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.

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 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 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 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 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.

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.

Background T helper cell 17 (Th17),a newly discovered subset of CD4+ T cells,have been found to play an important role in dry eye disease in animal model.Further investigation should be done on the immunopathogenesis of Th17 cells in dry eye patients.Objective This study was to analyze the expression status of interleukin-17 (IL-17) and IL-22 in tear and supernatant of peripheral blood mononuclear cells (PBMCs) of dry eye patients and their correlation with clinical symptom and sign.Methods Twenty Sj(o)gren syndrome (SS)patients,twenty non-Sj(o)gren syndrome (NSS) patients were included in Wuxi Second Hospital from 2010 to 2011,and twenty healthy volunteers were recruited at the same period.All of subjects understood the purpose and procedure of research and written informed consent was obtained form each subject initial of this study.Dry eye symptom questionnairs were self-answered and multiple dry eye disease-related clinical tests,including the breakup time of tear film (BUT),Schirmer Ⅰ test (S Ⅰ t) and corneal fluorescein staining were performed.The periphery blood of 3 ml and tear were collected in all the subjects,and IL-17 and IL-22 levels in supernatant of PBMCs and tear were detected by enzyme-linked immunosorbent assay (ELISA).The correlations between levels of IL-17 and IL-22 with BUT,S Ⅰ t,corneal fluorescein staining and dry eye scores were analyzed.Results The dry eye scores reduced,BUT prolonged,S Ⅰ t increased and corneal fluorescein dye decreased from SS group,NSS group to normal control group,with significant differences among the three groups (dry eye scores:H =40.81,P＜0.01 ; BUT:H =40.15,P＜0.01 ;S Ⅰ t..H=50.07,P＜0.01 ;corneal dye scores:H=40.52,P＜0.01).The concentration of IL-17 in the supernatant of PBMCs in the SS patients,NSS patients and normal controls were (964.92±124.83)ng/L,(718.85± 115.89)ng/L and (341.95±85.08) ng/L,showing a statistically significant difference among them (F=162.95,P＜0.01).The levels of IL-17 in the tear were (440.69±126.09) ng/L,(364.33±126.85) ng/L and (61.16±11.60) ng/L in the SS group,NSS group and normal control group respectively,exhibiting an elevated level in the SS group and NSS group compared with the control group (F=75.27,P＜0.01).In addition,the levels of IL-22 in the supernatant of PBMCs in the SS patients,NSS patients and normal controls were (98.77± 11.27) ng/L,(79.65 ± 11.01) ng/L and (32.78±9.34) ng/L,and those in the tear were (22.22 ± 8.96) ng/L,(14.92 ±4.35) ng/L and (10.47 ± 2.67) ng/L,with significant differences among the three groups (F =206.27,P＜0.01 ;F =19.87,P＜0.01).The significant correlations were found between the IL-17 and IL-22 concentration in the supernatant of PBMCs and tear with corneal fluorescein staining scores and S Ⅰ t.Conclusions The contents of IL-17 and IL-22 in PBMCs and tear upregulate in the SS and NSS patients,indicating that Th17 plays a key role in the immunity mechanism of dry eye.

Background The incidence of myopia is gradually increasing,and how to choose a better corrective method of myopia for the best visual demand is very important.Objective This study was to compare visual quality of implantable collamer lens (ICL) implantation with femtosecond laser in situ keratomileusis (FSLASIK) for moderate and high myopia using double-pass optical quality analysis system (OQAS).Methods A non-randomized controlled clinical trail was performed.Fifty-two eyes with-4.00 to-9.00 D of 26 consecutive patients were included in NO.1 Hospital of Xi'an from January 2015 to January 2016.Twenty-four eyes of 12 patients with the corneal thickness ＜500 μm received ICL implantation as ICL group and 28 eyes of 14 patients which corneal thickness was ≥500 μm underwent FS-LASIK surgery as FS-LASIK group.The demography was matched between the two groups (all at P＞0.05).All the patients were followed-up for 3 months after surgery.The preoperative best corrected distance visual acuity (BCDVA),spherical equivalent (SE),postoperative uncorrected distance visual acuity (UCDVA),BCDVA and SE were examined and compared between two groups.The parameters from OQAS were evaluated and intergrouply compared,including the objective scattering inders (OSI),modulation transfer function (MTF) cut off frequency,Strehl ratio and OQAS values under the contrast of 100％,20％ and 9％ (OV100,OV20,OV9).Results The postoperative BCDVA was not significantly different from preoperative UCDVA in both ICL group and FS-LASIK group (-0.04±t0.10 vs.0.05±0.12;-0.07±0.12 vs.0.00±0.12) (t=3.128,2.358,both at P＞0.05).No statistically significant differnces were found in SE,UCDVA and BCDVA after operation between ICL group and FS-LASIK group (t =1.292,0.900,-0.653,all at P＞0.05).OQAS examination showed that MTF cut off,OSI,Strehl ratio,OV100 were not significantly different after operation between ICL group and FS-LASIK group (t=-2.032,-1.440,-0.224,all at P＞0.05).The postoperative OV20 and OV9 were 0.82±0.14 and 0.80±0.21 in the ICL group,which were significantly higher than those in the FS-LASIK group(0.59±0.15 and 0.47±0.13) (t =4.105,4.702,both at P＜0.05).Conclusions Both ICL implantation and FS-LASIK provide good optical and visual quality for moderate to high myopic eyes,and ICL appears to have a better visual quality in comparison with FS-LASIK under the contrasts of 20％ and 9％.