通的间接指标 ?ST段迅速回降(2小时内>50%);?胸痛迅速缓解(2小时内); ?再灌注心律失常(2小时内室颤,室速, 缓慢性心律失常);?CPK酶峰值提前(14小时内) 37、??房室传导阻滞的心电图表现 ?P-P间期相等,R-R 间期相等;?P波与QRS波群无固定时间关系(P-R间期不等); ?心房率快于心室率;?QRS波群正常(提示心室起搏点在房室交界区) 38、左心功能不全有哪些症状 ?肺淤血:进行性劳力性呼吸困难?夜间阵发性呼吸困难?端坐呼吸?急性肺水肿 ?咳嗽、咳痰、咯血 ?心输出量:疲劳、乏力、神志异常 ?少尿、肾功能损害 ?体征:HR,奔马律, P2,两肺底湿啰音(下垂部位) 39、慢性心功能不全时，减轻心脏负荷的措施有哪些 ?休息:1度心衰限制体力劳动，3度需卧床休息;?限制钠盐摄入量; ?合理应用利尿剂:可减轻组织、器官的水肿，减少血容量，减轻心脏负荷，注意出入量，及时检测电解质和肾功能，避免电解质紊乱及肾功能不全。 ?合理应用血管扩张剂:血管扩张剂能扩张周围小动脉，减轻心脏排血的阻力，降低心脏的后负荷，而扩张周围小静脉，可减少回心血量，减轻了心脏前负荷。 40、急性左心衰竭的临床表现和处理原则 临床表现:早期表现:1)交感神经兴奋;2)阵发劳力性呼吸困难;3)双肺捻发音或干啰音; 4)舒张早期奔马律 典型表现:1)突发严重呼吸困难;2)烦躁、不能平卧;3)四肢冷汗、口唇发绀 ;4)频繁咳嗽，粉红色泡沫痰;5)重者神志不清、休克 ;6)听诊是两肺满布湿性罗音和哮鸣音，心尖第一心音减弱，频率快，同时舒张早期奔马律，肺动脉瓣第二心音亢进 处理原则:1)体位:坐位，双脚下垂;2)高流量(5L/min)吸氧; 3)开通静脉通道，监测生命体征;4)静注吗啡、速尿、地塞米松; 5)静脉滴注血管扩张剂 41、急性左心衰竭的急救措施有哪些, ?患者取坐位，双腿下垂，以减少静脉回流，减轻心脏负荷 ?高流量给氧 ?吗啡:3-5mg缓慢静脉注射或5-10mg皮下注射 ?快速利尿:呋塞米20-40mg，4小时后可重复1次 ?血管扩张剂:减轻心脏负荷，以静脉滴注为主。硝酸甘油、硝普钠或酚妥拉明 ?洋地黄类药物:西地兰0.2-0.4mg稀释后缓慢静推，2-4小时酌情重复 ?氨茶碱，机械辅助治疗 42、二尖瓣狭窄肺动脉高压产生机制 ?左心房压升高;?肺小动脉收缩(反应性肺动脉高压); ?长期严重的二尖瓣狭窄，持续的肺小动脉收缩，最终导致肺血管床器质性闭塞 43、二尖瓣狭窄的临床表现及并发症 ?症状 1)呼吸困难:劳力性呼吸困难?阵发性夜间呼吸困难和 端坐呼吸?急性肺水肿 2)咯血:?突然大量咯血(重度二狭);?血性痰或痰中带血丝; ?大量粉红色泡沫状痰(急性肺水肿);?肺梗死伴咯血 3)咳嗽;4)声嘶:扩大的左房和肺动脉压迫左喉返神经 ?体征:“二尖瓣面容” 1)MS心脏体征:?心尖搏动正常或不明显:?舒张期震颤:?第一心音亢进和开瓣音 ?心尖区有低调的隆隆样舒张中、晚期杂音，局限，不传导 2)肺动脉高压和右心室扩大的心脏体征:P2亢进或分裂，Graham Steel杂音肺动脉瓣关闭不全时，在胸骨左缘第2肋间闻及舒张早期吹风样杂音三尖瓣区闻及收缩性杂音，右心室扩大伴相对性三尖瓣关闭不全时，吸气时增强 并发症:心房颤动;急性肺水肿;血栓栓塞;右心衰竭;感染性心内膜炎;肺部感染 44、感染性心内膜炎疾病的抗微生物药物治疗原则 早期、剂量要足;疗程长(4-6周);选用杀菌剂;监测血清杀菌低度、调整药物剂量; 联合用药;静脉应用 45、一肺心病患者，近一周咳、喘加重，肢端青紫明显，并出现全身浮肿，尿少，自服速尿三日，尿量增多，但症状不见好转，欲服地高辛，医生则检查血气及血离子后方可服用，为什么, 46、消化性溃疡的主要临床表现 上腹痛是消化性溃疡的主要症状。疼痛的特点:?慢性过程呈反复发作;?发作呈周期性与缓解期相交替，发作常有季节性;?发作时上腹痛呈节律性，表现为空腹痛即餐后2,4小时或(及)午夜痛。部分患者以出血穿孔等并发症为首发症状，溃疡活动时可有上腹轻压痛。 47、消化性溃疡的并发症有哪些 出血，穿孔，幽门梗阻，癌变 48、男性,45岁患者,规律性上腹部疼痛5年,反复发作,近1个月加重,伴返酸嗳气,钡餐透视于十二指肠球部见一龛影.诊断是什么,治疗原则? 诊断:十二指肠球部溃疡. 治疗原则:?抑制胃酸分泌,如H2受体拮抗剂,泵阻滞剂. ?保护胃粘膜药物,如铋剂. 49、女性，38岁，慢性下腹痛8年，伴间断腹泻，每日2到3次，近一周上述症状加重，有里急后重，便呈粘液，表面有脓血，查体一般状态尚可，下腹部压痛，请说出还需与哪些疾病鉴别(至少三种)，最可能的诊断，为明确这一诊断还需做哪些检查，典型的改变是什么, 诊断:溃疡性结肠炎 鉴别诊断:急性自限性结肠炎、阿米巴肠炎、血吸虫病、克罗恩病、大肠癌 还需检查:结肠镜检查、血液检查、粪便检查、X线钡剂灌肠检查 典型改变:粘膜血管纹理模糊、紊乱、充血、水肿;弥漫性糜烂和多发性浅溃疡;活动期表现为表面糜烂、溃疡、隐窝炎、隐窝脓肿 50、幽门螺旋杆菌根除:PPI或胶体铋+克拉霉素或甲硝锉或阿莫西林(两种) 51、溃疡性结肠炎与克罗恩病的鉴别诊断 项目 克罗恩病 溃疡性结肠炎 症状 腹泻，脓血便少见，发热常见 脓血便，发热少见，腹部肿块少见 腹痛明显，腹部肿块常见 病变分布 节段性 连续性 直肠受累 少见 大多 末端回肠受累 多见 少见 肠腔狭窄 多见 少见 瘘管形成 多见 少见 内镜 纵行，匍行溃疡，伴周围粘膜 浅溃疡，粘膜弥漫性充血、水肿、 正常或卵石样改变 颗粒状，脆性增加 病理 节段性全壁炎，非干酪性肉芽肿 粘膜层浅溃疡，隐窝脓肿，杯状细胞减少 52、氨基水杨酸制剂——柳氮磺胺吡啶(SASP)的适应症 轻型，初发，或中重度经激素治疗已有缓解者 53、简述肝硬化时，肝功能减退和门脉高压的临床表现有哪几方面 ?肝功能减退:全身症状(乏力)、消化道症状(食欲不振)、黄疸、出血倾向与贫血、 内分泌紊乱(继发性醛固酮增多症) ?门脉高压:脾大——淤血脾，脾功能亢进，血细胞三少，出血倾向及贫血 侧支循环的建立和开放——食管和胃底静脉曲张、腹壁静脉曲张、出血 腹水——突出的临床表现，腹胀，移动性浊音阳性 54、肝硬化的并发症有哪些 食管胃底静脉曲张破裂出血、感染、肝性脑病、电解质和酸碱平衡紊乱、原发性肝细胞癌、 肝肾综合征(HRS)、肝肺综合征(HPS)、门静脉血栓形成 55、试述肝硬化腹水的治疗方法 ?限钠、水摄入——基础治疗;?利尿剂(安体舒通、速尿);?提高血浆胶体渗透压 ?难治性腹水:放腹水加输注白蛋白、腹水浓缩回输、经颈静脉肝内门体分流术(TIPS) 56、原发性肝癌AFP的诊断标准 ?大于500μg/L持续4周以上;?AFP在200μg/L以上的中等水平持续8周以上; ?AFP由低浓度逐渐升高不降。 57、原发性肝癌的并发症:肝性脑病、上消化道出血、肝癌结节破裂出血、继发感染 58、肝性脑病的诊断依据:?有严重肝病和广泛门体侧支循环形成的基础;?出现精神紊乱、昏睡或昏迷，可引起扑翼样震颤;?有肝性脑病的诱因;?反映肝功能的血生化指标明显异常级血案增高;?脑电图异常。 59、慢性肝性脑病的常见诱因有哪些 ?药物:抑制大脑和呼吸中枢，造成缺氧;(苯二氮卓类、麻醉剂、酒精) ?增加氨的产生、吸收及进入大脑;(蛋白食物摄入过多、消化道出血、感染) ?低血容量:导致肾前性氮质血症，使血氨增高;(利尿、腹泻、大量放腹水) ?门体分流和血管阻塞:肠源性氨进入人体循环(手术、门静脉血栓) ?原发性肝癌:肝脏对氨的代谢能力明显减退 60、试述肝性脑病的治疗原则及措施 ?消除诱因:纠正离子紊乱，止血，通便，抗感染 ?减少肠内毒物的生成和吸收;?促进有毒物质清除代谢;?纠正氨基酸代谢紊乱 ?其他:人工肝、肝移植、重症监护 61、上消化道出血的常见病因 消化性溃疡、食管胃底静脉曲张破裂、急性糜烂出血性胃炎、胃癌 62、紧急输血指征:?改变体位出现晕厥，血压下降，心率增快;?失血性休克; ?血红蛋白低于70g/L或血细胞比容低于25% 63、上消化道出血的止血措施 ?食道胃底静脉曲张破裂出血止血措施 1)药物止血:垂体后叶素、生长抑素 ;2)三腔二囊管压迫止血; 3)内镜治疗(硬化、套扎、组织粘合剂);4)手术或经颈内静脉肝内门体分流术 ?非门脉性上消化道出血的止血措施 1)抑制胃酸分泌药 :PPI或H2RA ;2)手术; 3)内镜治疗(热探头、高频电、激光、微波、止血夹、注射); 4)介入治疗(造影+栓塞) 64、男性,54岁,患肝硬化失代偿期多年,晚餐进食3个鸡蛋后出现记忆力下降,多言多语等表现,问该患可能并发了什么病,其诱因是什么? 肝性脑病(肝昏迷) 使血氨升高,诱发肝性脑病. 诱因:进食蛋白多, 65、试述原发性肾小球疾病的临床分 型 急性肾小球肾炎，急进性肾小球肾炎，慢性肾小球肾炎，隐匿性肾小球肾炎，肾病综合征 66、肾病综合征的诊断标准 尿蛋白大于3.5g/d;血浆白蛋白低于30g/L;水肿;血脂升高 67、肾病综合征的特点:水肿、低蛋白血症、蛋白尿、高脂血症 68、简述激素治疗肾病综合征的原则及初始治疗剂 量 治疗原则:起始足量、缓慢减药、长期维持 初始治疗剂量:泼尼松1mg/(kg?d),口服8周，必要时可延长至12周 69、原发性肾病综合征应与哪些继发性肾病综合征相鉴别,请举出常见的四种疾病 系统红斑性狼疮性肾炎,过敏性紫癜性肾炎,多发性骨髓瘤性肾炎,糖尿病性肾病,淀粉性肾病,遗传性肾炎,淋巴瘤 70、女性上尿路感染的治疗原则 ?最好根据药物敏感试验选择有效抗生素，在无药敏结果时，应首选对G-杆菌有效的抗生素;?宜选用血、尿浓度均高的抗生素;?选用肾毒性小、副作用少的抗生素;?单一药物治疗失败、严重感染、混合感染、耐药菌株出现时应联合用药;?对不同类型的尿感给予不同的治疗时间 71、慢性肾盂肾炎诊断标准:反复发作的尿路感染病史 ?肾外形凹凸不平，且双肾大小不等;?静脉肾盂造影可见肾盂肾盏变形、缩窄 ?持续性肾小管功能损害 ?或?任一条加第?条则可诊断慢性肾盂肾炎 72、慢性肾衰竭根据内生肌酐清除率如何分 期 肾功能代偿期(50,80ml/min);肾功能失代偿期(20,50 ml/min); 肾功能衰竭期(10,20 ml/min);尿毒症期(,10 ml/min) 73、尿毒症代谢性酸中毒的原因 肾衰(GFR,25ml/min)时，因肾脏排泄障碍，体内代谢产物如磷酸等酸性物质潴留。发生尿毒症性酸中毒 74、尿毒症饮食规律及原则 ?限制蛋白饮食:GFR50ml/min以下，需进行蛋白质限制。优质蛋白质(富含必需氨基酸) 0.6g/kg体重。减少BUN的产生，降低血磷，减轻酸中毒;?高热量摄入:摄入足量的碳水 化合物和脂肪。热量每日需30kcal/kg体重。食物富含维生素C、维生素B族和叶酸;?其 他:水肿、高血压和少尿者要低盐饮食;限钾摄入;低磷饮食;水肿、心衰和尿少者要限水; ?必需氨基酸的应用:必需氨基酸或α-酮酸;避免发生营养不良 75、肾性贫血的原因 ?肾脏产生促红细胞生成素减少;?铁及叶酸摄入减少;?红细胞寿命缩短; ?血中存在抑制红细胞生成的物质 76、简述引起缺铁性贫血的常见原因及治疗原则 病因:铁摄入不足而需要量增加(儿童、妊娠、哺乳); 铁吸收障碍(胃切除术后、慢性肠炎);铁丢失过多(胃肠道失血、月经过多) 治疗原则:祛除病因，补充铁剂，补足贮存铁。(口服铁剂、注射铁剂) 77、缺铁性贫血的临床表现 ?贫血表现:头晕、乏力、活动后心悸气短、 记忆力减退;皮肤、粘膜苍白 ?组织缺铁表现:精神异常，体力下降，舌乳头萎缩 ，皮肤干燥及指甲变平甚至反等，吞 咽困难和异嗜癖 ?缺铁原发病表现:如消化性溃疡导致的黑便、血便或腹部不适等 78、缺铁时，口服铁盐后原有的胃溃疡症状加重，应采用什么办法治 疗, 右旋糖酐铁，肌肉注射，每次50mg，每日或隔日1次，缓慢注射 79、缺铁性贫血(IDA)的诊断标准 ?小细胞低色素性贫血;?血清铁,8.95umol/L，转铁蛋白饱度,15%， 总铁结合力,64.44umol/L;?骨髓铁染色外铁消失，内铁减少 ; ?FEP,0.9umol/L,FEP/Hb,4.5ug/gHb;?血清铁蛋白,12ug/L ; ?有明确的缺铁病因和临床表现;?铁剂治疗有效。 符合第?条和?-?条中任何2条以上者可诊断为缺铁性贫血。 80、关于再生障碍性贫血，目前有那几种学说 造血干祖细胞缺陷 (种子学说)、造血微环境缺陷 (土壤学说)、免疫功能紊乱(虫子学说) 81、再生障碍性贫血的骨髓象特点及分型标准 骨髓象特点:增生明显减低。造血细胞均减少，非造血细胞比例升高。骨髓活检显示造血组织均匀减少，脂肪组织增加。 分型标准:根据患者的病情、血象、骨髓象及预后，可分为重型(SAA)和非重型(NSAA)。 82、再生障碍性贫血的诊断标准 ?全血细胞减少，RC,0.01;网织红细胞降低，淋巴细胞比例增高;?一般无肝脾大; ?骨髓多部位增生减低或重度减低;?造血细胞减少，非造血细胞比例增高; ?除其他引起全血细胞减少的其他疾病;?一般抗贫血治疗无效 83、治疗自身免疫性溶血性贫血的首选方法是什么?若效果不好,第二线治疗方法是什么? 首选治疗是:糖皮质激素的应用. 二线治疗是:脾切 除. 84、急性慢性溶血性贫血的比较 急性HA 慢性HA 起病 急 慢 症状 腰背，四肢酸痛，高热寒战，呕吐，Hb尿 以贫血为主表现 体征 面色苍白，黄疸 贫血，黄疸，肝脾肿大 并发症 循环衰竭，急性肾衰 胆石症，肝功损害 85、血管内溶血时应有哪些实验室发 现 ?血清游离血红蛋白血管内溶血时大于40mg/L ?血清结合珠蛋白低于0.5g/L。溶血停止约3到4天后，结合珠蛋白才恢复原来水平 ?血红蛋白尿尿常规示隐血阳性，尿蛋白阳性，红细胞阴性 ?含铁血黄素尿:镜检经铁染色的尿沉渣，在脱落上皮细胞内发现含铁血黄素 86、霍奇金淋巴瘤的分型 86、霍奇金淋巴瘤的临床表现 ?淋巴结肿大(无痛性、进行性);?压迫症状;?全身症状:发热、盗汗、乏力、消瘦 ?皮肤骚痒，带状泡疹;?肝，脾肿大---黄疸;?咽淋巴环病变占NHL的10-15% ?结外浸润 88、霍奇金淋巴瘤的临床分期及分组 ?期 病变仅限于1个淋巴结区(?)或单个结外器官局部受累(IE) ?期 病变累及横隔同侧二个或更多的淋巴结区 (?)，或病变局限浸犯淋巴结以外器官及横隔同侧1个以上淋巴结区 (?E) ?期 横隔上下均有淋巴结病变(?)。可伴脾累及(? S)、结外器官局部受累(? E )，或脾与局限性结外器官受累(? SE ) ?期 1个或多个结外器官受到广泛性或播散性浸犯，伴或不伴淋巴结肿大。肝或骨髓只要受累均属?期 分组:无全身症状者为A组，有全身症状者为B组，全身症状包括:?发热;?6个月内体重减轻10%以上;?盗汗 89、特发性血小板减少性紫癜(ITP)的诊断要点 ?皮肤粘膜及内脏广泛性出血;?多次检查血小板计数减少;?脾不大; ?骨髓巨核细胞增多或正常，有成熟障碍;?强的松或脾切除治疗有效; ?排除其他继发性血小板减少症 90、1型与2型DM(糖尿病)的鉴别要 点 临床特点 T1DM T2DM 起病年龄 <30岁 >40岁 体型 消瘦 肥胖 起病方式 较急 缓慢 酮症倾向 常见 相对少见 慢性并发症 发病数年才出现 发病时多已合并 Ins and CP 低下 正常或较低 ICA,IAA,GADA (+) (-) Ins 治疗 必须 特殊时需要 91、糖尿病的并发症 ?急性严重代谢紊乱:糖尿病酮症酸中毒;高血糖高渗状态;乳酸酸中毒 ?感染性并发症;?皮肤(疖、痈、癣)，肺结核，泌尿系感染;?慢性并发症 92、糖尿病的诊断标准 具有糖尿病症状+下列之一 ?空腹血糖(FPG)? 7.0mmol/L;?随机血糖? 11.1mmol/L ?75g OGTT ，2h血糖(2h PG)? 11.1mmol/ L 93、口服降糖药的种类及其副作用 ?促胰岛素分泌剂(磺脲类、格列奈类):低血糖反应、体重增加、皮肤过敏反应、消化系统(上腹不适、食欲减退)、心血管系统 ?双胍类(二甲双胍):消化道反应，皮肤过敏，乳酸性酸中毒 ?噻唑烷二酮类TZDs(罗格列酮):水肿、体重增加 ?a-葡萄糖苷酶抑制剂AGI(阿卡波糖):胃肠反应(腹胀、腹泻) 94、胰岛素治疗的适应证有哪些 T1DM;DKA、HHS、乳酸性酸中毒伴高血糖;各种严重的糖尿病急性或慢性并发症; 手术、妊娠和分娩;T2DM β细胞功能明显减退者;某些特殊类型糖尿病 95、糖尿病酮症酸中毒的治疗原则. ?积极补液:生理盐水,当血糖降至250mg/dl左右时,改输5,G S ?胰岛素:小剂量胰岛素静滴疗法,0.1u/kg/h ?纠正电解质及酸碱平衡失调,PH,7.1时输碳酸氢钠,见尿补 钾 ?去除诱因，处理并发症 96、简述甲状腺功能亢进症(Graves病)的典型临床表 现 ?甲状腺毒症表现:高代谢综合征(疲乏无力，怕热多汗，多食善饥，体重下降显著);精神神经系统(多言好动，焦躁易怒，失眠不安);心血管系统(心悸气短，心动过速，脉压增大，心律失常);消化系统(稀便，排便次数增加);肌肉骨骼系统(甲状腺毒症性周期性瘫痪);造血系统;生殖系统 ?甲状腺肿:弥漫性，对称性，质地不等，无压痛，可触及震颤，闻及血管杂音 ?眼征:单纯性突眼(非浸润性突眼);浸润性眼征 97、试述Graves病药物治疗的适应证 病情轻、中度患者;甲状腺轻、中度肿大;年龄,20岁;手术前和 I治疗前准备; 孕妇、老年或由于其他严重疾病不适宜手术者;手术后复发且不适宜 I治疗者 98、抗甲状腺药物的主要副作用有哪 些 粒细胞减少或缺乏;皮疹;中毒性肝病;药物性甲减 99、类风湿关节炎的关节X线表现 ?早起可见关节周围软组织肿胀影、关节端骨质疏松;?进而关节间隙变窄; ?关节面出现虫蚀样改变;?晚期可见关节半脱位和关节破坏后的纤维性和骨性强 直 100、急性中毒的诊断原则? ?有毒物接触史;?有中毒的临床表现;?有实验室检查证 据 101、中毒的治疗原则 立即终止接触毒物;清除进入人体内已吸收或尚未吸收的毒物;使用特效解毒剂; 保护重要脏器，抢救生命;对症支持治疗 102、特效解毒剂 金属中毒—螯合剂:依地酸二钠钙——铅中毒;二巯基丙醇——砷、汞中毒 亚硝酸盐: 亚甲蓝(美蓝) 氰化物中毒:亚硝酸盐---硫代硫酸钠疗法; 有机磷中毒:阿托品、解磷定 中枢神经抑制剂中毒:纳洛酮—阿片类、酒精 安定中毒:氟马西尼-—苯二氮卓类受体拮抗 103、中间型综合征:发生于中毒后24—96h或2—7d，在胆碱能危象和迟发性神经病之间，故称中间综合征。主要表现以肌无力为突出，涉及颈肌，肢体近端肌，颅神经?-- ?和?所支配的肌肉，重者累及呼吸肌。表现为:抬头困难，眼睑下垂，睁眼困难，复视，颜面肌咀嚼肌无力，声音嘶哑，吞咽困难，呼吸肌麻痹，进行性缺氧致意识障碍，昏迷以致死亡 104、一氧化碳中毒程度分类 ?轻度:头痛、头晕四肢无力、恶心呕吐、嗜睡、意识模糊;COHb% ,10% ?中度:浅昏迷状态，反射迟钝，生命体征可有改变;COHb%,30% ?重度:深昏迷，各种反射消失，伴有脑水肿、肺水肿，呼吸抑制、休克、上消化道出血。急性肾功衰竭，COHb%,50% 105、患者女性，36岁，反复上腹痛伴反酸8年，再发一个月，夜间痛明显，近5天上腹痛加重伴 呕吐，呕吐物伴发酵味。查体:上腹部压痛，有振水音。该患者最可能的诊断是什么,行何 种检查对诊断最有帮助,应如何治疗, 诊断:十二指肠溃疡并幽门梗阻 检查:胃镜 治疗:?胃肠减压;?补液或维持水电解质、能量平衡;?应用抑酸剂;?必要时外科手术 07级医疗，预防，临药，影像内科学试题 论述 1.肺心病时肺动脉高压的成因6’ 2.举例说明降压药的分类6‘ 3.肝性脑病的治疗原则与措施6‘ 简答 1.肺心病时吸高压氧会怎样，原因3’ 2.急性心梗急性期的心电图表现3‘ 3.再障的诊断标准5’ 4.