The authors conceive of dispersing and transferring medical risks by means of insurance. They suggest developing two modules of insurance business, including malpractice insurance and medical accident insurance. They also discuss such basic issues as risk financing, financial compensation and choice of insurance undertakers.

Cirrhosis of the liver results in portal hypertension, which is a tortuous and dilated portal vein. The hemorrhage of digestive tract caused by dilation and rupture of lower esophagus and gastric fundus is the main cause of death in patients with cirrhosis. The treatment methods of digestive tract hemorrhage in liver cirrhosis include drug therapy, endoscopic hemostasis, interventional therapy to control hemorrhage and surgical hemostasis. These methods are mainly used to control hemorrhage and solve hypersplenism, but cannot solve the fundamental problem of cirrhosis. Stem cells can repair damaged liver cells and help restore liver function. Under the guidance of B-ultrasound, precise intrahepatic portal vein puncture and infusion of autologous bone marrow nucleated cells can improve cirrhosis through autologous bone marrow stem cells. Little damage to patients, little risk. Cell therapy combined with conventional therapy can treat both the symptoms and the root causes of digestive tract hemorrhage in cirrhosis.

OBJECTIVETo introduce a simple, fast and universal measuring method used in measurement of the surface area of scalp flap over the cranial defect after decompressive craniectomy.

METHODSThe first step: CT images of the patient with craniocerebral trauma after decompressive craniectomy were obtained and imported into Mimics. The second step: based on the defined threshold, the 3D geometric models of brain and skull were reconstructed after the original Dicom format pictures three-dimensional processed by Mimics. The third step: based on the two builded 3D models, utilizing the segmentation and measurement tools of Mimics to conduct cutting, splitting and measuring operations for the 3D model of brain. The forth step: estimating the surface area of scalp flap over the removed bone flap by using mathematical computation methods.

RESULTSThe application of the introduced method estimated the surface area of scalp flap over the cranial defect of different people with different position of craniocerebral trauma.

CONCLUSIONSThis paper introduces a simple, fast and universal new measuring method. We can conveniently estimate the surface area of scalp flap by using the introduced method.

Decompressive Craniectomy ; methods ; Humans ; Imaging, Three-Dimensional ; Models, Anatomic ; Scalp ; surgery ; Surgical Flaps ; Tomography, X-Ray Computed

Being introduced in Korean peninsula, Chinese medicine, which is called Korean medicine in Korea, has caused great influence in Korean ethnomedicine, culture and living.Korean medicine takes an important part in Korean medical education and medical treatment. This paper introduces the origin of Korean medicine, the current mode and feature of Korean medicine education, as well as the overview and characteristic of Korean Hospital Affiliated Qing Xi University and Korean Hospital Affiliated Daejeon University. The mode of Korean medical education and hospital can offer reference for Chinese medicine education.

BACKGROUND:Primary human lung epithelial cel s are difficult to be isolated and cultured in vitro, which is characterized as limited sources, low cel viability, slow proliferation capacity, and lacking of differentiation capability.
OBJECTIVE:To establish an air-liquid interface model of lung epithelium by in vitro proliferation of human bronchiolar epithelial cel s, which is used for research on function of lung epithelial cel s.
METHODS:Primary human bronchiolar epithelial cel s were isolated using Pronase and DNase I combined digestive methods, and then proliferated using medium containing ROCK kinase inhibitor. The proliferated cel s were used for establishment of the air-liquid interface epithelium model. Cel differentiation was identified using scanning electron microscope, phase contrast microscope and immunofluorescent staining.
RESULTS AND CONCLUSION:The primary human bronchiolar epithelial cel s could be expanded successful y using medium containing ROCK kinase inhibitor, and the basal cel marker Cytokeratin14 was preferential y expressed in the proliferated cel population, indicating that these basal cel s might be the main subpopulation of human lung epithelial stem cel s. Subsequently, the proliferated cel s under the air-liquid interface could differentiate into ciliated cel s and non-ciliated column cel s. The results suggest that the proliferation and differentiation of human bronchiolar epithelial cel s were maintained in the presence of ROCK kinase inhibitor, and the air-liquid interface could promote the differentiation of human bronchiolar epithelial cel s.

Summarize the application of SOAP in the medical field and find out its problems in the course of traditional Chinese medicine, to explore the significance and value of SOAP in teaching practice in TCM. Organize relevant literature and discuss the application of SOAP in the course of Chinese medicine. SOAP is widely used in various aspects of medicine, and there are still some problems in the course of TCM. The use of SOAP model for teaching and assessment has important practical significance and value in the course of Chinese medicine internal medicine practice, and SOAP emphasize the practice of the post competence oriented teaching, which is worth promoting.

