Through the comparative analysis of traditional medical dispute handling methods and the concept of the third party mediation in medical dispute,this paper discussed that the third party mediation method in medical dispute obtain the recognition of both doctor and patient with its advantages such as neutrality,impartiality,convenience,and it had good running effect in the practice from place to place.But there still remain Some Problems,in cluding the intervention lacks initiative;the amount of indemnity lacks scientificity;the conciliation agreementlacks coercive enforcement;the privacy lacks protection;the institution development is limited.So we must improve the third party mediation work mechanism,identification process,operation mechanism and the relevant insurance system.

Objective:Peripherally inserted central catheter(PICC) has been application in clinical for many years,but the training in the knowledge about maintenance wasn't univesal systematically yet.To analyze the existed problems on the clinical peripherally inserted central catheter in washpipe technology and find out countermeasures. Methods: The self-made questionnaire was used to survey a total of 46 nurses in every department and make on-site operation demonstration. Results: Only 12 nurses' operation was completely correct and the correct rate was 26.1percent,which was related to the training,manager's attention,nurses' participate awareness. Conclusion: The training on nurses' operation of red tube needed to be strengthen.

Objective To investigate whether and how regulatory T cells(Tr) affect macrophages foam-cell formation, and thereby investigate the mechanism of Tr in the development of atherosclerosis. Methods Tr were isolated from lymphocyte suspensions by magnetic cell sorting-column and analyzed by flow cytometry. Macrophages were cultured alone, with CD4~+ CD25~+ T, or CD4~+ CD25~- T cells in the pres-ence of oxLDL for 48 h to transform macrophages into foam cells. Oil red O staining and cellular lipid meas-urement were used to identify macrophage foam cell formation. Semi-quantitative PCR, quantitative real-time PCR and Western blot analysis were carried out to explore the mechanism of Tr-mediated suppression on macrophages foam cell formation. Results Foam cell formation, as identified by oil red O staining, was readily apparent in cells treated with CD4~+ CD25~- T cells and without T cells. After treatment with Tr, a marked decrease(13.9% ± 5.6% ) in foam cell count was observed, compared with untreated cells(13.9% ±5.6% vs 52.9% ± 10.4%, P<0.001 ) or CD4~+ CD25~- T-treated cells(13.9% ± 5.6% vs 53. 1% ± 17.2%, P<0.001 ), 52.9% ± 10.4% and 53.1% ± 17.2%, respectively (P<0.001). The similar effect of Tr was obtained when extracted oil red O and measured by a spectrophotometer. Cholesteryl ester ac-cumulation also used to quantify foam cell formation. Compared with untreated (no T) and CD4~+ CD25~- Tr-treated macrophage cells (CD25~-), the lipids accumulation in CD4~+ CD25~+ Tr-treated macrophage foam cells(CD25~+) was significantly reduced. Total cellular cholesterol and cellular cholesteryl ester was siginifi-cantly reduced in CD25~+ cultures relative to no T[TC(total cholesterol): 57.46 ± 17.92 vs 159.48 ± 16.38, P<0.01 ; CE(esterified cholesterol): 26.68 ± 8.88 vs 102.54 ± 16.67, P<0.001] or CD25~- (TC: 58.50±7.00 vs 150.55±25.11, P<0.01; CE: 26.68±8.88 vs96.90 ± 11.95, P<0.001) cul-tures. Moreover, PCR and Western blot analysis showed that the expression of both CD36 and SRA in Tr-treated macrophage foam cells was significantly down-regulated. Conclusion Results collectively suggest that CD4~+ CD25~+ Tr cells may inhibit macrophage foam-cell formation, which is largely attributed to a down-regulated expression in scavenger receptor in Tr-treated macrophage foam cells.

Objective To use peer education to guide community diabetic patients to adopt diet therapy using food exchange method in order to explore effective method for diet therapy of diabetes mellitus. Meth-ods 91 diabetic patients were selected using simple sampling method and randomly divided into the peer ed-ucation(45 cases) and the common education group(46 cases), the two groups adopted food exchange method for diet therapy for 1 year. The blood glucose, blood lipid, glycosylated hemoglobin and body weight index were compared between the two groups using t test. Results The blood glucose, blood lipid, glycosylated hemoglobin and body weight index all decreased in the two groups after intervention, but the the decreased de-gree in the peer education group was more obvious. The fasting blood glucose, 2 hour postprandial blood glu-cose, glycosylated hemoglobin, triglyceride, low-donordensity lipid protein and body weight index in the peer education were lower thanthose of the common education group, but HDL-C was higher. Conclusions Peer education is more effective in health education of food exchange method.