何为类风湿因子，类风湿性关节炎的病理变化2‘ 5.上消化道出血最常见的四个病因4’ 6.肾病综合征的诊断标准4， 7.患者多语，定位障碍————是HE哪一期1‘ 8.SLE皮肤典型变化2’ 9.心绞痛的疼痛性质5‘ 10.肺心病应用利尿剂的副作用3’ (英文版 ) Two regulations promulgated for implementation is in the party in power for a long time and the rule of law conditions, the implementation of comprehensive strictly strategic plan, implementation in accordance with the rules and discipline to manage the party, strengthen inner-party supervision of major initiatives. The two regulations supporting each other, the < code > adhere to a positive advocate, focusing on morality is of Party members and Party leading cadres can see, enough to get a high standard; < rule > around the party discipline, disciplinary ruler requirements, listed as "negative list, focusing on vertical gauge, draw the party organizations and Party members do not touch the" bottom line ". Here, the main from four square face two party rules of interpretation: the first part introduces two party Revised regulations the necessity and the revision process; the second part is the interpretation of the two fundamental principles of the revision of laws and regulations in the party; the third part introduces two party regulations modified the main changes and needs to grasp several key problems; the fourth part on how to grasp the implementation of the two regulations of the party. < code > and < Regulations > revised the necessity and revised history of the CPC Central Committee the amendment to the Chinese Communist Party members and leading cadres honest politics several guidelines > and < Chinese Communist Party discipline and Punishment Regulations > column 1 by 2015 to strengthen party laws and regulations focus. Two party regulations revision work lasted a Years, pooling the wisdom of the whole party, ideological consensus, draw historical experience, respect for the wisdom of our predecessors, which reflects the unity of inheritance and innovation; follow the correct direction, grasp the limited goals, adhere to the party's leadership, to solve the masses of the people reflect a focus on the problem. The new revision of the < code > and < rule >, reflects the party's 18 and the eighth session of the third, the spirit of the fourth plenary session, reflecting the experience of studying and implementing the General Secretary Xi Jinping series of important speech, reflects the party's eighteen years comprehensive strictly practice. (a) revised two regulations of the party need of < the ICAC guidelines > in < in 1997 Leaders as members of the Communist Party of China clean politics certain criteria (Trial) > based on revised, the promulgation and implementation of January 2010, to strengthen the construction of the contingent of leading cadres play an important role. But with the party to manage the party strictly administering the deepening, has not been able to fully meet the actual needs. Content is too complicated, "eight prohibition, 52 are not allowed to" hard to remember, and also difficult to put into practice; the second is concisely positive advocated by the lack of prohibited provisions excessive, no autonomy requirements; the third is banned terms and discipline law, both with the party discipline, disciplinary regulations repeat and Criminal law and other laws and regulations repeat; the fourth is to "clean" the theme is not prominent, not for the existing problems, and is narrow, only needle of county-level leading cadres above. < rule > is in 1997 < Chinese Communist Party disciplinary cases (Trial) > based on revision, in December 2003 the promulgation and implementation, to strengthen the construction of the party play very important role. Along with the development of the situation, which many provisions have been unable to fully meet the comprehensive strictly administering the practice needs. One is Ji law, more than half of the provisions and criminal law and other countries laws and regulations Repetition; two is the political discipline regulations is not prominent, not specific, for violation of the party constitution, damage the authority of Party Constitution of misconduct lack necessary and serious responsibility to pursue; third is the main discipline for the leading cadres, does not cover all Party members. Based on the above situation, need to < the criterion of a clean and honest administration > and < rule > the two is likely to be more relevant regulations first amendment. By revising, really put the authority of Party discipline, the seriousness in the party tree and call up the majority of Party members and cadres of the party constitution of party compasses party consciousness. (II) two party regulations revision process the Central Committee of the Communist Party of China attaches great importance to two regulations revision . Xi Jinping, general books recorded in the Fifth Plenary Session of the eighth session of the Central Commission for Discipline Inspection, on the revised regulations < > made clear instructions. According to the central deployment, the Central Commission for Discipline Inspection from 2014 under six months begin study two regulations revision. The Standing Committee of the Central Commission for Discipline Inspection 4 review revised. Comrade Wang Qishan 14 times held a special meeting to study two regulations revision, amendment clarifies the direction, major issues of principle, path and target, respectively held a forum will listen to part of the province (area) secretary of the Party committee, Secretary of the Discipline Inspection Commission, part of the central ministries and state organs Department The first party committee is mainly responsible for people, views of experts and scholars and grassroots party organizations and Party members. Approved by the Central Committee of the Communist Party of China, on 7 September 2015, the general office of the Central Committee of the Party issued a notice to solicit the provinces (autonomous regions, municipalities) Party, the central ministries and commissions, state ministries and commissions of the Party (party), the General Political Department of the military, every 3 people organization of Party of two regulations revision opinion. Central Commission for Discipline Inspection of extensive solicitation of opinions, careful study, attracting, formed a revised sent reviewers. In October 8 and October 12, Central Committee Political Bureau Standing Committee and the Political Bureau of the Central Committee After consideration of the two regulations revised draft. On October 18, the Central Committee of the Communist Party of China formally issued two regulations. Can say, two laws amendment concentrated the wisdom of the whole party, embodies the party. Second, < code > and < Regulations > revision of the basic principles of two party regulations revision work and implement the party's eighteen, ten eight plenary, the spirit of the Fourth Plenary Session of the Eleventh Central Committee and General Secretary Xi Jinping important instructions on the revised < low political criterion > and < Regulations >, highlighting the ruling party characteristics, serious discipline, the discipline quite in front of the law, based on the current, a long-term, advance as a whole, with Bu Xiuding independent < rule > and < rule >. Main principle is: first, adhere to the party constitution to follow. The constitution about discipline and self-discipline required specific, awaken the party constitution of party compasses party consciousness, maintaining the authority of the constitution. General Secretary Xi Jinping pointed out that "no rules, no side round. Party constitution is the fundamental law, the party must follow the general rules. In early 2015 held the eighth session of the Central Commission for Discipline Inspection Fifth Plenary Session of the 16th Central Committee, Xi Jinping again pointed out that constitution is the party must follow the general rules, but also the general rules." the revision of the < code > and < rule > is Method in adhere to the regulations established for the purpose of combining rule of virtue is to adhere to the party constitution as a fundamental to follow, the constitution authority set up, wake up the party constitution and party rules the sense of discipline, the party constitution about discipline and self-discipline specific requirements. 