The paper reviews the background and current situation of medical disputes and puts forward the concept of the reaction chain of medical disputes in view of their high occurrence rate and the difficulty in handling them. It discusses the framework, chief content, basic principles and major features of the reaction chain of medical disputes and argues that as a commonly used tool for handling medical disputes, the reaction chain renders it possible to check from the angje of the interests of the patients whether each party involved in the dispute has fulfilled its duties. Intended to improve the professional ethics of the physicians and the quality of medical care and calling on the patients to rebuild their confidence in the physicians, the reaction chain indicates that it is necessary to scientifically analyze the entire process and various influencing factors of medical disputes and bring into play the advantages of integration so as to successfully resolve medical disputes.

Objective:In order to find a safe and healthy way to control fish diseases caused by Aeromonas hydrophila,the immune effect of Aeromonas hydrophila inactivated vaccine on Carassius gibelio was studied.Methods: Three groups were randomly made by each of 10 fishes.Injection groups was made intraperitoneally ( i.p.) with 200 μl, and soaked group with 3 L volumes of inactivated vaccine suspensions respectively while the control group with same volumes of saline.Tissues and blood samples of carassius gibelio were collected after the second vaccination.Then the histopathological, immunological indicators and survival percentage were detected.Results:The relative survival percentage of two groups was 90%and 60%respectively.The serum enzymes of injection and soaked group showed significant differences contrasted with the control group.Histopathological studies revealed that the important tissues have been damaged obviously after the bacterium challenge, while the experiment groups were no damage.Conclusion:Therefore the inactivated vaccine could prevent carassius gibelio diseases that caused by A.hydrophila.

Objective To investigate the changes of nitric oxide content and inducible nitric oxide synthase (iNOS) activity in rat brain tissues after explosive craniocerebral wound and observe the influence of emodin on these changes. Methods After rats were subjected to electric detonators, emodin (10 mg/kg) was injected intraperitoneally at 10 minutes. Water content of brain tissues was measured by using dry-wet methods. The content of nitric oxide and the activity of iNOS were measured at 2, 4, 12 and 24 hours respectively after wound by means of nitrade reductase and colorimctrie method. Results The content of nitric oxide and the activity of iNOS kept at a high level (P<0.01). The content of nitric oxide and the activity of iNOS in model group were increased significantly and reached peak at 2 hours after wound. While the content of nitric oxide and the activity of iNOS in emodin group were significantly lower than that in model group (P<0.01). Conclusion Emodin plays a role in decreasing water content of brain tissues and inhibiting activity of iNOS and may exert a protective effect on brain injury during pathological course after explosive craniocerebral wound.

Objective To compare a novel mirror-overlap method with the traditional manual measurement and the subjective assessment in assessing breast symmetry after oncoplastic surgery.Methods 59 patients with breast cancer who underwent conservation/reconstruction surgery were recruited.The post-operative assessment for breast symmetry was conducted using manual measurement,subjective assessment by the patient,their family member and a nurse,and the mirror-overlap method respectively.The latter method involved using the Photoshop to assess the area differences in breast outlines and shadows created by a flashlight when bilateral images were overlapped in the axis of midline.Results The distance differences between bilateral breasts measured using manual method were negatively correlated with symmetric coefficients in the mirror-overlap method (P＜0.05).There was a positive correlation between the average scores in the subjective assessment and symmetric coefficients of mirror-overlap method (P＜0.05).Conclusion The mirror-overlap method is an easy,feasible and cheap method which collects 3D breast information and provides an effective approach to assess breast symmetry after oncoplastic surgery.

There are abundant cancer stem cells (CSCs) in triple-negative breast cancer TNBC).CSCs can maintain their phenotype by unique molecular mechanism and tumor microenvironment,and can promote the chemotherapy resistance and recurrence of TNBC.Blocking these key molecules or altering tumor microenvironment can reduce CSCs,and then inhibited cancer growth and reverse chemotherapy resistance of TNBC.

Methods:Two thousand standard sections images werre collected from 2 000 clinical retrospective pediatric hip ultrasound videos from January 2019 to January 2021. All standard sections were annotated by the annotation team through the self-designed software based on Python 3.6 environment for image cross-media data annotation and manual review standardization process with unified standards. Among them, 1 753 were randomly selected for training the deep learning system, and the remaining 247 were used for testing the system. Further, 200 standard sections were randomly selected from the test set, and 8 clinicians independently completed the film reading annotation. The 8 independent results were then compared with the AI results.Results:The testing set consists of 247 patients. Compared with the clinician's measurements, the area under the receiver operating characteristic curve (AUC) of diagnosing hip joint maturity was 0.865, the sensitivity was 76.19%, and the specificity was 96.9%. The AUC of AI system interpretation under Graf detailed typing was 0.575, the sensitivity was 25.90%, the specificity was 89.10%. The 95% LoA of α-angle determined by Bland-Altman method, of -4.7051° to 6.5948° ( Bias -0.94, P<0.001), compared with clinicians' measurements. The 95% LoA of β-angle, of -7.7191 to 6.8777 ( Bias -0.42, P=0.077). Compared with those from 8 clinicians, the results of AI system interpretation were more stable, and the β-angle effect was more prominent. Conclusion:The AI system can quickly and accurately measure the Graf correlation index of standard DDH ultrasonic standard diagnosis plane.