Female ; Hand-Arm Vibration Syndrome ; diagnosis ; Humans ; Hypothermia ; diagnosis ; Male ; Reference Standards ; Skin Temperature ; physiology ; Young Adult

Acupuncture Therapy ; Adolescent ; Craniocerebral Trauma ; complications ; Humans ; Male ; Optic Nerve Injuries ; etiology ; physiopathology ; therapy ; Vision, Ocular

Environmental Microbiology is an important basic course of Environmental Engineering.Its characteristic is content broad,quick development and strong practicality,thus this curriculum's teaching has certain degree of difficulty.Some suggestions and concrete measures about teaching reform,which included curriculum's course content,teaching method,experiment teaching and assessment methods were proposed in this paper.

Objective To evaluate the effect and safety of glucocorticosteroids in prevention of post-ERCP pancreatifis(post-endo- scopic retrograde cholangiopancreatography pancreatitis,PEP).Methods The database of Cochrane Library(issue 4,2006),Medline (1966-2007.1),EMBASE(1986-2007.1)and CBM(1978-2007.1)were searched.The cited literature of obtained articles and some core English and Chinese medical journals(July,2006-Jan,2007)relevant to gastro-enterolngy were also searched by hand.All random- ized controlled trials(RCT)comparing glucocorticosteroids to placeboes in prevention of PEP were included.Data collection and literature evaluation were performed by two reviewers independently.RevMan 4.2.8 was used for statistical analysis.Result Six RCTs were includ- ed in meta-analysis which showed no statistical difference for the incidence of overall PEP between the glucocorticosteroids group and place- bo group(RR=1.11,95%CI 0.89-1.39).Stratified by severity of PEP,four trials were included.Meta-analysis showed no statistical difference for the incidence of mild to moderate PEP and severe PEP between the two groups(RR=1.17,95%CI 0.91-1.51 for mild- moderate PEP;RR=1.79,95%CI 0.69-4.65 for severe PEP).Stratified by therapeutic ERCP,three RCTs were included.Meta-analy- sis showed no statistical difference for the incidence of PEP between the two groups(RR=1.24,95%CI 0.91-1.67).3 trials as to inter- im-analysis were excluded by sensitive analysis.Meta-analysis also showed no statistical difference for the incidence of PEP between the two groups(RR=0.73,95%CI 0.44-1.20).Conclusion Based on current evidence,glucocorticosteroids is not beneficial in preventing the occurrence of PEP.Further high quality study is needed to disclose the efficacy of glucocorticosteroids in prevention of PEP.

Academe hash't got the same view about science attribute of traditional Chinese medicine(TCM)up to now.This article demonstrates the scientific attribute of the traditional Chinese medicine from the nature of science,the seientific attribute of medical science and the relationship between the traditional Chinese medicine and medical science.TCM needs development.In order to develop the traditional Chinese medicine quickly,on the basis of inheriting tradition,we should make the best use of modem scientific technology.Not simply copy the theories and methods of western medicine but using the scientific measurement to build up the measurement of TCM symptoms,the relationship between symptoms and the change of the body,explore the process of physiology and pathology,and combine with western medicine to develop a mature science-medical science.

Objective To compare the clinical-pathology features between male breast cancer ( MBC) and female breast cancer(FBC)patients.Methods Clinical data of 37 MBC and 300 FBC patients admitted in the First Affiliated Hospital of Zhengzhou University from Jun .2003 to Jun.2013 was retrospectively reviewed . Results The ratio of MBC to FBC was 54:10000.The age of MBC patients ranged from 39 to 80 years with the median age of 62 years old, older than FBC patients(t=3.117, P=0.002).The percentage of invasive ducal carcinoma was much higher in MBC patients than in FBC patients (χ2 =7.535,P=0.023).MBC patients in clinically stage III and IV were more than FBC patients (χ2 =16.471,P=0.000).The positive rate of estrogen receptor(ER)was significantly higher in MBC patients than in FBC patients (χ2 =6.294,P=0.043).The posi-tive rate of human epidermal growth factor receptor-2 ( HER2 ) was lower in MBC patients than in FBC patients (χ2 =11.222,P=0.004).The main surgical method of MBC was modified radical mastectomy , and there was no breast-conserving surgery for MBC, while the surgical method of FBC was various (χ2 =7.720,P=0.021). Conclusion There are significant differences between FBC and MBC patients in clinicopathological features , surgical method and even prognosis , which were important to guide the treatment of MBC and FBC .