Objective By comparing the medical complaints and disputes between the two tertiary general hospitals in Beijing and Lhasa, this paper proposed on how to build a harmonious doctor-patient relationship.Methods A study of annual reports of these two hospitals analyzed descriptively patient complaint rate, rate of medical disputes registered for court jurisdiction, makeup of medical disputes, and their solutions.Results In 2016, the patient complaint rate, and rate of medical disputes registered for court jurisdiction were 3.5/10 000 and 12.4/10 000 respectively, much higher than 0.8/10 000 and 1.1/10 000 of the Lhasa counterpart hospital.A significant gap was also found in the makeup of medical disputes, their solutions, and role of hospital leadership between the two hospitals.Conclusions Beijing is recommended to appoint hospital leader on duty, to assist in handling medical complaints and disputes, and ease doctor-patient contradictions.Lhasa is recommended to improve the medical dispute handling mechanism, improve medical service competency and management.

China ; epidemiology ; Humans ; Occupational Diseases ; epidemiology

A complete explanation of the new idea,grounds,spirit,inner-contradiction of the 3 major documents in the new framework of epileptic knowledge re-defined by International League Against Epilepsy was made in accordance with the International League Against Epilepsy original articles.And the different recognition about them nowadays existed among our nerologists was also deeply explored.

Objective To establish an animal model for immunological contact urticaria in mice.Methods A total of 60 BALB/c mice were randomly and equally divided into 5 groups:anti-dinitrophenol IgE monoclonal antibody (anti-DNP IgE) + 2,4-dinitrofluorobenzene (DNFB) group and anti-DNP IgE + trimellitic anhydride (TMA) group both injected with anti-DNP IgE via tail veins firstly,followed by topical treatment with DNFB and TMA respectively on the ears at 24 hours after the injection,DNFB group,TMA group and normal saline (NS) group all injected with NS via the tail vein firstly,followed by topical treatment with DNFB,TMA and NS on the ears 24 hours after the injection.In the following 14 days,mice were observed daily for the appearance of wheals and for scratching behavior.All the mice were sacrificed at the end of the study followed by determination of the percentage of degranulated mast cells and spleen index as well as observation of pathological changes.Results Wheals were observed in all the mice (12/12) in the anti-DNP IgE + DNFB group,some mice (8/12) in the anti-DNP IgE + TMA group,but not observed in any mice in the other 3 groups.Compared with the NS group,both the anti-DNP IgE + DNFB group and anti-DNP IgE + TMA group showed a significant increase in the percentage of degranulated mast cells (70.21％ ± 26.01％ and 54.25％ ± 39.57％ vs.14.45％ ±6.79％,F=14.41,P=0.000),spleen index (7.54 ± 1.56 and 7.87 ± 1.18 vs.5.37 ± 1.16,F=4.29,P=0.004) and scratching frequency ((31.58 ± 3.58)/h and (22.17 ± 3.81)/h vs.(2.00 ± 0.85)/h at 30 minutes,F =437.86,P ＜ 0.01).Conclusion A stable mouse model for immunological contact urticaria can be established quickly by sensitization with anti-DNP IgE and challenge with DNFB.

ObjectiveTo detect the mutations of GJB3 and GJB4 genes in two sporadic cases of erythrokeratodermia variabilis(EKV).MethodsGenomic DNA was extracted from two sporadic patients with EKV,their family members,and 100 normal human controls.All the exons and adjacent splice sites of GJB3 and GJB4 genes were amplified by PCR.Mutation scanning was carried out via direct bidirectional DNA sequencing.ResultsA G134C mutation was found at the GJB3 gene in patient 1,which caused a substitution of glycine by alanine at codon 45 (G45A).No mutation was found in the GJB4 gene in case 1 or GJB3 and GJB4 genes in case 2.ConclusionA missence mutation G45A in GJB3 gene is found in a patient with EKV.

China ; epidemiology ; Hexanes ; toxicity ; Humans ; Occupational Diseases ; epidemiology ; Trichloroethylene ; toxicity

Objective: To study the influence of inflammatory cytokine TNF-? on the expression of adhesion molecules and specific markers of rat MSCs, and to study the optimal stimulation of MSCs with inflammatory factors in inducing adhesion molecule expression which promotes migration of MSCs to the ischemic area in liver. Methods: The MSCs stimulated with different concentration of TNF-? were detected for adhesion molecules and stem cells markers on cell surface with the method of flow-cytometry, MSCs which were stimulated with the optimal concentration of TNF-? and labeled with 1, 1-Dioctadecyl-3, 3, 3, 3-tetramethylindocarbocyanine Iodade(DiI)were delivered intravenously to the rats whose liver was injured by ischemia, the liver function of the experimented animals were tested, and liver samples in the ischemic area were obtained, the number of MSCs was counted under a fluorescent microscope. Results: Stimulated with TNF-?, MSC ex-pression of VCAM-1 increased, while that of stem cell markers did not change markedly. Exposed to lower concentration of TNF-?, the adhesion ability of MSCs obviously increased and more MSCs rested in the ischemic areas in the rat liver, compared to the control groups. Conclusions: TNF-? can increase the expression of VCAM-1 on rat MSCs while exert little effect on the stem cell character of MSCs. Suitable concentration of TNF-? can promote MSCs migration to the damaged tissue, which provides rationale for the treatment of liver disease.

