Objective To enable medical institutions and personnel in the case of a medical encroachment dispute to provide precise proof in court, use standard format for the legal complaint, employ the appropriate proofgathermg method, ensure the simplicity of the proof-providing procedure, and avoid the waste of manpower and material resources and the liability of economic compensations in the course of compromise settlement, mediation by the health administrative department or adjudication by the court. Methods Regulations were laid down within the hospital for proof-providing procedures, methods, contents, the contents and format of legal complaints and reply letters, and documents in preparation for the provision of proof. Results Through the handling of over 900 medical encroachment disputes, the above methods proved to be practical, applicable and up to the standard. They could save the time of the hospital, the patient and the lawyer on blind surveys, reduce proof-providing time, and improve efficiency in handling medical encroachment disputes. Conclusion Standardizing proof-providing procedures, methods, and contents and the format of legal complaints or reply letters is of great significance in improving efficiency in handling medical encroachment disputes and reducing the hospital's chances of losing lawsuits.

Objective To evaluate the effect of intravenous lidocaine on postoperative pain and acute rehabilitation after laparoscopic hysterectomy.Methods Ninety-six patients scheduled for lapa-roscopic hysterectomy under general anesthesia were randomized into 2 groups (n = 48 ).In test group,lidocaine 1.5 mg/kg was administered at induction,then with a continously infusing rate of 2 mg·kg-1 ·h-1 until the end of surgery.In control group,saline was instead.Record the resting and coughing pain scores at 6,12,24 and 48 h after surgery,morphine consumption during the first 48 h, time to first flatus,6 min walk test (6MWT)result,and side effects such as dizzy,nausea and vomi-ting.Results Resting VAS scores at 6,12 and 24 h postoperatively were lower in test group than in control group (P <0.05).Coughing VAS scores in test group were lower than in control group at all time points (P <0.05).The morphine consumption was lower in test group than in control group (P<0.05).Time to first flatus was earlier in test group than in control group (P <0.05 ).6MWT at day 4 and 5 were significantly enhanced in test group (P <0.05 ).Conclusion Intravenous lidocaine can reduce postoperative pain scores and morphine consumption,as well as improve early rehabilita-tion after laparoscopic hysterectomy.

ObjectiveThe research is that pulse magnetic acupuncture in scalp point affects the nerve function and endothelin-1(ET-1)capacity of acute cerebral ischemia rat. Methods70 rats were divided randomly into seven groups: normal, artificial operation, model, static magnetic acupuncture, normal acupuncture, electric acupuncture and pulse magnetic acupuncture, every group had 10 rats and the nerve function and plasma ET-1 capacity of rats were examined.ResultsStatic acupuncture, electric acupuncture, pulse magnetic acupuncture and normal acupuncture can improve the nerve function and decrease the capacity of ET-1, but pulse magnetic acupuncture and normal acupuncture improve obviously.Conclusions Pulse magnetic acupuncture and normal acupuncture have the same effect to improve the nerve function and decrease the capacity of ET-1.

Objective To summarize the clinical experience of surgical intervention for cardiac neoplasm in a fetus . Methods A 32-year-old pregnant woman was admitted to our hospital for complaint of fetal cardiac neoplasm .A separated het-erogenic cardiac occupying lesion was identigied at right atrium of the fetus by echocardiography , whose size is 2.85 cm ×2.25 cm, but the pathogenic origin still remained uncertain, maybe originate from ether pericardium or atrium.The annulus of tri-cuspid valve was compressed nearly 50% with the presence of amount of pericardial effusion.The fetal heart rate decreased at some fetal position resulting in the compression to the heart.So an Ex-utero Intrapartum Therapy(EXIT) procedure was per-formed under the supply of placenta at the 32 weeks of pregnancy.Cesarean section was performed with intact umbilicus and fe-tal circulation by obstetricians.Consequently, the median sternotomy of this fetus and pericardiotomy were performed , with 30 ml clear pericardial effusion drained .The tumor was confirmed to be giant right atrial neoplasm after the intraoperative explora-tion.Considering on the high risk of the cardiopulmonary bypass and limited time for EXIT , the giant atrial neoplasm was left alone with delayed sternum closure after the effectively decompression of the heart .The omphalotomy was successfully per-formed after the EXIT surgery.The neoplasm resection and the repair for its defect on right atrium were performed with cardiop-ulmonary bypass 2 days later.Results Convalesce of this mother was quite good after cesarean resetion .Hemodynamics of the premature baby was satisfatory after the resection of right atrial neoplasm which pathological report was benign hemangioma . Conclusion Via multiple disciplines collaboration , EXIT intervention for fetus is feasible and safe under adequate prepara-tion.