To investigate the role of cardiac magnetic resonance imaging (CMRI) in evaluating pulmonary hemodynamics and right ventricular function in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PAH); and the relationship between CMRI parameters and pulmonary function parameters, blood gas analysis parameters and 6-minute walk test (6MWT) parameters in patients with COPD complicated with PAH. Methods Thirty-seven patients were diagnosed with COPD in the department of respiratory and critical care discipline of Ningxia Medical University General Hospital from October 2013 to October 2016, who underwent transthoracic echocardiography (TTE) to measure pulmonary arterial systolic pressure (PASP), and were divided into COPD group and COPD+PAH group according to whether there was PAH [PASP > 40 mmHg (1 mmHg = 0.133 kPa) was defined as PAH]. All patients completed pulmonary function tests [1 second forced expiratory volume to forced vital capacity ratio (FEV1/FVC), FEV1 predicted value (FEV1pred)], blood gas analysis [arterial blood oxygen partial pressure (PaO2), arterial blood carbon dioxide partial pressure (PaCO2)], CMRI examination [relative dilatation of the main pulmonary artery (mPAD), mean pulmonary artery pressure (mPAP), left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), right ventricular end-diastolic myocardial mass (RVMED), right ventricular end-systolic myocardial mass (RVMES)], and 6MWD [6-minute walk distance (6MWD)] within 1 week. The obtained clinical parameters had been compared between the groups, and correlation was analyzed. Results Among the 37 patients with COPD, 16 patients were complicated with PAH. There were no significant differences in FEV1/FVC, FEV1pred, PaO2, PaCO2 and other baseline indicators between the two groups. In the COPD group, TTE obtained PASP of 2 patients were normal (PSAP < 40 mmHg), while CMRI measured mPAP were higher than the normal limit (> 25 mmHg). Compared with the COPD group, mPAD, RVEF and 6MWD were significantly decreased in the COPD+PAH group [mPAD: (25.64±5.01)% vs. (44.00±22.52)%, RVEF: 0.525±0.054 vs. 0.592±0.071, 6MWD (m): 319.3±116.5 vs. 408.2±38.0, all P < 0.01], mPAP, RVMED and RVMES were significantly increased [mPAP (mmHg): 28.89±3.16 vs. 20.18±2.43, RVMED (g): 57.19±15.46 vs. 40.71±15.44, RVMES (g): 45.99±11.16 vs. 33.71±13.39, all P < 0.01], and there was no significant differences in LVEF (0.663±0.082 vs. 0.699±0.075, P > 0.05). Correlation analysis showed that mPAD was positively correlated with FEV1/FVC and FEV1pred (r1 = 0.538, P1 = 0.021; r2 = 0.448, P2 = 0.049);RVMED was negatively correlated with PaO2 (r = -0.581, P = 0.015), and positively correlated with PaCO2 (r = 0.592, P = 0.014); 6MWD was positively correlated with RVEF (r = 0.485, P = 0.041), and had no correlation with LVEF (r = 0.271, P = 0.104). Conclusions Compared with COPD patients, changes in pulmonary hemodynamics and right ventricular function in COPD patients with PAH are related to the severity of airflow limitation. CMRI can early monitor pulmonary hemodynamics and right heart function changes in patients with COPD. Once PAH appears, pulmonary hemodynamics, right heart function and exercise tolerance have changed.

Objective To study the clinical effect of Yaotongning capsule combined with etoricoxib for the pain and inflammation of lumbar vertebrae in elderly patients with lumbar osteoarthritis. Methods 120 elderly patients with lumbar osteoarthritis admitted to our hospital from January 2016 to June 2018 were randomly divided into the control group and the observation group, with 60 patients in each group. Patients in the control group were treated with etoricoxib, while patients in the observation group were treated with etoricoxib plus Yaotongning capsule orally. Both groups received medications for 2 weeks. Spinal pain and quality of life score changes were recorded. The inflammatory cytokines in serum TNF-α, GM-CSF, COX-2 and BMP-2 levels were monitored. The clinical efficacy was compared and drug safety profile was evaluated for two groups. Results The effective rates of the control group and the observation group were 78.33% and 91.67% respectively. The effective rate in the observation group weas significantly higher (P<0.05). After treatment, the VAS score for the patients in the observation group was significantly lower than that in the control group (P<0.05). The SF-36 score in the observation group was significantly increased (P<0.05), and the levels of TNF-α,GM-CSF and COX-2 in the serum were significantly lower than those in the control group (P<0.05), and the levels of BMP-2 were significantly increased (P<0.05). Conclusion Yaotongning capsule combined with etoricoxib in the treatment of senile lumbar osteoarthritis has definite curative effect. It significantly reduced lumbar pain, improved quality of life, inhibited inflammatory reaction, and had a better drug safety profile. The further clinical investigation for the combination therapy is warranted.