1.New method to deal with the doctor-patient dispute
Yingchun LAN ; Li CHEN ; Min WANG
Chinese Medical Ethics 1994;0(05):-
The 'set the duty to offer proof upside down',the conduct and actions put forth effort the exception in the civil case in court as the principle to the deal with medical treatment dispute,it will necessarily provide a good measure and a guarantee to get the doctor-patient relationship for the better.How to treat the 'set the duty to offer proof upside down'is a brand-new topic.Now,the author bing upped some suggestions.
2.Clinical study of terminating biochemical pregnancy and early clinical pregnancy with mifepristone and misoprostol
Cui-Lan LI ; Min WEI ; Mei-Fang FU ; Min LI ;
Chinese Journal of Obstetrics and Gynecology 2001;0(08):-
Objective To explore the efficacy and safety of terminating biochemical pregnancy (the stage in which intrauterine or ectopic pregnancy cannot be confirmed) with mifepristone and misoprostol. Methods Mifepristone (150 mg) combined with misoprostol (600 ?g) 3 days later were given to 500 biochemical pregnancies (G_1),500 early clinical pregnancies (G_2) and 500 clinical pregnancies (G_3) which were classified according to amenorrhea days,serum human chorionic gonadotropin-beta subunit (?- hCG) and vaginal B-ultrasonic examinations.All were observed for 6 hours after taking misoprostol and returned for assessment per week.Results Expulsion of conceptus was G_1 123 (24.6%,123/500),G_2 438 (87.6%,438/500) and G_3 467 (93.4%,467/500).Failure rate was G_1 6 (1.2%,6/500),G_2 24 (4.8%,24/500) and G_3 79 (15.8%,79/500) for ongoing pregnancies,hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding.Bleeding cases during the administration of mifepristone were G_1 272 (54.4%,272/500),G_2 141 (28.2%,141/500) and G_3 87 (17.4%,87/500);the mean bleeding days were G_1 (5.8?1.5),G_2 (9.0?2.9) and G_3 (14.3?5.9) days.Other side effects including abdominal pain,nausea,vomiting and diarrhea were low and light in each group,increasing with advancing gestational age.Menses recovery was 486 (97.2%,486/500),452 (90.4%,452/500) and 433 (86.6%,433/500) for each group on scheduled time.Satisfaction was 499 (99.8%,499/500),485 (97.0%,485/500) and 369 (73.8%,369/500) respectively.Conclusion Mifepristone and misoprostol in combination is as safe,and effective for termination of biochemical pregnancies as ordinary medical abortion.It does not need to wait till ectopie pregnancy is excluded.
3.Cystic fibrosis in 2 children with Pseudomonas aeruginosa infection
Mengni LI ; Huan LEI ; Juan FAN ; Min LI ; Lan LI
Chinese Journal of Applied Clinical Pediatrics 2021;36(4):300-302
Clinical data of 2 children with cystic fibrosis (CF) and Pseudomonas aeruginosa infection in the Department of Pediatrics of Sichuan Provincial People′s Hospital from April 2018 to June 2019 were retrospectively analyzed.Patient 1 was an 11-year-old girl with no history of recurrent respiratory infections. Pseudomonas aeruginosa was found in the first sputum culture.A large number of yellow and white secretions were visible under repeated fiberoptic bronchoscopy.Chest CT showed multiple spots and tree-in-bud signs around the bronchi of both lungs. CFTR gene test results revealed 3 heterozygous mutations: c.2909G>A (chr7: 117246728), c.*133T>A (chr7: 117307295) and c. *125delT (chr7: 117307285). The other patient was a 7-year-old boy with a history of recurrent respiratory infections.His parents were close relatives.Multiple cultures of sputum and bronchoalveolar lavage fluid of the boy were Pseudomonas aeruginosa, and chest CT suggested dilation and inflammation in bronchi of both lungs.Gene detection showed that the c. 380T>G homozygous mutation at chromosome chr7-117171059 resulted in an amino acid change p. leu127stop (nonsense mutation). This article suggests that CF should be considered for Pseudomonas aeruginosa infected children having signs of bronchiectasis on chest CT and a large number of secretions under bronchoscopy.Besides, it is necessary for such kind of children to perform genetic testing in time to confirm the diagnosis as soon as possible.
