The application of the law of medical disputes has become hot debate in law experts and the actual trial with the growing number of medical treatment damages litigation.There has been binary phenomenon of applicable the law of "The Medical Accident Handle Regulation"and the General Principles of Civil Law.The compensation,which is closely related to the law suffered the same problem.The emergence of this phenomenon is inseparable from the shortcomings of "The Medical Accident Handle Regulation".The author will explore the issue and make recommendations.

Gene therapy has been widely explored as a promising therapeutic tool in modem medical treatment. It is one of key steps for gene therapy to choose efficient carrier. In spite of the high transfection efficiencies of viral vectors, their utilization has been impaired due to immunogenicity and safety. Nanoparticles made by chemical reaction act as non-viral vector, which solved above-mentioned problems, enhanced efficiency of gene transfection. In recent years, polyethyleneimine-based nanoparticles have become ideal carriers in the research of gene transfection, drug controlled release system and cell biology. This review focuses on properties,preparation and application of nanoparticles based on polyethyleneimine.

Objective To realize intelligent and refined management of medical war storage materials by designing a management platform based on context awareness.Methods The conditions of medical war storage materials and its storage environment were monitored dynamically,and technologies of context awareness,radio frequency identification,temperature and humidity sensing and etc were used to establish the platform.Results The platform improved the traditional medical war storage materials management system in intelligence and refinement,and implemented auto update and intelligent alarm for the information on medical war storage materials.Conlusion The platform fulfills automatic and intelligent medical war storage materials management,and thus has practical values for medical service support.

Objective To investigate folic acid and vitamin B12 on the plasma homocysteine (Hcy) levels and neurological function in young and middle-aged acute ischemic stroke patients with hyperhomocysteinemia (HHcy).Methods Young and middle-aged acute ischemic stroke patients with HHcy were enrolled.They were randomly divided into either an intervention group or a control group.The patients with cerebral infarction in both groups were treated with conventional treatment.At the same time,the patients in the intervention group were treated with folic acid 5 mg and vitamin B12 25 μg,3 times a day for 4 weeks.Those in the control group were given placebo.The next day after admission and thereafter,the plasma Hcy levels were determined once every week.At the time of admission and after 4-week treatment,the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological deficits.Results A total of 78young and middle-aged acute lschemic stroke patients with HHcy were enrolled (n =39 in each group).The baseline plasma Hcy levels and the NIHSS scores in all patients had significant linear correlation (r =0.717;P＜0.01).Four weeks after treatment,the plasma Hcy levels of the intervention group were significantly lower than those of the control group (15.07 ± 2.01μmol/L vs.21.29 ± 2.48 μmol/L; t =4.539; P ＜0.05),but there was no significant difference in the NIHSS scores (4.87 ± 2.17 vs.5.13 ± 1.67; t =0.585,P =0.560).Conclusions The baseline plasma Hcy level was positively correlated with the severity of stroke.Folic acid in combination with vitamin B12 could effectively decrease the plasma Hey level in young and middle-aged acute ischemic stroke patients with HHcy,but it had no significant effect on the improvement of neurological function.

Objective To investigate the clinical distribution and drug resistance of multidrug-resistant (MDR)Pseudomonas aeruginosa to provide reference for clinical rational use of antibacterial drugs.Methods The strains were originated from bacterial culture in the samples of sputum,urine and wound secretion collected from the inpatients admitted in our hospital from January 2009 to December 2013.Results 200 strains of Pseudomonas aeruginosa were isolated during this period,in which 51 strains were MDR,accounting for 25.5%.The isolated MDR Pseudomonas aeruginosa strains were mainly distributed in the the respiratory de-partment(80.4%)and the surgical department(17.9%).MDR strains isolated from the sputum specimens accounted for 64.7%, followed by the wound secretion(19.6%)and urine(11.8%).Pseudomonas aeruginosa was seriously resistant to ampicillin-sulbac-tam with the resistance rate of was 100.0%,but had the low resistance rate to amikacin,imipenem,meropenem,piperacillin/tazobactam,ciprofloxacin,levofloxacin,polymyxin E,which were 28.9%,29.4%,25.0%,30.4%,34.5%,34.5% and 8.3%;the resistance rate to commonly used antibacterial drugs was 39.0%-58.3%.14 strains were pan-drug resistant Pseudomonas aerugi-nosa(PDR-PA);The detection rate was 7.0%.Conclusion The drug resistance of MDR Pseudomonas aeruginosa is more serious, the clinical application of anibiotics should be perfromed based on the result of drug susceptibility test.

Objective: To establish multiple seasonal autoregressive integrated moving average model (ARIMA) according to the hand-foot-mouth disease incidence in Changsha, and to explore the feasibility of the multiple seasonal ARIMA in predicting the hand-foot-mouth disease incidence. Methods: EVIEWS 6.0 was used to establish multiple seasonal ARIMA according to the hand-foot-mouth disease incidence from May 2008 to August 2013 in Changsha, and the data of the hand-foot-mouth disease incidence from September 2013 to February 2014 were served as the examinedsamples of the multiple seasonal ARIMA, then the errors were compared between the forecasted incidence and the real value. Finally, the incidence of hand-foot-mouth disease from March 2014 to August 2014 was predicted by the model. Results: Atfer the data sequence was handled by smooth sequence, model identiifcation and model diagnosis, the multiple seasonal ARIMA (1, 0, 1)×(0, 1, 1)12 was established. The R2 value of the model iftting degree was 0.81, the root mean square prediction error was 8.29 and the mean absolute error was 5.83. Conclusion: hTe multiple seasonal ARIMA is a good prediction model, and the iftting degree is good. It can provide reference for the prevention and control work in hand-foot-mouth disease.

