This paper investigates 240 cases of medical disputes and interviews involved patients with questionnaires,explores patients′ behaviors,attitudes,and complaints in medical disputes,and analyzes the reasons and motivations for those behaviors and attitudes,in order to provide reference for reduce medical disputes and improve physician-patient relationship.

Objective To explore humidifying effects for artificial airway of mechanically ventilated patients by heat/moisture exchanger(HME) combined closed endotracheal suctioning(CS).Methods A total of 114 patients who had mechanical ventilation for at least 48h were randomly divided into two groups with 59 cases in experimental grooup and 55 cases in control group.HME combined CS were used in the experimental group,heated humidifier combined open endotracheal suctioning were used in the control group.The effect of humidification, the reserved time of artificial airway,the time on mechanical ventilation, the time of stay in ICU, the incidence of ventilator-associated pneumonia(VAP) and the mortality rate between the two groups were compared.Results Significant differences were found in the effect of humidification between the experimental group and the control group,more cases found insufficiency of humidification or excessive humidification and airway spasm in the control group, however,less time on mechanical ventilation and stay in ICU in the experimental group.The incidence of VAP in the control group was significantly higher than that in the experimental group.There were no significant differences existed in the reserved time of artificial airway and the mortality rate between the two groups.There were no accident of humidification occurred in the experimental group,while 8 cases complicated with choking with water in the control group.Condusion HME combined CS,used in mechanically ventilated patients ,could help to improve the effects of airway humidification and reduce the incidence of VAP,also shorten the duration of mechanical ventilation.

Objective To observe recombinant plasmids were constructed with the macrophage colony-stimulating factor ( GM-SCF) , interleukin -21 (IL-21) and retinoic acid early transcription factor-1 (Rae-1), and observe the inhibitory effects in subcutaneous liver cancer model in mice with the recombinant plasmids.Methods The recombinant plasmids of GM-SCF, IL-21 and Rae-1 were constructed with RT-PCR method, mouse model was constructed, the model mice were randomly divided into six groups including control, IRES/GFP, IRES/IL21, IRES/GM-SCF, IRES/GM-SCF-IL21 and IRES/combination with 10 mice included in each group, each groups (15 mice) were treated with the corresponding gene therapy.The survival rate were observed after 60 days.The blood levels of interferon -γ(IFN-γ) and interleukin -2 (IL-2) were detected in each group.Results The pGM-CSF-GFP-IRES-Rae-1-IL-21 has been successfully constructed.All mice had demised 14 and 16 days after treatment in the control and IRES/GFP groups, respectively.There were 2, 1, 11 mice remaining after 60 days of treatment in the IRES/GM-SCF, IRES/IL21 and IRES/GM-SCF-IL21 groups respectively.The survival rate of mice at 60 days of treatment was 73.33%, 13.33%, and 6.67% for groups IRES/GM-SCF-IL21, IRES/GM-SCF and IRES/IL21, respectively.The survival rate of the mice was significantly higher in IRES/GM-SCF-IL21 than the other groups.The levels of IL-2 and INF-γof mice 1-6 days after treatment gradually increased in the IRES/combination groups, including IRES/GM-SCF-IL21, IRES/GM-SCF and IRES/IL21.They were highest in the IRES/combination group and lowest (P<0.01) in the IRES/GM-SCF and IRES/IL21 groups, with the IRES/GM-SCF-IL21 group showing intermediate levels.By 6-10 days after treatment, IL-2 and INF-γlevels had stably increased in the IRES/combination groups, but had gradually decreased in the IRES/GM-SCF-IL21, IRES/GM-SCF and IRES/IL21 groups.At the end of treatment, IL-2 and INF-γlevels were significantly (P<0.01) higher in the IRES/GM-SCF-IL21 than were found in either the IRES/GM-SCF group or IRES/IL21 group, which were also significantly (P<0.01) higher than either the IRES/GFP or control groups.The levels of IL-2 and INF-γwere highest in the IRES/combination group ( P<0.01) and not significantly different among the IRES/GM-SCF, IRES/IL21, IRES/GFP, and control groups.Conclusion The inhibitory effects in subcutaneous liver cancer model in mice were obvious significantly, and its mechanism maybe be related to the activation of the body's immune.

Objective To generally analyze the current situations and advancement of the study on immunotherapy for colorectal cancer. Methods The pertinent published papers about the current situation and research advancement of the immunotherapy of colorectal cancer were retrospectively investigated. And also the immunogenicity and the varying principles of immunoresistance, the functional targets, the practicality, and some other characteristics of different immunotherapy for colorectal cancer were reviewed. Results The main treatments and the research focuses in the immunotherapy of colorectal cancer are initiative nonspecific immunotherapy, adoptive immunotherapy, monoclonal antibody immunotherapy, initiative specific immunotherapy, and targeted therapy. They work by fighting against the cancer itself, cutting off the tumor’s nutrition supply, activating the immune system specifically or breaking the immune tolerance and so on. Though there are still many problems unsolved, immunotherapy has a promising clinical prospect. Conclusion As a beneficial complement for surgery, chemotherapy and radiotherapy, immunotherapy plays an important auxiliary role in the combined therapy for colorectal cancer.

