The crime of accident of medical treatment is the new crime added to the Criminal law of 1997.Since it appeared in the Criminal law of 1997,there have been many debates about it.One of them is how to comprehend the "serious hurt".I think the prescript itself lacks pertinence and we should make the GBH as the standard of judging the "serious hurt".

BACKGROUND:Bone marrow mesenchymal stem cel s are likely to repair renal injury by differentiating into renal parenchymal cel s. OBJECTIVE:To explore the effect and mechanism of bone marrow mesenchymal stem cel s in the renal repair after mesangial proliferative glomerulonephritis. METHODS:Thirty Sprague-Dawley rats were randomized into normal group, model group and treatment group (n=10 per group). Model group and treatment group were treated with tail vein injection of mouse anti-rat monoclonal antibody Thy1.1 to prepare mesangial proliferative glomerulonephritis models. One week after modeling, rats in the treatment group were given 2×106 bone marrow mesenchymal stem cel s via the tail vein, and rats in the other two groups were given the same volume of normal saline. Two weeks after transplantation, urinary protein, urea nitrogen, creatinine levels were detected;hematoxylin-eosin staining was used for observing pathological changes of the renal tissue under microscope;and the expression of transforming growth factor beta 1 was detected by immunohistochemistry method. RESULTS AND CONCLUSION:The levels of urinary protein, urea nitrogen and creatinine as wel as the expression of transforming growth factor beta 1 in the renal tissue arranged in descending order were listed as fol ows:model group>treatment group>control group, and there were significant differences among three groups (P<0.05). In the model group, diffuse glomerular hyperplasia was observed with the presence of increased extracel ular matrix, partial glomerular sclerosis, and interstitial infiltration of inflammatory cel s;in the treatment group, glomerular hyperplasia, mesangial proliferation and inflammatory cel infiltration were al mitigated compared with the model group. Therefore, bone marrow mesenchymal stem cel transplantation may contribute to renal repair after mesangial proliferative glomerulonephritis, by inhibiting overexpression of transforming growth factor beta 1 in the kidney.

Objective From knowledge,attitude,practice,and environment dimensions to investigate the status of oral health self-management in adolescents receiving fixed orthodontics and analyze its influencing factors.Methods A self-designed questionnaire developed from an evaluation index system for adolescents receiving fixed orthodontics was used to investigate 300 adolescent orthodontic patients in a stonatological hospital in Shanghai,who were 11 to 17 years old,receiving fixed orthodontics for more than three months.Results For adolescents receiving fixed orthodontics,self-management knowledge score was 0.99-±0.18,attitude score was 0.92±0.13,practice score was 1.11±0.21,and environment score was 0.66±0.15.The scores of oral health self-management knowledge,attitude,practice,and environment were significantly different between boys and girls(P＜0.01).There was significant difference in the scores of oral health self-management practice in adolescents with different age(P＜0.05).The scores of oral health selfmanagement were significantly different for adolescents with different stages of receiving fixed orthodontics(P＜0.05).Multiple stepwise regression analysis showed that oral health self-management status was affected by gender and age.Conclusion The oral health self-management status of adolescents receiving fixed orthodontics needs to be further improved.Female adolescents have better oral health self-management status than male adolescents.The increasing of age cannot necessarily improve self-management status.Orthodontic time has the greatest influence on oral health self-management practice.Medical staffs can provide targeted health education and guidance based on the status and influencing factors for adolescent orthodontic patients in order to improve their oral health self-management status.

Abstract: Objective To construct a shuttle vector pHT315-AaCPR100A with two spore-producing-dependent promoters and the target gene AaCPR100A in Escherichia coli-Bacillus thuringiensis. Methods The forward promoter of Cry3A, named Pro-1 (+), was amplified by PCR using pSVP27A plasmid as the template, and the target gene AaCPR100A was amplified using Aedes aegypti RNA reverse conversion cDNA as the template. The plasmid pHT315 was linearized by digestion with Hind Ⅲ and Sal Ⅰ. The forward promoter and the target gene were inserted into the linearized vector pHT315 successively by in-fusion cloning according to the transcription direction. The synthesized plasmid containing the Cry3A reverse promoter sequence was used as the template, and the Pro-1 (-) reverse promoter was amplified by PCR. The intermediate vector containing the forward promoter and the target gene was linearized by EcoR I restriction enzyme, and the reverse promoter was inserted downstream of the target gene by in-fusion cloning in the direction of transcription. Results By agarose gel electrophoresis, the forward promoter, target gene AaCPR100A and reverse promoter bands were clear and of good quality, which could be used for in-fusion cloning experiments. The two spore-producing-dependent promoters and target gene fragments were connected by In-fusion cloning. The recombinant vector pHT315-AaCPR100A was verified by PCR. The forward promoter, target gene fragment and reverse promoter were successfully amplified in the recombinant vector. Nucleotide sequencing verified that the sequencing results of the bidirectional promoter sequence and the target gene sequence were basically consistent with the sequence alignment results, which met the requirements of the construction of vector elements and proved that the recombinant vector was successfully constructed. Conclusions Based on the above results, this study proves that the recombinant shuttle vector with two spore-producing-dependent promoters can be successfully constructed by in-fusion cloning technology, laying the foundation for the construction of engineered Bacillus thuringiensis expressing dsRNA of AaCPR100A.

