Harmonious relationship between medicine and patients is an important component constructing harmonious society. Bad harmonious relationship between medicine and patients and medical tangle case is increasing. The article introduced the concept and the causes of medical disputes. Clinical examples of medical disputes are analysed in department of cariology and endodontolo-gy,guanghua school of stomatology,sun yat-sen university.

Objective To study the differential expression of apoptosis related genes in GJB2 gene conditional knockout mice (cCx26Pax2Cre ) cochlea membranous labyrinth ,and to explore the mechanism of GJB2 gene mutations causing deafness .Methods Two developmental stages of P10 and P18 were selected from the knock out mice and the wild type ones (BALB/C) .The total RNA was isolated from cochlear membranous labyrinth and PCR array was performed using mouse apoptosis PCR arrays .Results Compared with wild -type mice ,significant up or down -regulation in gene expression was detected in 16 genes in cCx26Pax2Cre ones at P10 .Of the 16 genes ,14 ones were down-regulated .Among the 14 genes ,9 ones can be classified as anti -apoptosis or pro -proliferation genes ,5 ones can be classified as pro -apoptosis or pro -inflammation genes .The other 2 genes expression was up-regula-ted ,and their main role was to promote apoptosis .Compared with time -matched controls ,significant up or down-regulation in gene expression was detected in 4 genes in cCx26Pax2Cre mice at P18 .Of the 4 genes ,3 ones expression was down-regulated ,were anti-apoptosis ones .The expression of the other one gene among the 4 ones was up-regulated ,which acted as pro -apoptosis genes .Bcl2l10 and Tnfrsf10b expression showed significant down or up -regulation at both stages . Compared with P10 , the expression of caspase - 8 was up - ragulated at P18 in cCx26Pax2Cre mice .Conclusion It is suggested that GJB2 mutation may up -regulate the expression of DR5 ,which can trigger the death receptor pathway to cause apoptosis in cCx 26Pax2Cre mice cochlea directly .At the same time , caspase-8 in death receptor pathway may activate the mitochondria pathway indirectly and amplify the apoptosis further in cCx26Pax2Cre mice cochlea .The final result of the above activated pathways is the wide range of cochlear cells apoptosis and the profound hearing loss in cCx 26Pax2Cre mice .

OBJECTIVE Infection control(IC) is one of the most important issues involved in the administration of modern hospitals in the world.The aim of this survey is to analyze the necessities to set up some courses on IC for undergraduates during their 5-year studying.METHODS In this study,71 academic staffs in Guanghua School of Stomatology and 74 fourth and fifth year undergraduates were surveyed by questionnaires about the necessities and knowledge of IC.RESULTS The finding showed that both academic staffs and students did not have well-educated knowledge of infection control,and they all agreed with an importance of IC course in college education system.CONCLUSIONS Setting-up an infection control course may be essential as an elemental education course in college.

Objective To investigate the training demaneds of nursing administrators in Dongguan district. Method A self-designed questionnaire was used to investigaste 744 nursing supervisors from 68 hospitals in Dongguan. Results Among them, master,bachelor and primary professional title account for 1.35%,60.35%and 30.25%respectively, Risk and crisis manngement and quality control are the main training demands.The influencing factors are as follows,funds,time and supports from leaders or/and by on-the-spot visits.Conclusion The training for the nursing administrators should be need-oriented in different forms.