4.Ulinastatin attenuates paraquat-induced myocardial injury
Li LI ; Min DI ; Chao LAN ; Changhua SUN
Chinese Journal of Emergency Medicine 2012;21(11):1192-1197
Objective To investigate the effect of ulinastatin (UTI) on endogenous antioxidant systems in the process of myocardial oxidative stress injury induced by paraquat (PQ),so as to elucidate UTI protecting cadiocytes against PQ-induced injury.Methods Thirty Japan white rabbits were randomly (random number) divided into A,a sham control group; B,PQ intoxication model group and C,D,E,three UTI groups as per different dosages of UTI given.PQ (30 mg/kg) was administered by intraperitoneal route to the rabbits of PQ intoxication model and rabbits of three UTI groups.UTI in doses of 15 000,30 000,50 000 U/kg was administered intravenously every day to the rabbits of three UTI groups respectively for 7 days after PQ intoxication.After the rabbits were sacrificed with 10% chloral hydrate,left ventricles of rabbits were taken.Histomorphological changes of myocardium were observed by using HE staining.Hydroxyproline was measured by alkaline hydrolysis method,myocardial oxidative stress evaluated by 4-hydroxy-2-nonenal (4-HNE) immunohistochemistry staining,transcription levels of transforming growth factor-β1 (TGF-β1),adiponectin,peroxisome proliferator-activated receptor α (PPAR-α),AMP-activated protein kinase-β1 (AMPK-β1),uncoupling protein-1 (UCP-1) were assayed with reverse transcriptionpolymerase chain reaction (RT-PCR).The differences between two groups were analyzed by t test ; for multiple comparisons,data were analyzed by One-Way ANOVA followed by Dunnett' s post hoc test; for two and multiple ranked data comparisons,Mann-Whitney U test and Kruskal-Wallis test were used,and Spearman rank correlation analysis was used to investigate the correlation between UTI dose and transcription levels of endogenous antioxidant.Results Compared with group A,left ventricular cadiocytes in group B became swelled and disarranged,concentration of tissue HYP was elevated to (2.37 ± 0.49),P =0.001;scores of 4-HNE and TGF-β1 mRNA expressions were all upregulated (both P =0.001).Compared with group B,disordered myocytes in UTI treated groups tended towards normal,4-HNE scores in group D and group E descended respectively to (1.83 ± 0.53) and (1.70 ± 0.47),both P =0.001,HYP concentration reduced to (3.51 ±0.39) μg/mg and (3.29 ±0.37) μg/mg (P =0.002; P =0.001),and expressions of TGF-β1 mRNA in these two groups were decreased (both P =0.001).Transcription levels of four endogenuous antioxidant components,adiponectin,PPAR-α,AMPK-β1 and UCP-1,were all augmented in the group E with high dose UTI.The mRNA expressions of these four components positively correlated with the dose of UTI in the myocardium of PQ intoxicated rabbits.Conclusions UTI could protect myocardia against PQ-induced injury by increasing endogenous antioxidant systems.
5.Clinical Study on Acupuncture and Ischemic Stroke
Lan LI ; Ping ZHENG ; Xin CHEN ; Yang BAI ; Min MAO
Journal of Acupuncture and Tuina Science 2009;7(3):137-139
Objective:To study the clinical efficacy of acupuncture for ischemic stroke and its effect on ET-1 levels in IS cases.Method:The 63 cases were randomized into a treatment group (31 cases),receiving acupuncture and routine method,and control group (32 cases),receiving routine method alone.Seven days constitute a course of treatment,a 2-day interval between two courses.The clinical efficacy and ET-1 level in two groups were compared after four weeks.Result:The total effective rate in the treatment group and control group were 96.8% and 75% respectively,with a statistical significance (P<0.05);the ET-1 level in blood plasma also with a statistical significance after the treatment (P<0.05);the pre-treatment and post-treatment ET-1 level in the treatment group showed a statistical significance (P<0.01),whereas the control group didn't.Conclusion:Acupuncture is effective for ischemic stroke and can lower the ET-1 level in ischemic stroke cases.