Objective To analyze clinical outcomes of the spouse donor kidney transplantation for evaluating the security.Methods Sixty-three cases of living-renal transplantation were divided into two groups, spouse donor group (12 cases) and the other related donor group (53 cases). Twelve cases of spouse-donor(SD)renal transplantation were summarized, that were compared with the nospouse transplantation cases of the other living-related renal transplantation in the same period, which were similar in basic conditions and in immunosuppressant scheme. The observational parameters included average hospitalization time, rate of acute renal necrosis, acute rejection incidence within 1 year, serum creatinine at 7 d, 30 d and 1 year after transplantation.Results The recipient age of the 2 groups was (39±3)years and (37±3)years(P=0.05), dialysis time was (4.7±3.2)months and (4.4±2.9)months(P=0.78), the average hospitalization time was (20.9±8.3)d and (23.0±7.8)d(P=0.41). There was no significant difference between the spouse donor group and the no spouse related donor group. The acute rejection incidence within 1 year was 33.3%(4/12) in spouse group and 3. 9%(2/51) in the other related group, there was significant difference between the 2 groups(P＜0.05). The rate of acute renal necrosis was 16.7%(2/12) in spouse group and 3.9%(2/15)in no spouse related group, there was no significant different between the 2 groups(P＞0.05).SCr was (206.47±47.22)μmol/L and (163. 75±25.91)μmol/L in spouse group at post-operation 7 d and 30 d, and was (142.79±89.42)μmol/L and (119. 99±15.03)μmol/L in no spouse group. There was significant difference between the groups(P=0.02, P=0.00). One year after operation, SCr was (133. 40±6. 11)μmol/L in spouse group and (121. 00±34.12)μmol/L in no spouse group,there was no significant difference between the 2 groups (P=0.25).Conclusions Preoperative comprehensive assessment of the spouse donors and recipients renal transplantation is the guarantee for the success.Short-term outcomes of spouse donor renal transplantation is ideal, but rate of acute rejection within 1 year is higher than that of the other living-relative donor kidney transplantation, which dose not influence the long-time survival of spouse recipients.

Objective To analyze the clinical outcomes and evaluate the safety of living related live donors in kidney transplantation.Methods One hundre and thirty-two cases of living related donors were studied retrospectively for psychological and physiological parameters. The parameters including life quality, urinalysis, serum biochemistry tests, glomerular filtration rate (GFR) and endogenous creatinine clearance rate (CCr) were analyzed.Results There was no significant difference between living related donors and normal people in the aspect of life quality. In living related donors,SCr was (78.33±15.94)μmol/L before operation and was (108.49±19.88)μmol/L at 7 days postoperation, P＜0.05. SCr was (112.47±20. 38)μmol/L at 6 months post-operation. There was no significant difference in SCr levels between 7 days and 6 months post-operation (P=0. 109). CCr was (95.80±20.92)ml/min in pre-operation and was (57.36±14. 92)ml/min at 7 days post-operation,P＜0.05. CCr was (65. 49±8. 25) ml/min at 6 months post-operation. There was no significant difference in CCr between 7 days and 6 months post-operation.The pre-operative total GFR was(74.08±18.51)ml/min. Of which, the right kidney GFR was (38.43±10.33)ml/min. The residual right kidney GFR was (56. 49±13. 01 ) ml/min 6 months after operation, which decreased 17. 59 ml/min (23.8%) compared with pre-operative total GFR (P＜0.05) and increased 18. 06 ml/min (47.0%) compared to the pre-operative right kidney GFR. Surgical complications included 1 case of splenectomy, 1 case of descending colon rupture and 5 cases of wound fat liquefactions.Conclusion Pre-operatively systemic psychological and physiological evaluation on living related donors, detailed consent consultation, standardized operating techniques, careful perioperative management and strict follow-up can improve the safety of living related donors.