AIM: To establish an identification method of Fritillaria based on near-infrared diffuse reflectance spectroscopy(NIRDRS). METHODS: Seven certified Fritillaria,i.e.,F.przewalskii Matim,F.cirrhosa D.Don,F.unibraacteate Hsiaaoet.K.C.Hsia,F.thunbergii Mig,F.pallidiflora,F.ussuriensis Matin and F.kupehensis Hsiaet K.C.Hsia,and three fake "Fritillaria",i.e.,F.thunbergii Varchekiugensis Hsiaet K.C.Hsia,Tulipa edulis and Iphigeniaindica were dried,grinded and sieved before their NIRDRS spectra were detected.Cluster analysis,convolution transform-visualization-similarity analysis were further employed to(identify) the NIRDRS of the ten herbal medicines. RESULTS: The zero-order NIRDRS spectra of the ten herbal medicines were too similar to be identified respectively.The cluster analysis helped differentiate the three fake "Fritillaria" from seven certified Fritillaria,but the identification between the certified Fritillaria remained dissatisfactory.The convolution transform-visualization-similarity analysis magnified and then quantified the minute differences between the certified Fritillaria,which significantly improved their identification. CONCLUSION: NIRDRS is a direct,non-destructive analytical method of solid samples.Coupled with information treatment techniques,DIRDRS provides a new identification method of crude traditional Chinese medicines.

Objective: To investigate immune responses to influenza virus infections and the immunogenicity of trivalent split-virus influenza vaccine among elderly populations in Jiangbei District, Ningbo City, so as to provide the support for promoting influenza vaccination among elderly populations. Methods: The elderly populations at ages of 60 years and older were recruited in Jiangbei District of Ningbo City from September to November, 2020, and the participants were assigned to the vaccination group and the control group according to vaccination intention. The titers of haemagglutination inhibition ( HI ) antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were measured using the micro HI test prior to vaccination and 30 days post-vaccination, and the protective rate, geometric mean titer ( GMT ) and seroconversion rate of antibodies were analyzed before and after vaccination. Results: There were 290 participants in the vaccination group, including 132 men (45.52% ), and 290 controls, including 132 men ( 45.52% ). There were no significant differences between the vaccination group and the control group in terms of the protective rate or GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV prior to vaccination ( P>0.05 ). Following vaccination, the protective rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 98.62%, 94.14% and 88.28%, and the GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV increased by 9.26, 6.19 and 10.09 folds, while the seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 78.62%, 68.28% and 71.38%, respectively. The protective rates, GMT and seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were all significantly greater in the vaccination group than in the control group post-vaccination ( P<0.05 ). A lower increase was seen in the GMT of antibodies against the influenza virus BV among residents at ages of 80 years and older (increase by 7.91 folds) than among residents at ages of 70 to 79 years ( increase by 12.53 folds ) and 60 to 69 years (increase by 13.32 folds) in the vaccination group post-vaccination ( P<0.05 ), and the seroconversion rate of antibodies against the influenza virus BV was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 70 to 79 years ( 83.33% ) ( P<0.05 ), while the positive conversion rate of antibodies against the influenza virus A ( H3N2 ) was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 60 to 69 years ( 91.30% ) ( P<0.05 ). Conclusions Low-level immune responses are detected to antibodies against influenza virus A ( H3N2 ) and BV among elderly populations in Jiangbei District of Ningbo City, and trivalent split-virus influenza vaccine shows a high immunogenicity among elder populations. An emphases on improvements in coverage of influenza vaccination among elderly populations at ages of 60 to 69 years, and development of influenza vaccines with a higher protective efficacy for residents at ages of 80 years and older are recommended.

Objective: To establish capillary zone electrophoresis method for determination of sildenafil citrate (Viagra) content in its troche. Methods： Using tetrandrine as internal standard(IS), the electrophoretic separation was achieved with 25 mmol/L borate (pH=7.89) running buffer. And a voltage of 14 kV was applied to the 40 cm×75 μm(i.d) capillary. The analytes were introduced into capillary by siphon (1 s) and determined with on-column monitoring at 214 nm. Results：The determination could be completed within 4 min and the minimum concentration of detection was 5 μg/ml.The analytical results of sildenafil citrate samples demonstrated a good linear relationship within the range of 24-480 μg/ml.The relative standard deviations (RSD) of intra-day was less than 1.58% and that of inter-day was less than 2.46%.The present recoveries were between 95%-105％. Conclusion：The CZE method is accurate, simple, rapid and reliable, so it can be applied to the determination of sildenafil citrate content.

Objective To investigate the incidence of recurrence and occurrence rate of recurrence of hand-foot-and-mouth disease (HFMD)in Jiangbei District of Ningbo City between 2012 and 2014,analyze the influencing fac-tors,and provide a scientific basis for the prevention and control of HFMD.Methods Data of HFMD in Jiangbei in 2012-2014 were collected from China Disease Surveillance Information System,immunization data were from Im-munization Programme Information System of Ningbo City,the recurrent infectious cases were selected and analyzed by descriptive epidemiological methods.Results The occurrence rate of recurrent HFMD in Jiangbei in 2012-2014 was 5.40% ,the median month of patients with single occurrence and recurrence of HFMD were 33.77(20.03, 47.83)and 38.26(22.05,54.75)months respectively,median month of patients with the initial occurrence were 23.93(15.87,36.87)months,median of time interval of recurrent HFMD was 10.27(5.23,16.06)months. The oc-currence rate of recurrence was the highest in 3- years old group(χ2= 37.51,P<0.001). Most were scattered chil-dren and children in child-care center. Female was a protective factor of recurrence of HFMD (OR,0.73[95% CI, 0.57-0.92]),while children in child-care center was a risk factor (OR,1 .46[95% CI,1 .16-1 .84]). The median attack rate of recurrence in HFMD group and control group in blocks within 7 days were 10.36(9.29,11.44)/100000 and 8.95(8.16,9.74)/100000 respectively,there was significant difference(Z= -2.68,P<0.001). In-oculation frequency between recurrent HFMD group and control group was not significantly different (Z= -1.38,P= 0.17).Conclusion The epidemic of recurrence of HFMD was serious in Jiangbei District of Ningbo City between 2012 and 2014,boys and children in child-care center should be paid attention,contacts with patients should be re-duced,and targeted prevention and control measures should be carried out.