4 second is to adhere to in accordance with the regulations governing the party and the party. The Party of rule of virtue "de", mainly refers to the party's ideals and beliefs, excellent traditional style. The revised the < code > closely linked to the "self-discipline", insisting on the positive initiative, for all members, highlight the "vital few", emphasized self-discipline, focusing on the morality, and the majority of Party members and the ideological and moral standards. The revised < > Ji method separately, Ji, Ji Yan to Method, as a "negative list", emphasizing the heteronomy, focusing on vertical gauge. Is this one high and one low, a positive reaction, the strict party discipline and practice results transformation for the integration of the whole party to observe moral and discipline requirements, for the majority of Party members and cadres provides benchmarking and ruler. Third, insist on to. In view of the problems existing in the party at the present stage, the main problems of Party members and cadres in the aspect of self-discipline and abide by the discipline to make clearly defined, especially the party's eighteen years strict political discipline and political rules, organization and discipline and to implement the central eight provisions of the spirit against the four winds and other requirements into Disciplinary provisions. Not one pace reachs the designated position, focusing on in line with reality, pragmatic and effective. After the revision of major changes, major changes in the < code > and < rule > modified and needs to grasp several key problems (a) < code > < code > adhere to according to regulations governing the party and party with morals in combination, for at the present stage, the leadership of the party members and cadres and Party members in existing main problems of self-discipline, put forward principles, requirements and specifications, showing Communists noble moral pursuit, reflected at all times and in all over the world ethics from high from low 5 common requirements. One is closely linked to the "self-discipline", removal and no direct relation to the provisions of . the second is adhere to a positive advocate, "eight prohibition" 52 are not allowed to "about the content of the" negative list moved into synchronization amendment < cases >. Three is for all the party members, will apply object from the leadership of the party members and cadres to expand to all Party members, fully embodies the comprehensive strictly required. The fourth is prominent key minority, seize the leadership of the party members and cadres is the key, and put forward higher requirements than the ordinary Party members. Five is to simplify, and strive to achieve concise, easy to understand, easy to remember. The revised < code > is the ruling Party since the first insists on a positive advocate forAll Party members and the self-discipline norms, moral declaration issued to all members of the party and the National People's solemn commitment. > < criterion of a clean and honest administration consists of 4 parts, 18, more than 3600 words. After the revision of the < code >, a total of eight, 281 words, including lead, specification and Party member cadre clean fingered self-discipline norms, etc. Part 3 members low-cost clean and self-discipline, the main contents can be summarized as "four must" "eight code". Lead part, reiterated on ideal and faith, fundamental purpose, the fine traditions and work style, noble sentiments, such as "four must" the principle of requirements, strong tone of self-discipline, The higher request for 6 and supervised tenet, the foothold in permanent Bao the party's advanced nature and purity, to reflect the revised standards requirements. Members of self-discipline norms around the party members how to correctly treat and deal with the "public and private", "cheap and rot" thrifty and extravagance "bitter music", put forward the "four norms". Party leader cadre clean fingered self-discipline norms for the leadership of the party members and cadres of the "vital few", around the "clean politics", from civil servant of the color, the exercise of power, moral integrity, a good family tradition and other aspects of the leadership of the party members and cadres of the "four norms" < > < norm norm. "The Party member's self-discipline norms" and "party members and leading cadre clean fingered self-discipline norms," a total of eight, collectively referred to as the "eight". "Four must" and "eight" of the content from the party constitution and Party's several generation of leaders, especially Xi Jinping, general secretary of the important discussion, refer to the "three discipline and eight points for attention" statements, and reference some embody the Chinese nation excellent traditional culture essence of epigrams. (2) the revised regulations, the main changes in the revised Regulations > to fully adapt to the strictly requirements, reflects the according to the regulations governing the law of recognition of deepening, the realization of the discipline construction and Jin Ju. < rule > is party a ruler, members of the basic line and follow. And the majority of Party members and cadres of Party organizations at all levels should adhere to the bottom line of thinking, fear discipline, hold the bottom line, as a preventive measure, to keep the party's advanced nature and purity. 1, respect for the constitution, refinement and discipline. Revised < rule > from comprehensive comb physical constitution began, the party constitution and other regulations of the Party of Party organizations and Party discipline requirements refinement, clearly defined in violation of the party constitution will be in accordance with regulations to give the corresponding disciplinary action. The original 10 categories of misconduct, integration specification for political discipline, discipline, honesty and discipline masses Ji Law and discipline and discipline and other six categories, the content of < rule > real return to Party discipline, for the majority of Party members and listed a "negative list. 7 2, highlighting the political discipline and political rules. > < Regulations according to the stage of the discipline of outstanding performance, emphasizing political discipline and political rules, organization and discipline, in opposition to the party's leadership and the party's basic theory, basic line, basic program and basic experience, the basic requirement of behavior made prescribed punishment, increase the cliques, against the organization such as violation of the provisions, to ensure that the central government decrees and the Party of centralized and unified. 3, adhere to strict discipline in the law and discipline In front, Ji separated. Revised < Regulations > adhere to the problem oriented, do Ji separated. Any national law existing content, will not repeat the provisions, the total removal of 79 and criminal law, repeat the content of the public security management punishment law, and other laws and regulations. In the general reiterated that party organizations and Party members must conscientiously accept the party's discipline, die van comply with national laws and regulations; at the same time, to investigate violations of Party members and even criminal behavior of Party discipline and responsibility, > < Regulations distinguish five different conditions, with special provisions were made provisions, so as to realize the connection of Party discipline and state law. 4, reflect Wind building and anti-corruption struggle of the latest achievements. < rule > the party's eighteen years implement the spirit of the central provisions of the eight, against the requirements of the "four winds" and transformation for disciplinary provisions, reflecting the style construction is always on the road, not a gust of wind. In the fight against corruption out of new problems, increase the trading rights, the use of authority relatives profit and other disciplinary terms. Prominent discipline of the masses, the new against the interests of the masses and ignore the demands of the masses and other disciplinary terms and make provisions of the disposition and the destruction of the party's close ties with the masses. Discipline to protect the party's purpose. 