ObjectiveTo investigate the clinical phenotypes of familial hypercholesterolemia (FH) caused by exon 13 A606T mutation in low deusity lipoprotein receptor.MethodsClinical data of the suffered family were collected and analyzed,as well as measurement of perivascular intima-medial thickness and follow-mediated-dilation function by ultrasonography.ResultsThere were totally 11 sufferers including 4 males and 9 females,aged 8-90 years,with 2 homozygotes and 9 heterozygotes.Among them, one homozygote showed angina pectoris and hematuria,both homozygotes had skin xanthomata.TC,TG,LDL-C and HDL-C were(7.39 ± 1.30) mmol/L,(0.93 ± 0.36) mmol/L,( 11.76 ± 1.10) mmol/L and ( 1.22 ±0.17) mmol/L,respectively.The left/right sided intima-medial thickness of the common,internal,external and bulb carotid artery were ( 1.15 ±0.45) mm/( 1.30 ±0.60) mm,(0.82 ±0.30) mm/( 1.00 -0.66)mm,(0.77 ±0.28) mm/(0.78 ±0.30) mm and ( 1.40 ±0.59) mm/( 1.46 ±0.71 ) mm respectively.The brachial artery flow mediated dilation rate was (4.85 ±4.80)％.Echocardiography revealed 2 patients with cardiac valvular disease and 3 with atrium septum aneurysm. ConclusionFH patients show a variety of phenotypes incuding extraordinary hypercholesterolemia,subcutaneous xanthomata and premature coronary heart disease.

Objective To explore the mechanism and effects of basic fibroblast growth factor( bFGF)on skin wound healing. Methods Fibroblasts( FB)were isolated from normal skin and hypertrophic scar and cultivated by direct adherence method. FB were then treated with different concentrations of bFGF(0,0. 1,1,10,100,1 000 ng·mL-1 )and cultivated with serum-free medium for 72 hours. The proliferation and apoptosis of FB in each group were detected by cell counting and trypan blue staining. Content and gene expression of typeⅠand type Ⅲ collagen and fibronectin were determined by ELISA and RT-PCR,respectively. Results bFGF promoted the proliferation of FB at low concentrations promoted apoptosis of FB at higher concentrations. The proliferation of FB from hypertrophic scar was slower than that from the normal skin. bFGF significantly inhibited type Ⅰ collagen production from hypertrophic scar FB but not from the normal skin. Moreover,bFGF up-regulated fibronectin expression in the normal fibroblasts,but not in the hypertrophic scar. No change in type Ⅲ collagen expression and production was observed in FB from either source. Conclusion bFGF has differential effects and mechanisms on FB of the normal skin and hypertrophic scar,suggesting that bFGF may play a role in early phase of skin wound healing and scar formation.

Objective To determine whether it is necessary to execute pre-labor pubic shaving.Methods Women(336 cases)who received pubic shaving through vaginal delivery from 2003 to 2006 were set as the control group.Women(103 cases)who were waiting for delivery currently in our hospital were set as the test group.The test group only received perineal cleaning without pubic shaving.If episiotomy was needed during the operation,the perineal hair Was cut by scissors.The perineum infectious rate and postpartal infection Was compared in the two groups.We interviewed the patients attitude for pubic shaving and counted the numing time used for pubic shaving.Results The perineal infection in the test group was 5.8%,which was no statistically different from that of the control group(2.4%),U=0.33,P＞0.05.Totally 95% women in the test group support this method demonstrated humanization.In the telephone folow-up visit for patients in the control group they comphined itch and discomfort during the regeneration of pubes.The average numing time for pubic shaving Was(4.6±0.6)minutes.Conclusions No pubic shaving for pre-labor skin preparation was feasible.If operation was disturbed by pubes we could use scissors to cut it short.This method could reduce the skin infection and propagation of blood-derived infectious disease.It increased the comfort of parturient,saved time and proved to be a nursing method of humanization.

Internet-based practice of stomatology hospitals plays an important role in promoting hierarchical medical system and overcoming the social problems of " high costs and difficulties of medical services" . The authors introduced the practice of free online consultations at a tertiary stomatology hospital during this period. They also analyzed such characteristics of the practice as the doctors′ response rate, doctors′ response timeliness, as well as the specialties and timeframe distribution of patient consultations. The hospital provides online consultations on Guangdong cloud-based hospital platform in two modes. For example, the normal consultation mode operates in a many-many manner, with services provided by attendings and associate chief physicians appointed less than three years. In off hours, patients can also raise questions online. The expert consultation mode offers consultations during business hours in a one-to-one manner, with services provided by associate chief physicians appointed over three years and chief physicians. From February 10 to March 22 2020, 2 156 persons/times of consultations were served in the normal mode, and 1 043 persons/times received in the expert mode. The response timelines of the latter (16.19 min) was much better than the former (27.10 min). In terms of consultation workload of sub-specialties, oral medicine ranked the top (69.30%), while the consultations of the normal mode in work hours accounted for only 73.47% of total consultation workload. It is recommended to optimize resources deployment, introduce artificial intelligent inquiry service, explore an online-offline combined stomatological service, and improve performance management. These measures, when in place, can promote sustainable development of Internet-based stomatology hospitals.

