The defects in observation methodology of diseases,in knowledge of diseases,and in doctors' clinical knowledge and skill were analyzed in this article,which were believed as main medical internal defects(MID).High risks as well as medical disputes cannot be avoided in medical practice due to MID,which also led to ethical challenges in medical disputes prevention and treatment.Emphasis on the knowledge of MID during public education on medical disputes prevention may decrease medical disputes.

Objective To investigate the fasting plasma insulin (FINS) and free fatty acid (FFA) in overweight or obesity patients with type 2 diabetes mellitns (T2DM) Methods 263 patients of T2DM were selected and divided into normal weight group(n = 108) and overweight or obesity group(n = 155) according to body mass index (BMI) , FINS level was detected by chemiluminescence method , and FFA level by colorimetry. 72 subjects without T2DM were taken as controls. Results FINS [(6.18±1.86) mIU/L vs (4.60±2.58) mIU/L, P < 0.01)] and FFA [(0.58±0.25) mmoL/L vs (0.35±0.14) mmoL/L,P < 0.01)] in T2DM group was significandy higher than that of control group. FINS in overweight or obesity group [(7.20±1.99) mIU/L] was higher than that in normal weight group[(5.31±1.21) mIU/L] and control group[(4.60±2.58) mIU/L] (P <0.01). In T2DM group,FiNS was positively correlated with duration(r =0. 334,P <0.01) ,BMI(r =0. 532,P <0. 01) and diastolic pressure (DBP) [r =0. 342 ,P <0.01). Conclusion The FINS level in overweight or obesity patients with T2DM is significantly higher compared to T2DM with normal weight T2DM,and the FFA level in patients of T2DM is significantly higher increased compared to control group,both of which participate in insulin resistence as well as the occurrence and development of T2DM.

Objective To investigate the relationship between rules of local metastasis and the operation for rectal cancer. Methods Literatures about rules of local metastasis and operation for rectal cancer were reviewed and analysed. Results The study of rules of local metastasis results in the change and refinement of the operation for rectal cancer. Conclusion With the development of basic research for rectal cancer,the operation for rectal cancer is changing and refining, and the result of the treatment is more favourable.

Objective To establish the method for determination of borax in food by RP-HPLC. Methods Borax in food was extracted by acid methanol followed by turmeric acetic acid derivation and then detected by HPLC. Symmtry C18(150 mm?4.6 mm, 5 ?m) was used as the stationary phase, methanol-water (80+20) as the mobile phase, the detection wavelength was 550 nm. Results The detection limit was 6.4 ng/kg, the relative error was 2.3%, the recovery rates were between 90.63% and 96.88%, the liner range of the borax was 0.032-0.32 ?g/ml, the regressive equation of calibration curve was y=3 210 000x+121 000, r=0.999 2. Conclusion The present method is simple, rapid, accurate with satisfactory results.

Objective To explore the feasibility for determination of chloroform and tetrachloromethane in drinking water with DB-5, Rtx-1 and DB-1 capillary columns. Methods For the mild solubility of chloroform and tetrachloromethane in drinking water, chloroform and tetrachloromethane were analysed by static headspace gas chromatography with DB-5, Rtx-1 and DB-1 capillary columns and electron capture detectorECD, external standard method was used for quantification. Results Three kinds of columns were used for determination of chloroform and tetrachloromethane,the retention time was lower than 3 min, for chloroform and tetrachloromethane the average recovery rates were 92.06%-104.95% and 78.33%-103.22% respectively, RSD were 2.06%-2.71% and 1.76%-5.59% respectively. Conclusion DB-5, Rtx-1 and DB-1 capillary columns are suitable for determination of chloroform and tetrachloromethane in drinking water.

Objective To investigate the organochlorine and pyrethroid pesticide residue in leafy vegetables on sale in Xi’an and to assess the safety of the leafy vegetables. Methods Eight kinds of leafy vegetables samples were collected at five wholesale markets and five supermarkets in Xi’an from 2007 to 2008. The content of 15 kinds of pesticides residues were analyzed by GC method and the evaluation was made according to GB 2763—2005. Results The rate of detection for the pesticides was 9.8% (465/4 725)and the disqualified rate was 1.2%(57/4 725).There was a significant seasonal difference in the detection rate of pesticides (P

