The defects in observation methodology of diseases,in knowledge of diseases,and in doctors' clinical knowledge and skill were analyzed in this article,which were believed as main medical internal defects(MID).High risks as well as medical disputes cannot be avoided in medical practice due to MID,which also led to ethical challenges in medical disputes prevention and treatment.Emphasis on the knowledge of MID during public education on medical disputes prevention may decrease medical disputes.

It was the honor to participate in the exchange program between University of Malta and Soochow University focusing on Dementia care;gerontology and elderly rehabilitation care from September 2016 to January 2017. During those 5 months, as a nursing graduate student, the experience which made me a deeply impression is the point of view ofperson-centred carefrom the medical care I′ve seen in Malta. This essay combined with the exchange experience through clinical observation and practice at hospitals in Malta, is going to highlight the point of view of person-centred care. That can reflect on some shortages of domestic in the medical care environment in China, hoping for a morehumane, moreperson-centred, andperson in heartmedical care environment.

AIM: To observe the influences of Jianwei Yuyang Pills(Radix pseudostellariae,Pericarpium citri reticulatae,Rhizoma dioscoreae, Fructus hordei germinatus,and Fructus crataegi) on the recurrence of peptic ulcer(PU),and the expressions of IL-1 and analyze its potential mechanism. METHODS: Thirty-six patients with gastric ulcer were chosen as Jianwei Yuyang Pills treatment group.In addition,the normal control group was set up(12 cases).The biospy specimens of gastric mucosa was detected to observe the change in immunohischemistry of IL-1 and in the contents of ninohexose and phosphatide of ulcerated gastric mucosa. RESULTS: The contents of ninohexose,phosphatide of PU patients increased in Jianwei Yuyang Pills group.There was a statistical significance between Jianwei Yuyang Pills group(before treatment) and Jianwei Yuyang Pills group(after treatment)(P

Objective To investigate the effect and monitoring point of continuous veno-venous hemofil-tration (CVVH) in patients with multiple organ dysfunction syndrome (MODS). Methods In 22 patients with MODS,a double lumen catheter was put into the central vein,and the CWH was performed with the BRAUN Diapact CRRT. The level of BUN,Scr,serum potassium and arterial blood gas were measured 30 minutes before and after CVVH. The plasma TNF-α、IL-1、IL-8 were measured by ELISA. Vital signs were monitored dur-hag treatment process. Results The vital signs of all patients` was stable, the levels of BUN,Scr and serum potassium decreased significantly after CVVH. The plasma concentrations of TNF-α,IL-1 and IL-8 gradually decreased. Conclusions CWH can improve the blood biochemical markers,remove inflammatory cytokines in plasma,stsblize the vital signs during treatment,which is suitable for patients with MODS.

Objective To evaluate the effect of malaria surveillance and control of Guangxi Zhuang Autonomous Region in 2013,and explore the suited surveillance and management of imported malaria cases,so as to provide the evidence for formulat?ing the scientific control measures of imported malaria. Methods The endemic data and control measures of malaria in Guangxi in 2013 were collected and analyzed statistically. Results A total of 1 251 malaria cases were found in Guangxi in 2013,with 88.25%(1 104 cases)of falciparum malaria,8.63%(108 cases)of vivax malaria,0.64%(8 cases)of quartan malaria,1.52%(19 cases)of ovale malaria,and 0.96%(12 cases)of mixed infection;93.21%(1 166 cases)were off?farm workers;96.56%(1 208 cases)were imported from Africa and mainly consisted of falciparum malaria cases;3.44%(43 cases)were imported from southeast Asia and mainly consisted of vivax malaria cases. The cases of imported malaria were increasing and the infection rate in 2013 was increased by 464%compared with that in 2012. Conclusion The imported malaria cases in Guangxi mainly come from Africa at present. Promoting the health education and professional skill of malaria control and treatment ,as well as the diagnosis and treatment of the patients in early time are important measures to control the imported malaria.

