Put forward opinions and suggestions about characteristics of the new era of medical disputes pre -vention treatment through the analysis of a hospital in the past five years occurred in 44 medical disputes .We must fo-cus on innovation and long -term mechanism to prevent medical malpractice , medical malpractice to further improve the prevention, comprehensive mechanism , and continuously improve the effectiveness of medical dispute processing services.

Objective To explore the effect of serum leptin on puberty development in schoolboys.Methods 170 health schoolboys were investigated on the first spermatorrhea time and detected the levels of serum leptin, testosterone,follicle stimulating hormone (FSH), luteinizing hormone (LH). Case-controlled study was carried by multivariable logistic regression in puberty development of schoolchildren with and without spermatorrhea. Meanwhile, follow-up studies on the independent influencing factors on the puberty development were applied to this investigation in continuous two years.Results The levels of serum leptin, testosterone,FSH and LH of schoolboys with spermatorrhea were significantly higher than those of schoolboys without spermatorrhea. Multiple logistic regression analysis demonstrated that the serum leptin,testosterone, FSH, and bodyweight were the independent influence factors in puberty of the schoolboy.The levels of serum leptin,testosterone of pre-spermatorrhea schoolboys were significantly higher than schoolboys without spermatorrhea.Conclusions Serum leptin,testosterone, FSH, and bodyweight were the independent influence factors in puberty of the schoolboy.The levels of serum leptin and testosterone had obviously changed before spermatorrhea.

Objective To explore the impact of transtheoretical model on sun protection behaviors of soldiers in plateau area.Methods A total of 208 male soldiers trained in 4 200 meters altitude and medically supported by our hospital were randomly divided into the experimental group(n=104) and the control group(n=104).The experimental group received health education based on the transtheoretical model,and the control group received routine health education.Score of sun protection behaviors questionnaire,sunscreen using behavior and score of the Dermatology Life Quality Index (DLQI) before and after the intervention between two groups were compared.Results Score of sun protection behaviors questionnaire in the experimental group was higher than that in the control group (P＜0.05),sunscreen using behavior in the experimental group was better than the control group(P＜0.05),score of the Dermatology Life Quality Index in the experimental group was lower than the control group(P＜0.05).Conclusion Health education guided by the transtheoretical model can improve the plateau soldiers' sun protection behaviors,and it is an effective method of health education.

[Objective]To summarize the experiences of total hip replacement with cementless joint components in the treatment of osteoarthritis secondary to acetabular dysplasia in adults and to evaluate its early effect. [Method]From March 2000 to March 2007, thirty hips in 25 adult patients with osteoarthritis secondary to acetabular dysplasia undergoing total hip replacement with cementless joint components were included in this study. Of the patients, 5 were male and 20 were female.Their ages ranged from 35 to 55 years with an average age of 55 years. The patients mainly complained of pain and claudication. According to the Hartofilakidis classification , Semi-dislocation occurred in 21 hips and high-dislocation in 9 hips.Five patients underwent bilateral total hip replacements and twenty patients had unilateral total hip replacement.[Result]The duration of follow-up ranged from 8 months to 7 years ( average 3 years and 9 months ) . The average Harris score was increased from 36.09 to 88.21 points, They could take care of themselves and returned to their previous job. All the patients were pain-free and there was no sign of aseptic looseing or subsidence.[Conclusion]Total hip replacement with cementless joint components is an effective method for the treatment of osteoarthritis secondray to acetabular dysplasia in adults.The key point to the success for operation are appropriate cementless joint components, deepened medial wall of the acetabulum and improved the techniques of bone graft in the true acetabulum.

Objective To investigate risk factors and characteristics of the pathogens for hospital-acquired pneumonia(HAP) in elderly psychiatric patients Methods Data were collected from 259 psychiatric patients aged over 60 hospitalized between January 2012 and December 2014,and risk factors for HAP and characteristics of the pathogens were analyzed.Results The incidence of HAP in the elderly psychiatric patients was 40.4％.Main risk factors for HAP included long-term bed rest,dysphagia,specific types of mental illness,underlying comorbidities,length of hospitalization,psychiatric medications,and age.A total of 137 pathogenic microbialstrains were isolated,of which,Gram-negative species accounted for 55.47％,with 32.12 ％ as Gram-positive species and 12.41 ％ as fungal species.Conclusions The main risk factors for HAP in elderly psychiatric patients are long-term bed rest,dysphagia,specific types of mental illness,underlying comorbidities,length of hospitalization,psychiatric medications,and age.The most common pathogens are Gram-negative microorganisms,followed by Gram-positive microorganisms and fungi.It is very important to take proactive measures to prevent the occurrence of HAP and improve prognosis.