Predicting the protein binding rate of drugs in plasma is helpful to us in understanding the pharmacokinetic characteristics of drugs, with much value of reference for early research on drug discovery. In this study, plasma protein binding rate information of 2 452 clinical drugs were collected.Two pieces of software, Molecular Operating Environment (MOE) and Mordred, were used to calculate molecular descriptors, which were used as input features of the model.Extreme gradient boosting (XGBoost) algorithm and random forest (RF) algorithm were then used to build a machine learning model.The results showed that, compared with MOE, the prediction performance of the constructed model was better using the molecular descriptor calculated by Mordred as the input of the model.The prediction performance results of the model constructed using the XGBoost algorithm and the RF algorithm were similar, and the R2 of the optimal model were both 0.715.According to the research results, it can be concluded that the drug plasma protein binding rate is closely related to some physical and chemical properties of the drug molecule, such as water solubility, octanol/water partition coefficient and conjugated double bonds.Using these parameters to predict the plasma protein binding rate of drugs has the advantages of convenience and efficiency, which can provide reference for related pharmacokinetic studies.

Objective:To discuss the medication law in prescriptions of Professor Shao Nianfang in the treatment of kidney deficiency and bone marrow loss in senile dementia based on data mining.Methods:Medical cases of kidney deficiency and bone marrow loss in senile dementia in the Geriatric Hospital of Shandong University of Traditional Chinese Medicine from 1st Jan. 2014 to 31st Oct, 2019 were collected. Through hospital electronic medical records system prescription statistics, using ancient and modern medical case cloud platform (V1.2.4), medication frequency, property ans taste, efficacy analysis, correlation rule analysis, clustering analysis and complex network analysis were performed.Results:Totally 110 cases were included in medical cases, involving 238 kinds of Chinese materia medica. The top 10 Chinese materia medica with use frequency were Poria, Acori Tatarinowii Rhizoma, Corni Fructus, Dioscoreae Rhizoma, Rehmanniae Radix Praeparata, Alpiniae Oxyphyllae Fructus, Rehmanniae Radix, Astragali Radix, Chuanxiong Rhizoma, Atractylodis Macrocephalae Rhizoma; the properties were mainly mild, warm slight cold, and cold; the tastes were mainly sweet, bitter, pungent, and light; the meridians were mainly spleen, liver, lung and kidney meridians; the efficacy was clearing dampness and promoting diuresis, clearing heat and promoting blood circulation, calming mind, clearing heat and detoxification, reducing dampness and promote appetizing, tonifying spleen; the association analysis found 15 groups of drug combinations used more than 25 times, they were: Corni Fructus and Poria, Corni Fructus and Dioscoreae Rhizoma, Dioscoreae Rhizoma and Corni Fructus, Rehmanniae Radix Praeparata and Corni Fructus, Dioscoreae Rhizoma and Poria, Astragali Radix and Poria, Alismatis Rhizoma and Poria, Moutan Cortex and Poria, Rehmanniae Radix Praeparata and Poria, Rehmanniae Radix and Poria, Polygalae Radix and Acori Tatarinowii Rhizoma, Moutan Cortex and Corni Fructus, Moutan Cortex and Dioscoreae Rhizoma, Alismatis Rhizoma and Corni Fructus, Alismatis Rhizoma and Dioscoreae Rhizoma; clustering analysis identified four groups of new prescriptions, the first group: Poria, Rehmanniae Radix, Rehmanniae Radix Praeparata, Alismatis Rhizoma, Moutan Cortex, Corni Fructus, Dioscoreae Rhizoma; the second group: Acori Tatarinowii Rhizoma, Cistanches Herba, Morindae Officinalis Radix; the third group: Alpiniae Oxyphyllae Fructus, Chuanxiong Rhizoma, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle; the fourth group: Atractylodis Macrocephalae Rhizoma, Codonopsis Radix, Astragali Radix, Angelicae Sinensis Radix; the results of complex network analysis showed that the core prescription was modified Liuwei Dihuang Pills. Conclusion:This study found that in view of kidney deficiency and bone marrow loss in senile dementia, Professor Shao pays attention to strengthening the healthy qi, and focuses on tonifying deficiency, taking into account the methods of clearing dampness, clearing heat, detoxification, removing blood stasis and restoring consciousness. The four new prescriptions found in the study can provide a reference for modified medication for syndrome differentiation.

