As the public sanitation product of the government for the society,most of the public hospitals have the privilege of the free taxations and the finance subsidies.In theory,the hospitals have the duty to offer all the patients the timely and rational cure,especially the dying patients.In reality,some hospitals often appear some kinds of nonfeasance unfortunately when they face the dying patients because of the public policy and the private rule "ready money cure".The direct aftereffect is that the patient will get worse or even die.Consequently,it's necessary to confirm the characters and the components of the nonfeasance theoretically.Thus it's easy to distinguish the hospital duty and the patient right and also the legal relationship between them on further degree,and the liabilities in accordance.

Although dyslipidemia is common in the patients with end-stage renal disease undergoing dialysis, it is still controver-sial in the efficacy and safety of lipid-modulating agents used in the patients. In this paper, current large-scale randomized controlled trials and observational studies were reviewed, and the influence and characteristics of dyslipidemia as well as the application of com-mon lipid-modulating agents in dialysis patients were summarized. The current clinical evidence suggested that the use of statins with or without ezetimibe could effectively reduce the level of blood lipid in dialysis patients without increased risk of adverse events, while it had limited role in cardiovascular protection;fibrates had higher risks in dialysis patients; nicotinic acids had limited use mainly be-cause of their unbearable side effects.

Objectives To study the induction and tolerance properties of antigen-specific T cell anergy.Methods APC:T:B cell reactive system was established in vitro.T cell proliferation was analyzed by using 3H-TdR incorporation in the blockade of B7/CD28 with B7-1 mAb and CsA.B cell antibody production was assayed by using ELISA ResultsAntigen-specific T cell anergy can be successfuily induced by the combination of CsA and B7-lmAb in vitro.Anergic T cell can not produce IL-2.but can secrete IL4.Anergic T cells can inhibit MLR.B cell proliferation and specific antibody production.Exogenous IL-2 can prevent T celt anergic induction,but can not reverse the state of tolerance.Conclusions Antigenspecific T cell anergy could be induced by CsA-combined with B7-1 mAb,which would provide theoretical evidence for prevention of transplantation rejection.

Objective To investigate the drug resistance of Staphylococcus haemolyticus and provide basis for selection of clini‐cal drugs .Methods A total of 59 strains of Staphylococcus haemolyticus were isolated from patients ,and analyzed the clinical dis‐tribution and drug resistance of them .Results Staphylococcus haemolyticus were mainly isolated from the sputum and oropharyn‐geal swabs in pediatric and ICU .The patients were mainly newborns .Staphylococcus haemolyticus mainly included methicillin re‐sistant Staphylococcus haemolyticus (MRSH) ,accounting for 89 .8% (53 strains) .MRSH showed high‐drug resistance and multi‐drug resistance .However ,it was sensitive to vancomycin ,teicoplanin and linezolid ,the antibiotic sensitive rate was 100 .0% .Conclu‐sion Staphylococcus haemolyticus is an important coagulase negative staphylococci ,mainly including MRSH ,which shows high‐drug resistance and multi‐drug resistance .

Objective To observe the effect and its factors of open reduction and internal fixation of calcaneal fractures,and the influencing factors.Methods A retrospective analysis of 116 cases of calcaneal fracture were made.All patients were treated with open reduction and internal fixation,the effect was evaluated by Maryland foot score.The relation of the data before surgery (sex,age,cause of injury,associated injuries,injury and surgery,frac-tures sanders classification,opening and closing,diabetes,smoking history)and the effect,the surgical data (graft case,fixation,fractures,postoperative Bohler angle)and the effect were analyzed.The independent factors of the effect were analyzed by Logistic regression analysis.Results 116 patients with calcaneal fracture had been followed up for 6 -12 months,the excellent -good rate of Maryland foot score was 74.14%.Univariate analysis showed that different types of fractures,open and closed,with or without diabetes,with or without a history of smoking,different fixation methods,different fractures,patients with different postoperative Bohler angle foot function excellent rate differences were statistically significant (χ2 =17.194,4.077,6.766,9.116,5.136,6.919,4.458,all P <0.05).Logistic regres-sion analysis showed that the type of fracture,fixation,fractures,postoperative Bohler angle were independent risk factors for foot function excellent rate(OR =0.052,0.048,0.056,0.386,all P <0.05).Conclusion It has exact efficacy for open reduction and internal fixation with calcaneal fractures,the fracture type,fixation,fractures,postoper-ative Bohler angle are independent risk factors for affecting the calcaneal fractures patients.Perioperative treatment should take appropriate measures to avoid adverse factors affecting the efficacy of improved clinical efficacy.

Objective To study Tephroseris Kirilowii Turez.Houlub extract on cell cycle and apoptosis marker AnnexinV/PI of U266 in vitro..Methods U266 cells were cultured together with Tephroseris Kirilowii Turez.Houlub extract.Cell cycle and apoptosis marker AnnexinV/PI were detected by flow cytometry(FCM).Results After exposure of U266 cells to Tephroseris Kirilowii Turez.Houlub extract.the cell cycle distribution was changed.There Was a decrease of cells in the G0/G1 phase with an increase of cells in the S phase and G2/M phase and apoptosis.FCM with staining of Annexix V FITC/PI showed a dependence of apoptotic cells with the dosage of Tephroseris Kirilowii Turez.Houlub extract.Conclusion Tephroseris Kirilowii Turez extract has strong cell apoptosis effect on U266 cells.

