The application of the law of medical disputes has become hot debate in law experts and the actual trial with the growing number of medical treatment damages litigation.There has been binary phenomenon of applicable the law of "The Medical Accident Handle Regulation"and the General Principles of Civil Law.The compensation,which is closely related to the law suffered the same problem.The emergence of this phenomenon is inseparable from the shortcomings of "The Medical Accident Handle Regulation".The author will explore the issue and make recommendations.

Objective To evaluate the effectiveness and safety of liraglutide for obesity or overweight. Methods Random controlled trials of liraglutide for obesity or overweight were gathered from MEDLINE, EMbase, CENTRAL, CNKI, VIP and WanFang. We screened the retrieved studies according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analyses with The Cochrane Collaboration's Revman 5. 3. 0 software. Results Twelve randomized controlled trials of liraglutide for obesity or overweight were included, in which 11 trials were written in English and one trial in Chinese. The results of meta-analyses showed that the body weight was significantly reduced in the liraglutide group than in placebo, insulin, exenatide and glimepiride groups [RR=-0. 91,95%CI(-1. 01,-0. 81),P<0. 000 01;RR=-2. 88,95%CI(-3. 37,-2. 39),P<0. 000 01; RR=-1. 12,95%CI(-1. 32,-0. 92),P<0. 000 01; RR=0. 45,95%CI(-0. 62,-0. 27),P<0. 000 01]. Moreover, liraglutide had significant effect in decreasing HbA1c and systolic blood pressure of patients with obesity or overweight. Conclusion Liraglutide is effective for controlling body weight of patients with obesity or overweight. But its long-term efficacy still needs to be confirmed by performing more RCTs with high quality, large sample and long term follow-up.

10.3969/j.issn.2095-4344.2013.26.019

Objective To analyze and summarize the clinical , pathological features of 16 patients with centronuclear myopathy.Methods All of the 16 patients performed clinical examination and sporadic patients and a proband with family history ( n=6 ) performed serum creatine kinase , electromyography and open muscle biopsies , and the specimens were used for a standard series of histological and histochemical stainings.The clinical and pathological features of these patients were analyzed.Results The proportion of centronuclear myopathy in suspected myopathy cases was 0.127%(6/4 724) in our department.The onset time ranged from infancy to adulthood.The common initial symptoms included mild to moderate weakness of lower limbs and bilateral ptosis ( n =4 ).The other symptoms were facial weakness ( n =1 ) and ophthalmoplegia (n=1).There were 12 patients performing distal weakness exceeding proximal weakness . One family with autosomal dominant inheritance of 11 patients had a later age of onset than the sporadic ones and manifested bilateral ptosis , bilateral lower limbs weakness , especially in distal muscle.Muscle biopsies showed pronouncedly increased amount of fibers with centrally placed nuclei with predominant type Ⅰfibers and a clear perinuclear halo surrounding the centrally placed nuclei and an appearance of spoke of a wheel in some fibers.Conclusions This series of centronuclear myopathy patients manifest clinical heterogeneity.Muscle biopsies show features of centralized nuclei pronounced increase , type Ⅰfibers predominance , etc.These can provide evidences for the diagnosis of the disease.

The effect of plant growth regulator forchlorfenuron (CPPU) 1 x 10(-6), 0.67 x 10(-6), 0.5 x 10(-6) on fruit morphology and effective components lignans was studied. Those morphologies were the combination of four basic morphological changes. The result showed, diametre were increased and longitudinal diametre of fruits were inhibited by foliage fertilizers including CPPU. At the same time, 1 000-grain weight and yield showed the varying degrees increase under CPPU. The order of the degree was 0.5 x 10(-6) > 1 x 10(-6) > 0.67 x 10(-6). Six lignans content of Schisandra chinensis of different harvest time and different CPPU processing groups were determined, the results showed that lignans accumulation occurred mainly in periods of premature the half mature fruiting stages. Under the 0.67 x 10(-6) CPPU treatment, schisandrol B, schisandrin B, schisandrin C content of S. chinensis showed different increase.
Chromatography, High Pressure Liquid ; Cyclooctanes ; analysis ; metabolism ; Dioxoles ; analysis ; metabolism ; Dose-Response Relationship, Drug ; Fruit ; drug effects ; growth & development ; metabolism ; Lignans ; analysis ; metabolism ; Phenylurea Compounds ; pharmacology ; Polycyclic Compounds ; analysis ; metabolism ; Pyridines ; pharmacology