BACKGRUND:The high prevalence of hepatitis B virus(HBV) is related with the sexual characteristics in drug abusers.How about the relationship between prevalence of HBV/hepatitis C virus(HCV) co infection and the sexual characteristics in drug abusers? OBJECTIVE:To investigate the relationship between sexual characteristics and HBV/HCV co infection in drug abusers. DESIGN:A cross sectional survey taking the drug abuser as the subjects. SETTING:A department of clinical laboratory of a municipal hospital,an epidemiological department of the college of public health of a university,a professional drug abuser treatment center. PARTICIPANTS:Totally 452 male and 320 female drug abusers were randomly selected from the Changsha Xinkaipu Drug Abusers Treatment Center and Zhuzhou Baimalong Female Drug Abusers Treatment Center as the subjects from 1st to 31st January 2001. INTERVENTIONS:A self designed questionnaire was used to investigate the sexual characteristics of drug abusers.HBV surface antigen and HCV antibody were detected in the serums of the participants with ELISA. MAIN OUTCOME MEASURES:The relationship between HBV/HCV co infection and the sexual behavior, numbers of sexual partners,and the usage of condom in drug abusers. RESULTS:The total prevalence of HBV/HCV co infection in drug abusers was 21.24% ; the prevalence of HBV/HCV co infection in male drug abusers was 29.6% ),which was significantly higher than that in females(9.4% )(χ 2=46.016,P< 0.01).There was no significant difference in the prevalence of HBV/HCV co infection between male and female drug abuser whether they had or had not sexual behaviors(χ 2=3.775,P >0.05).The prevalence of HBV/HCV co infection was in an ascending tendency with the increase of sexual partner(χ 2=9.846,P< 0.05).The using frequency of condom was significantly higher in females than in males(U=14.80,P< 0.01). CONCLUSION:There is no correlation between sexual experience and prevalence of HBV/HCV co infection;male drug abusers have higher prevalence of co infection than females;the number of sexual partners is correlated with the prevalence of HBV/HCV co infection,the more sexual partners,the higher prevalence is.The protective effect of condom is greater in female drug abusers than in males.

Objective To evaluate whether therapeutic ultrasound, applied alone or with urokinase, may have a thrombolytic effect on blood clots in vitro, and the other factors influencing the urokinase-mediated thrombolysis. Methods Experiments were carried out in an in vitro blood clot model.The blood clots were divided into four groups as physiological solution group(NS), urokinase group(UK),physiological solution plus ultrasound group(NS + US), urokinase group plus ultrasound group(UK + US).After intervention of one hour in static 37 ℃ water bath, each group of blood clots was weighed. After that,the weight loss and thrombolysis rate of the blood clots in each group were calculated. To observe the impact of the age of the blood clots on urokinase-mediated thrombolysis rate, the thrombolysis rate of eight time points 3, 4, 5, 6, 7, 8, 9, 10 hours was tested. The time was determined from the blood drawn from the body to the initiation of thrombolysis test. Results In terms of thrombolysis rate, there was significant difference between UK group and UK + US group(LSD-t 12. 1, P ＜ 0.01), with a thrombolysis rate 29. 3% ±8. 2% and 37. 5% ±7. 9%, respectively. However, the difference of thrombolysis rate between NS group and NS + US group with a thrombolysis rate 13. 4% ±4. 4% and 14. 5% ± 5.4%, respectively,was not statistically significant with a P value of 0. 08(LSD-t 1.8). The age of the blood clots had a negative correlation to the thrombolysis rate to some extent. Conclusion Therapeutic ultrasound has a significant effect on thrombolysis in combination with urokinase rather than used alone. To a certain extent,the thrombolysis rate decreases with the age of blood clot.

Objective To provide anatomical basis for the free saphenous branch of descending genicular artery flap and evaluate its clinical outcomes for the hand soft-tissue defects. Methods Fifteen fresh cadavers injected with lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a spiral computed tomography scanner. The origin, course and distribution of the perforators of descending genicular artery were observed.From January 2005 to October 2011,seven patients with skin defect on the distant limbs were treated.The flap size was 5 cm × 6 cm-11 cm × 14 cm,vascular pedicle length 5.4 (4-7)cm. ResultsThe saphenous branch was consistent. It arised from the descending genicular artery (68％) or femoral artery(32％).The diameter of the saphenous branch was 1.5(1.1-1.7)mm at its origin above 9.0(4.0-16.0)cm from the medial epicondylar.Seven cases of flaps all survived,the average followup of 28 months,close to hand flap of skin texture,some sensory recovery,two-point discrimination 8-12mm. Conclusion Free saphenous branch of descending genicular artery flap is a reliable option for the treatment of soft tissue defect in hands. The pedicles were invariable of anatomy, thickness of the flaps is comparable,and procedure is simple and time saving.

Day care is described in the paper in terms of its meaning and management.As to areas deserving attention given the initial success,the authors proposed to priortize medical insurance compensation policy,medical resource deployment,patient safety and follow-up for discharged patients.These efforts may further quality of care and patient satisfaction.

Objective To use phage display for generating surrogate peptides of candida albicans mycelial-phase protein as mimic antigen to develop an enzyme-linked immunosorbent assay (ELISA) assay for detection of candida albicans antibodies.Methods A monoclonal antibody against candida albicans mycelial-phase protein P47, was used in this study for selecting immunoreactive peptides, mimotopes, from a 12 mer phage library.The peptides were characterized immunologically and used for coating antigen in ELISA to detect antibodies against candida albicans in the patients' serum.Results The sensitivity, specificity and replication of the ELISA assay was good enough for clinical use. The antibody was positive in all of 10 samples of patients with confirmed systemic candida albicans infection and the results were same to those obtained with the purified mycelial-phase protein P47; The positive rates in patients receiving immunosuppressive drug cyclosporin A are 33% and the healthy 2% respectively.Conclusion The surrogate peptides from a 12 mer phage library can be used in ELISA for detecting the antibodies of candida albicans P47.