Heilongjiang Provincial Hospital has scored an initial success in dealing with medical disputes since the medical liability insurance and third-party mediation mechanism were introduced into the hospital in 2013.The paper identified problems found in the practice,and recommended the following:rationalizing the cost of insurance coverage,expanding scope of third-party mediation properly,enhancing professional authority in assessment of medical dispute cases,simplifying insurance compensation procedure,and consolidating the legal status of the medical dispute mediation institutions,for better resolution of such disputes.

Objective To analyze the clinical features of 35 cases of Kennedy's disease and the correlation be?tween clinical features and CAG repeat size to strengthen the understanding of KD and to avoid misdiagnosis and delayed diagnosis.Methods Clinical data, including clinical signs and symptoms ,serum lipid, serum sex hormone level, electro?myography, the number of CAGs and (amyotrophic lateral sclerosis muscular atrophy,ALS) rating scale were collected from 35 patients genetically diagnosed of Kennedy disease and proceed system analysis. Results Patients with KD were adult onset with the average age of (40.77 ± 8.57) years and the average confirmed course were (8.32 ± 4.17) years. Forty-two point nine percent of the patients had family history. Clinical features included medulla oblongata and spinal muscular atrophy and weakness, limbs tremor, perioral muscles twitch and endocrine function and metabolic disorders in some cases. Creatine kinase, triglyceride, low density lipoprotein, follicle estrogen and prolactin were significantly in?creased compared to healthy adults (P:0.000,0.018,0.000,0.000,0.003). The number of CAG repeat was negatively correlated with the onset age (r=-0.549, P=0.001) but not associated with the illness severity (ALS rating scale) (r=0.001, P=0.998). ALS score was negatively correlated with course of disease(r=-0.540, P=0.001).Conclusions Chinese KD pa? tients share similar clinical phenotypes with those of other races but exhibit slightly different clinical characteristics. The length of the CAG repeat influences age at onset but not the severity of disease. Severity of disease is related to the course of disease.

Objective To observe the clinical efficacy of fire needling plus Chinese herbal medicine in treating alopecia areata. Method Fifty patients with alopecia areata were randomized into a treatment group of 35 cases and a control group of 15 cases. The treatment group was intervened by fire needling plus Chinese herbal medicine, while the control group was by oral administration of Chinese herbal medicine alone. The clinical efficacies were compared after 3-month treatment.Result The total effective rate was 97.1% in the treatment group versus 73.3% in the control group, and the difference was statistically significant (P<0.05).Conclusion Fire needling plus Chinese herbal medicine is an effective method in treating alopecia areata.

OBJECTIVE:To observe effects and safety of Kangfuxin solution combined with intense pulsed light in the treat-ment of rosacea. METHODS:A total of 50 rosacea patients in our hospital during May 2014-Jun. 2016 were divided into control group(25 cases)and observation group(25 cases)according to random number table. Based on oral administration of Metronida-zole tablets,control group received intense pulsed light. Observation group was additionally given Kangfuxin solution for local wet compress after 4 to 6 layers of gauze saturated with liquid,5-10 min,qn. Both groups received treatment for 4 weeks. Clinical effi-cacies,as well as symptom score and DLQI score were compared between 2 groups before and after treatment,and the occurrence of ADR was recorded. RESULTS:The response rate of observation group was 92.0%,which was significantly higher than 64.0%of control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in erythema,pap-ules,pustules,itching,telangiectasia score and total score,DLQI score with before treatment(P>0.05). After treatment,erythe-ma,papules,pustules,itching,telangiectasia score and total score,DLQI score of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). The incidence of ADR in observation group was 16.0%,which was significantly lower than 40.0% in control group,with statistical significance(P<0.05). CONCLUSIONS:Kangfuxin solution combined with intense pulsed light show significant efficacy for rosacea,and can effectively improve erythema,papules,pustules,itching and telangiectasia,and improve the quality of life with good safety.

Stigma is common in patients with head and neck cancer, which greatly affects their physical and mental health and the quality of life. This article summarizes the research progress of stigma in patients with head and neck cancer from the aspects of research status, measurement tools, influencing factors and intervention strategies, in order to provide a reference for carrying out the research on stigma in patients with head and neck cancer in China.

Objective:To translate the Cumulated Ambulation Score (CAS) into Chinese and test its reliability and validity in elderly inpatients, to provide a basis for assessing elderly inpatients′ basic mobility during hospitalization.Methods:This was a cross-sectional study. After obtaining the authorization of the original author, the Chinese version of CAS was formed by WHO′s cross-cultural translation process. A total of 414 hospitalized elderly inpatients from Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and Shanghai Yangpu District Kongjiang Hospital were selected between March and September 2021. Cronbach′s α coefficient was used to test internal consistency, linear weighted Kappa was employed to assess inter-rater reliability, and concurrent validity was examined using items related to mobility of Barthel Index scores as a reference standard.Results:Of the 414 patients, 221 were males and 193 were females, and the patients aged (76.67 ± 9.98) years old; 122 cases (29.5%) had a perfect score of 6 with normal basic mobility, 89 cases (21.5%) had a score of 0 with complete loss of mobility, and the remaining 203 patients had a score of 1-5 with varying degrees of reduced mobility. The Chinese version of CAS demonstrated good assessment performance for basic mobility in elderly inpatients with a Cronbach′s α coefficient of 0.952. Weighted Kappa values for individual items and total scores showed excellent agreement among raters (>0.85), while concurrent validity yielded a value of 0.935 ( P<0.01) when compared with Barthel Index scores.Total score of CAS was significantly correlated with item scores and total score of Barthel index ( r values were 0.423 to 0.944, all P<0.01). Conclusions:The Chinese version of CAS has good reliability and validity. The items are concise, clear and easy to understand. It is suitable as a preliminary screening tool for clinical departments to evaluate the basic mobility of elderly inpatients.