Objective:To explore the effect of intratracheal transplantation human umbilical cord blood mesenchymal stem cells on pulmonary interstitial fibrosis by bleomycin in mice,compare the treatment in pulmonary fibrosis of intratracheal transplantation with tail vain injection human umbilical cord blood mesenchymal stem cells.Methods:The second generation of HUCBMSCs were cultured to the fourth generation.Sixty specific pathogen free male Kunming mice were randomly divided into 4 groups:negative control group ( Cont group) ,bleomycin group( BLM group) ,HUCBMSCs transplantation groupⅠ( MⅠgroup) and HUCBMSCs transplantation groupⅡ(MⅡ group),each group 15 mice.Pulmonary fibrosis models were induced by bleomycin via intratracheal perfusion in the latter three groups.Twenty four hours after model establishment,5-bromo-2-deoxyuridine( Brdu) marked HUCBMSCs were poured in trachea in MⅠgroup ,the same were injected into tail vein in MⅡ group.At the 7th,14th,28th day,5 mice in each group were executed re-spectively.The morphological changes of the lung tissues were observed by HE staining and Masson staining.The localization and distribution of human umbilical cord blood mesenchymal stem cells were determined by the method of immunohistochemistry.The hydroxyproline contents were measured by alkali hydrolysis assay.The protein levels of transforming growth factor β-1 ( TGF-β1 ) and smooth muscle alpha-actin(α-SMA) were detected by Western blot.Results:In the two mesenchymal stem cell transplantation groups, there were Brdu marked cells at the 7th,14th,28th days in lung tissue.The alveolitis and fibrosis in lung of the two mesenchymal stem cell transplantation groups were milder than which of the the bleomycin group(P<0.05).Hydroxyproline levels in the bleomycin groups at 3 time points showed a gradually rising trend,the highest level was at 28th day( P<0.01).The protein levels of TGF-β1 andα-SMA in the lung tissues ranked as follows:BLM group>MⅠ,MⅡgroup>Cont group(P<0.05),the difference between MⅠgroup and MⅡgroup was not statistically significant(P>0.05).Conclusion:The colonization of human umbilical cord blood mesenchymal stem cells can be seen in the damaged tissue via intratracheal transplantation which can alleviate pulmonary fibrosis in mice caused by bleomycin.

Objective To explore the influential facts of betel quid chewing for patients with oral submucous fibrosis (OSF) in Haikou,Hainan Province.Methods One hundred and twenty three patients in the Haikou City People's hospital were investigated regarding their clinical information,including age,sex,origins,kinds and time of betel nut chewing,obvious clinical features,cognition for its harmfulness and so on.Results (1)The mean age was 36.5 years old,the most common patients were the group between the ages of 30 and 50 among 123 patients,male preferred to chewing betel nut,the female fond of betel nut were mostly Li minority women.(2)People chewing the dry betel nut had the higher incidence than the ones who prefer the fresh in five years.The both were significant difference (x2 =18.79,P ＜0.01),however,the incidence difference between the patients at the same time and the ones chewing kinds of betel nut was not significant (P ＞ 0.05).(3)The early clinical features of some OSF patients included stimulating pain,mucosal blanching,gradual inability to open the mouth and fibrous bands.(4)Although 61 patients (49.59％) knew about the harmfulness of betel nut chewing for their oral health,they could not change their lifestyle.Conclusions Male prefers to chewing betel nut,the female fond of betel nut are mostly Li minority women in Haikou area,the parts of patients could not overcome the habit ofchewing betel nut; people chewing the dry betel nut has the higher incidence than the ones who prefer the fresh's at early period,and of the two the former prone to disease than the latter.

OBJECTIVETo analyse the constitution of 5459 cleft lip and palate cases and to review the development of surgical treatment to them.

METHODSThe data of the 5459 cleft lip and palate cases were collected and classified. The ratio of sex and disease pattern were calculated and analyzed statistically. Also, by means of classification of the disease pattern, the operation methods and the operation time, the change of the surgical methods and the first operation age were analyzed.

RESULTSIn the cleft lip and palate cases, the sex ratio is different. There were obvious differences in the first operative ages in different periods. The main repair methods for cleft lip and palate changed with time.

CONCLUSIONThe male is more than the female in the cleft lip and palate patients. The average first operation age has been decreased and the main repair methods have changed since 1980.

China ; epidemiology ; Cleft Lip ; epidemiology ; pathology ; surgery ; Cleft Palate ; epidemiology ; pathology ; surgery ; Female ; Humans ; Male ; Sex Factors ; Statistics as Topic

Based on an analysis of the compensation policy and its problems of the primary medical and health institutions, this paper put forward the corresponding reform framework in Zhejiang province. It proposed to change the compensation policy of " predefining revenue and expenditure, subsidizing its gap after performance appraisal" into " a mixed system of special subsidy and pay for performance". Related policies were also described including governmental functions, special subsidies for input-based payments, classified payments for output services, precautions against financial risks, etc. This paper also suggested that we focus on dealing with the six pairs of balance, such as that between subsidy for the supply and demand sides, and that between internal market and external market.

OBJECTIVETo compare the content of six lignans of different parts of Schisandra chinensis.

METHODAgilent TC-C18 (4.6 mm x 250 mm, 5 microm) was used with acetonitrile-water gradient system as mobile phase. Wave length was 250 nm. The flow rate was 1 mL x min(-1). Column temperature was 30 degrees C.

RESULTThe total lignans content of wild Schisandra chinensis was higher than that of the cultivated varieties. The total lignans content of different parts varied significantly, wherein the root > main branch > side branches > leaf.

CONCLUSIONThis method is stable, reliable, can be used for the quality evaluation of different parts of Schisandra.

Chromatography, High Pressure Liquid ; methods ; Lignans ; analysis ; Schisandra ; chemistry