Compelling medical relation is one kind of administrative legal relationships. In the process of compelling treatment, when illegal or improper treatment by medical staff hurts patient's body, life or psychology, the country must be responsible for compensation to the patient. To effectively avoid the risk of infection due to compelling medical service, the special liability insurance of medical risk for the medical staff should be set up. Furthermore, the patient is supposed to hold the power of receiving legally free cure.

G protein-coupled receptor 30 ( GPR30),a sort of novel functional estrogen transmembrane receptor,extensively participate in the pathological and physiological regulation by mediating the rapid nongenomic effects of the estrogen,which plays an important role in the occurrence and development of the hormone-related malignant neoplasms.

ObjectiveTo investigate the associations of plasma homocysteine (Hcy) and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels with dementia.MethodsThe patients with dementia admitted to hospital were enrolled retrospectively.They were divided into a vascular dementia (VaD) group, a mixed dementia (MD) group, and an Alzheimer's disease (AD) group according to the Hachinski Ischemic Score, and the dementia severity was further divided into a mild group, a moderate group and a severe group according to the Mini-Mental State Examination.The non-demented patients hospitalized during the same period were selected as controls.The demographics, vascular risk factors, and plasma Hcy and Lp-PLA2 levels in each group were compared.Logistic regression analysis was used to determine the independent associations of the plasma Hcy and Lp-PLA2 levels with the risk of dementia and severity.ResultsA total of 125 patients with dementia were enrolled, including 52 (41.6%) in the VaD group, 21 (16.8%) in the MD group, and 53 (41.6%) in the AD group.There were 49 patients (39.2%) in the mild group, 51 (40.8%) in the moderate group, and 25 (20%) in the severe group.A total of 40 non-demented patients were enrolled as control group.The plasma Hcy and Lp-PLA2 levels in VaD, MD and AD groups were significantly higher than those in the control group (all P<0.001).Multivariable logistic regression analysis showed that the advanced age (odds ratio[OR] 1.12, 95% confidence interval [CI] 1.03-1.21;P=0.010), high plasma Hcy level (OR 1.44, 95% CI 1.21-1.71;P<0.001), high Lp-PLA2 level (OR 1.01, 95% CI 1.00-1.02;P=0.006), and previous stroke (OR 4.29, 95% CI 1.50-12.36;P=0.007) were the independent risk factors for dementia;high Hcy level (OR 1.48, 95% CI 1.21-1.82;P<0.001, high Lp-PLA2 level (OR 1.01, 95% CI 1.00-1.03;P=0.002), and previous stroke (OR 152.78, 95% CI 20.41-999.97;P<0.001) were the independent risk factors for VaD;advanced age (OR 1.10, 95% CI 1.02-1.17;P=0.008) and high Hcy level (OR 1.41, 95% CI 1.25-1.58;P<0.001) were the independent risk factor for severe dementia.ConclusionsThe increased plasma Hcy and Lp-PLA2 levels are associated with dementia.Reducing the plasma Hcy and Lp-PLA2 levels may be beneficial to the treatment and prevention of dementia.

Background and purpose:More than 70 percent of ovarian cancer patients were diagnosed in the advanced stage. Currently the 5-year disease free survival (DFS) of stageⅢC-Ⅳovarian cancer patients wsa about 10 percent after first line chemotherapy. This study aimed to improve the 5-year DFS by three-step chemotherapy according to the mechanisms of ovarian cancer biological characteristics, cytodynamics and pharmacology. Methods:In arm A, the patients received three-step chemotherapy after primary debulking surgery, step one with paclitaxel plus carboplatin (TC regimen), every 3 weeks for 6 to 8 cycles;step two with etoposide plus cyclophosphamide, every 4 weeks for 6 cycles;step three wit carboplatin plus cyclophosphamide every eight weeks for six cycles. In control arm B, we retrospectively analysed 51 cases withⅢC-Ⅳstage ovarian cancer, who had completely response after standard chemotherapy with six to eight cycles of TC after primary surgery during 2007. We compared the 5-year DFS between the two arms. Results:The 5-year DFS of 15 cases in arm A was 80%(12/15), which was signiifcantly higher than that of arm B (5.9%, 3/51, P<0.01). Conclusion: The three-step chemotherapy after optimal debulking surgery in stageⅢC-Ⅳ can improve the 5-year DFS. This regimen is high efficacy, mild side-effect witn low cost, which deserves further exploration.

Objective To evaluate the effect of wild feces detection in Oncomelania hupensis environments on the surveil?lance of infection source of schistosomiasis,and find the weakness in schistosomiasis control in Hubei Province,so as to put for?ward the targeted strategies and measures. Methods Four environments with O. hupensis snails in endemic areas of Hubei Provinces,where human and livestock often haunted,were selected according to the river systems,namely the Juzhanghe River beach in Jingzhou City,Changjiang River beach in Jiayu County,Hanbei River beach in Tianmen City,and Changshou River beach in Zhongxiang City,then the snail survey and wild feces detection were implemented in the selected environments. Re?sults There were O. hupensis snails,livestock,wild feces of cattle or sheep as well as positive cattle feces found in all the 4 environments,and the positive rate of schistosome miracidium incubation was 47.62%. Conclusion The schistosome miracidi?um positive rate of wild feces of cattle is high in the environments with snails in endemic areas of Hubei Province ,which has high risk for schistosomiasis transmission.