BACKGROUND:Whether adipose-derived mesenchymal stem cells are able to exert immunomodulatory effects in the treatment of myocardial infarction, as wel as the best time, is less reported.
OBJECTIVE:To observe the effect of adipose-derived mesenchymal stem cells on inflammatory reaction and ventricular remodeling after myocardial infarction, and to explore the possible mechanisms of adipose-derived mesenchymal stem cells for the treatment of myocardial infarction.
METHODS:Enzyme digestion method was employed to isolate and culture rat adipose-derived mesenchymal stem cells. By ligation of the left anterior descending coronary artery, we established animal models of myocardial infarction in 40 rats. The rats were randomly divided into four groups:sham group, control group (injected high-glucose Dulbecco’s modified Eagle’s medium), 3-hour transplantation group (transplanted adipose-derived mesenchymal stem cells after 3 hours of myocardial infarction), 7-day transplantation group (transplanted adipose-derived mesenchymal stem cells after 7 days of myocardial infarction). After 14 days of operation, the levels of tumor necrosis factor-αand interleukin-10 in the plasma were detected by enzyme linked immunosorbent assay. After 28 days of operation, the left ventricular end diastolic diameter, left ventricular end systolic diameter, left ventricular ejection fraction and left ventricular fractional shortening were measured by echocardiography.
RESULTS AND CONCLUSION:Compared with the control group, in the 3-hour transplantation group and 7-day transplantation group, the levels of tumor necrosis factor-αwere significantly lower (P<0.01), and the levels of interleukin-10 were significantly higher (P<0.01) at postoperative 14 days;the left ventricular end diastolic diameter and left ventricular end systolic diameter in the two transplantation groups were also significantly smal er (P<0.05), but left ventricular ejection fraction and left ventricular fractional shortening were significantly elevated (P<0.05), which was more apparent in the 3-hour transplantation group than the 7-day transplantation group. Adipose-derived mesenchymal stem cells transplantation in acute phase of myocardial infarction can suppress the inflammatory response, regulate the cytokine network equilibrium, and thus delay ventricular remodeling and improve cardiac function.

Apoptosis ; Cell Proliferation ; Cell Transformation, Neoplastic ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; MicroRNAs ; classification ; genetics ; metabolism ; physiology ; Neoplasms ; genetics ; metabolism ; pathology ; Signal Transduction

Objective To evaluate the therapeutic efficacy of YunKe and prednisone on moderate and severe thyroid associated ophthalmopathy(TAO).Methods 1 08 hyperthyroidism patients with moderately severe TAO were randomly divided into YunKe group,hormone group and the control group.All of the patients were given anti -thyroid medication(ATD)treatment.By thyroid hormone level upper limit every times higher than normal for a sulfhydryl imidazole 5mg/day to calculate daily dosage,based on thyroid hormone level adjusted a sulfhydryl imidazole dose every two weeks,make thyroid hormone levels in the normal range.YunKe set:intravenous push note YunKe per day A +B agent four groups (including cloud 20mg),each treatment medicine for five days in A row,interval of 25 days to the next period of treatment,medication six procedures.Hormone group:oral prednisone for 6 months,monthly dose in the order 1 mg·kg -1 ·d -1 ,0.75mg·kg -1 ·d -1 ,0.5mg·kg -1 ·d -1 ,0.25mg·kg -1 ·d -1 ,0.1 25mg·kg -1 ·d -1 , 0.062 5mg·kg -1 ·d -1 ,1 time a day,took at 8 o'clock in the morning.The control group treated ATD.Before and 6 months after treatment,all of the patients were checked the TNF -αand TRab,CT scan to measure degree of exophthalmus.Six months after treatment,respectively,on the basis of TAO classification (NOSPECS)and TNF -α, TRab level changes to determine the efficacy of treatment.Data entry Excel 2003 statistical software,used SPSS 1 9.0 statistical software to analyze data.Non parametric tests of three groups of data with Kruskal Wallis test.Not matching the two independent samples nonparametric test with the Mann -Whitney test,with P <0.05 for the difference was statistically significant.Results The markedly effective rate,effective rate and ineffective rate of YunKe group were 36.1 %,47.2% and 1 6.7% respectively,which of the hormone group were 20.0%,37.1 % and 42.9%,which of the control group were 1 3.9%,22.2% and 63.9%.The efficacy among the three groups had statistically significant differences (Kruskal -Wallis χ2 =1 0.736,P =0.005 ).The lighter exophthalmos,tge curative effect was better (Mann -Whitney Z =-4.599,P <0.001 ).The changes of TNF alpha,TRab levels among the three groups had significant differences(YunKe group,the TNF alpha,TRab levels markedly reduced 75.0% and 80.6%,respectively, which of the hormone group were 37.1 % and 34.3%,which of the control group were 1 9.4% and 27.8%,TNF χ2 =23.527,P <0.001 ;TRab χ2 =23.831 ,P <0.001 ).Conclusion The therapeutic efficacy of YunKeon TAO is better than prednisone,but the long -term effect deserves more investigation.