Objective To investigate the status of humanistic care on patients with cardiac surgery of operating room nurse and explore the implementation of perioperative humanistic care on patients with cardiac surgery.Methods Purposive sampling method was used to deeply semi-structured interview 10 operating room nurses in a class-three grade A hospital of Guangxi from July 2016 to August 2016. The interview data was analyzed by using Colaizzi analysis method.Results There were three themes. The knowledge level of humanistic care was related to seniority, professional title and practical experience. The poor performances in the implementation of humanistic care were as following: the preoperative interview was not in place, nurses were lack of effective communication skills, and nurses did not pay attention to the protection of the privacy of patients and postoperative visits. The implementation of humanistic care improved the satisfaction of patients. Conclusions Operation room managers should arrange humanistic care topics and fully implement the humanistic nursing care of patients undergoing cardiac surgery in operation room so as to improve the patients' satisfaction.

Objective To understand the situation of nursing teamwork against a background of high-quality nursing service and to explore the influencing factors of nursing teamwork so as to find out practical solutions to improve the level of nursing teamwork.Methods A total of 380 nurses of a classⅢ grade A general hospital in Shanghai Municipality were investigated with the nursing teamwork survey (NTS) by cluster sampling in June 2016. The data were analyzed with SPSS 20.0.Results The median of the total score of NTS among nurses was 4.31 (the full marks are 5). The scores of four dimensions from the highest to the lowest were: team leader (4.75), shared mental models (4.50), trust and support (4.38), team-oriented (4.00). The influencing factors of nursing teamwork included departments, weekly working hours, overtime hours and most often shift nearly three months, whether planed to leave current operating post and departments human resource allocation with significant differences (P<0.05).Conclusions There is still room for improvement in nursing teamwork. Promot teamwork among nurses through reasonably allocating nursing human resources, scientifically scheduling, strengthening humanistic concern and reducing negative effects.

Objective:To explore the effectiveness of body weight support in gait training after surgery for an ankle fracture.Methods:Thirty-eight ankle fracture patients who received surgery were divided at random into an observation group and a control group, each of 19. In addition to 3 sessions of routine gait rehabilitation training a week for 6 weeks, only those in the observation group received body weight support training with body weight support boots. Gait data were collected using the GaitWatch three-dimensional gait action capture and training system before the training and after 2, 4 and 6 weeks of the training.Results:At each assessment the gait frequency, gait cycle, stride length, stride rate, bilateral step length, step length deviation, bilateral support phase and bilateral swing phase of both groups had improved significantly. After 6 weeks the average stride frequency, gait cycle, stride length on both sides and speed of the observation group had improved significantly more than among the control group. Step length deviation was not significantly different, however. At each evaluation the proportions of affected and healthy side support had decreased significantly in both groups, but affected and healthy side swing had increased and the proportion of bilateral support had decreased significantly.Conclusion:Body weight support training with body weight support boots can significantly improve gait after ankle fracture surgery. Its effect is superior to that of conventional gait training.

Objective:To analyze the survival time and to explore the releated factors of antiretroviral therapy among HIV/AIDS patients in LiangShan Prefecture, Sichuan Province for reduction of AIDS death rate.Methods:The retrospective research method was used to collect relevant information from the Management Database of Antiviral Treatment from the National AIDS Comprehensive Prevention Information System. The Kaplan-Meier method was used to describe the survival distribution and to analyze the survival time by single factor and the model of Cox proportional riskanalysis was performed to analyze the survival time of HARRT by multi-factors analysis.Results:Total 14 219 adults and young persons aged ≥15 HIV/AIDS patients received antiviral treatment from 2005 to 2015. The average age of all cases was (36.10±9.41) years old and 10 021 were males (70.5%). The main route of infection was intravenous drug use (61.0%, 8 678 cases). At the end of the observation, 10001 cases (70.3%) were still treated, and 1 425 cases (10.0%) died; Cox Regression analysis showed that female (0.67 (0.55-0.81)), route of sexual infection (0.67 (0.56-0.79)), baseline CD4 +T lymphocyte count 200-350 (0.41 (0.35-0.47)) and ≥350 (0.28 (0.24-0.34)), was a protective factor in death. At the beginning of treatment, the patient is clinically staging stage Ⅱ (0.70 (0.58-0.84)) and abnormal BMI (1.75 (1.50-2.03)), is a risk factor for death ( P<0.05). Conclusion:Early antiviral treatment is of great significance in improving the anti-viral treatment effect of AIDS. Compliance education should be further strengthened so as to enhance their knowledge. And it is feasible to enhance the effect of treatment through nutritional support for prolonging patients survival time and improving the quality of life.