With the adoption of the inversion of the burden of proof in medical malpractice disputes, it is imperative for hospitals to document, fix and keep intact evidence of their diagnosis, treatment and nursing activities in the course of delivering emergency care, testing and examination, diagnosis, treatment and nursing according to the evidence specifications for lawsuits and criminal suits and the demand for fixing and keeping intact evidence in an objective, genuine, timely, comprehensive and legal manner. This will enable hospitals to better deal with lawsuits involving medical malpractice disputes.

Objective:To evaluate the effect of pinus massoniana bark extract (PMBE) and grape seed extract (GSE) on dentin demineralization caused by acid.Methods:40 root dentin blocks with half of the surface covered were randondy divided into 4 groups (n =10).All samples were subjected to pH cycling for 8 days,and deionized distilled water(DDW),0.1％NaF,12％ PMBE solution and 12％ GSE solution were used as the experimental solutions in the 4 groups.The dentin mineral density(DMD) of the both sides was determined using micro-computed tomography.The D-value of DMD between nn-demineralized and demineralized side (△DMD)was calculated.The samples were observed with field emission scanning electron microscops (FE-SEM).Results:The △DMD of DDW,NaF,PMBE and GSE groups was 198.64 ±59.97,45.94 ±24.21,90.23 ±28.77 and 105.07 ±29.53 respectively.The △DMD between PMBE and GSE groups had no significant difference (P ＞ 0.05),which were both higher than that of NaF group (P ＜ 0.05) and lower than that of DDW group(P ＜ 0.05).The FE-SEM revealed that the dentin tubules in DDW group were completely open,but in NaF group were essentially closed in PMBE group and GSE group were spindle shaped or narrow crack opening.Conclusion:PMBE and GSE had almost the same effect on improving the acid resistance of dentin.

OBJECTIVETo investigate the distribution of HBV genotypes in Changzhou area and to clarify the genotype-related difference in the liver function, the level of HBV DNA and the long-term effect of lamivudine in the pathogenicity of HBV.

METHODSNested PCR and sequence analysis were conducted in 14 acute hepatitis (AH), 104 chronic hepatitis (CH), and 28 liver cirrhosis or hepatocellular carcinoma (LC/HCC) patients.

RESULTSOne hundred and forty six samples were positive for HBV DNA, and 51 samples were classified as genotype B (34.9%), 95 samples were classified as genotype C, serum ALT value was 383.8 +/- 335.7 IU in patients with HBV genotypes B, and 364.3 +/- 333.7 IU in genotypes C, HBV DNA value was 10(7.795 +/- 1.22) copies/ml in genotypes B and 10(7.69 +/0- 1.19) copies/ml in genotypes C, and there were 36 and 64 HBeAg positive cases in patients with genotypes B and C; there were no significant difference on the level of ALT, HBV DNA and the expression of HBeAg (P>0.05), but genotype C in LC/HCC was higher than CH (P<0.01). Twenty three genotype B and forty five genotype C patients received lamivudine treatment, after 48 weeks, 18 genotype B and 14 genotype C patients had higher ALT or HBV DNA positive.

CONCLUSIONSThese results indicate that genotype B and C existing Changzhou area; genotype C is associated with the development of severe liver disease and better therapeutic effect could be obtained in the patients with genotype C.

Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; genetics ; Female ; Genotype ; Hepatitis B ; complications ; drug therapy ; Hepatitis B virus ; genetics ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; etiology ; virology ; Liver Neoplasms ; etiology ; virology ; Male ; Middle Aged ; Polymerase Chain Reaction ; Treatment Outcome

Medical physicists play an important role in the delivery of radiotherapy. Compared with China′s mainland, Hong Kong has established a more mature training mode and a more complete management system for medical physics talents. In this article, the authors introduced the current state of medical physics talent training, as well as the recruitment, certification and promotion of medical physicist in Hong Kong by querying the official websites of medical physics organizations, reviewing related literature and interviewing senior medical physicists in Hong Kong. The authors also analyzed the shortcomings in the construction of medical physics talent system in China′s mainland and made valuable suggestions.

AIM: Given the biofilm formation abili- ty of different ST-type Klebsiella pneumoniae, our study was aimed at exploring the inhibitory and clearance of azithromycin combined with levofloxacin on the biofilm of Klebsiella pneumoniae of different ST-types and providing a new strategy for the prevention of biofilm formation in the treatment of post-infectious Klebsiella pneumoniae. METHODS: 9 strains of Klebsiella pneumoniae from all susceptibility groups, 19 strains of Klebsiella pneumoniae producing extended-spectrum β - lactamases (ESBLs), and 37 strains of Carbapenem-resistant Klebsiella pneumoniae (CRKP) were randomly collected from the samples of patients hospitalized in the First Affiliated Hospital of Wannan Medical College from August 2019 to November 2021. The isolates were identified using VITEK MS IVD KB V3.2 and VITEK 2-Compact 60. Multilocus sequence typing (MLST) was performed to analyze the homology of each strain; crystal violet staining was used for semi -quantitative detection of biofilm to compare the differences in biofilm formation ability between different ST-type Klebsiella pneumoniae. Different ST-type strains were selected, and the partial inhibitory concentration index (FICI) was calculated by micro broth dilution method to judge the combination effect and select the optimal combination concentration; crystalline violet staining method was used to investigate the inhibition and clearance effect of azithromycin combined with levofloxacin on the biofilm of different ST-type Klebsiella pneumoniae; laser scanning confocal fluorescence microscopy was used to observe the structural changes of the biofilm of Klebsiella pneumoniae before and after the effect of the antibacterial drugs. RESULTS: MLST typing results showed that the sensitive group of Klebsiella pneumoniae strains had 8 sequences such as ST86, ST727, etc., the ESBLs group strains belonged to 14 sequence types such as ST15, ST37, ST11, etc., of which ST15 accounted for 26.32% (5 / 19). The CRKP group strains belonged to 9 sequence types such as ST11, ST15, ST656, etc., of which ST11 accounted for 48.65% (18/37), ST15 accounted for 27.03% (10/37); ST15 (ESBLs), ST11 (CRKP), ST15 (CRKP) type Klebsiella pneumoniae biofilms all reached maturity on the 5th day, the ST15 (ESBLs) group had a stronger ability to produce material to be membranous than the ST15 (CRKP) group. The ST11 (CRKP) group had a stronger ability to produce material to be membranous than the ST15 (CRKP) group (P<0.01); the results of azithromycin combined with levofloxacin drug sensitivity showed that it had an additive effect on different ST-type Klebsiella pneumoniae bacteria; in the inhibition of biofilm formation and clearance test, the 2×MIC azithromycin group and the combined concentration group had a stronger inhibition of biofilm formation of different ST-type Klebsiella pneumoniae bacteria, and the inhibitory ability of the combined group was better than that of the single-drug group, and the highest inhibition rate could reach 89.93%; the clearance effects were all combined drug group>azithromycin>levofloxacin, and the highest clearance rate was 44.79%. CONCLUSION: There are differences in biofilm formation ability between different ST-type Klebsiella pneumoniae, and azithromycin combined with levofloxacin has a better inhibitory effect on different ST-type Klebsiella pneumoniae biofilm, conbined application can be used in the treatment of biofilm infections early stage.