Compelling medical relation is one kind of administrative legal relationships. In the process of compelling treatment, when illegal or improper treatment by medical staff hurts patient's body, life or psychology, the country must be responsible for compensation to the patient. To effectively avoid the risk of infection due to compelling medical service, the special liability insurance of medical risk for the medical staff should be set up. Furthermore, the patient is supposed to hold the power of receiving legally free cure.

@@

ObjectiveTo investigate the associations of plasma homocysteine (Hcy) and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels with dementia.MethodsThe patients with dementia admitted to hospital were enrolled retrospectively.They were divided into a vascular dementia (VaD) group, a mixed dementia (MD) group, and an Alzheimer's disease (AD) group according to the Hachinski Ischemic Score, and the dementia severity was further divided into a mild group, a moderate group and a severe group according to the Mini-Mental State Examination.The non-demented patients hospitalized during the same period were selected as controls.The demographics, vascular risk factors, and plasma Hcy and Lp-PLA2 levels in each group were compared.Logistic regression analysis was used to determine the independent associations of the plasma Hcy and Lp-PLA2 levels with the risk of dementia and severity.ResultsA total of 125 patients with dementia were enrolled, including 52 (41.6%) in the VaD group, 21 (16.8%) in the MD group, and 53 (41.6%) in the AD group.There were 49 patients (39.2%) in the mild group, 51 (40.8%) in the moderate group, and 25 (20%) in the severe group.A total of 40 non-demented patients were enrolled as control group.The plasma Hcy and Lp-PLA2 levels in VaD, MD and AD groups were significantly higher than those in the control group (all P<0.001).Multivariable logistic regression analysis showed that the advanced age (odds ratio[OR] 1.12, 95% confidence interval [CI] 1.03-1.21;P=0.010), high plasma Hcy level (OR 1.44, 95% CI 1.21-1.71;P<0.001), high Lp-PLA2 level (OR 1.01, 95% CI 1.00-1.02;P=0.006), and previous stroke (OR 4.29, 95% CI 1.50-12.36;P=0.007) were the independent risk factors for dementia;high Hcy level (OR 1.48, 95% CI 1.21-1.82;P<0.001, high Lp-PLA2 level (OR 1.01, 95% CI 1.00-1.03;P=0.002), and previous stroke (OR 152.78, 95% CI 20.41-999.97;P<0.001) were the independent risk factors for VaD;advanced age (OR 1.10, 95% CI 1.02-1.17;P=0.008) and high Hcy level (OR 1.41, 95% CI 1.25-1.58;P<0.001) were the independent risk factor for severe dementia.ConclusionsThe increased plasma Hcy and Lp-PLA2 levels are associated with dementia.Reducing the plasma Hcy and Lp-PLA2 levels may be beneficial to the treatment and prevention of dementia.

G protein-coupled receptor 30 ( GPR30),a sort of novel functional estrogen transmembrane receptor,extensively participate in the pathological and physiological regulation by mediating the rapid nongenomic effects of the estrogen,which plays an important role in the occurrence and development of the hormone-related malignant neoplasms.

Objective To evaluate the effect of wild feces detection in Oncomelania hupensis environments on the surveil?lance of infection source of schistosomiasis,and find the weakness in schistosomiasis control in Hubei Province,so as to put for?ward the targeted strategies and measures. Methods Four environments with O. hupensis snails in endemic areas of Hubei Provinces,where human and livestock often haunted,were selected according to the river systems,namely the Juzhanghe River beach in Jingzhou City,Changjiang River beach in Jiayu County,Hanbei River beach in Tianmen City,and Changshou River beach in Zhongxiang City,then the snail survey and wild feces detection were implemented in the selected environments. Re?sults There were O. hupensis snails,livestock,wild feces of cattle or sheep as well as positive cattle feces found in all the 4 environments,and the positive rate of schistosome miracidium incubation was 47.62%. Conclusion The schistosome miracidi?um positive rate of wild feces of cattle is high in the environments with snails in endemic areas of Hubei Province ,which has high risk for schistosomiasis transmission.

Objective To investigate the water infectivity in key water regions,and analyze the transmission risk of schisto-somiasis in suspicious and high-risk environments in Hubei Province in 2016. Methods Schistosome-endemic areas of the Yangtze River,the Hanbei River and the Fu River were chosen as the surveillance and forecast sites. The water infectivity was detected by using the sentinel mice during the flood season. The infection status of residents in the villages around the surveil-lance sites and the activities of human beings and domestic animals were surveyed. The emergency response system was initiated when the water infectivity areas were detected. Results From May to June,among the ten surveillance sites of the first batch, two positive spots with infected mice were found,accounting for 20％. All the recovered mice(totally 200)were dissected:five mice were infected,with a total infection rate of 2.5％. Totally five schistosome adult worms were collected,with mean worm bur-den of 1 worm per infected mouse. The site with cercariae-infected water body started the emergency response and no epidemic occurred. From August to September,among the eight surveillance sites of the second batch,the recovered mice(totally 160) were dissected,and no infected sentinel mice were found. Conclusion The sentinel mice method plays an important role in an-alyzing the schistosomiasis transmission risk in Hubei Province.

