The special nature of medical care determines the high riskiness of the medical profession that is lacking in other professions. In view of the high-techness and high riskiness of the medical profession, it is only proper to start thinking about setting up corresponding mechanisms for guarding against and dissolving the risks so as to safeguard the legitimate rights of the doctors. Guarding against and dissolving risks of the medical profession fall into a systematic framework of regulations and legal arrangements that are composed of mechanisms for dispersing risks of the medical profession, mechanisms for sharing medical liabilities and systems of medical care and social security.

Objective To study the prevention of gentamicin ototoxicity by resveratrol(Res) in guinea pigs.Methods Auditory brainstem response and cochlear preparation transmission electron microscope were used to evaluate the effects of hair cell on hearing threshold and morphology of hair cell. Serum levels of GM were also tested. It was comprised of five groups,each group had eight animals.GM and Res were tested alone and in combination,besides control group.Results GM group developed a progressive threshold shift. Injury in high frequency was significantly more severe than that in low frequency (P

ObjectiveTo investigate the relation between each subtype of cerebral ischemic stroke classified by NEW-TOAST criteria and the levels of blood sugar. MethodsA retrospective study in 624 patients hospitalized with acute cerebral ischemic stroke. All the patients were classified using NEW-TOAST classification standard. Blood glucose in patients with different stroke subtypes was recorded, and analyzed for the incidence of abnormal glucose metabolism in each subtype. The correlation of glucose to blood sugar,blood pressure and blood fat was analyzed using odd ratio (OR) and 95％ confidence intervals (CI).Results(1) Among 624 patients, the most common stroke subtype by NEW-TOAST classificationis atherothrombosis (AT), followed by small arterial occlusion (SAO). One hundred and nineteen patients (19. 1％ ) had diabetes history; another 40 patients(7.5％ ) were newly diagnosed with diabetes in this study; and 71 patients ( 11.4％ ) were found to have glycoregulation abnormality. The incidence of abnormal glycometabolism was high in patients with AT ( 40. 4％ ) and SAO ( 39. 7％ ). ( 2 ) Association analysis between stroke subtypes and blood sugar: x2 =14. 83,P =0. 020, r =0. 152; in SAO patients, OR was 1. 925 (95％ CI 1. 392-2. 664) ; in the patients with AT, there was no correlation to blood sugar levels.Association analysis of high blood pressure in stroke subtypes: in AT patients, OR was 2. 874 (95％ CI 1. 957-4. 222) ; in SAO, OR was 1. 609 (95％ CI 1. 100-1. 235). Association analysis of high LDL-C in each subtype: OR in SAO was 1.419 (95％ CI 1.026-1. 962) ;No significant correlation of LDL-C in AT patients, P =0. 929 ; (3) There is significant difference of frequency of abnormal glycometabolism between stroke subtypes: x2 =17. 79 ,P =0. 000; between AT and SAO patients, x2 =0. 024,P =0. 877; between AT or SAO patients to other three subtypes, P ＜ 0. 05. ConclusionsAmong the subtypes of cerebral ischemic stroke by NEW-TOAST classification, AT and SAO are the most common subtypes.All the subtypes have correlation to the high level of blood sugar, and SAO has the highest correlation to blood sugar levels. High blood pressure may affect both large vessels and small vessels, while high LDL-C may mainly affect small vessels.

Objective The research is to understand students' mobile learning (M-learning) attitudes and behaviors,and provide a reference for the development of mobile learning systems and learning resources.Methods The research used the method of questionnaires to investigate nursing students' present situation of M-learning.Results About 2/3 of the students were so eager to have targeted mobile tutorial course.Most of the students were not satisfied though there were a lot of resources.More than 2/3 of the students used telephone to surf on the internet almost every day (mainly on reading web pages and communicate with classmates using chat software,see / write blog lowest).The mobile learning time of more than 60％ students was not more than 10 minutes.1/3 of students used the time between 10 to 30 minutes.The highest cost that students spent on monthly mobile learning was less than 10 Yuan,accounting for the total number of 1/3.Compared with the junior college students,the proportion of undergraduates who support to use phone to surf on the internet was higher.Undergraduate students were more likely to read pages and see multimedia,most of them hope to see courseware within 2 to 5 minutes,etc.Conclusions Nursing students have good hardware conditions on mobile learning.Students are recognized on mobile learning.The current mobile learning resources are chaos and lack of design so that it hindered the development of mobile learning.Mobile learning courses should be short and pithy,rich and colorful.Application design of mobile blog in mobile learning needs to be strengthened.Generally speaking,undergraduate college students are more actively to take mobile learning into their learning and life.