Aim To observe the differences of tonify-ing blood effect for the combination of Danggui and Honghua ( GH) with different proportions on blood de-ficiency mice, and choose the proportion of GH which has the optimal tonifying blood effect. Methods The blood deficient mice model was induced by injection of phenylhydrazine and cyclophosphamide. On the basis of multi-attribute comprehensive index method, the op-timal dose was determined through three doses of GH 1: 1 , which was the highest frequency proportion of GH used in the “Dictionary of Chinese Medicine Prescrip-tions”. According to the optimal dose, the change reg-ulation of tonifying blood effect of GH with different proportions was observed. Results Among three do-
ses (1, 3 and 5 times of clinical dose), the tonifying blood effect of GH was best when the dosing concentra-tion of GH was clinical dose. Among nine proportions (1 : 0, 4 : 1, 2 : 1, 3 : 2, 1 : 1, 2 : 3, 1 : 2, 1 : 4 and 0 : 1), GH 1 : 1 had the best effect. Conclusion The results are consistent with regulations of medi-cine usage that GH 1 : 1 has the highest frequency used in Herbal Formulae, which could provide scientif-ic basis for more effective application of Danggui and Honghua in modern clinic medicine.

The combination of Danggui and Honghua (GH) is a popular herb pair commonly used in clinic for the treatment of blood stasis syndrome in China. To evaluate the activating blood circulation and dissipating blood stasis effects of the combination of different proportions of Danggui and Honghua on acute blood stasis rats, and optimize the proportion of GH to have the best activating blood circulation and dissipating blood stasis effect. Acute blood stasis rat model was induced by subcutaneous injection of adrenaline and ice water bath. The blood stasis rats were administrated intragastrically with GH (1 : 0, 4 : 1, 2 : 1, 3 : 2, 1 : 1, 2 : 3, 1: 2, 1 : 4 and 0 : 1) extracts. The whole blood viscosity (WBV), plasma viscosity (PV), and high shear whole blood relative index (HSWBRI), low shear whole blood relative index (LSWBRI), and erythrocyte aggregation index (EAI) were tested to observe the effects of GH on hemorheology of blood stasis rats. And the maximum aggregation induced by adenosine diphosphate (ADP) was tested to observe the effect of GH on platelet aggregation index of blood stasis rats. In addition, the prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and plasma fibrinogen (FIB) were tested to observe the effects of GH on blood coagulation function of blood stasis rats. Then principal component analysis and multi-attribute comprehensive index methods were both used to comprehensively evaluate the total activating blood circulation and dissipating blood stasis effects of GH. The results showed that the hemorheological indexes and coagulation parameters of model group both had significant differences with normal group. Compared with model group, GH (1 : 0, 4 : 1, 2: 1, 3 : 2, 1 : 1, 2 : 3, 1 : 2, 1 : 4 and 0 : 1) could improve all the blood hemorheology indexes and regulate part indexes of blood coagulation function and platelet aggregation in acute blood stasis rats. Based on principal component analysis and multi-attribute comprehensive index methods, GH 1 : 1 and GH 3 : 2 both had the best effect of blood circulation and dissipating blood stasis, and the effect of GH 1 : 1 was slightly better than GH 3 : 2. These results suggest that GH could obviously ameliorate the abnormality of hemorheology and blood coagulation function in acute blood stasis rats. The optimized proportion of GH was consistent with regulations of medicine usage that GH 1 : 1 had the highest frequency used in traditional Chinese formulae. It could provide scientific basis for more effective application of the compatibility between Danggui and Honghua in modern clinic medicine.

