Many issues in the management of medical care security are under heated discussion.This paper makes a tentative definition for the management of medical care security,and further points out the risks of the absence of security management and relevant countermeasures.

104 teeth with large defect were repaired by Ceramage polymeric porcelain inlay(Ceramage group)and 94 by casting porcelain inlay(casting group).After 1 year there was no statistical significance in all indexes between two groups(P >0.05).After 3 year,Restora-tion fracture was observed in 3.1% of Ceramage group and 10.6% of casting group(P <0.05).No statistical significance was found in other indexes between the two groups.

BACKGROUND:To date little is reported clinicaly on bone marrow mesenchymal stem cels (BMSCs) for acute respiratory distress syndrome (ARDS).
OBJECTIVE:To study the effect of BMSCs in ARDS rats.
METHODS:Sixty-three Sprague-Dawley rats were randomly assigned into normal control group, model and BMSCs groups (n=21 per group), folowed by establishment of ARDS models. After awakening, rats in the model group were given no treatment, while those in the BMSCs group given tail vein injection of fluorouracil-labeled BMSCs. Then, pathological observation of the lung tissue was conducted using hematoxylin-eosin staining, and ELISA method was employed to detect interleukin-1β level in the rat lung tissue homogenates. Repair effects on lung injury were compared between two groups.
RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that inflammation, edema and congestion in the rat lung tissue were vanished gradualy, but no consolidation was found in the BMSCs group, while there was visible edema and congestion in the lung tissue of rats in the model group. Compared with the model group, pulmonary edema and interleukin-1β level in the lung tissue were significantly reduced in the BMSCs group (P < 0.05). Therefore, the whole bone marrow culture method is suitable to obtain BMSCs that have desired effects on ARDS in rats. In ARDS rats, due to inhalation of lipopolysaccharide, BMSCs can be directly involved in lung epithelial repair by reducing the release of inflammatory factors.

Objective To assess the elasticity value of shear wave elastography (SWE)in quantitative evaluation the achilles tendons of familial hypercholesterolemia (FH).Methods Eleven patients with FH achilles tendons and 14 healthy volunteers were examined.Each achilles tendons were divided into the following 3 sections for grey scale ultrasound and SWE images evaluation,including proximal,middle and distal.The thickness and mean elasticity values obtained at different sections of achilles tendons were statistically analyzed.Results The thickness of proximal,middle and distal sections of achilles tendons in healthy volunteers were (4.5 1 ±0.63)mm,(4.5 1 ±0.63)mm and (4.32±0.39)mm,respectively.Grey scale feature was hypoecho with parallel linear hyperecho.The mean elasticity value of proximal,middle and distal sections in healthy volunteers achilles tendons were (404.94 ± 37.37 )kPa,(412.78 ± 36.65 )kPa and (400.53±35.1 7)kPa,respectively.The thickness of proximal,middle and distal sections of achilles tendons in FH were (5.45±1 .92)mm,(8.46±4.55)mm and (6.44± 1 .90)mm,respectively.Grey scale feature was thickened and hypoecho with irregular and haphazard linear hyperecho.Three of them had arc shaped calcifications. The mean elasticity value of proximal, middle and distal sections in familial hypercholesterolemia achilles tendons were (287.43±39.77)kPa,(280.75±59.78)kPa and (260.37±39.09) kPa,respectively.Statistically significant differences were found for the thickness measured at proximal, middle and distal sections between the healthy volunteers and FH (all P <0.05 ),and for mean elasticity value (all P <0.01).Conclusions The thickness,grey scale feature and elasticity value by SWE can reflect the stiffness of the achilles tendon,and provide more information for the quantitative assessment of FH's achilles tendon.

