Medical imperfection is the major reason for medical bother.How to avoid medical imperfection and guarantee medical security are the key issues of medical administrators.By investigating,integrating and analyzing the causation of the medical imperfection and the ways of prevention,we conclude that human context has an important effect.

Objective:To screen for peptides that specifically bind to PreS1 antigen from a phage-displayed peptide library.Methods: The PreS1 antigen was used as the target molecule to screen the binding peptide from the Ph.D.-7 peptide library with phage display technique,and the positive clones were identified by ELISA.Results: After three rounds of biopanning,the binding peptides were screened from the peptide library by ELISA and competitive inhibiting ELISA.Sequencing result showed that the binding peptides had high affinity and specificity.Conclusion: A peptide binding PreS1 antigen has been successfully obtained by screening the phage display library,which paves a way for the diagnosis and treatment of hepatitis B infection.

Medical defects are the main reason for medical disputes,also the important factors which influence the health care order and medical service quality and cause tension between doctors and patients. The occurrence of medical defects highlights deficiency of humanism. We should reinforce liberal education in the medical services and medical education,prevent the occurrence of medical defects fundamentally,and improve the quality of medical services comprehensively.

Humanistic quality is the basis of spirit maturity,the pursuit of medical spirit,the core of vocational morality and the fundamentality of walk.Enhancing humanistic quality is the foundation to understand medicine as well as engage in doctoral profession and the requirement to face society and achieve their own values for the students.

Objective:To screen for simulation peptide binding specifically to the first and the second extra-cellular domain of CC chemokine receptor 5(CCR5),and to observe their therapeutic effect on mice with experimental autoimmune encephalomyelitis(EAE).Methods:Phage display peptide library was used to screen for peptide sequence binding specifically to CCR5;ELISA was used to identify its binding activity and analyze its DNA sequence.The simulation peptide was synthesized and was injected into abdominal cavity of the EAE mice.Spinal cord tissues were obtained and the pathologic changes were studied by H-E staining in EAE control group and simulation peptide group.Results:Twenty phage clones were randomly chosen for identification and ELISA showed that there were eighteen clones had a strong binding activity with CCR5.The positive clones were sequenced and four peptides of high frequency were obtained:STFTTTL,TPIPQLL,SLPLPKP,and QTSSAAL.Mean clinical score of mice in the EAE model group was 3 and that of the simulation peptide group was 1.H-E staining found that the spinal cord tissues in EAE model group had great number of inflammatory cells and evident demyelination changes;the simulation peptide group had less inflammatory cells and no demyelination changes.The four short peptides had an effect of suppressing and delaying the development of EAE,with the average inhibition rate being 43%(P

microRNAs (miRNAs) are a class of small non-coding,single-stranded RNAs,which regulate gene expression by binding messenger RNA (mRNA).Thyroid cancer is the most common endocrine cancer.Papillary thyroid carcinoma (PTC) is a common type of thyroid cancer,and its incidence has dramatically increased worldwide.Recent evidence suggests that miRNAs play an important role in thyroid carcinogenesis,development and prognosis,especially in PTC.

Objective:To establish a method for the determination of chloramphenicol and hydrocortisone in chloramphenicol hy-drocortisone ear drop. Methods:An HPLC method was used with a Shiseido SPOLAR C18 column (250 mm ′4. 6 mm, 5 mm). The mobile phase was 0. 01 mol·L-1 sodium heptane sulfonate buffer solution (6. 8 g potassium dihydrogen phosphate was dissolved in 0. 01 mol · L-1 heptane sodium sulfonate buffer solution and diluted to 1000 ml, 5 ml triethylamine was added and mixed, and then the pH was adjusted to 2. 5 by phosphoric acid)-methanol (40︰60). The column temperature was 30℃ and the flow rate was 1. 0 ml · min-1 . The detection wavelength was 245 nm and the injection volume was 10 μl. Results: Chloramphenicol and hydrocortisone had a good linear relationship within the range of 50. 26-753. 84 μg · ml-1 ( r =0. 9996 ) and 10. 93-163. 92 μg · ml-1 ( r =1. 0000), respectively. The average recovery of chloramphenicol was 100. 21% and RSD was 0. 48%(n=9). The average recovery of hydrocortisone was 100. 82% and RSD was 0. 37% (n=9). Conclusion:The method has the advantages of high specificity, good reproducibility and high precision, and can be used as a method for the determination of chloramphenicol and hydrocortisone in chlor-amphenicol hydrocortisone ear drop.