Objective To explore airway remodeling and air trapping in asthmatic patients with low dose CT scanning and quantitative analysis. Methods 52 stable asthmatic patients in which 29 were severe and 23 were slight,and 20 healthy control cases were underwent low dose dual phase CT scanning. The LA/BSA, WA/BSA, TA/BSA, WA%and Pi10WA were analyzed as airway remolding indexes. The MLD of expiratory, VI-850 (%) of expiratory, MLD E/I, VI-850E-I (%) and VI-850/-950E-I (%) were analyzed as air-trapping indexes. One-Way ANOVA or H Kruskal-Wallis was used to analyze the above indicators. Results Airway remodeling indexes and LA/BSA were (9.6 ± 2.6), (11.0 ± 3.4) and (12.6 ± 3.0)mm2/m2 in severe asthmatics group, non-severe asthmatics group and healthy control group respectively, and there was significant difference between the three groups (F=5.60, P=0.006). WA%of each group was (65.1 ± 2.5)%, (63.3 ± 4.4)%and (62.0 ± 3.0)%, and there was significant difference between the three groups (F=5.53,P=0.006). The Pi10WA was (18.4±2.6), (17.7±3.1) and (16.4±1.4) mm2 respectively with significant difference between the three groups (F=3.59 ,P=0.033). Air-trapping indexes, MLD of expiratory of each group was-(771 ± 59),-(724 ± 43) and-(676 ± 60) HU respectively with significant difference (F=5.60, P=0.006). VI-850(%) of expiratory of each group was 30.79(30.45)%, 13.53(12.09)%and 2.85(6.87)%respectively with significant difference (H=17.20,P<0.001). Conclusions Low dose of CT scan and quantitative analysis can provide an objective and quantitative information for patients with airway disease of asthma, and both WA% and Pi10WA were objective indexes. The severe asthmatic patients were associated with obvious airway remodeling and air trapping compared with non-severe asthmatic patients.

Objective To investigate the expression and possible mechanism of miR-21 and Ski-related novel protein N( SnoN) in the renal fibrosis diabetic process.Methods The animal model was established by tail-vein injection of Streptozotocin,and the other group were normal control ( NC) group.After 10 weeks, the rats were sacrificed to measure biochemical parameters and renal index , and to observe the changes of pathomorphology by HE staining as well.Meanwhile, immunohistochemistry and Western blot were employed to examine protein ex-pression of E-cadherin,α-smooth muscle actin(α-SMA), fibronectin(FN), collagen-Ⅰ(Col-Ⅰ), collagen-Ⅲ(Col-Ⅲ), transforming growth factor-β1(TGF-β1), Smad3, p-Smad3(Ser423/425) and SnoN in the renal tissue. In addition, the expression of SonN mRNA and miR-21 were detected by qPCR.Results In DM group,the ex-pressions of Col-Ⅰ, Col-Ⅲ and FN in renal interstitium were increased ( P <0.05 ) , TGF-β1 increased (P<0.05),while E-cadherin decreased(P<0.05).Compared with NC group, the expression of α-SMA,p-Smad3 (Ser423/425) protein increased in DM group(P<0.05),while the protein level of SnoN decreased but the level of SnoN mRNA increased ( P <0.05 ) .Moreover, the level of miR-21 markedly increased in DM group ( P <0.05 ) .Conclusions TGF-β1 may up-regulate the expression of miR-21 but restrain the translational expression of SnoN, aggravating fibrosis.