8 of these regulations, a total of three series, Chapter 15, 178, more than 24000 words, after the revision of the regulations a total of 3 series, Chapter 11, 133, 17000 words, divided into "general" and "special provisions" and "Supplementary Provisions" Part 3. Among them, add, delete, modify the provisions of the proportion of up to nearly 90%. 1, the general general is divided into five chapters. The first chapter to the regulations of the guiding ideology, principles and scope of application of the provisions, highlight the strengthening of the party constitution consciousness, maintenance the authority of Party Constitution, increase the party organizations and Party members must abide by the party constitution, Yan Centralized centralized, would examine at all levels of the amended provisions implementing and maintaining Party discipline, and consciously accept the party discipline, exemplary compliance with national laws and regulations. The second chapter of discipline concept, disciplinary action types and effects of the regulations, will be a serious warning from the original a year for a year and a half; increase the Party Congress representative, by leaving the party above (including leave probation) punishment, the party organization should be terminated its representative qualification provisions. The third chapter of the disciplinary rules of use prescribed in the discipline rectifying process, non convergence, not close hand classified as severely or heavier punishment. "Discipline straighten "At least eighteen years of five years, these five years is to pay close attention to the provisions of the central eight implementation and anti -" four winds ". The fourth chapter on suspicion of illegal party disciplinary distinguish five different conditions, with special provisions were made provisions, to achieve effective convergence of Party and country 9 method. < rule > the provisions of Article 27, Party organizations in the disciplinary review found that party members have committed embezzlement, bribery, dereliction of duty dereliction of duty and other criminal law act is suspected of committing a crime shall give cancel party posts, probation or expelled from the party. The second is < Regulations > Article 28 the provisions of Party organizations in the disciplinary review But found that party members are stipulated in the criminal law, although not involved in a crime shall be investigated for Party discipline and responsibility should be depending on the specific circumstances shall be given a warning until expelled punishment. This situation and a difference is that the former regulation behavior has been suspected of a crime, the feeling is quite strict, and the latter for the behavior not involving crime, only the objective performance of the provisions of the criminal code of behavior, but the plot is a crime to slightly. < Regulations > the 29 provisions, Party organizations in the discipline review found that party members and other illegal behavior, affect the party's image, the damage to the party, the state and the people's interests, we should depend on the situation Seriousness given disciplinary action. The loss of Party members, seriously damaging the party's image of behavior, should be given expelled from the party. At this article is party member is in violation of the criminal law outside the other illegal acts, such as violates the public security administration punishment law, customs law, financial laws and regulations behavior. The fourth is < cases > Article 32 stipulates, minor party members and the circumstances of the crime, the people's Procuratorate shall make a decision not to initiate a prosecution, or the people's court shall make a conviction and exempted from criminal punishment shall be given within the party is removed from his post, probation or expelled from the party. Party members and crime, sheets were fined in accordance with For acts; the principal Ordinance amended the provisions of the preceding paragraph. This is the new content, in order to achieve Ji method effective convergence. Five is < > the thirty third article 10 of the provisions, the Party member due to an intentional crime is sentenced to criminal law (including probation) sheets or additional deprivation of political rights; due to negligence crime and was sentenced to three years or more (excluding three years) a penalty, shall give expelled punishment. Due to negligence crime is convicted and sentenced to three years (including three years) in prison or be sentenced to public surveillance, detention, shall in general be expelled from the party. For the individual may not be expelled from the party, should control Approval. This is followed and retained the original > < Regulations the provisions of punishment party authorization rules and report to a level party organizations. For is "party members with criminal acts, and by the criminal punishment, generally should be expelled from the party". The fifth chapter of probationary Party member of the discipline and discipline after missing members of the treatment and punishment decisions, such as the implementation of the provisions, clear the related party discipline and punishment decision made after, for duties, wages and other relevant alteration formalities for the longest time. 2, sub sub section will the original regulations of 10 categories of acts of violation of discipline integration revised into 6 categories, respectively, in violation of the punishments for acts of political discipline "in violation of discipline behavior of punishment" in violation of integrity of disciplinary action points "of violation punishments for acts of mass discipline" "the violation of work discipline, punishment" in violation of discipline of life behavior punishment "6 chapters. 3, annex" Supplementary Provisions "clear authority making supplementary provisions of, cases of interpretative organ, as well as regulations implementation time and retroactivity etc.. 11 (3) learning understanding > < regulations needs to grasp several key problems The first problem -- about the violation of political discipline behavior > < new ordinance chapter 6 the political discipline column for the six disciplines, that is the main opposition to Party leadership and the opposition of the basic theory, basic line, basic program and basic experience, basic requirements of misconduct made provisions of the disposition, especially the eighteen since the CPC Central Committee put forward the Yan Mingzheng treatment of discipline and political rules requirements and practical achievements transformation for Discipline article, increase the false debate central policies, cliques, against the organization review, make no discipline of the principle of harmony terms. These are the party's eighteen years in comprehensive strictly Process combined with the practice of rich content. (1) false debate the central policies and undermine the Party of centralized and unified the problem is made in accordance with the provisions of the party constitution. Constitution in general programme requirements adhere to democratic centralism is one of the requirements of the construction of the party must adhere to the four cardinal. Application of this principle is not only the party the basic organization principle and is also the mass line in party life, it requires that we must fully develop inner-party democracy, respect for the dominant position of Party members, safeguarding the Party member democratic rights, give full play to the enthusiasm and creativity of the party organizations at all levels and Party members, at the same time, also must implement the right concentration, ensure the party's mission < the chaos in unity and concerted action to ensure that the party's decision to get quickly and effectively implementing. The Party Central Committee formulated the major principles and policies, through different channels and ways, fully listen to the party organizations and Party members of the opinions and suggestions, but 12 is some people face to face not to say back blather "" will not say, after the meeting said, "" Taiwan does not say, and nonsense ", in fact, not only disrupt the people thought, some causing serious consequences, the