The paper analyzes the potential drawbacks of the current medical liability insurance from the perspectives of hospitals, insurance companies and patients. It puts forward suggestions for the sustainable development of medical liability insurance, viz. involvement of insurance brokers in coordinately solving the issue of application for medical liability insurance, involvement of loss assessors in solving medical disputes, adoption of compulsory medical liability insurance in due time, and further expansion of the scope and categories of insurance.

The force of hospital culture is a kind of flexible spiritual productivity.First,it can improve in a comprehensive way the quality of a team and the ideological level of all the employees,make the cultural content permeate the various layers within the organizational framework,and ensure that the employees fulfill quality and quantity requirements in completing their tasks.Second,it can impel people to have a sense of identification,mission and pride concerning the hospital's overall objectives,increase the initiative of both individuals and the organization,and result in the exercise of self-control and self-management on the basis of mechanisms and ideology.Third,it can create a life-learning environment for the employees,raise their awareness of and capability for innovation and the hospital's mechanisms for innovation,and bring about enduring spiritual support to the core values of the hospital.Finally,it can make patients associate the hospital with a unique image of service,create a unique culture of service,and increase patients' trust in the hospital.

Excessive and fast rise of medical expenses in China recent years has worsened the financial burden of both the government and individuals alike,making it a hotspot issue countrywide.To alleviate the difficulties of "accessibility to medical services" and "poverty or repoverty resulting from sickness" faced by the Chinese people at large,we built a multi-factor analysis model to identify key factors contributing to such a fast rise of medical expenses based on an analysis of the medical expenses in Shandong Province.In addition,we discussed the causes for GDP and headcount of medical staff in relation to the rise of medical expenses,and the strategies to curb expenses.

MicroRNA-375 (miR-375) is closely related to the development of cancer,such as liver cancer,gastric cancer,pancreatic cancer,endometrial cancer,esophageal cancer,non-small cell lung cancer,etc.The mainly tumor pathogenesis related miR-375 includes that miR-375 is combined with specific target genes,can degrade mRNA or inhibit protein translation in the transcriptional level,and plays antitumor effect of inhibition of cell proliferation,promoting cell apoptosis and inhibiting the invasion and metastasis.miR-375 is expected to be a new target for cancer therapy,which may become an important biomarker for the diagnosis,treatment and prognosis of cancer.

Objective To investigate the association between the neck circumference and central obesity in the elderly.Methods The neck circumference(NC),height,weight,waist circumference (WC) and hip circumference(HC) of 2820 subjects aged over 60 years were detected from some communities in Nanchang.All subjects were divided into different groups,according to the two different obesity indicators of WC and BMI.The relationship between NC and obesity was analyzed.A multiple linear regression analysis was conducted using the Enter method.An R()C curve analysis was employed to judge the tangent point of NC in central obesity.Results The height,weight and BMI were reduced along with age (all P＜0.05),and the waist hip ratio(WHR) was increased along with age(P＜0.01) in the elderly.The NC was decreased along with age in males(P＜0.01),and the WC was increased along with age in females(Pt＜0.01).The NC was longer in males than in females [(36.5±3.0) cm vs.(32.6±2.4) cm,P＜0.01].The NC was increased along with body weight,WC and BMI in the elderly:with each 1 kg increase in body weight,the NC was increased by 0.079 cm in males and 0.139 cm in females;with each 1cm increase in WC,the NC increased by 0.073 cm in males and 0.040 cm in females;with each 1 kg/m2 increase in BMI,the NC increased by 0.121 cm in males and 0.065 cm in females;with 1 year increase in age,the NC was decreased by 0.033 cm in males(all P＜0.05).when obesity was diagnosed according to both BMI and NC,the NC was longer in the obesity group than in the control group,(P ＜ 0.01).The area under receiver operating characteristic(ROC) curve of NC for diagnosing central obesity showed that the area was 0.802 and 0.743 in males and females,and the optimal cut-off value of NC was 36.85 cm and 31.75 cm in males and females,respectively.Conclusions NC is increased along with the increases of body weight,WC and BMI in the elderly.NC is significantly associated with central obesity.NC is more predictive of the central obesity when the value ＞36.85 cm in males and ＞31.75 cm in females.

Objective To summarize the method and effects of extracorporeal membrane oxygenation (EC-MO) for eight patients with sever heart or(and) lung diseases,and to get some reliable advises by analysis of retro-spoctive indications,timing and result in ECMO therapy. Methods Eight patients,aging from 26 to 82 and weighted from 57-87 kg were observed. Vein-artery ECMO was used in all patients,with the flow in 40-70 ml/(kg·min) and the activated clotting time(ACT) kept at 160-200 s. Results The time of ECMO support varied from 9.5 h to 84.1 h;Among the eight patients,one didn't weaned from ECMO and died,two who were weaned died 38 h ,6 h af-ter ECMO;five patients weanned succsesefully from ECMO and discharged. Conclusions ECMO do well in treat-ment of severe cardiopulmonary failure, resuscitation and support post cardiosurgery,and the indication and timing performance are important to the final result.