Objective To investigate whether Tian Jiu therapy can regulate Th1/Th2 ratio effectively for bronchial asthma patients.Methods A total of 30 bronchial asthma patients who were treated with Tian Jiu therapy in the hospital were enrolled in the study as patients group and 20 healthy individuals were enrolled as control group.The mRNA of T-bet,GATA3,Foxp3 and STAT-6 were detected by using realtime-PCR,while IFN-γ and IL-4 were detected by using ELISA for control group and patents group before and after treatment. Flow cytometry was used to detect Th1/Th2 ratio.Results After Tian Jiu therapy,Th2 proportion decreased and Th1/Th2 ratio increased,secretion of IFN-γ decreased,mRNA of T-bet and GATA3 significantly in-creased,while STAT-6 decreased significantly(P<0.05).Conclusion Tian Jiu therapy has therapeutic effect on bronchial asthma patients through decreasing Th2 proportion and regulating Th1/Th2 ratio.

Objective:To evaluate the knowledge of autism among child health care professionals in primary health care institutions.Methods:The study was a cross-sectional survey. An online questionnaire survey was conducted from February to March 2023 in primary health care institutions in Guangzhou to investigate the knowledge on autism among medical staff engaged in children′s health services and the influencing factors.Results:A total of 341 questionnaires were returned and 312 questionnaires were valid with a recovery rate of 91.5%. The age of 312 respondents was (35.9±7.9) years, of which 303 (97.1%) were female. One hundred and fifty-two (48.7%) child health care professionals in primary health care institutions had received specialist training in assessing the psychological and behavioral development of children, and only 139 (44.6%) reported that they were aware of the"five no"principle for early identification of autism. The questionnaire scores were 88.1% pass (275/312) and 53.2% excellent (166/312). The three questions with low accuracy were: autism can be cured with drugs, autism has a genetic basis and rehabilitation training has no effect, and the accuracy for these questions was 42.6% (133/312), 52.2% (163/312) and 70.2% (219/312), respectively. The passing of autism-related knowledge was positively associated with receiving relevant training ( OR=2.585, 95% CI:1.200-5.569), and the excellence was positively associated with the highest education ( OR=1.939, 95% CI:1.220-3.083) and receiving relevant training ( OR=2.016, 95% CI:1.247-3.260). Conclusions:There is a need for more professional training in autism knowledge among child health care professionals in primary health care institutions.

Objective To study the effects and mechanism of norcantharidin(NCTD)on proliferation and apoptosis of NB4 and K562 human leukemic cells by regulating phosphoprotein phosphatase 5 catalytic(PPP5C).Methods PC3.1 and PPP5C-PC3.1 plasmids were electroporated into NB4 and K562 cells.Stable NB4 and K562 cell lines were selected with geneticin(G418).Protein and mRNA expression levels of PPP5C were measured by Western blot and RT-qPCR,respectively.Proliferation,migration,and apoptosis of NB4 and K562 cells were determined by a CCK-8 assay,transwell assay,and Live & Dead? animal cell viability/toxicity detection kit,respectively.NB4 and K562 cells were divided into 0 μg/mL NCTD group and various NCTD dose groups,and cultured in RPMI 1640 medium containing 0,8,16,or 32 μg/ml NCTD.The Live & Dead? animal cell viability/toxicity detection kit measured the numbers of dead and live cells,and cell morphology was observed under a microscope.Western blot was used to measure protein expression levels of caspase 3,Cleaved caspase 3,JNK,p-JNK,p38,p-p38,and α-Tubulin.Results Proliferation,migration,and apoptosis of NB4 and K562 cells were enhanced by overexpression of PPP5C.Compared with 0 μg/mL NCTD group,NCTD promoted apoptosis in a dose-dependent manner.PPP5C overexpression antagonized the killing effect of NCTD on leukemic cells.Mechanistic investigations showed that PPP5C reduced the protein level of p-JNK by dephosphorylating and regulating the expression of apoptosis-related protein Cleaved caspase 3.Conclusions NCTD promotes apoptosis of NB4 and K562 cells and inhibits their proliferation by inhibiting PPP5C.

Objective:To estimate tissue/organ doses and effective dose to operators in the overexposure incident during an interventional procedure using Monte Carlo method.Methods:The phantoms were constructed for both the operators and the patient based on the adult mesh-type reference computational phantoms (MRCPs) recommended by the International Commission on Radiological Protection (ICRP) Publication 145 and phantom deformation technology. Models of exposure scenario were constructed based on the on-site equipment and the irradiation conditions. The Monte Carlod simulation method was used to evaluate the absorbed dose to critical tissues and organs, such as the operator′s eye lens and thyroid, as well as the effective dose.Results:In the particular exposure conditions, the maximum absorbed doses in the primary organs of the two operators were in the left eye lens, with doses of 1.216 and 0.223 mGy, respectively. The thyroid absorbed doses were 0.074 and 0.019 mGy, while the effective doses to the two operators were 0.088 and 0.021 mSv, respectively. The reduction rates of effective dose for the two operators when wearing lead aprons and lead thyroid collars were 67.16% and 78.79%, respectively.Conclusions:The combination of Monte Carlo method and MRCPs can be used to restore a specific irradiation scenario to a high degree and to estimate the physical dose of to the irradiated persons.