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 investigate the efficacy of postoperative transcatheter arterial chemoembolization (TACE) on survival of patients after resection of huge hepatocellular carcinoma. Methods: This study retrospectively collected the clinical data of 256 huge hepatocellular carcinoma patients who had received radical resection. Among them 136 patients received postoperative adjuvant TACE 4-6 weeks post resection, and the other 120 patients received surgical resection only. Stratification analysis was performed on all the patients according to with or without high risk factor for residual tumor (satellite nodules, tumor thrombosis in the > 2nd stream of the portal vein, and un-integrated membrane). Survival rate was compared between the two groups. Results: For patients who had huge HCC without high risk factor for residual tumor, the 1-, 3-, and 5-year survival rates were 80.43%, 59.92%, and 47.18% for post-operative adjuvant TACE group, respectively; 74.05%, 53.40%, and 45.77% for surgical resection group, respectively. There was no statistical difference in the survival rate between the two groups (P = 0.7693). For those with high risk factor for residual tumor, 1-, 3-, and 5-year survival rates were 72.15%, 32.27%, and 22.35% for postoperative adjuvant TACE group, respectively; and 45.36%, 22.47%, and 19.67% for only surgical resection group, respectively. There was statistical difference between the two groups (P = 0.004 9). COX regression analysis indicated that postoperative adjuvant TACE (HR:0.620, 95% CI: 0.442 - 0.870) and high risk factor for residual tumor (HR:2.235, 95% CI: 1.491-3.351) were independent risk factors for postoperative long-term survival. Conclusion: Postoperative TACE is highly helpful in increasing the long-term survival rate of patients with huge hepatocellular carcinoma, and it is more effective in elongating the postoperative survival time of patients with high risk factor for residual tumor.

Objective To investigate the clinical efficacy, the toxicity and side reactions of interventional chemoembolization with FOLFOX4 regimen through both hepatic artery and superior mesenteric artery, i.e. dual access technique, in treating primary hepatocellular carcinoma. Methods Between November 2010 and March 2013 at authors’ hospital, a total of 21 patients with advanced primary hepatocellular carcinoma (the study group) were treated with FOLFOX4 regimen by using dual access interventional technique. FOLFOX4 regimen included hepatic arterial infusion of 5-fluorouracil 400 mg/m2, hepatic arterial chemoembolization with iodipin and oxaliplatin 85 mg/m 2, intravenous administration of calcium folinate 200 mg/m2 IV on the first and second day, trans-superior mesenteric artery continuous infusion (lasting for 22 hours) of 5 -Fuorouracil 600 mg/m2 on the first and second day. During the same period other 21 patients with primary hepatocellular carcinoma were selected (used as the control group) to receive conventional hepatic arterial chemoembolization. In both groups, the treatment was repeated after 4-6 weeks. The therapeutic effect and the toxicity and side reactions were evaluated after the second treatment. Results The effective rate for the study group and the control group was 61.9% and 28.6% respectively, and the median survival time for the study group and the control group was 14.7 months and 9.4 months respectively. The differences in the effective rate and the median survival time between the two groups were statistically significant (P = 0.030 and P = 0.034). The occurrence of toxicity and side reactions, such as digestive tract reactions and the damage of liver function, in the study group were strikingly lower than those in the control group. Conclusion Through dual approach of hepatic artery and superior mesenteric artery catheterization, interventional chemoembolization with FOLFOX4 regimen is outstandingly effective for primary hepatocellular carcinoma, meanwhile, the side effects are very slight.