Objective To construct and express a recombinant plasmid pGEX-Sj 14-3-3-Sj32 of Schistosoma japonicum in Escherichia coli (E.Coli) BL21 (DE3).Methods Sj14-3-3 and Sj32 antigen genes were amplified by PCR from template of plasmids pGEX-Sj14-3-3 and pET28α-Sj32 which were extracted from recombinant bacteria BL21 (pET28α-Sj32) and BL21 (pGEX-Sj14-3-3) stored in Institute of Infectious and Parasitic Disease of the First Affiliated Hospital of Chongqing Medical University.Sj14-3-3-Sj32 fusion gene obtained with gene SOEing was cloned into the vector pGEX-1λT to construct pGEX-Sj14-3-3-Sj32 which was identified by double digestion.The recombinant plasmid pGEX-Sj 14-3-3-Sj32 was transformed into E.Coli BL21 (DE3).The recombinant strains were induced by isopropyl-β-d-thiogalactoside (IPTG),and the expressed products were analyzed and identified by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting.Results The 1 750 bp Sj14-3-3-Sj32 fusion gene was successfully amplified by gene SOEing and cloned into the vector pGEX-1 λT verified by restriction analysis,the recombinant plasmid pGEX-Sj 14-3-3-Sj32 was successfully constructed.The molecular mass of the expressed recombinant protein was proximately 73 × 103 as detected by SDS-PAGE.Western blotting confirmed that the expressed protein could be recognized by the immune sera from rabbit infected with Schistosomajaponicum.Conclusion The recombinant plasmid pGEX-Sj14-3-3-Sj32 is successfully constructed and could be highly expressed in E.coli and the expressed recombinant protein has specific antigenicity.

Objective: To explore the relationships between housework and cancer among adult women in urban Shanghai. Methods: Shanghai Women's Health Study (SWHS) included 74,942 participants. Physical activity and social demographic information were collected in the baseline recruitment survey. Descriptive analysis and logistic regression analysis were conducted to describe the housework and the association with selected cancers. Results: Overall, 14 hours per week were spent in housework, and approximately 2/3 (68.3%) women reported that they were responsible for doing major part of housework. Energy expenditure from housework contributed about one a quarter of total non occupational physical activity. Housework energy expenditure was inversely associated with cancers of breast, rectum, ovarian and lung, with the odds ratios of 0.79 (95% CI: 0.73, 0.87), 0.53 (95%CI: 0.42, 0.70), 0.71 (95% CI: 0.55, 0.95) and 0.52 (95% CI: 0.36, 0.73), respectively. Stratification analysis showed that there was a dose-response relation when comparing lower and higher housework categories (Trend test, P≤0.05). The housework had no effect on cancers of colon and endometrium, with ORs of 0.85 (95% CI: 0.68, 1.05) and 1.03 (95% CI:0.79, 1.33). Conclusion: Housework could be one of the major part of the physical activities among adult women, and was inversely associated with commonly-seen malignant tumor such as breast cancer, etc.

OBJECTIVE To probe the pathogen′s distribution of ventilator-associated pneumonia(VAP),in order to offer the evidence of clinical therapy,prevent the onset of VAP and apply the antibiotics reasonably.METHODS We applied the methods of etiology,microscopic identification,bacteria culturing etc on 74 mechanical ventilation patients,and analyzed the etiology of early-onset and late-onset VAP in contrast.RESULTS Totally 121 pathogens were cultivated altogether in all 74 VAP patients.In the 36 pathogens which were cultivated from 29 early-onset VAP patients,there were 66.67% of simple culture(24 patients,24 strains) and 33.33% of co-culture(5 patients,12 strains),and in the 85 pathogens which were cultivated from 45 late-onset VAP patients there were 17.64% of simple culture(15 patients,15 strains) and 82.35% of co-culture(30 patients,70 strains).The proportion of co-culture in the late-onset VAP patients was prominantly higher than that in the early-onset ones(?2=27.821,P

Objective To compare the effects of no-rinse skin cleanser and warm water with paraffin oil in first brush bath of the new-born. Methods About 42 newborns who were born from January to March 2016 were set as control group and used warm water with paraffin oil in first brush bath. About 43 newborns who were born from April to June 2016 were set as observation group and used no-rinse skin cleanser in first brush bath. The cleaning time and effect ,the rectal temperature before and after sponge and dermatitis were compared. Results Both groups did not develop dermatitis. But the observation group had better cleaning satisfaction , less cleaning time, faster rewarming than those of the control group with statistical significance (all p<0.05). Conclusion No-rinse skin cleanser used in the first brush for the new-born can reduce cleaning time and difference of temperature, which is safe for clinical application.