AIM: To investigate the effect of a Chinese medicime, Dan-Shao-Hua-Xian capsule, on liver fibrosis induced by CCl_4 by observation of apoptosis and cell cycle variation in the liver cells. METHODS: Animal models were produced through eight-week treatment of the rats with CCl_4, alcohol and diet of high fat/low proteins, and then administration of Dan-Shao-Hua-Xian to the rats (1 g/kg) via stomach-tube-pouring for eight weeks was performed. Liver index, serum hyaluronic acid (HA) and glutamate pyruvate transaminase (ALT) were measured and hydroxyproline (Hyp) content in urine were determined. The extent of the liver fibrosis was observed under light microscope and apoptosis and cell cycle were also examined by cytometry between the two groups. RESULTS: Compared to the liver fibrosis group, the liver index, serum HA, ALT in the treatment group decreased, the development of liver fibrosis delayed, the urine Hyp and the number of apoptosed cells and the ratio of G_0/G_1 cells increased, as well as the S phase cells decreased, yet unable to return to normal. All those changes detected were statistically significant. CONCLUSIONS: The Dan-Shao-Hua-Xian is effective in treating the CCl_4-induced liver fibrosis in rats partly by virtue of inhibition of the growth of hepatic stellate cells and induction of apoptosis.

Objective To discuss the association of allele polymorphisms SNP-rs1799724(C>T)in the TNF-αand SNP-rs11559013(G>A)in the ALCAM with HCV chronic infection in Han population in Yunnan province. Methods 434 HCV chronic infectious patients and 444 healthy individuals of Han Chinese population in Yunnan province were recruited. Two single nucleotide polymorphisms(SNPs)in the SNP-rs1799724(C>T) of TNF-αgene and SNP-rs11559013(G>A)of ALCAM gene were determined by real-time TaqMan polymerase chain reaction. We evaluated the associations of the two SNPs with HCV chronic infection. Results The distributions of allele and genotype of SNP-rs1799724(C>T)in the TNF-αand SNP-rs11559013(G>A)in the ALCAM between hepatitis C virus(HCV)chronic infectious patients and the healthy controls were not statistically significant(P > 0.05). Conclusion SNP-rs1799724(C>T)in the TNF-αand SNP-rs11559013(G>A) in the ALCAM have no association with HCV chronic infection in the Han population in Yunnan province.

OBJECTIVETo assess the association of single nucleotide polymorphisms (SNPs) of the low molecular weight polypeptide (LMP) gene with chronic hepatitis C virus (HCV) infection among ethnic Han population from Yunnan.

METHODSA total of 427 patients with chronic HCV infection and 412 healthy controls were recruited. SNPs rs1351383, rs17587 and rs2127675 from the promoter region of the LMP2 gene and rs2071543 from the promoter region of the LPM7 gene were genotyped using a TaqMan probe. The haplotypes were constructed. Frequencies of various alleles, genotypes and haplotypes of the selected SNPs were calculated, and their association with chronic HCV infection was analyzed.

RESULTSThe frequencies of rs1351383 and rs2127675 alleles of the LMP2 gene, as well as the A-G-A and C-G-G haplotypes of the rs1351383/rs17587/rs2127675 loci, had differed significantly between the two groups (P<0.05).

CONCLUSIONThe C allele of the rs1351383 locus and G allele of the rs2217675 locus of the LMP2 gene may be susceptible factors for chronic HCV infection among ethnic Han people from Yunnan. The A-G-A haplotype of the rs1351383/rs17587/rs2127675 loci may confer a protective effect, while the C-G-G haplotype may be a susceptible factor for chronic HCV infection in this population.

Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; China ; Female ; Gene Frequency ; genetics ; Genetic Predisposition to Disease ; genetics ; Haplotypes ; genetics ; Hepatitis C ; genetics ; Humans ; Male ; Peptides ; genetics ; Polymorphism, Single Nucleotide ; genetics

OBJECTIVE: To retrospectively analyze the results of chromosomal microarray analysis (CMA) and parental origins of unbalanced translocations among 17 patients, so as to provide reference for their genetic counseling. METHODS: The results of CMA for 7 001 samples tested in Chengdu Women and Children's Central Hospital from January 2019 to January 2022 were retrospectively reviewed. Unbalanced reciprocal translocation was defined as two non-homologous chromosomes with lost and gained segments respectively or both with gained segments, and their parental origins were identified by parental chromosomal karyotyping and/or fluorescence in situ hybridization (FISH). RESULTS: In total 17 unbalanced translocations were identified. In three cases, two non-homologous chromosomes both had gained segments, which constituted a derivative chromosome, with the total number of chromosomes being 47. In the remaining 14 cases, there was a terminal deletion on one chromosome and a terminal duplication on the other, 10 of which were confirmed by karyotyping, with the total number of chromosomes being 46. In the derivative chromosome, the lost segment was replaced by a gained segment from another chromosome. Among 15 cases undergoing parental origin analysis, 12 had paternal or maternal chromosomal abnormalities, including 11 balanced translocations and 1 unbalanced translocation. The unbalanced gametes therefore may form through meiosis. In 3 cases, the parental chromosomes were normal, indicating a de novo origin. CONCLUSION Discovery of terminal duplication and deletion or gained segments on two non-homologous chromosomes by CMA is suggestive of parental balanced translocation, which can facilitate genetic counseling and assessment the recurrence risk for subsequent pregnancies.
Child ; Pregnancy ; Humans ; Female ; In Situ Hybridization, Fluorescence ; Retrospective Studies ; Translocation, Genetic ; Microarray Analysis ; Chromosomes