Objective To observe the therapeutic effect of Shenluo'an Decoction(SD) for the treatment of obese patients with early diabetic nephropathy and to explore the possible mechanism.Methods A total of 68 obese patients with early diabetic nephropathy were randomly assigned into control group and treatment group,34 cases in each group.Both groups were given conventional western medicine treatment including lifestyle regulation,dietary control,and medicine for lowering blood pressure,blood glucose and blood lipids.Additionally,the control group was given oral use of Irbesartan,and the treatment group was given oral use of SD combined with Irbesartan.Before and after treatment,we observed the traditional Chinese medical syndrome scores,body mass index(BMI),blood levels of cystatin C (Cys C),β2-microglobumin(β2-MG),homocysteine (Hcy) and fasting blood glucose (FBG),and urine parameters of urinary monocyte chemoattractant protein-1 / urinary creatinine (UMCP-1/UCR),urinary factor of regulated on activation in normal T cell expressed and secreted / urinary creatinine (URANTES/UCR),urinary albumin-to-creatinine ratio (UACR) and urinary albumin excretion ratio (UAER) before treatment and after treatment for 16 weeks.After treatment,the clinical efficacy and safety were also evaluated.Results (1) During the treatment,5 cases were dropped out,and a total of 63 cases (32 from the treatment group and 31 from the control group) completed the experiment.(2) The total effective rate of the treatment group(90.6％) was significantly higher than that of the control group(67.7％),the difference being significant(P ＜ 0.05).(3)BMI of the two groups after treatment was significantly lower than that before treatment (P ＜ 0.05).(4) After treatment,the traditional Chinese medical syndrome scores,blood parameters (Cys C,β2-MG,Hcy,FBG) and urine parameters (UMCP-1/UCR,URANTES/UCR,UACR,UAER) in the treatment group were decreased as compared with those before treatment and those in the control group after treatment(P ＜0.05).(5) A positive correlation was present among the parameters of UMCP-1/UCR,URANTES/UCR,UACR and UAER.(6) No abnormal changes took place in the blood and stool routine examination,hepatic function,or electrocardiography of the 63 cases.Conclusion SD combined with western medicine exerts certain therapeutic effect for obese patients with early diabetic nephropathy,and is effective on relieving clinical symptoms anddecreasing BMI,Cys C,β2-MG,UACR,UAER,UMCP-1 and URANTES.Its mechanism is probably related with the inhibition of chronic renal inflammation.

Objective To observe the influence of Shenkang injection with Irbesartan on urinary albumin excretion rate(UAER)in 24 hours,serum lipid and blood rheology in early diabetic nephropathy.Methods One hundred and fifty normotensive early diabetic nephmpathy were randomly divided into control group,Shenkang injection group and Shenkang injection with Irbesartan group.Three groups were treated with diabetic education,dietary regimen,suitable physical activity and oral anti-hyperglycemic agents till their fasting blood glucose(FBG)was less than 7.0 mmol/L and postprandial blood glucose(PBG)was less than 10.0 mmol/L.The control group was treated with oral anti-hyperglycemic agents or/and insulin.Shenkang injection group was additionally treated with Shenkang solution.Shenkang solution was mixed by Shenkang injection 100 ml,5% glucose 250 ml and insulin 2-3 U.Shenkang solution was intravenously guttaed once a day.Shenkang injection with Irbesartan group was additionally treated with Irbesartan 0.15 g,once a day,taken orally.A course was taken for 3 weeks.The levels of UAER,serum lipid and blood rheology were detected immediately and 9 weeks after treatment.Results In the Shenkang injection group,compared with those before treatment,them were significant difference in UAER (87.44 ±10.06)μg/min vs.(116.55 ± 33.42)μg/min),serum lipid( (4.22 ± 0.70)mmol/L vs.(4.88 ± 0.69 )mmol/L)and blood rheology( (5.77 ±0.53)mPa·s vs.(7.38 ± 0.41)mPa·s)(P ＜ 0.05).In the Shenkang injection with Irbesartan group,compared to those before treatment,there were also significant difference in UAER ( (61.90 ±28.02)μg/min vs.(123.37 ± 29.98)μg/min),serum lipid( (4.00 ± 0.14)mmol/L vs.(4.90 ± 0.12)mmol/L)and blood rheology( (5.11 ±0.41)mPa·s vs.(7.27 ± 0.44)mpa·s)(P ＜ 0.05).Whearas in the control group,no significant difference were found compared with those before treatment.Furthermore,the improvements in the Shenkang injection with Irbesartan group were better than those in the Shenkang injection group(P ＜ 0.05).Conclusions Shenkang injection can reduce UAER,decrease serum lipid and improve renal blood rheology.Iteffectively prevents diabetic nephropathy in earlier period and maybe have synergy with Irbesartan.

Objective To explore the effect of 14,15-epoxyeicosatrienoic acids (14,15-EET) on the inflammatory response of BV2 cells under oxygen and glucose depriviation/reoxygenation (OGD/R) conditions.Methods BV2 cells were randomly divided into three groups,blank control group,vehicle control group,and 14,15-EET group.Under treatment of 14,15-EET,the concentration of inflammatory factor in BV2 cell culture media was detected by ELISA at different time points (reoxygenation for 0,3,6,12,24 h) after OGD1h.The viability of BV2 cells was detected by MTT assay at different time points.At the same conditions,using Transwell migration experiment,migration ability of BV2 cells was observed.Results The 14,15-EET group had the lower levels of inflammatory factor secretion,lower viability and weaker ability of migration than the vehicle control group.The above results were most statistically significant at OGD1h/R12h.Conclusion 14,15-EET can inhibit the inflammation of BV2 cells induced by the injury of OGD reperfusion.