OBJECTIVETo evaluate the clinical outcome of accessory navicular fusion for treatment of the painful accessory navicular bone of type II in adults.

METHODSFrom June 2006 to June 2012, a total of 38 feet (in 35 adult patients) with painful accessory navicular with type I underwent an fusion operation of the primary and accessory navicular bones,including 26 males and 9 females with a mean age of (32.4±7.3) years old ranging from 18 to 44 years old. The course of disease ranged from 3 to 10 months. The perioperative complications and radiological outcomes were observed and recorded. The foot function before and after operation were assessed by the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score, and the easement of the pain was evaluated by visual analog score (VAS).

RESULTSTwo patients had transient superficial inflammation of the incision, no obvious perioperative complications occurred. All patients were follow-up for (53.5±14.7) months (12 to 84 months). Bone union was confirmed on plain radiography in 32 cases (35 feet). The mean time from the operation to union was (13.7±2.3) weeks (9 to 18 weeks). Postoperative pain VAS score was improved obviosly than preoperative (V=12.14,P< 0.01). The talar-to-first metatarsal angle [(9.4±3.5)° vs (8.3±2.7)°, t=0.736, P>0.05)], calcaneal tilt angle [(17.7±2.2)° vs (18.9±3.4)°, t=0.794, P>0.05],talonavicular uncoverage angle [(14.3±3.4)° vs(12.5?4.6)°,t=0.947, P>0.05) ],and height of the first tarsometatarsal joint [(14.8±3.1) mm vs (15.9±2.8) mm,t=0.814,P>0.05)] before and after operations had no statistic difference. The AOFAS midfoot score was improced from preoperative 45.6±5.3 to postoperative 82.5±7.4 (t=3.214,P< 0.01).

CONCLUSIONFor the painful accessory navicular bone of type II in adults, if the patient has a large navicular bone and not complicated with rigid flatfoot, once the conservative treatment fails, fusion of the primary and accessory naviculars may be a successful intervention. Overall, the procedure provides reliable pain relief, definite foot function improvement, and good patient satisfaction.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Foot Diseases ; physiopathology ; surgery ; Humans ; Male ; Tarsal Bones ; abnormalities ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

By preventing mesenchymal stem cells (MSCs) from adhering to precoated agarose to create a model of MSC suspension in vitro, we investigated anoikis in MSCs and the role of caspase-3 in the anoikis. The cultured MSCs were randomly divided into 3 groups: the anoikis group, caspase-3 inhibitor group and control group. Before experiment, we coated dishes with 1.5 % agarose; in the anoikis group, MSCs were put into the precoated dishes; and in the inhibitor group, caspase-3 inhibitor and MSCs were also put into the precoated dishes; but there were not intervention in the control group. MSCs were collected at 2 h, 6 h, 12 h and 24 h. The alteration of caspase-3 activity was evaluated by caspase-3 fluorometric assay and western blot analysis. The apoptosis rates were detected by flow cytometry. MSCs were round and suspended sufficiently in the anoikis and inhibitor groups. Caspase-3 fluorometric assay showed that there were significant differences in statistics between the anoikis group and the others (P<0.05). Western blot analysis discovered that caspase-3 expression in the anoikis group was more than that in the control and inhibitor groups (P<0.05). Flow cytometry showed that the apoptosis peak appeared in all the three groups, but it increased dramatically in the anoikis group. The apoptosis rates in the inhibitor and control groups were low and stable. And there were significant differences in statistics between the anoikis group and the others (P<0.05). MSCs will undergo anoikis in suspended condition if they are separated from the extracellular matrix. Caspase-3 inhibitors can suppress caspase-3 activity and reduce the apoptosis rate significantly. Caspase-3 plays a vital part in induced MSC anoikis in vitro. MSCs suspension culture system might be set up with argorose and caspase-3 inhibitor.

Objective To observe the changes of expressions of glucose transporter 1,3 gene(GLUT1 mRNA and GLUT3 mRNA) in hippocampus after hypoxic-ischemic brain damage in newborn rats and effects of progesterone on them.Methods Forty SD rats(7-day-old) were divided randomly into 4 groups:normal group,sham operation group,hypoxic-ischemic group and progesterone group.Rats were subjected to right common carotid artery ligation and exposed to 80 mL/L oxygen and 920 mL/L nitrogen gas for 2 hours to establish hypoxic-ischemic model in hypoxic-ischemic group and progesterone group.The rats in sham operation group only received right common carotid artery ligation.Progesterone(8 mg/kg) or sesame oil(of same volume) was given intraperitonealy in progesterone group or other groups 30 minutes before operation.All rats were killed 24 hours after operations.The expressions of GLUT1 mRNA and GLUT3 mRNA in hippocampus of rats in every group were assessed by adopting RT-PCR technique.Results The expressions of GLUT1 mRNA and GLUT3 mRNA in the hypoxic-ischemic group(0.674?0.083,0.785?0.093) increased markedly compared with those in sham operated group(0.374?0.061,0.519?0.060)(Pa0.05).Conclusions Progesterone maintain the energy supply of the brain by up-regulating the expression of GLUT1 mRNA and GLUT3 mRNA and accelerating the transportation of glucose into brain,which may be one of the protective mechanisms.