ObjectiveTo analyze the complaints of outpatient of Guang’anmen Hospital, China Academy of Chinese Medical Sciencse, discuss the countermeasures to alleviate the contradiction and promote the normalization of the relationship between doctors and patients.Methods Based on analysis of outpatient complaints from Jan. 2008 to Dec. 2012 in our hospital, statistics and classification data were obtained from the aspects of service attitude, medical errors, process and communication.ResultsOutpatient amount of our hospital form Jan. 2008 to Dec. 2012 was 10.55 million. There were 1426 outpatient complaints (service attitudes 24.2%, medical errors 11.5%, process 40.3%, and communication 24%), etc. Complaints rate was 0.135‰ and satisfaction degree of dealing with complaints was 99.3%.Conclusion Through active service, the complaints of outpatients has been reduced, and diagnostic and treatment quality and satisfactory degree have been increased of our hospital.

Objective To investigate the clinical efficacy of sodium nitroprusside on the treatment of pulmonary edema in elderly patients with heart failure. Methods 50 elderly cases with heart failure and pulmonary edema From January 2015 to January 2017 were divided into the control group and the observation group according to the different treatment methods. The control group were received conventional therapy, the observation group were given conventional drug combined with sodium nitroprusside. The experimental data was recorded and compared. To investigate the effect of sodium nitroprusside on the rescue of elderly heart failure and pulmonary edema. Results The clinical effect in the observation group is better than that in the control group. The protein related indexes about heart failure and pulmonary edema were significantly improved (P<0.05). The difference of adverse reaction rate in the two groups has no statistically significat. Conclusion Conventional drug therapy combined with sodium nitroprusside were used on the treatment of elderly patients with heart failure, pulmonary edema, which can improve the clinical symptoms, related serum protein, without increasing the incidence of adverse reactions, it is worthy of clinical application.

Objective:To investigate the impact of adding human menopausal gonadotropin (hMG) for in vitro fertilization-embryo transfer pregnancy outcomes in a standard population of non-advanced age with normal ovarian reserve function using a long follicular phase protocol.Methods:Clinical data of 489 patients with normal ovarian reserve function, who were admitted from January 2018 to January 2020 in the Affiliated Hospital of Guizhou Medical University and underwent in vitro fertilization for the first time with the long follicular phase protocol in fresh cycles, were retrospectively analyzed. The patients were divided into three groups according to whether or not to add urine-derived hMG and the timing of addition: non-addition group (group A), medium-term hMG group (group B1), whole course hMG group (group B2); the laboratory parameters of each group were observed, and the effect of ovulation induction drugs and pregnancy outcomes were compared.Results:The ages of B1 and B2 groups were significantly higher than that of group A ( P=0.019 and P=0.011). The basal FSH level of group B2 was significantly higher than those of group A and group B1 ( P<0.01 and P=0.006), and the basal FSH/LH ratio of group B2 was significantly higher than that of group B1 ( P=0.009). Antral follicle counts of group A and group B1 were significantly higher than that of group B2 ( P=0.007 and P=0.017). The superior embryo rate of group B2 [(47±27)%] was significantly higher than that of group A ( P=0.017). The embryo implantation rate of group B1 was significantly lower than those of group A and group B2 ( P=0.043 and P<0.01). The clinical pregnancy rate of group B2 [76.7% (155/202)] was significantly higher than those of group A ( P=0.039) and group B1 ( P<0.01). The live-birth rate of group B2 [67.3% (136/202)] was significantly higher than those of group A ( P=0.017) and group B1 ( P=0.001). Conclusions:For non-advanced aged patients with normal ovarian reserve function, the long protocol of follicular phase is suitable for those with relatively low ovarian reserve function. Adding hMG in the whole course of ovulation induction after gonadotropin-releasing hormone agonist reduction could improve the pregnancy outcomes by improving the quality of embryos.