Objective:To research the correlation of serum levels of IL-21,TGF-β1,TNF-α and IgA1 in children with allergic purpura and the purpura nephritis.Methods:57 cases with allergic purpura who were treated in our hospital from November 2015 to May 2016 were selected and 29 cases were diagnosed with general allergic purpura,and another 28 cases were diagnosed with purpuric nephritis.30 healthy children were selected as the control group.Then the serum levels of IL-21,TGF-β1,TNF-α,IgAl,immunoglobulin A (IgA),C3 and C4 between the three groups were observed and compared.Results:The serum levels of IL-21,TGF-β1,TNF-α,IgA1 and IgA in the purpuric nephritis group were higher than those of the control group and the general allergic purpura group,and the differences were statistically significant (P＜0.05);The serum levels of IL-21,TGF-β1,TNF-α,IgA1 and IgA in the general allergic purpura group were higher than those of the control group,and the differences were statistically significant (P＜0.05);There was no statistically significant difference about the C3 and C4 in the three groups (P＞0.05).Conclusion:The serum levels of IL-21,TGF-β1,TNF-α and IgA1 may be involved in the development ofhenoch-schonlein purpura and purpura nephritis.

The X-ray computed tomography (CT) appearance of 4 cases with pulmonary cryptococcosis (PC) diagnosed by pathological examination in our hospital was retrospectively analyzed. The appearances of PC on CT were various: solitary lesion in 1 case, multiple lesions in single lobe in 2, and multiple lesions in multiple lobes in 1. There were total 52 lesions in 4 cases; the diameter of nodules or masses was 3 - 75 mm. Cavitations were found in 1 case; lesions appeared obviously enhanced and one lesion showed central necrosis. Two cases underwent pulmonary lobectomy; and 2 cases received core cutting needle biopsies, after antifungal therapy for 3 months to 1 year the lesions showed being absorbed. In summary, the CT appearance of PC is non-specific with various modes and forms. PC should be considered when multiple nodules or masses scattered in subpleural zone, accompanied with ground-glass opacity and obviously enhanced. The examination of pathogen and pathology at the beginning is crucial for improving diagnostic accuracy.

Objective To study the effect and mechanism of Xinkai Kujiang method(TCM treatment with the pungent and bitter herbs to regulate the gastrofunctions)on the functional dyspepsia(FD)rats.Methods Twenty-four rats were randomized into control group,model group,and Weikangning(herbal medicine for dyspepsia)group,with 8 in each.After a 7-day adaptive feed,the FD models were made with the clipping tail stimulation.Seven days after modeling,the Weikangning group was given Weikangning Capsule 0.625g/kg by gavage,twice a day,and the other two groups were given normal saline in the same dosage.The medication was appliey in succession for 12 days,and on the thirteenth day,the serum and gastric tissues were collected for detecting the lab indications:plasma motilin(MTL),plasma nitric oxide(NO),gastric tissue MTL,nitric oxide synthase(NOS),and the expression of Cajal interstitial cells(ICC)and gastrointesinal smooth muscle cells(SMC).Results Compared with the control group,the level of plasma MTL in the model group was significantly decreased,the level of NO significantly increased,and the expression of MTL,ICC and SMC positive neurons in the stomach myenteric nerve plexus was significantly weakened,but the expression of NOS positive neurons was significantly strengthened(P

Objective. To study whether or not noradrenaline system participates in the process of orexin-A wakepromoting from alcohol coma. Methods Twenty-four adult female SPF SD rats were divided into four groups, 6 each, and the model of alcohol coma was reproduced. Experimental rats were then divided randomly into rats receiving injection of artificial cerebrospinal fluid (ACSF, control group), orexin-A (orexin-A group), noradrenaline α1 receptor antagonists--prazosin (prazosin group), or prazosin + orexin-A (prazosin-orexin-A group) into the lateral ventricle. The depth of coma was evaluated by the duration of loss of righting reflex (LORR) and δ wave in electrocorticogram (ECoG). Result The duration of LORR was significantly longer and the ratio of δ wave higher in the prazosin-treated rats than those in control group (P<0.01). Both of the duration of LORR and the ratio of δ wave in ECoG were the same between the control group and the rats treated with prazosin + orexin-A (P>0.05). But the values were significantly different from those in the orexin-A group (P<0.01). Conclusion Noradrenaline system may participate in the wake-promoting process of alcohol coma by orexin-A.