Objective:Total 621 cases of medical disputes occurred during 2000 to 2013 were analyzed retro-spectively, to investigate the dispute factors and analysis of improvement, to promote doctor-patient relationship. Methods:621cases of medical disputes from 2000 to 2013, on a case by case attributes are classified, analyzed two year interval comparison, find the dispute factors in evolution.Results:Through the analysis of 621 cases of disputes over property, complications of the disease cause dispute case first, economic reasons, the second medical defect.Conclusions:Analysis of the two year interval comparison shows:how to strengthen the hospital scientific management, innovative service mode, the medical system implemented is the important link of reducing medical disputes.

Objective To summarize the curative effect of repairing large area soft tissue defects in heel and crus by flaps with double blood-supply of posterior tibial artery perforators and saphenous nerve nutrient vessels.Methods From January 2006 to February 2012,twenty cases took operation under the guide of Continuous Wave Doppler and design of tibial artery perforator as rotation point.And in all cases,island flaps with the blood supply from saphenous nerve nutrient vessels and tibial artery perforator were retained to repair large area soft tissue defects in heel and crus.In operations,the range of flap area were ranged from 19 cm × 11 cm to 11 cm × 8 cm.Skin flaps incision was up to the patella margin level,low to medial malleolus on edge,former to crus former median line,rear to after crus median line and farthest to the surface of wound on the metatarsophalangeal joint.Results Nineteen cases survived,and 1 case of skin flap mild necrosis at the farthest side took a second-phase line skin flap to repair.Followed-up from 6 months to 24 months was taken in all cases at the mean time of 10 months,with a result of good recovery and no ulceration for the flaps.To varying degree,all flaps recover sense of pain and deep touch.Conclusion There is no wound to posterior main tibial artery in repairing large area soft tissue defects in heel and crus by flaps with double blood-supply from posterior tibial artery perforators and saphenous nerve nutrient vessels,meanwhile to maintain double blood-supply from posterior tibial artery perforators and saphenous nerve nutrient vessels and expand the range of blood supply of posterior tibial artery perforators.In this operation,a blood circulation for the flap can be guaranteed so as for a large wound in heel and crus.

Objective: To observe the effect of yoghurt supplementation on the growth rate of preschool children in Beijing suburb. Methods: 402 healthy children (217 males, 185 females), aged 3-5 years old, were selected as subjects with height and/or weight less than WHO standard from 7 kindergartens in Beijing suburb. The children were divided randomly into control group (CG 201) and yoghurt supplemented group (YG 201). Children in YG were supplemented with yoghurt (125g) for 5d per week for 9 mo, and children in CG not supplemented. Height, weight and upper-arm circumference were measured every month. Blood biochemical parameters (Hb,TP) were detected every 3 mo. Results: Calcium, zinc and VB2 were consumed more in YG than CG. Hb in YG was also higher than CG . The height incease and weight gain of YG was significantly higher than CG during 3, 6 and 9mo. Conclusion: Yoghurt supplementation for 9 months can increase calcium, zinc and VB2 intake, and improve preschool childrens nutritional status, therefore increase their height increase and weight gain.

Objective To investigate the experience of laparoscopic complete mesocolic excision ( CME) for colon cancer. Methods There were102 patients,of which 68 cases with colon cancer were performed laparoscopic CME,34 cases were treated by traditional surgery. The 2 groups were reviewed retrospectively. Results As compared with the traditional group,the operation time,time of first flatus,hospital stay in the CME group increased. The postoperative suction drainage was decreased in CME group. The CME group had less blood loss and more mean lymph nodes clearance than the traditional group. The complication incidences had no significant differences between 2 groups. Conclusion Laparoscopic CME for colon cancer,with the advantages of less tumor spreading and more thoroughly lymph node dissection,is worthy of clinical application.

Objective To discuss the antiviral effect and anti-contact dermatitis efficacy of JingFuYe. Methods Made contact dermatitis mice model by DNFB, measured the central thickness of mice left ear in each medication group and adopted the ABC immunohistochernical method to detect the number of Langerhan spcell(LCs). Infect guinea pig vaginal by HSV-2. Changes of symptoms were evaluated by Symptom score method. Detect the number of HSV-IgG and IgM in guinea pig serum. Results Compared with the control group, the ear thickness difference and the number of LCs in the experimental group were significantly reduced. JingFuYe have inhibitive effect to the Lesions caused by HSV-2 vaginal infection in guinea pig On different extents. Conclusion JingFuYe has inhibitive function to the murine experimental contact dermatitis and anti-virus effects.