6.Effects of Tangxinping Capsule on angiotensin II and its type 1 receptor and myocardial ultrastructure in diabetic rats.
Min LI ; Qing NI ; Xiaoyan CHU ; Zhaoli WANG ; Lan LIN
Journal of Integrative Medicine 2008;6(11):1164-9
To investigate the protective effects of Tangxinping Capsule, a compound traditional Chinese herbal medicine, on diabetic cardiomyopathy in rats.
7.A cross-lagged regression analysis between resilience, mental health and psychological stress of recruits during training
Yi MIAO ; Min LI ; Yong LAN ; Yupei ZHANG ; Bo CHEN
Chinese Journal of Behavioral Medicine and Brain Science 2012;21(1):59-62
ObjectiveTo explore the resilience and mental health of recruits during training,and to investigate mutual prediction of resilience between mental health and psychological stress to provide the scientific evidence for the mental health training and psychological selection of recruits.MethodsConnor-Davidson resilience questionnaire ( CD-RISC),symptom checklist ( SCL-90 ),psychological stress self-evaluation test ( PSET),satisfaction with life scale (SWLS),positive and negative affect scale (PANAS) were applied to 650 recruits in 2011 before starting training and after two months of training.Results ① Chinese recruits had good resilience,and the CD scores of pre-and post-test were (61.60 ± 14.36) and (61.41 ± 14.55 ) respectively.②Mental health (SCL-90) of two tests were good in recruits.③ Correlation analysis showed that the same premise of phase correlation,resilience (pre-test) could significantly predict mental health (post-test) ( β =0.070,P < 0.05 ),mental health ( pretest) could not predict resilience (post-test) (β =0.015,P > 0.05 ).Resilience (pre-test) could significantly predict psychological stress (post-test) ( β =0.075,P < 0.05 ),psychological stress (pre-test) could not predict resilience (post-test) (β =0.017,P > 0.05 ).④ Compared with high resilience group,low-resilience group of recruits had higher total score of SCL-90 and psychological stress and less positive emotion,more negative emotion and lower life satisfaction.ConclusionThe recruits training have good resilience.Resilience of recruits have predictive ability to mental health,psychological stress during training.
8.Mechanism of Isometric Exercise in Cardiac Rehabilitation
Shifang ZHOU ; Jianan LI ; Weiying ZHAO ; Min LAN
Chinese Journal of Rehabilitation Theory and Practice 1999;5(2):49-53
Isometric exercise(IE) is an essential component of daily living activities.Lack of IE may result in deconditioning of IE capacity.IE has not been used in cardiac rehabilitation because of poor understanding in cardiovascular response to IE and the Valsalva Maneuver associated with IE.Eingteen healthy young subjects aged 23.7 yrs on average was studied by administration of beta blocker and antagonist of opioids during IE.The result demonstrated that the regulation of cardiovasular response during IE is attributed to both sympathetic system and opioids activity.Twenty patients with coronary artery disease (CAD) were also studied during brief maximal IE,sustained maximal IE and dynamic exercise(DE).The patients included 13 cases with more than one vessel lesions and 7 post myocardial infarction and/or angina.Ten age matched apparent healthy subjects were examined as the control group.The result showed that IE without the Valsalva Maneuver in patients with CAD might increase coronary artery perfusion by enhancing diastolic pressure and prolonging diastolic period,which had no harmful effect on CAD.Hemodynamic responses and cardiac function were weaker during IE than DE.The intensity of the responses to IE was correlated to the central command but not to the absolute work load.It is concluded that significant release of endogenous opioids due to strong central command during IE,especially perceived maximal sustained IE,may help to attenuate activity of sympathetic system,thus reducing risk of exercise in patients with CAD.
