Discussions were made regarding the burden of persuasion and that of proof in tort lawsuits,distribution of the burden of persuasion in both medical tort cases and those in non-medical malpractice tort lawsuits.It is found that in cases involving tort of medical institutions,medical behavior tort and non-medical tort cases should be set apart depending on the nature of the lawsuit.Under the existing legal system,it is also necessary to distinguish the medical behavior tort incurred by medical malpractice from that irrelevant to malpractice.which will be critical for distribution of the burden proof and calculation of the compensation.

China ; Drugs, Chinese Herbal ; standards ; Ethics, Medical ; Humans ; Medicine, Chinese Traditional

The current graduate student curriculum of medical colleges and universities has not been able to satisfy the actual need of cultivating the medical graduate students. In certain extent it stresses the natural sciences, theory curriculum and knowledge instruction more than humanities social sciences,technical curriculum, and cultivation of students' ability. Based on the reform of our curriculum setup, the author put forward some suggestions such as expanding the course resources, enriching the content,implementing the second-level management system, being clear about the different cultivation flow and the curriculum name; paying attention to staff construction and perfecting graduate student curriculum assessment and so on.

From the three aspects of university,family and the students themselves,the article points out that universities should transform the teaching thought and approaches and give the students poor in study the teaching guidance and humane care,parents should grasp the laxation of educating their children and students should pay attention to regulation and self-regulation.Only through the joint efforts,can the students walk out of study confusion to realize the healthy development

BACKGROUND:To delay the onset of Alzheimer’s disease, transplantation of viable and wel-differentiated stem cel s is expected to repair neural tissue, which has been an issue of concern. OBJECTIVE:To explore the effects of different doses of human umbilical cord mesenchymal stem cel s (hUCMSCs) on learning and memory ability of Alzheimer’s disease rats. METHODS:Fifty Sprague-Dawley rats, 7 months of age, were randomized into normal, model, high-, middle-and low-dose hUCMSCs groups (n=10 per group). Rats in model and UCMSCs groups were used to make Alzheimer’s disease animals through intraperitoneal injection of 150 mg/kg D-galactose for 90 days, and rats in the normal group were given intraperitoneal injection of normal saline for 90 days. In the three hUCMSCs group, passage 3 hUCMSCs at doses of 1×105/0.2 mL/20 g, 5×105/0.2 mL/20 g, and 1×106/0.2 mL/20 g were injected via the tail vein, respectively. Forty-five days after cel transplantation, Morris water maze test was used to detect rat’s learning and memory abilities, and hematoxylin-eosin staining was used to observe pathological changes of the rat hippocampal CA1 region. RESULTS AND CONCLUSION:Compared with the normal group, the rats in the model group showed significant reduction in the ability of learning and memory. Compared with the model group, the escape latency was significantly shortened in the middle-dose hUCMSCs group (P<0.05), while the number of passing times through the platform was increased significantly (P<0.05). In the model group, the cel s in the hippocampal CA1 region were arranged irregularly with unclear nucleoli and a part of cel s were concentrated and deeply stained. In the middle-dose hUCMSCs group, the cel s in the hippocampal CA1 region were arranged regularly with clear nucleoli, and only individual cel s were stained deeply. These findings indicate that middle-dose hUCMSCs transplantation can improve the learning and memory abilities of Alzheimer’s rats.

Objective To investigate the effect of early embryonic mouse pancreatic tissue transplantation in the treatment of mouse experimental diabetes.Methods C57BL/6 mouse models of streptozocin-induced diabetes mellitus were established and then randomly divided into two groups:transplantation group,in which,five to seven pieces of pancreatic tissue of mice at embryonic 16.5 days were transplanted into mouse renal capsule,and sham-operated (SO) control group,in which,0.05 ml RPMI1640 culture medium was injected into mouse renal capsule.When blood glucose level of the transplantation group mouse was ≤ 11.2 mmol/L,the endocrine function of embryonic pancreatic tissue transplanted was detected by IPGTT and IPITT methods and then the transplanted graft was removed for observing the blood glucose surge.In vitro,levels of insulin secretion were measured in serum,E16.5 pancreatic tissue and graft (3.3 mmol/L and 16.7 mmol/L) glucose stimulation by ELISA.Histology and immunohistochemistry were observed before or after pancreatic tissue transplantation to detect insulin and glycagon production.Results (1) The glucose level decreased significantly in the TX group after 4-6 weeks of transplantation (13.4 ± 6.5 vs 28.9 ± 2.5,P ＜ 0.05),and the body weight gaining (P ＜ 0.05).Compared to SO group,glucose level decreased significantly (P ＜ 0.001).The graft can modulate insulin secretion; (2) Insulin can be detected in E16.5 embryonic mouse.Insulin and glycagon were produced more in TX group than pretransplantated pancreatic tissue.Conclusions E16.5 embryonic mouse pancreatic tissue transplantation effectively controls serum glucose level and restore the nondiabetic pattern of weight gaining in diabetic mouse.