Objective To investigate the water infectivity in key water regions,and analyze the transmission risk of schisto-somiasis in suspicious and high-risk environments in Hubei Province in 2016. Methods Schistosome-endemic areas of the Yangtze River,the Hanbei River and the Fu River were chosen as the surveillance and forecast sites. The water infectivity was detected by using the sentinel mice during the flood season. The infection status of residents in the villages around the surveil-lance sites and the activities of human beings and domestic animals were surveyed. The emergency response system was initiated when the water infectivity areas were detected. Results From May to June,among the ten surveillance sites of the first batch, two positive spots with infected mice were found,accounting for 20％. All the recovered mice(totally 200)were dissected:five mice were infected,with a total infection rate of 2.5％. Totally five schistosome adult worms were collected,with mean worm bur-den of 1 worm per infected mouse. The site with cercariae-infected water body started the emergency response and no epidemic occurred. From August to September,among the eight surveillance sites of the second batch,the recovered mice(totally 160) were dissected,and no infected sentinel mice were found. Conclusion The sentinel mice method plays an important role in an-alyzing the schistosomiasis transmission risk in Hubei Province.

Objective To assess the schistosomiasis endemic situation in the national surveillance sites in Hubei Province, so as to provide the evidence for the prevention and control of schistosomiasis. Methods According to the national surveillance protocol,a longitudinal surveillance of endemic situation of schistosomiasis was carried out in 16 national surveillance sites from 2005 to 2010. Results In general,the positive rates of IHA,Kato-Katz technique and infection rates of Schistosoma japonicum decreased from 15.67%,10.93%and 1.71%in 2005 to 10.48%,8.54%and 0.90%in 2010,and declined by 33.12%,22.70%and 47.95%,respectively. The infection rates of S. japonicum of the male were higher than that of the female,and the peak infec-tion rates were in the groups aged above 30 years. The endemic situation of fishermen and farmers were relatively serious. The in-fection rates of S. japonicum in cattle decreased from 11.69%in 2005 to 1.41%in 2010,and declined by 88.01%(χ2 =298.79, P<0.001). The areas with infected Oncomelania hupensis snails,the densities of living snails,the rates of infected snails and the densities of infected snails decreased by 90.88%,61.66%,80.00%and 92.00%,respectively. Conclusion The schistosomiasis endemic situation in the national surveillance sites in Hubei Province mitigates in 6 years,but the prevention is still a very daunt-ing task.

Objective To study the endemic trend of schistosomiasis japonica in Hubei Province,so as to provide the theo?retical basis for surveillance and forecasting of schistosomiasis. Methods The time?series auto regression integrated moving av?erage(ARIMA)model was applied to fit the infection rate of residents of Hubei Province from 1987 to 2013,and to predict the shot?term trend of infection rate. Results The actual values of infection rate of residents were all in the 95%confidence inter?nals of value predicted by the ARIMA model. The prediction showed that the infection rate of residents of Hubei Province would continue to decrease slowly. Conclusion The time?series ARIMA model has good prediction accuracy,and could be used for the short?term forecasting of schistosomiasis.

Objective To analyze the surveillance results of schistosomiasis and understand the transmission situation in Hu?bei Province in 2014. Methods According to the Scheme of Schistosomiasis Surveillance in Hubei Province(the 2009 edi?tion),207 endemic sites were selected,where the schistosome infections of residents and livestock,and the distribution of On?comelania hupensis snails were investigated. Results In the 207 sites,there were 27 sites without positive results of the blood tests and 129 sites without positive results of the stool tests. The infection rates of residents and cattle were 0.17%and 0,respec?tively. The density of living snails was 0.339 3 snails/0.1m2,the rate of living snails was 10.12%,and the infection rate of snails was 0. The infection rate of residents in the inner embankment type was 0.22%,higher than the rates in the other types. In differ?ent age groups,the infection rate in the 50-59 years age group was higher than the rates in other age groups. The infection rates of residents in farmer and fisherman were higher than those in the other occupation groups. The infection rate of floating people was 0,and no acute schistosomiasis patients were found. Conclusion The endemic situation of schistosomiasis has decreased obviously in Hubei Province,and the whole province has achieved the criteria for transmission control of schistosomiasis.

Objective To grasp the distribution and epidemiology of confirmed cases of schistosomiasis in Hubei Province, so as to provide the evidence for promoting the prevention and control work. Methods The confirmed cases of schistosomiasis in Hubei Province from 2010 to 2014 were epidemiologically investigated,and the prevalence characteristics and main influenc?ing factors were analyzed. Results A total of 10 102 confirmed cases from 2010 to 2014 were surveyed. There were 1 062 local infected patients,accounting for 10.51%and including 354 repeated infections and 17 newly infected. There were 290 foreign?infected patients,accounting for 2.87%,with 206 repeated infection cases and 84 newly infected. There were 8 750 historical patients,including 2 229 patients who leaked the former schistosomiasis investigations,accounting for 22.06%;570 patients missed treatment,accounting for 5.64%;3 640 patients were treated with non?standard therapy,accounting for 36.03%;2 311 patients were treated with poor medication efficacy,accounting for 22.88%. The multivariate non?conditional Logistic regres?sion,targeting at confirmed cases in 2014,showed that,for the leaking investigations,the potential risk factors included the age,educational level,and latrine renovation(b>0,OR>1),the protective factors were the times of previous treatment,cat?tle feeding in villager team,and Oncomelania hupensis snails in surroundings(b<0,OR<1);for the treatment?missing,the age,educational level,snails in the surroundings of residence were risk factors(b<0,OR<1);for the substandard treat?ment,the risk factors included the occupation and snails in the surroundings of residence(b>0,OR>1),and the educational level and snails in the own field were protective factors(b<0,OR<1). Conclusion The epidemiological investigation on the confirmed cases of schistosomiasis could grasp the epidemic factors so as to improve the management and carry out the scientific control.