Objective:To explore the surgical method and therapeutic effect of repairing thumb pulp defect with pedicled transposition of radial proper palmar digital artery flap of middle finger.Methods:Since June, 2006 to May, 2020, 17 cases(17 fingers) with thumb pulp defect were repaired by pedicled transposition of radial proper palmar digital artery flap of middle finger. The sizes of flap ranged from 1.5 cm × 1.5 cm to 4.2 cm × 2.0 cm. The antegrade pedicled flap of radial proper palmar digital artery of middle finger was used in 2 cases and the retrograde pedicled flap of middle finger was used in 15 cases. After the flap was resected, the donor sites were covered with a medium thickness skin graft transferred from the wrist or elbow. The skin graft did not need to be packed. The dorsal branch of the digital nerve was included in the flap and it was anastomosed with the proper nerve of the injured thumb stump. After 16-22 days of the operation, the pedicles were cut off. The patients were instructed to perform digit function exercise after the pedicle was cut off. After the operation, the patients were included in regularly follow-up through outpatient visit, telephone or WeChat interview. The appearance and sensation of the thumb and finger pulps and the function recovery of the thumb and finger joints were observed through the followed-ups.Results:All 17 flaps and donor site skin grafts survived over 3 to 32 months of follow-up. The flaps achieved good texture and natural appearance. The TPD recovered to 5~11 mm. According to the Michigan Hand Function Questionnaire, all the 17 patients were very satisfied with the overall appearance and function of the hands. According to TAM, the 17 cases were all in excellent.Conclusion:Repairing thumb pulp defect with radial proper palmar digital artery pedicled flap of middle finger, the flap resection is simple, and the donor site is hidden. The appearance and texture of flap is good. It is a safe, effective and good method.

Objective: To evaluate the daily airborne pollen concentrations and visiting rate of patients with allergic rhinitis (AR) and their correlation during 2012-2014 in Beijing. Methods: Daily airborne pollen concentrations (55 998 numbers in total and 549 numbers in average) and its constitution from April to September each year (2012 to 2014) were compared. The number of patients with AR (44 203 in total) who visited the outpatient department of Otorhinolaryngology Head and Neck Surgery, Peking University Third Hospital between January 2012 and December 2014 was analyzed by month. Using SPSS 22.0 software, Kruskal-Wallis test was done for the comparison of visiting rate of patients with AR and airborne pollen concentrations. Correlation analysis between them was made as well. Results: χ² value of airborne pollen concentrations between different months in 2012 to 2014 was 110.7, 108.4 and 121.4, respectively; all P<0.01. The airborne pollen concentrations had two peaks per year, respectively: April to May, August to September. χ² value of visiting rate of patients with AR between different months in 2012 to 2014 was 175.0, 185.1 and 134.5, respectively; all P<0.01. Visiting rate of patients with AR showed two scattering peaks each year, respectively: April to May, August to September. The highest pollen concentration of spring (April to May) was in early and middle April. Tree pollen was the major portion in spring, which were poplar pollen, pine tree pollen, ash tree pollen, cypress tree pollen and birch trees pollen. The highest pollen concentration of autumn (August to September) was in late August and early September. Weed pollen was the major portion in summer and autumn, which were artemisia pollen, chenopodiaceae pollen and humulus japonicas pollen. The visiting rate of patients with AR showed significant correlation with airborne pollen concentrations (r value was 0.537, 0.484 and 0.566, respectively; all P<0.01). Conclusion The visiting rate of patients with AR showed positive correlation with airborne pollen concentrations in recent three years.

[摘 要] 目的：探讨敲减中心体相关激酶2（never in mitosis A-related kinase 2，NEK2）对结直肠癌细胞5-FU化疗敏感性的影响及其可能的机制。方法：采用qPCR和Western blotting检测结直肠癌细胞中NEK2 mRNA及蛋白的表达水平。构建针对NEK2基因的小干扰RNA（siRNA）并转染至结直肠癌细胞HCT116及SW620，实验分为阳性干扰组1（转染NEK2 siRNA1）、阳性干扰组2（转染NEK2 siRNA2）和阴性对照组（转染si-NC），均用5-FU处理。采用CCK-8实验、V-FICT/PI Annexin双染色流式细胞术实验观察敲减NEK2基因对5-FU作用下结肠癌细胞的增殖、周期分布及凋亡的影响，采用Western blotting检测敲减NEK2基因对5-FU作用下结直肠癌细胞内Wnt/β-catenin信号通路相关蛋白表达的影响。结果：NEK2蛋白及mRNA在结直肠癌细胞HCT116、SW620中均呈高表达（P<0.05或P<0.01），转染NEK2 siRNA可高效抑制HCT116、SW620细胞中NEK2蛋白及mRNA表达（均P<0.01）。经不同浓度5-FU作用后，阳性干扰组1和阳性干扰组2的细胞存活率和IC50均显著低于阴性对照组（均P<0.01），细胞发生G0/G1期阻滞且凋亡率显著升高（均P<0.01），胞核β-catenin、c-myc和cyclin D1表达水平显著下降而胞质β-catenin表达水平升高（均P<0.01）。结论：敲减NEK2基因可有效提高人结直肠癌细胞对5-FU的化疗敏感性，该作用可能是通过调控Wnt/β-catenin信号通路相关蛋白表达来实现的。