Objective To investigate the liver histological characteristics of children with chronic hepatitis B (CHB).Methods We recruited data of children with CHB and liver biopsy,then analyzed their liver histopathological characteristics and their associations with laboratory parameters.Results One hundred and twenty-four children with CHB were included in the present study,including 114 (91.9％) HBeAg-positive CHB children and 10 (8.1％) HBeAg-negative CHB children.In HBeAg-positive CHB children,the frequency of significant necroinflammation stratified by ALT levels was 32.1％ (9/28) in ALT ≤ULN,60.7％ (17/28) in ALT(1-2) ×ULN and 81.0％ (47/58) in ALT＞2 ×ULN group,while significant fibrosis was 46.4％ (13/28) in ALT ≤ ULN,71.4％ (20/28) in ALT (1-2) × ULN and 74.1％ (43/58) in ALT ＞ 2 × ULN group,respectively.Significant liver histological abnormalities were much higher in the ALT ＞ 2 × ULN and ALT (1-2) × ULN groups than the ALT ≤ ULN group.Logistic analysis indicated only AST levels associated with significant inflammation (OR =1.032,P =0.008) and significant fibrosis (OR =1.026,P =0.007).Conclusion Frequencies of significant liver histological abnormalities in children with CHB are high,and AST levels are associated with them.

Objective To analyze the cancer incidence and mortality in Hebei cancer registry available areas in 2011.Methods Data were collected from 8 population-based cancer registries systems in Hebei province.Incidence and mortality rates stratified by areas (urban/rural),sex,age group and cancer site were analyzed.10 common cancers in different groups,proportions and cumulative rates were calculated.The Chinese population census in the year 2000 and Segi's populations were used for age-standardized incidence/mortality rates.Results In all the 8 cancer registries that covering a total of 4 573 293 population (2 139 779 in urban and 2 433 514 in rural areas),data was used for the analysis.The total new cancer incidence cases and deaths were 11 269 and 7 477,respectively.All the morphologically verified cancer cases (MV％) accounted for 75.26％ while 3.85％ of the incident cases were identified only through death certification records (DCO％).The mortality to incidence ratio appeared as 0.66.The crude incidence appeared in the Hebei cancer registration areas was 246.41/105 (264.55/105 in males and 227.75/105 in females).The age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) appeared as 207.13/105 and 206.61/105 respectively,with the cumulative incidence rates as (0-74 age years old) 23.57％.The cancer incidence and ASIRC were 242.64/105 and 200.19/105 in urban areas,whereas 249.72/105 and 214.11/105,respectively in rural areas.The crude mortality in Hebei cancer registration areas was 163.49/105(196.54/105 in male,129.51/105 in female),with age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) as 144.48/105 and 147.69/105.The cumulative mortality rate (0-74 age years old) was 14.71％.The cancer mortality (167.91/105) in rural areas seemed higher than the mortality (158.47/105) in urban areas.The most common sites of cancers were:stomach,lung,esophagus,breast,liver and colorectal,which accounted for 71.66％ of all the cancer cases.Lung cancer,stomach cancer,esophagus cancer,liver cancer and colorectal cancer were the major causes responsible for the cancer deaths in the areas with data of cancer registration,which accounted for 74.79％ of all the cancer deaths.Conclusion The coverage of Hebei cancer registration population could reflect the cancer burden in various areas and populations.The most commonly seen cancers were stomach,lung,esophagus,breast,liver,and colorectal,in Hebei province.In order to reduce the burden of cancers,prevention and control measures should be strengthened.

PURPOSE: Although the effect of lysosome-associated protein transmembrane 4 beta (LAPTM4B) on the proliferation, migration, and invasion of breast cancer (BC) cells has already been studied, its specific role in BC progression is still elusive. Here, we evaluated the effect of different levels of LAPTM4B expression on the proliferation, invasion, adhesion, and tumor formation abilities of BC cells in vitro, as well as on breast tumor progression in vivo. METHODS: We investigated the influence of LAPTM4B expression on MCF-7 cell proliferation, invasion, adhesion, and tube formation abilities in vitro through its overexpression or knockdown and on breast tumor progression in vivo. RESULTS: Cell growth curves and colony formation assays showed that LAPTM4B promoted the proliferation of breast tumor cells. Cell cycle analysis results revealed that LAPTM4B promoted the entry of cells from the G1 into the S phase. Transwell invasion and cell extracellular matrix adhesion assays showed that LAPTM4B overexpression increased the invasion and adhesion capabilities of MCF-7 cells. More branches were observed in MCF-7 cells overexpressing LAPTM4B under an electron microscope. In comparison with LAPTM4B overexpression, LAPTM4B knockdown decreased the expression of vascular endothelial growth factor-A and significantly inhibited the vasculogenic tube formation ability of tumors. These results were also verified with western blot analysis. CONCLUSION: LAPTM4B promoted the proliferation of MCF-7 cells through the downregulation of p21 (WAF1/CIP1) and caspase-3, and induced cell invasion, adhesion, and angiogenesis through the upregulation of hypoxia-inducible factor 1 alpha, matrix metalloproteinase 2 (MMP2), and MMP9 expression. This specific role deems LAPTM4B as a potential therapeutic target for BC treatment.
Blotting, Western ; Breast Neoplasms ; Breast ; Caspase 3 ; Cell Cycle ; Disease Progression ; Down-Regulation ; Extracellular Matrix ; Hypoxia-Inducible Factor 1 ; In Vitro Techniques ; Matrix Metalloproteinase 2 ; MCF-7 Cells ; S Phase ; Up-Regulation ; Vascular Endothelial Growth Factor A

OBJECTIVETo study the relationship between carbon dioxide combining power(CO₂-CP) and contrast-induced acute kidney injury (CI-AKI) in patients with ST segment elevation myocardial infarction and undergoing percutaneous coronary intervention.