damage to the Party of the centralized and unified, hinder the central policy implementation, but also a serious violation of the democratic system of principles. There is no doubt that shall, in accordance with the Regulations > 4 Specified in Article 6 to give the appropriate punishment. For did not cause serious consequences, to give criticism and education or the corresponding tissue processing. (2) about the destruction of the party's unity < New Regulations > the forty eighth to fifty second article, to damage Party's unity unified and violation of political discipline, punishment situation made explicit provisions. Article 52 of the new "in the party get round group, gangs seek private gain, cliques, cultivate private forces or through the exchange of interests, for their own to create momentum and other activities to gain political capital, given a serious warning or withdraw from their party posts disposition; if the circumstances are serious, to give Leave a party to observation or expelled from the party. (3) on against the organization review of the provisions of the constitution, party loyalty honesty is party members must comply with the obligations. Members must obey the organization decision, shall not violate the organization decided encounters by asking questions to find organization, rely on the organization, shall not deceive the organization, against the organization. For example, after the investigation does not take the initiative to explain the situation, but to engage in offensive and defensive alliance, hiding the stolen money is against survey organization, is a violation of the behavior of political discipline. Article 24 of the original > < Regulations, although the provisions of the interference, hinder group review the behavior of the fabric can be severely or 13 Aggravated punishment, but did not put this kind of behavior alone as a discipline for qualitative amount of discipline. > < new regulations increase the Article 57, "anti organization review, one of the following acts, given a warning or serious warning; if the circumstances are relatively serious, giving removed from or placed on probation within the party post; if the circumstances are serious, give expelled from the party: (a) on supply or forged, destroyed, transfer, conceal evidence; (II) to prevent others expose, providing evidence Material; (III) harboring co personnel; (4) to the organization to provide false information, to hide the fact; (5) the him against the acts of the organization review. "< rule > add this clause to the Constitution requires more specific, the previous no punishment in accordance with the definite list and put forward clear punishment in accordance with. (4) about organizing or participating in superstitious activities as < Regulations > about engage in activities of feudal superstition obstruction of social management order" violations of Article 164 the provisions, but according to the original < rule > only in disrupting production, work, social life order The case to be disciplinary treatment, in other words, alone make the feudal superstition, organize or participate in the activities of feudal superstition of, does not constitute a violation. Which is not consistent with the requirements of our party's political party. > < new regulations in this change is, superstitious activities on the political discipline, increase the Article 58, is the organization of Party members, in superstitious activities included in violation of the negative list of political discipline deserves punishment, which and Party members should adhere to the correct political principle, political standpoint and viewpoint is consistent. 14 the second question about organization and discipline violation behavior of democratic centralism is our The party's fundamental organizational system. < New Regulations > Chapter 7 "in violation of the behavior of organizational discipline punishment" mainly for violation of democratic centralism, contrary to the "four obey the discipline behavior for source classification rules. Increased not in accordance with the relevant provisions or requirements to the organization for instructions to report on major issues; do not report truthfully report about personal matters; falsify personal archives; hide before joining the party serious mistakes; leading cadres in violation of the relevant provisions of the organization, will participate in the spontaneous formation of the old Xiang, Alumni Association, comrades in arms; to obtain illegal country residence abroad or foreign nationality, illegal for private frontier Documents such as discipline terms. (1) on the report truthfully report personal matters in 2010 the Central Committee of the Communist Party of China office, office of the State Council introduced < provisions on issues related to the leading cadres to report personal >, is clear about the request, deputy division level and above leading cadres should truthfully report changes in my marriage and spouse, children, moved to the country (territory), practitioners, income, real estate, investment and other matters, for failing to report, do not report, concealed and unreported, according to the seriousness of the case, giving criticism and education, and to make a correction within a time limit, shall be ordered to make a check, the commandment Jiemian conversation, informed criticism or jobs, free Post processing, constitute violations, in accordance with the relevant provisions shall be given a disciplinary sanction. But since the original < Regulations > and there is no corresponding specific terms, the violation of the regulations, do not report, as a false report about personal matters, there is no corresponding disciplinary action terms, in practice it is difficult to operate. In this regard, in order to solve is not reported, as a false report about personal matters 15 asked censure, the new < Regulations > add the Article 67 of violation of personal matters related to reporting requirements, report truthfully report the clear punishment basis, making this kind of violation behavior is no longer free drilling for Exhibition on matters of personal checks to verify and supervision of cadres, discipline review provides a powerful discipline guarantee. (2) about the illegal organization, to fellow, alumni, friends of the war will < regulations stipulated in Article 68 of >, leading cadres of the party in violation of relevant provisions of the organization, will participate in the spontaneous formation of fellow, Alumni Association, comrade in arms to give the punishment according to the seriousness of the case. Here special needs note is three points: this provision for only the leading cadres ", reflecting the high requirements of leading cadres; second violation in 2002, the Central Commission for Discipline Inspection, the central Organization Department and the The relevant provisions of the General Political Department jointly issued the < off in leading cadres not to participate in the initiative to set up "the villagers would be" alumni "" comrades in arms organization notice >. That is to say, to the spontaneous formation of fellow, Alumni Association, comrades in arms will constitute the premise of discipline is a violation of the provisions of this. The notification specified, leading cadres are not allowed to participate in the spontaneous incorporation of fellow, alumni, between comrades association would like the organization and shall not bear the sorority Human and the organizer shall not hold the corresponding position in the sorority; shall not borrow machine woven "network" and engage in kiss sparsely, round and round the gangs, but not "align" "Jieyi Gold Orchid" behavior. The third is to emphasize here that shall be organized to participate in the initiative to set up the villager, Alumni Association, comrades in arms. The so-called 16 spontaneous was established mainly means without registration. Therefore, Party members include leading cadres in the normal range of fellow, alumni, comrades in the party is not a violation of the rules of Party discipline. The three problem about integrity violations discipline Lian Jie discipline has been eighteen years clean government and anti The focus of the work of corruption. This Ordinance to