Background and purpose:More than 70 percent of ovarian cancer patients were diagnosed in the advanced stage. Currently the 5-year disease free survival (DFS) of stageⅢC-Ⅳovarian cancer patients wsa about 10 percent after first line chemotherapy. This study aimed to improve the 5-year DFS by three-step chemotherapy according to the mechanisms of ovarian cancer biological characteristics, cytodynamics and pharmacology. Methods:In arm A, the patients received three-step chemotherapy after primary debulking surgery, step one with paclitaxel plus carboplatin (TC regimen), every 3 weeks for 6 to 8 cycles;step two with etoposide plus cyclophosphamide, every 4 weeks for 6 cycles;step three wit carboplatin plus cyclophosphamide every eight weeks for six cycles. In control arm B, we retrospectively analysed 51 cases withⅢC-Ⅳstage ovarian cancer, who had completely response after standard chemotherapy with six to eight cycles of TC after primary surgery during 2007. We compared the 5-year DFS between the two arms. Results:The 5-year DFS of 15 cases in arm A was 80%(12/15), which was signiifcantly higher than that of arm B (5.9%, 3/51, P<0.01). Conclusion: The three-step chemotherapy after optimal debulking surgery in stageⅢC-Ⅳ can improve the 5-year DFS. This regimen is high efficacy, mild side-effect witn low cost, which deserves further exploration.

Background Graft rejection is a primary cause of corneal transplantation failure,especially in high-risk keratoplasty.How to extend the survival time of graft is a problem to be solved.Objective This study was to investigate the influence of immune tolerance on high-risk rat keratoplasty induced by donor bone marrowderived immature dendritic cells (imDCs) transfected by chemokine receptor 7 (CCR7) recombinant adenovirus (Ad).Methods Bone marrow-derived imDCs were isolated and cultured from femur marrow of one male Wistar donor rat.The cells were transfected using recombinant Ad vector with rat CCR7 gene and resuspended in 500 μl PBS containing 1％ fetal bovine serum with the cells 1 × 107.High-risk corneal transplantaion models were established using monolateral corneal alkali-burn method in 60 SD rat recipients, and then allograft keratoplasty was performed with the 30 Wistar rats as donors.The models were randomized into the PBS group,imDCs group,imDCs with blank Ad vector group and imDCs with Ad-CCR7 group following the corresponding solution injection via caudal vein on preoperative day 7 and postoperative day 3 respectively.The survival time of graft was evaluated under the slit lamp microscope once per day.On the 14th day after operation, corneal sections were prepared from 6 eyes of each group for the pathological examination,and the relative expression levels of T helper cell 1 (Th1)-related factors,interleukin-2 (IL-2) mRNA and interferon-γ(IFN-γ) mRNA,as well as Th2-related factors, IL-4 mRNA and IL-10 mRNA, were detected by reverse transcription PCR (RT-PCR).The use and care of animals complied with the ARVO statement Results The mean survival time of grafts was (10.44±1.88) , (16.00±2.18) , (15.11±2.03) and(23.67±2.83) days in the PBS group,imDCs group,imDCs with blank Ad group and imDCs with Ad-CCR7 group, respectively, with a significant difference among the 4 groups (F =53.005, P =0.000).Compared with the PBS group, the mean survival time of grafts was considerably extended in the imDCs group,imDCs with blank Ad group and imDCs with Ad-CCR7 group (t=5.220,4.385,12.423 ,all at P=0.000) ,and a remarkble prolongation of graft survival duration was seen in the imDCs with Ad-CCR7 group in comparison with the imDCs group and the imDCs with blank Ad group (t =7.204,8.039,both at P=0.000).The relative expression levels of IFN-γ mRNA and IL-2 mRNA in the grafts were significantly lower,but the relative expression levels of IL-4 mRNA and IL-10 mRNA were significantly higher in the imDCs group,imDCs with blank Ad group and the imDCs with Ad-CCR7 group than those in the PBS group (all at P＜0.05).Compared with the imDCs group and the imDCs with blank Ad group, the relative expression levels of IFN-γ mRNA and IL-2 mRNA in the grafts were remarkably delined,but the relative expression levels of IL-4 mRNA and IL-10 mRNA were remarkably elevated in the imDCs with Ad-CCR7 group (all at P =0.000).Conclusions Application of imDCs transfected with CCR7 recombinant Ad via vena caudalis can prolong the survival time of grafts after keratoplasty of SD rats probably by affecting the balance of Th1/Th2 cytokines.

Objective To improve the information level of schistosomiasis control by using the related functions of Corel-DRAW software. Methods Combining with the requirement of schistosomiasis control,the sketch map was drawn according to the linear element drawing,the geometric drawing,the color rendering and the text adding. Results The schistosomiasis epi-demic sketch map and the Oncomelania hupensis snail distribution sketch map at all levels were produced in CorelDRAW soft-ware. Conclusion The sketch map drawing in CorelDRAW software is beautiful and standardizing,and it can improve the lev-el of information management.

Objective To analyze the Oncomelania hupensis snail situation in schistosomiasis surveillance sites in Hubei Province from 2009 to 2014. Methods From 2009 to 2014,207 schistosomiasis endemic villages from 13 cities were selected as the surveillance sites in Hubei Province,where the surveillance of snail situation was performed,and the data about the in?dexes of snail situation during the 6 years were collected and analyzed statistically. Results From 2009 to 2014,totally 80 963.47 hm2 of snail areas were investigated,and 45 309.77 hm2 of area with snails as well as 364.93 hm2 of area with infected snails were found out,and 1 646 125 snails were captured. In the 207 surveillance sites,the density of living snails was reduced from 0.493 3 snail/0.1 m2 in 2009 to 0.339 3 snail/0.1 m2 in 2014,with a decline rate of 31.22%;the density of infected snails was reduced from 0.000 7 snail/0.1 m2 in 2009 to 0 in 2014;the infection rate of snails was reduced from 0.14%in 2009 to 0 in 2014. The infection rates of snails in the third?rank villages,endemic areas in inner embankment,ditch environment and weed environment were relatively higher. Conclusions The snail situation of Hubei Province has been declined steadily. However, the environment of snail breeding has not been changed completely. In order to consolidate the control achievements further ,the measures including mollusciciding and snail control projects should be strengthened.