OBJECTIVE:To observe clinical efficacy and safety of mosapride combined with flupentixol melitracen in the treat-ment of elderly functional heartburn. METHODS:106 elderly patients with functional heartburn in accordance with Rome IIIstan-dard were randomly divided into control group(52 cases)and treatment group(54 cases). The control group was treated with Mo-sapride dispersible tablets 5mg,tid,orally;the treatment group was additionally given Flupentixol melitracen tablets(containing flu-pentixol 0.5 mg and melitracen 10 mg),qd,on the basis of control group. Therapeutic efficacy of 2 groups were observed after 4 weeks. Hamilton anxiety scale(HAMA),Hamilton depressive scale(HAMD) and symptom score were conducted before and after treatment. RESULTS:The total effective rate of treatment group and control group were 87.0%and 53.8%;with statistical signifi-cance(P<0.05);there was statistical significance in symptom score,HAMA score and HAMD score between 2 groups after treatment (P<0.01). No severe ADR was found in 2 groups. CONCLUSIONS:Mosapride combined with flupentixol melitracen is safe and ef-fective in the treatment of elderly functional heartburn.

Objective　To investigate whether or not the antisense oligodeoxynucleotide (ODN) of vascular endothelial growth factor (VEGF) can supresses the protein expression of VEGF.Methods　SMMC 7721 is a cell line that expresses VEGF.Therefore the medium conditioned by SMMC 7721 stimulates proliferation of bovine aortic endothelial cell (BAEC).Synthesized antisense ODN complementary to one region of VEGF mRNA was added into the medium of SMMC 7721.The expression of VEGF and the stimulation effect of SMMC 7721 was then determined.Result　It was found that by means of inhibition of VEGF expression,the stimulation effect of SMMC 7721 was inhibited by the VEGF antisense ODN in a dose-dependent manner.At a dosage of 1,2.5,5,10μmol/L,the inhibition rate was 63.2%,82.4%,210% and 287.5%,respectively.Conclusion　It is promising that VEGF antisense ODN works as a new gene therapeutic modaliey for antiangiogenesis of HCC.

Objective To study the current research status of minichromosome maintenance protein 2 (MCM2), the cell cycle proliferation marker, in the diagnosis of colorectal carcinoma. Methods Literatures about the application of MCM2 in the study of colorectal carcinoma were collected and reviewed.Results MCM2, as a marker of cell dysplasia and malignancy, was usually used in the study of carcinoma. The study on expression of MCM2 in the cell of colorectum in different proliferational stage might help to screen colorectal carcinoma as early as possible. Conclusion As a relatively specific and sensitive marker of cell proliferation, MCM2 might become a promising mark for diagnosing colorectal carcinoma in the early stage.

Purpose: To explore the autocrinism of vascular endothelial growth factor ( VEGF) in human hepatocellular carcinoma cell and its significance. Methods: The expression of VEGF receptors was analyzed by reverse transcription-polymerase chain reaction (RT-PCR) in human hepatocellular carcinoma cell lines SMMC7721, HHCC and HepG2 in vitro. The expression of VEGF in human hepatocellular carcinoma cells was inhibited by synthetic antisense oligodeoxynucleotide (ODN). Phenotypic alterations in human hepatocellular carcinoma cells by antisense reduction of VEGF expression were observed. And the alterations for expression of VEGF receptors in human hepatocellular carcinoma cell membranes were analyzed by flow cytometry. Results: Flt-1 was expressed faintly in SMMC-7721 cell whereas KDR was expressed in HHCC cell and HepG2 cell in vitro. Compared to control, antisense ODN against VEGF inhibited HHCC cell proliferation in vitro in a dose-dependent manner and had no effects on SMMC-7721 cell and L929 cell. When the concentration of antisense ODN was 2.5 ?mol/L,5 ?mol/L and 10 ?mol/L, the proliferation of HHCC cell was inhibited by 26%, 41 % , and 50% respectively. Compared with control, flow cytometry analysis showed a decrease in cell number in S phase and a pre-apoptosis peak in HHCC cell treated by antisense ODN. There was no alteration of cell cycle in SMMC-7721 cell. The positive rate of KDR expression in HHCC cell membrane was 19. 2%, 29. 8% and 31. 2% in the antisense ODN, sense ODN and control groups, respectively. The expression of KDR in HHCC cell membrane was markedly inhibited by antisense ODN against VEGF compared with the control group, as measured by flow cytometry. There was no alteration for expression of Flt-1 in SMMC-7721 cell membrane. Conclusions: VEGF produced by human hepatocellular carcinoma cells acts directly upon human hepatocellular carcinoma in an autocrinal manner and may promote the proliferation and differentiation of human hepatocellular carcinoma cells via the activation of the KDR-dependent signaling pathway.