amend, honesty and discipline this biggest adjustment, the new content, most of which prescribed by the original < criterion of a clean and honest administration > 8 ban and 52 are not allowed into the basic this part. (1) the central eight provisions of the spirit and requirements into < New > in the regulations of the party's eighteen years, central resolutely implement the provisions of the eight and pay close attention to the node and intensive briefing, on public funds, private bus, public funds tourism, gifts of public funds, the big parade and lavish weddings and festive, illegal payment allowances and subsidies, illegal construction of buildings such as the original masses reflects the relatively strong, "four winds" problem of the Resolute rectification. But original < Regulations > to eat and drink, super standard reception and no clear and specific expression, new < rule > will implement eight Central provisions of the spirit of the problem increased to "clean cheap self-discipline" chapter, clear to exceed the standard, beyond the scope of the reception or borrow machine eating and drinking etc. some in violation of the provisions of the spirit of the eight central relevant persons responsible for punishment, once the violation will be according to the < rule > severely punished, binding, enhanced significantly. One is to add Article 87, about to obtain illegal, hold, and the actual use of the sports card, golf ball cards and other consumer card. Illegal access to private clubs made the punishment provisions. The second is increase the Article 97, has made provisions of the disposition of illegal self pay or 17 spamming allowances, subsidies and bonuses. The third is added to the Article 99, on violation of super standard, beyond the scope of the reception or borrow machine eat and drink to make the provisions of punishment. The fourth is to increase the Article 101, on the management of conference activities in violation of the provisions made sanctions regulations. The fifth is the increased Article 102, for violation of office space management provisions made the punishment provisions. Six is to split the original < rule > Article 78, formed article 98, Article 100 of public Models of tourism, violate the provisions on the administration of the use of discipline of the bus through the list of made a more detailed provisions, apply more operational. Seven is increased the article 96, in violation of the relevant provisions of the, to participate in public funds to pay for dinner, high consumption of entertainment, fitness activities and public funds to buy gift, send gifts to make the provisions of the disposition. On the violation of the central provisions of the spirit of the eight, in addition to > < new regulations into "violation of honesty and self-discipline" misconduct outside, is different with the original < Regulations >, revised < rule > clearly defined not only to disposition of the directly responsible persons, but also dispose of collar Guide responsibilities. (2) increased trading rights, use of authority or position influence as relatives and close to profit violation of the terms of the < New Regulations > absorption < clean politics several guidelines > the relevant provisions spirit, increase the "negative list, including trading rights, the functions and powers or duties of influence as relatives and staff around profit. Increase Article 81" mutual use of office or authority ring for each other and their spouses, children and their spouses and other relatives, around 18 personnel and other specific relationship between the people to seek benefits engage in trading rights, given a warning or serious warning Sanctions; if the circumstances are relatively serious, giving removed from or placed on probation within the party post; if the circumstances are serious, shall be expelled from the party. Increase Article 82 "connivance, acquiescence to the spouse, children and spouse etc. relatives and staff around the effect of Party members and cadres personal authority or position for personal gain, if the circumstances are relatively minor, given a warning or a serious warning; if the circumstances are relatively serious, giving removed from or placed on probation within the party post; if the circumstances are serious, the given Expelled from the party. Party members and cadres of the spouses, children and their spouses does the actual work and get salary or although the actual work but to receive significantly beyond the same rank salary standard, Party members and cadres informed fails to correct, in accordance with the provisions of the preceding paragraph. "(3) about the gifts, gifts misconduct from handling practices in recent years, engaged in official cadres received gifts, gifts problems more prominent. This has seriously affected the image of Party members and cadres, damaged the relations between the party and the masses, and is a hotbed of corruption, is really necessary for this kind of behavior to be disciplined. < rule > no on accepting gifts, gifts, Card consumption behavior to engage in simple "one size fits all", but the difference between the different separately. One is in accordance with the provisions of Article 83, accepting may affect the impartial enforcement of the official gifts, gifts, consumer cards to depending on the seriousness of the case shall be given disciplinary sanctions. That is to say, for may affect the fair execution of business gifts, gifts, consumer cards are not allowed to accept. 19 is in accordance with the provisions of Article 83, accepting was significantly higher than normal ceremony is still exchanges of gifts, gifts, consumer card to disciplinary action. This is new regulations that daily life is purely reciprocity, accepting the same thing, boys , fellow friends gifts, gifts, shopping cards, although and fair execution of business has nothing to do, also want to as the case shall be dealt with, the situation is obviously beyond normal reciprocity ". The so-called" reciprocity ", one is emphasizes the reciprocal in protocol. In other words is you to me how, I to you how, not only does not go. The second is to significantly exceeded the normal local economy level, customs and habits, economic capacity of individual gifts, gift value. Specific sanctions to according to the processing of a variety of factors to consider, as appropriate. The third is the root according to the provisions of Article 84," to Engaged in public service personnel and their spouses and children, children's spouses and other relatives and other specific relationship presented Ming Xianchao normal reciprocity of gifts, gifts, consumer card, if the circumstances are relatively serious, given a warning until probation. "In accordance with the above provisions, gift giving significantly beyond the normal reciprocity, giver constitute the discipline. (4) on illegal trading of stocks or of other regulations of securities investment < > Article 88 is engaged in punishment regulation of camp and activity in violation of the relevant provisions on. Among them, 3 will" buying and selling stocks or in other securities investment "column as one of disciplinary cases Out. First need to be clear, > < regulations did not change the provisions of the Ordinance. The ordinance of the provisions of the second paragraph of Article 77 provisions "who, in violation of the provisions of the sale of stocks" is one of the violation, and at the beginning of the first paragraph of this article "violation of 20 against the relevant provisions of the" textual representation of the repeat revision. In, just from the legislative technique removed the "personal" in violation of the provisions, content and not to change the original provisions. Need to clear is, "buy or sell a stock or of other securities investment" refers to violation of the relevant provisions refers to in April 2001, the Party Central Committee, the State Council promulgated the On the work of the party and government organs staff's personal investment in securities if dry provisions >. According to the provisions of Article 3, use of work time, office facilities, the sale of stocks and securities investment fund belongs to illegal behavior. The fourth question, about the violation of the masses of the disciplinary