Fetal omphalocele is a surgical disease with severe defect of fetal abdominal wall which requires emergency treatment after birth. The incidence rate is 2.1/10000, and the mortality rate is 52% to 67%. The improper handling of omphalocele can cause capsular rupture and intestinal exposure, leading to neonatal fluid loss, hypothermia, intestinal necrosis and other complications. It is the major cause of death in newborns. In this paper, we reviewed the characteristics, delivery mode, delivery time, umbilical cord care, and transferring of omphalocele newborns to provide reference for clinical nursing.

Objective To investigate the protective effect of protocatechuic acid(PCA)on the PC12 cell model of Alzheimer’s disease(AD)and to explore its mechanism . Methods Amyloid beta peptide 1-42(Aβ1-42)fiber polymers were identified by immunofluorescence. After PC12 cells were stimulated with the Aβ1-42 fiber polymers, the cellular morphology was observed at different time points of hour 0, 3, 6, 9, 12, 24 , and the cellular viability was tested by methyl thiazolyl tetrazolium(MTT)assay to monitor the modeling condition. The effect of PCA on PC12 cells was detected after PC12 cells were pretreated with the different contentions of PCA. Autophagy-related marker Beclin1 protein level was detected by Western blotting method to investigate the protective mechanism of PCA. Results Aggregated white Aβ1-42 mass was stable at hour 12 and 24, and showed no significant difference between the two time points, the cell damage rate being 40%. Therefore, we defined culturing time being 12 and 24 hours as the modeling condition of AD model. The cell viability was increased with 200-800 μmol/L of PCA after culturing for 24 hours(P<0.01) , and the Western blotting results showed that the Beclin1 protein expression was up-regulated by PCA. Conclusion PCA prevents PC12 cells from Aβ1-42-induced toxicity, the mechanism being related with the increase of cellular autophagy.

Objective To investigate the morphology change of posterior cricoarytenoid muscle myofiber in patients with idiopathic vocal fold paralysis and to provide experimental evidence for the clinical treatment of idio‐pathic vocal cord paralysis .Methods Thirty -nine cases of vocal fold paralysis patients were recruited into and di‐vided into 2 groups :idiopathic vocal cord paralysis group(n=16) ,and traumatic vocal cord paralysis group(n=23) . Both groups were further divided into 3 subgroups:0 .5~1 year(5 cases and 7 cases) ,>1~2 years(5 cases and 10 cases) ,>2 years(6 cases and 6 cases) .Part of posterior cricoarytenoid muscle(PCAM ) were acquired from all of vo‐cal cord paralysis patients .Normal human posterior cricoarytenoid muscles were treated as the control group (n=5) . They were all stained with Masson three-color staining ,the fiber crosssectional area of muscle tissue and collagen connective tissue were quantitatively analyzed with the image pro plus analysis system .Differences of two observa‐tion indexes were compared with each other among groups and subgroups .Results The number of myofibers was decreased ,but the numbers of the collagen fibers was increased with the onset time course extension ,the ratio of cross sectional area of myofibers to those of collagen fibers was progressively decreasd with increased time course of denervation and more decrease within 1 year .There was obvious difference between the control group and 0 .5~1 year ,>1~2 years ,>2 years subgroup of idiopathic vocal cord paralysis (P<0 .05) .Although without no signifi‐cant difference between >1~2 years subgroup and >2 years subgroup ,the trend of shrinking still existed .Com‐pared two observation indexes of traumatic vocal cord paralysis with the same period subgroup indexes of idiopathic vocal fold paralysis ,there was no significant difference about these two observation indexes (P>0 .05) .In some special cases with 10 years duration in idiopathic vocal cord paralysis group ,the posterior cricoarytenoid muscle at‐rophy fibrosis was not serious .However ,in some case which the course lasted for only 1 .5 years ,the muscle atrophy was very obvious .There were great individual differences among idiopathic vocal cord paralysis patients .Conclusion If there is no recovery after half year treatment ,for PCA muscle function recovery ,the recurrent laryngeal nerve injury repair surgery could be considered to carry out within 1 year .In some cases with long disease duration (>2 years) ,they may still have the muscle morphological basis for nerve repair .