9.Repair of Injured Adult Rat Brain by Inducing Neural Regeneration with Bioactive Material Scaffolds
Lan CHEN ; Min SUN ; Kaifeng ZHANG ; Zhaoyang YANG ; Xiaoguang LI
Chinese Journal of Rehabilitation Theory and Practice 2013;19(4):318-323
To repair the brain of adult rats with traumatic brain injury by inducing neural regeneration with biological scaffolds. Methods 52 adult male Wistar rats were divided into control group, lesion group, blank chitosan carriers group and bioactive material scaffolds group. The neural regeneration and the origin of the newborn neurons in the injury area were detected through histochemistry, immumochemistry and neural tracing on the 3rd day, 7th day, 2nd week, 4th week, 2nd month and 3rd month after operation. Results After application of bioactive material scaffolds, the BrdU+/Nestin+ and BrdU+/Dcx+ cells in gyrus dentatus (DG) of hippocampus and subventricular zone (SVZ) were significantly more than those of the other groups. The BrdU+/Nestin+, BrdU+/Dcx+ and BrdU+/MAP2+ neural cells in injury area of the bioactive material scaffolds group were significantly more than those of the other groups. After application of DiI to label the SVZ cells, DiI+/NeuN+ neurons were observed in the injury areas. Conclusion Bioactive material scaffolds can activate the neural stem cells in SVZ and DG. The neural stem cells in SVZ can migrate to the injury area and then differentiate into mature neurons.
10.Joint effects of hydroxyethyl starch and furosemide on acute lung injury induced by paraquat in swine
Chao LAN ; Lu LI ; Li LI ; Jinzhu WANG ; Haina LI ; Lanping LIU ; Min DI
Chinese Journal of Emergency Medicine 2015;24(12):1396-1401
Objective To discuss the jointly therapeutic effects of 6% hydroxyethyl starch 130/0.4 (voluven) and furosemide on acute lung injury induced by paraquat (PQ) in swine.Methods The ALI/ ARDS models were established with 20% PQ (20 mL) intraperitoneal injection in 18 healthy female piglets and randomly divided into three groups: voluven group (A), furosemide group (B) and voluven + furosemide group (C) (n =6 in each group).The heart rate (HR), mean arterial pressure (MAP), extravascular lung water index (ELWI), pulmonary vascular permeability index (PVPI), partial pressure of carbon dioxide (PaCO2) and oxygenation index (PaO2/FiO2) among the three groups were carefully measured by PICCO (pulse indicator continuous cardiac output) before modeling (baseline), just aftermodeling (t0), and 2 h (t2), 4 h (t4), 6 h (t6) and 8 h (t8) after trearment.Needle biopsies of lung tissue were made before modeling and at t0 and t8 and prepared for microscopy observation after Hematoxylineosin staining method (HE staning).Repeated measurement data were compared among repeated measures by the ANOVA and the difference between groups was compared by one-wey ANOVA.Results (1) The HR and MAP of all animals increased obviously while the oxygenation index declined significantly at modeling just made (t0) compared to those before modeling (all P < 0.05).At the same time, the HR and MAP of A and B groups were significantly lower than those of C group after treatment (all P < 0.05), while the oxygenation index of A and B were significantly higher (all P > 0.05).(2) The ELWI and PVPI of all animals increased obviously at modeling just made (t0) compared to those before modeling (all P < 0.05).The ELWI and PVPI were decreased after treatment.And at the same time, the ELWI and PVPI of A and B groups were significantly lower than those of C group after treatment (all P < 0.05).(3) The alveolar tissue showed obviously injured changes at modeling just made (t0).The injury was relieved 8h after trearment, which was most markedly in group C.Conclusions With the combination of 6% hydroxyethyl starch 130/0.4 and furosemide administered, the acute lung injury induced by paraquat poisoning can be effectively relieved, promoting gas exchange, and improve oxygenation.