actions < new regulations > would violate public discipline behavior of a single set of a class of restored "three rules of discipline and eight note" in the discipline of the masses of excellent traditional. < New Regulations > Chapter 9 "to violate the masses of disciplinary action", mainly the destruction of the party's close ties with the masses of misconduct made provisions on disciplinary; enrich and perfect the super standard, beyond the scope of Xiang Qun < All to raise fund and labor, in for involving the public affairs deliberately, chinakayao, in social security, policy support, disaster relief funds and materials and other matters assigned any kind and affectionate friends, obviously unfair acts against the interests of the masses of the disciplinary terms; increase the terms not in accordance with the provisions of the public party provided, government, factory and village (neighborhood) provided etc. violation of the people's right to know the behavior of the discipline. The fifth issue, on the violation of work discipline violation of work discipline added "negative list, including Party organizations carry out strictly Main responsibility for poor discipline terms. (1) the new party organization comprehensive strictly the main responsibility of the party does not fulfill the 21 or perform poor disciplinary terms < New Regulations > has a lead people to pay attention to the new terms, that is, in chapter ten "on the violation of work discipline behavior punishment" increase in the one hundred and fourteenth "party fail to perform comprehensive strictly the main responsibility of the party or to perform comprehensive strictly the main responsibility for administering the ineffective, resulting in serious damage or serious adverse effects, to the person directly responsible and the responsibility of leadership and give a warning or serious warning. The situation is serious, giving removed from their party posts or on probation Punishment. "Here the changes. For the first time, the main responsibility write < rule >. (2) new shall report does not report or false reporting discipline shall increase the 117 bar" in the higher level units to check to inspect the work or report to the parent unit, work report of shall report the matters do not report or do not report, cause serious damage or serious adverse effects of, to the person directly responsible and the responsibility of leadership, to give warning or a serious warning; if the circumstances are serious, giving removed from their party posts or placed on probation. "For example, during the tour visits to the region, the unit Members the obligation to the inspection teams to reflect the true situation, to conceal not reported or intentionally to the inspection teams to provide false information, causing serious damage or serious adverse effects of, the person directly responsible and the responsibility of leadership should be in accordance with the provisions of < rule > Article 117 to give the appropriate punishment. (3) the new not granted in accordance with the provisions of punishment, not according to the provisions of the implementation of disciplinary measures 22 violation of the provisions of Article 115 "Party organizations have one of the following circumstances, the direct leadership responsibility. Probation: members were sentenced punished, in accordance with the provisions give disciplinary action or in violation of state law Rules of behavior should be given disciplinary punishment and dispose of; disciplinary punishment by decision or complaint review the decision made, not in accordance with the provisions of the implementation decisions on punishment of the party, position, rank, and the treatment of the matters; Party members subject to disciplinary action, not in accordance with the cadre management authority and organizational relationships of by dispose of Party members to carry out education and supervision of daily management. "What needs to be pointed out is," cliff "demoted with cars, housing, secretary problem, implementation is not a discipline and party posts and ranks treatment by the organization department is responsible for the implementation, with cars, housing by the logistics department is responsible for the implementation of, Ji Commission responsible oversight responsibilities. The six questions, about the acts violating the discipline of life "in violation of discipline of life behavior punishment", mainly to "four winds" problems and a serious violation of social morality, family virtue acts of misconduct made provisions on disciplinary, an increase of extravagant life, contrary to the social public order and good customs disciplinary terms. Worth mentioning is, > < Regulations in Article 150 about "adultery" "mistress (Cardiff) formulation in the new < rule > is removed, to expand the scope of Article 127 provisions" and others hair improper sexual relations, let face disciplinary action Wider more strict. Four, and earnestly do a good job in the < code > and < rule > implement system of life lies in execution. < code > and < Regulations > is 23 Party organizations at all levels of a strong constraint and all Party members follow. Learning and implementing the < code > and < rule > is party committees (party), commission for discipline, discipline inspection group), the majority of Party members and cadres of the common responsibility, must party caught together, the party one execution. () Party committees (party) and play and implement comprehensive strictly the main responsibility, pays special attention to the two party regulations learning cross penetration. One is to Adhere to the party constitution is fundamental to follow, and resolutely safeguard the authority of the Party Chapter. The second is to adhere to the problem oriented, to strictly political discipline and political rule moments in the first place. The third is to adhere to the discipline and rules quite in front must not allow the bottom line to break the discipline. The fourth is to seriously organize the study of propaganda and education, in the city party members to create a disciplined, about the rules of the strong atmosphere. (II) Commission for Discipline Inspection at all levels (Discipline Inspection Group) to an important basis for the revised two party regulations as, adhere to easily blame, strengthen supervision and enforcement And early method in combining Ji, increase accountability efforts. One is to two regulations within the party important basis, adhere to the party constitution duties, with strict discipline to maintain the constitution authority. The second is to adhere to high standards and keep the bottom line, adhere to Ji Yan in law and discipline, the discipline and rules quite in front, grasping grasping small, easily blame, comprehensive use of supervision and discipline of "four kinds of form" in the discipline embodies the strict requirements and care for the discipline, tighten up, Yan. According to discipline in accordance with regulations to carry out disciplinary review. Increase the violations punishment, clues can initiate an investigation on the trial of cases According to the discipline on the provisions of the proportion of processing and control manager maintains discipline. To focus on investigating non convergence, don't accept hand serious disciplinary violations at the same time, pay more attention to the general review of discipline 24 behavior, and gradually increase the lighter punishment. Four is to illuminate two party regulations, combined with the local district of the Department of party conduct Lianzheng to relevant laws and regulations system clean, timely research proposes to establish, change, waste release opinion, avoid conflict, and the fasten system of cage, and gradually formed not rot, not rot, not want to rot system and working mechanism. (3) the leadership of the party members and cadres should play an exemplary role. The rate of higher consciousness of the front of the Ordinance to lead practice self-discipline norms, leading to maintain discipline of seriousness and authority. One is the above rate, demonstration and guidance, take the lead in learning and mastering the < code > and < > the requirements and regulations, do the deep understanding, learning