In September 2020, three pulmonary tuberculosis cases were identified during school physical examinations at a senior high school in a district (School B) of Hangzhou City. Immediate epidemiological surveys were performed by local district and Hangzhou Center for Disease Control and Prevention, and a pulmonary tuberculosis outbreak involving 9 cases in 6 schools were identified. All cases were once Grade 9 students in Class of 2019 at a junior high school (School A), and the source of infection might be a laboratory-confirmed cases (index case) in this class reported in April, 2019. Following exposure to index case, other cases developed disease onset or were screened after entering senior high schools. In November, 2020, tuberculin skin test and chest X-ray scan were performed to screen pulmonary tuberculosis among 43 students and teachers in a class of Grade 9 in Class of 2019 at School A, and 17 students strongly positive for tuberculin skin test were given prophylactic therapy. No pulmonary tuberculosis case were identified until June 2021. It is suggested that early epidemiological surveys facilitates the identification of the epidemiological correlation between cases. Active search for individuals with common exposure history and prophylactic therapy are required if a possible outbreak is found, which is helpful to avoid the spread of the outbreak.

Objective To analyze the epidemic characteristics of the imported malaria cases in Guangxi Zhuang Autono?mous Region in 2014,so as to assess the transmission risk and explore the prevention and control strategy. Methods The data of the malaria epidemic situation in the network direct report system of Guangxi in 2014 and the annual report of malaria epidem?ic situation in 14 cities were collected. The epidemiological information of the imported malaria cases was analyzed. Results A total of 184 malaria patients were reported in Guangxi in 2014,with a descent rate of 85.29%when compared to that in 2013 (1 251 cases),and the incidence rate was 0.35/100 000. All the cases were imported from abroad,and four species of Plasmodi?um were found in their blood samples. The number of falciparum malaria cases was the most(49.46%),followed by the ovale malaria cases(32.07%). All the cases were distributed in 32 counties(districts)of 11 cities ,and 65.76%of them were distrib?uted in Shanglin County. Most of the cases were male(98.37%),and those aged in 20-49 years accounted for 87.50%. The im?ported cases came from 14 countries of Africa(86.41%)and 2 countries of Southeast Asia(13.59%),in which,48.37%of the cases were imported from Garner. The main occupation of the cases in abroad was gold mining work(86.96%). The cases were reported all the year around,with no obvious seasonality. The interval time of back home to attack of the patients with tertian ma?laria and ovale malaria was longer. Conclusion Africa and Southeast Asia is the main source of imported malaria cases in Guangxi,and the migrant workers returning home may have the risk of malaria recurrence,which should be paid enough atten?tion to.

Objective To explore the effect of using smart products (including smart phones, computers and other electronic products),as well as having hobbies on their cognitive function in pension agency elderly people,and analyze if there is certain protective effect on cognitive function by using smart products and having hobbies.So as to reduce the risk of mild cognitive impairment in the future. Methods By convenience sampling, 160 residents living in the nursing home of suzhou city (mean age 60 or higher) were selected, and demographic data were collected by using a homemade questionnaire, their cognitive function was investigated by using the Montreal Cognitive Assessment Scale. Results Single factor analysis showed that the score of the elderly who often use smart products in every cognitive field and overall cognitive function were superior to those who could not use smart products,the difference was statistically significant(t=-4.47--2.15,all P<0.05).The scores of the elderly with hobbies were higher in the overall cognitive function and the other six areas except the orientation, than those who had no hobby,and the differences were statistically significant(t=-6.80--1.81,all P<0.05).After adjusting for age,gender,body mass index(BMI),cultural level,often using smart products in total cognitive function in the elderly(t=4.842,P<0.01)and executive function(t=4.008,P<0.01),attention(t=3.045,P=0.003), abstract(t=2.135,P=0.034),delayed recall(t=3.759,P<0.01),the directional(t=2.866,P=0.005)of the five areas showed significant correlation. The total cognitive function of the elderly with hobbies (t=3.496, P = 0.001) and the visual spatial execution function (t=3.316, P = 0.001), naming (t=3.241, P =0.001), abstract (t=2.643, P = 0.009), and delayed recall (t=2.073, P= 0.04) were all significantly correlated.Conclusions Often using smart products and having certain hobbies are protective factors of cognitive function,build corresponding intervention plans for the future,by cultivating the elderly hobby, guiding the elderly using intelligent products and other measures to achieve successful aging, slow the cognitive decline,thus reducing the risk of mild cognitive impairment.