Objective To set up a multiplex real time quantitative PCR method to detect the expression of WT1 and MDR1 gene simultaneously in acute leukemia patient. Methods Total RNA was extracted from k562 cell line and was reverse transcribed to cDNA by the outer primers of WT1 and MDR1 respectively. The cDNA of WT1 and MDR1 were purified and digested by Bam H Ⅰ and Bgl Ⅱ , and then the two fragments were ligated to form the recombinant fragment WT1 + MDR1. The outer forward primer of WT1 and outer reverse primer of MDR1 were used to amplify the recombinant fragment WT1 + MDR1. The PCR product was purified and cloned into pMD18-T vector, and then transferred into E. coli DH-5α. A new kind of WT1-MDRl-contained standard plasmid was obtained from the positive colony. The recombinant plasmid was verified by digestion with restriction enzyme and PCR amplification. A multiplex real time quantitative PCR method was set up with FAM-labeled MDR1 probe and VIC-labeled WT1 probe in one reaction tube. The WT1 and MDR1 gene expression was detected in forty-seven AL patients and thirty-two controls by this method. Seven patients were followed-up to elucidate the relationship between the gene expression levels and clinical prognosis. Results The recombinant plasmid was confirmed by EcoR1 digestion and PCR amplification. The multiplex real time quantitative PCR technique could reach the sensitivity of WT1 and MDR1 gene up to 102 copy/μl. The standard curve slopes were 0. 999 and 0. 998. The WT1 [ 37 000( 163-6 370 000 )copies/μg RNA ] and MDR1 [ 76 200( 179-18 000 000 )copies/μg RNA ]expression levels of AL patients were significantly higher as compared to the controls [ 258( 0-643 ) copies/μg RNA and 333( 0-779 )copies/μg RNA ]( Z= 6. 755,6. 736, P ＜ 0. 01 ). Following up seven patients with similar regimen of chemotherapy, the WT1 and MDR1 expression correlated to the clinical course. Three AL patients with WT1 and MDR1 expression levels (2 170 and 86 900, 1 130 and 5 860, 1 170 and 586 copies/μg RNA )significantly decreased after chemotherapy and kept in the low range ( 370 and 560,138 and 980, 150 and 690 copies/μg RNA ), and had a favorable outcome. Three AL patients with WT1 and MDR1 expression levels ( 1 600 and 11 800, 24 800 and 968, 48 200 and 1 100 000 copies/μg RNA )decreased after initial chemotherapy, but increased significantly afterwards (20 314 and 25 660,184 364 and 31 530, 15 680 and 878 000 copies/μg RNA ),and suffered clinical relapse. One patient with high WT1 and MDR1 expression levels ( from 81 600 and 1 200 000 copies/μg RNA to 124 100 and 7 632 400 copies/μg RNA )showed the persistence of disease. Conclusions A multiplex real time quantitative PCR method to detect WT1 and MDR1 gene simultaneously is constructed successfully. The expression of WT1 and MDR1 may provide useful information for AL patients prognosis.

To investigate the nature of syndrome of traditional Chinese medicine by means of pharmacokinetic (PK) method.

Objective:To establish an HPLC method for determining nectandrin B in Uygur medicine Arillus Myristicae. Meth-ods:The analysis was performed on a SunFireTM C18 column (150 mm × 4. 6 mm, 5 μm) at 30°C using methanol /water (52 ∶48) as the mobile phase at a flow rate of 1. 0 ml·min-1 with the UV detection wavelength at 228. 4 nm. Results:The linear range of nectan-drin B was 3. 98 -79. 60 μg·ml-1(r=0. 999 2). The average recovery was 99. 89% with RSD of 1. 11%(n=6). Conclusion:The method is accurate, convenient and reproducible in the determination of nectandrin B in Uygur medicine Arillus Myristicae.