to use. The second is to play an exemplary role in abiding by discipline rate, take the lead in practicing self-discipline norms, firmly establish before the discipline are equal, the system has no privilege, discipline is no exception, and consciously do standards, require more strict measures more practical. Third is to consciously accept supervision, conscientiously participate in the democratic life and debriefing honesty responsibility, such as Real to the party organization to report personal matters, and to accept the supervision of the work and life of the normal, habits under the supervision of the exercise of power, to carry out the work. The fourth is to set an example for the strict enforcement of discipline. Leading cadres should take the lead in the maintenance of discipline of seriousness and authority, to dare to seriously, dare to struggle, dare to offend people, for misconduct not laissez faire, but do not indulge, not tolerate to ensure the party constitution of party compasses party put in place. (4) the majority of Party members and cadres to set high standards and hold the bottom line, consciously abide by the < code > and < rule >. One is to control the < standard > and < 25 cases >, tight Close connection with their own thoughts, practical work and life, efforts to solve the problems, to enhance the study and implement of the effectiveness and pertinence. The second is to establish a high standard and hold the bottom line, consciously in the self-discipline pursuit of high standards, strictly in the party away from the red line discipline, discipline, about the rules and know fear, distrust, the formation of the honor system, comply with the system, safeguard system of good habits. Regulations and discipline regulations of < < New Revision of the Communist Party of China clean fingered self-discipline criterion > and < Chinese Communist Party Disciplinary Regulations > is the Party Central Committee in the new situation to promote the comprehensive strictly root of the lift, the regulations of the party construction of keeping pace with the times. We should study and implement the Standards > and < > as the primary political task, adhere to the party constitution duties, adhere to the discipline of, Ji Yan in law, the full implementation of supervision and discipline accountability responsibilities for coordination and promotion "four overall" strategic layout in XX District vivid practice to provide a strong guarantee. - Si Jian Wu, and effectively enhance the implementation of the implementation of the < code > < > The consciousness of General Secretary Xi pointed out that the party is in charge of the party, to manage the party; strictly, it can cure good party. Criterion > and < rule > keep pace with the times is our party to form a new potential strictly rules, to deepen understanding of the ruling law, is a comprehensive strictly, and strengthen the supervision within the party important grasper. Criterion > closely linked to the theme of self-discipline, self-discipline intensity-modulated, focusing on morality, for the majority of Party members and cadres set to see, feel the high standard, show the Communists noble moral sentiment; District Ordinance < < rule > the constitution of discipline integration into a political discipline, organization and discipline, honesty and discipline, discipline of the masses, work discipline, discipline, emphasize discipline, focusing on established rules, to draw the party organizations and Party members do not touch the bottom line. Party committees (party) to effectively strengthen the study and publicize the implementation of the < code > and < rule > the organization and leadership of criterion > and < > a full range, multi angle, deep publicity, the formation of study and publicize and implement the boom, in order to consolidate the development of good political environment to create a positive environment and atmosphere. The majority of Party members and cadres to strict requirements, the < rule > and < Ordinance cases > as a guide to action and behavior criterion, adhere to the moral standards and discipline of the bottom line, to maintain the discipline of worship and awe, learning, compliance, and maintain party discipline and rules of the model. The discipline inspection and supervision organs and cadres to the < code > and < > as the deepening of the "three", and strengthen supervision and discipline of accountability is important to follow correctly grasp the use of supervision and discipline of "four types", promote the comprehensive strictly in new roots. Strict discipline, adhere to the discipline and rules quite in front of the enterprise in the implementation of expensive to implement to execute. The discipline inspection and supervision organs to implement the < code > and < Efforts to investigate cases > as an opportunity, adhere to the party should manage the party strictly, serious performance of their duties to promote two regulations implementation. Change discipline concept. From the simple "investigation of illegal" to a comprehensive "stare at violate discipline"; from the business case to prosecute the big cases and timely solve the signs of tilt to. From the orientation to the normal supervision; from the tube "minority" to resist the "most". Guide Party members and cadres to seriously implement the < code > and < rule >, consciously abide by the political, organizational, honest people, work, life six discipline. Urge the leadership cadres sent to play an exemplary role, take the lead in strictly enforced. Relaxation and rest Strong wind is Su Ji, closely linked to the "four winds" prone to multiple, the masses reflect the strong important nodes and, glued to the four winds "new form, new trends, seriously investigate and deal with violations of the central eight provisions of the spirit, to increase the bulletin exposure intensity, the formation of Chajiu" four winds "loudly, continue to release and discipline must be strict signal. At the same time, extended supervision tentacles, through the development of the rural and fishery party conduct Lianzheng construction inspection, issued in a timely manner, Chajiu occurred in grassroots side of corruption and unhealthy, and earnestly safeguard the interests of the masses and social stability. The creativity and discipline. Grasp and make good use of the supervision and discipline of" four types ", to ensure the Promoting clues to lots of discipline and the law of the vacuum tube, strict together. Not only to the "less" and "very few" thorough investigation severely punished, but also the "most" to maintain zero tolerance trend through layers of conductive pressure, let the discipline about the rules for each party members and cadres consciously follow. At present, it is necessary to implement the "list" management, strictly follow the clues to the disposal of five standards, make the classification of disposal, dynamic cleanup. Zadok Party committees at all levels to implement the main responsibility, comprehensive use of disciplinary action and tissue processing and other means to effectively curb the commonplace, used to see do not blame the "small problem", not because of "practice" and "exception". Prominent Discipline characteristics, the problems of violation of discipline and rules into the focus of supervision and discipline and disciplinary review. At the same time, increase case double check the intensity, the serious problems of discipline violations or "four winds" ban but not absolutely, not only to be held directly responsible, but also held leadership responsibility; not only to pursue studies the main responsibility of the Party committee, and to pursue Commission for Discipline Inspection and supervision responsibilities and promote accountability to become the new norm. The implementation of supervisory responsibility. Maintain < code > and < rule > the seriousness and authority of the discipline and rules and truly become the party's ruler. Discipline as supervision within the party the specialized agency, we must strengthen the responsibility to act, adhere to the Impartial discipline accountability, earnestly will be strict discipline, discipline must be punished, and severely punish the acts in violation of rules and regulations.