METHODSWe retrospectively analyzed 174 patients admitted to our hospital from March 2012 to August 2013 with ST segment elevation myocardial infarction and underwent emergency percutaneous coronary intervention. Patients were divided into three tertiles according to pre-operative CO₂-CP: T1 (CO₂-CP < 22.62 mmol/L), T2(CO₂-CP 22.62-24.30 mmol/L), T3(CO₂-CP > 24.30 mmol/L). Baseline clinical data, CI-AKI incidence, in-hospital mortality and dialysis rate were compared among groups. An increase in serum creatinine of >26.4 µmol/L and/or >50% from baseline within 48 hours after contrast exposure was defined as CI-AKI. Univariate logistic regression analysis was used to identify the risk factors of CI-AKI. The relationship between CO₂-CP and CI-AKI was assessed by multivariate logistic regression analysis. Receiver operating characteristic curve was used to identify the optimal cutoff of the CO₂-CP for predicting CI-AKI.

RESULTSCI-AKI occurred in 25 (14.4%) patients, and lower CO₂-CP was related to higher incidence of CI-AKI (27.6% (16/58) in group T1, 5.3% (3/57) in group T2, 1.7 % (1/59) in group T3, P = 0.002) and higher in-hospital mortality (10.3% (6/58) vs. 0 and 1.7% (1/59), P = 0.010). Dialysis rate was similar among 3 groups (5.2% (3/58) vs. 0 and 1.7% (1/59), P = 0.168). The incidence of CI-AKI was significantly associated with CO₂-CP < 22.00 mmol/L in univariate analyses (OR = 6.767, 95% CI 2.731-16.768, P < 0.001). After adjusting for potential confounding risk factors, CO₂-CP < 22.00 mmol/L remained significantly associated with the incidence of CI-AKI (OR = 5.835, 95%CI 1.800-18.914, P = 0.003) in multivariate logistic regression. ROC analysis revealed that the optimal cutoff of CO₂-CP to predict CI-AKI was 22.00 mmol/L (sensitivity 64.0%, specificity 79.1%, AUC = 0.714).

CONCLUSIONSPre-percutaneous coronary intervention CO₂-CP in patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention is related to CI-AKI. CO₂-CP < 22.00 mmol/L predicts higher risk of CI-AKI in this patient cohort.

Acute Kidney Injury ; etiology ; Carbon Dioxide ; analysis ; Contrast Media ; Hospital Mortality ; Humans ; Incidence ; Kidney ; Logistic Models ; Myocardial Infarction ; complications ; physiopathology ; Percutaneous Coronary Intervention ; ROC Curve ; Retrospective Studies ; Risk Factors

Objective: To evaluate the safety and feasibility of treating de novo coronary lesions with paclitaxel-eluting balloon. Methods: This is a retrospective study, which enrolled 76 patients with 80 de novo coronary lesions treated with paclitaxel-eluting balloons(<30% residual stenosis and there was no blood flow limited dissection after pretreatment) from April 2015 to November 2016 in Guangdong general hospital. The data of basic characteristics,procedures,devices and follow-up information were retrieved and analyzed. The primary endpoint was the composite of cardiac death, recurrent myocardial infarction and target lesion revascularization. Results: (1)The age was (63.3±10.3) years. There were 68.4%(52/76) acute coronary syndrome patients, prevalence of type 2 diabetes was 36.8%(28/76), and 64.5%(49/76)patients with at least one high bleeding risk. (2)The lesion length was (17.4±7.6)mm, and the stenosis was (88.1±8.2)%.The reference vessel diameter≥2.75 mm accounted for 51.2% (41/80), and bifurcation stenosis accounted for 67.5%(54/80). (3)53.7%(43/80) lesions were pretreated with scoring balloon to optimize plaque modification. The paclitaxel-eluting balloon length and diameter were (22.3±5.5)mm and (2.74±0.52)mm.The residual stenosis was (12.3±10.3)%. Procedural success was 88.8%(71/80).Bail-out stenting rate was 5.0%(4/80). (4)The median follow-up duration was 12(6, 25) months. Primary endpoint occurred in 3 cases (3.9%), including 2 cardiac deaths(1 patient died of recurrent myocardial infarction, and 1 patient died of acute heart failure induced by severe mitral insufficiency), and one patient receivedtarget lesion revascularization. Conclusion In case of no more than 30% residual stenosis and no blood flow limited dissection after lesion pretreatment,it is safe and feasible to treat de novo coronary lesionsusing paclitaxel-eluting balloon.