Objective To find out early lesion of rentanl function in elderly patients with dipper essential hyperten-sion and morning blood pressure surge( MBPS) , and to find out the value of homocysteine( Hcy) with high-sensitiv-ity C reactive protein ( hs-CRP) in detecting early lesion of rentanl function in hypertensive patients. Methods Totally 168 elderly paritents with dipper essential hypertension were divided into MBPS group( observation group, n=73) and non-MBPS group (control group, n=95) according to the accompanying MBPS or not. The cystatin C ( Cys C) , urinary microcalbumin ( U-mAlb) ,urinary transferring( U-TRF) ,Hcy, hs-CRP,serum creatinine( SCr) , blood urea nitrogen(BUN), blood glucose(Glu),cholesterol(TCH),triglyceride(TG), high density lipoprotein cholesterol( HDL-C) and low density lipoprotein cholesterol( LDL-C) were tested. The differences in Cys C, Hcy, hs-CRP, the U-mAlb positive incidence and the U-TRF positive incidence between the two groups were analyzed. Results There were no statistical concernments in SCr, BUN, GLu, TCH, TG,HDL-C,and LDL-C between the two groups. The amplitude of variation in morning systolic pressure peak was higher in MBPS group than in non-MBPS group(P=0. 000). The obvious varieties in the Cys C, Hcy,and hs-CRP were higher in MBPS group than in non-MBPS group ( P=0. 000 ) . The U-mAlb positive incidence was higher in MBPS group than in non-MBPS group(χ2 =18. 014,P =0. 000). The U-TRF positive incidence was higher in MBPS group than in non-MBPS group(χ2 =19. 694,P=0. 000). Conclusion MBPS has a great effect on Cys C,U-mAlb,U-TRF,Hcy and hs-CRP. MBPS is apt to cause early lesion of rental function in elderly patients with dipper essential hypertension. And Hcy and hs-CRP can be used to diagnose the early renal insufficiency.

Neovascularization is the main cause of blindness, such as diabetic retinopathy, retinopathy of prematurity and age - related macular degeneration. Vascular endothelial growth factor( VEGF) plays an important role in the formation of angiogenesis, and is considered to be the most potent angiogenic growth factor. Placental Growth Factor(PlGF) is one of the VEGF family, which play a crucial role in endothelial cell proliferation and migration, angiogenesis, and immune - mediated inflammation. Meanwhile, PlGF is specifically expressed in pathological angiogenesis, but not in normal blood vessels. In recent years, there has been increasing attention to PlGF, therefore this article reviews the role of PlGF in neovascular ocular diseases.

OBJECTIVE: Post-traumatic healing style is an important link in the process of wound healing. Scarless healing of fetus skin after trauma is the ideal healing style that is hunted for by people. The results of studies on the mechanism of scarless healing were reviewed to explore the mechanism of scarless healing of fetus skin.DATA SOURCES: Computer was applied to retrieve Medline database on the articles relating to the mechanism of scarless healing of fetus skin from January 1970 to December 2003. Docuterms were "fetus, skin and scarless healing". Language in the articles was limited to English.STUDY SELECTION: The documents were examined at first to exclude the study on non-healing mechanism. Full texts were found in the surplus documents. The inclusive criterion was the foundational experiment on the mechanism of scarless healing. Clinical trial and phenomenal study on scarless healing were excluded.DATA EXTRACTION: Forty-eight articles on experimental study relating to embryonic scarless healing were collected in all. Sixteen experiments accorded with the inclusive criterion and 32 were excluded.DATA SYNTHESIS: Sixteen experiments discussed the relationship between the fetus and scarless healing on terms of growth environment, inflammation reaction to trauma and regulation of fibroblast in organism, extracellular matrix and nany cellular factors.CONCLUSION: Growth environment of fetus has not so much relationship with the mechanism of scarless healing after trauma. Low reaction of fetus to inflammation, different extracellular matrix, component of collagen fiber and cell factors may take part in scarless healing process. Regulation of gene expression may play an important role in the process. But the concrete mechanism of scarless healing is not clear yet and still needs more researches and elucidations.

Child, Preschool ; Foreign Bodies ; surgery ; Humans ; Intestines ; Laparoscopy ; methods