OBJECTIVE:To explore the general regularity and characteristics of adverse drug reactions (ADR) induced by Compound glycyrrhiza mixture/oral solution,and provide reference for clinical ration use of drug. METHODS:The literatures of ADR induced by Compound glycyrrhiza mixture/oral solution were retrieved in CJFD and Wanfang database from 1995 to 2014, and the collected 27 cases of ADR were classified,summarized and statistically analyzed. RESULTS:The 27 cases of ADR were more common in middle-aged and aged patients(18 cases,66.66%);all patients were orally administrated,and 9 of them had rel-atively larger dose;there were 12 cases with combination medication;the proportion of the incidence of ADR within 30 min and af-ter 1 d was similar,it was 29.63%;involved organs/systems were mainly skin and its appendages(27.59%),circulatory system damage (24.14%),nervous system damage (19.54%) and systemic damage (14.94%);26 patients were recoveried after drug withdrawal and treatment,one patient died. CONCLUSIONS:The incidence of ADR of Compound glycyrrhiza mixture/oral solu-tion should be reduced by actively carrying out medication propaganda and education,carefully asking patients before treatment, strictly select medication groups and methods and strengthening medication monitoring and warning,etc.

Objective To investigate the differentiation of marrow mesenchymal stem cells (MSCs) under various in vitro conditions and analyze its mechanisms. Methods Rat MSCs were isolated and passaged. MSCs were either cultured in conditioned medium, the combination of supernatant of cardimyocyte culture and common medium, or cocultured with neonatal cardiomyocytes at the ratio of 1∶1 (cocultured group), or under normal medium (control group). After 7 d of induction, immunofluorescence was employed to detect titin, early cytoskeletal protein of cardiomyocyte, myosin heavy chain (MHC) and Connexin43 (Cx43) expression in MSCs. Results ①Conditioned medium could induce MSCs into cardiomyocyte lineage. Z part and A part of titin, large quantity of Cx43 could be detected after 1 week while myosin heavy chain was absent; ②MSCs could form junctions with neighboring cardiomyocytes. Above mentioned cardiomyocyte proteins were expressed in cocultured MSCs. Sarcomeric-like structure was detected in the cytoplasm of cocultured MSCs. Cx43 was mainly distributed in the MSC-cardiomyocyte interface. ③Untreated rat MSCs expressed myocardial gap junction protein Cx43 and titin in a lower degree. Conclusion Microenvironment of cardiomyocyte can induce the differentiation of MSCs into myocyte phenotype in vitro, either by soluble signaling molecules or by direct cell-to-cell contact. Degree of differentiation depends on the signal properties.

Object To investigate the expression of inducible nitric oxide synthase(iNOS) and vascular endothelial growth factor(VEGF) in human esophageal squamous cell carcinoma and their clinical significances,and to evaluate the correlation between the expression of iNOS and VEGF.Methods Immunohisto-chemical SABC methond was used to detect the expression of iNOS and VEGF in 52 cases of esophageal squamous cell carcinoma and 20 cases of paired para-carcinama.The correlation between the expression of iNOS and VEGF was analyzed statistically.And the correlation between the expression of iNOS and VEGF and the clinical pathological features of the patients was analyzed statistically.Results The positive expression rates of iNOS and VEGF in esophageal squamous cell carcinoma were 63.46％ (33/52) and 67.31％ (35/52),respectively.The positive expression rates of iNOS and VEGF in paired para-carcinama tissues were 10％ (2/20) and 20％ (4/20)respectively.The positive expression rates of iNOS and VEGF in esophageal squamous cell carcinoma were significantly higher than those in paired para-carcinama tissues(x2 =14.455 6,P ＜ 0.01;x2 =9.508 9,P ＜ 0.01).There was significiat correlation between the expression of iNOS,VEGF and the pathological grade (P ＜ 0.01),clinic TNM stage(P ＜ 0.05),lymph noed metastasis(P ＜ 0.05),but there was no correlation between the expression of iNOS,VEGF and the patients sex (P ＞ 0.05).Expression of iNOS was positively correlated with that of VEGF(r=0.748 2,P ＜ 0.01).Conclusion iNOS and VEGF are highly expressed and correlated in esophageal carcinoma.It is speculated that a common activation mechanism may coexists between the two genes.The expression of iNOS and VEGF plays an important role in the malignant progression.

Objective To investigate the clinic features and regularity of anaphylactic shock induced by bupleurum injection,and to provide reference in clinic tor rational use of bupleurum injection.Methods Checked out the case reports of anaphylactic shock induced by bupleurum injection in the data-bases in China from 1996 to 2015 for statistics and analysis.Results 18 cases of anaphylactic shock were reported and sexual equality,and all were injected intramuscularly;13 cases (72.2％) occurred within 5min and cardiovascular system and central nervous system as the main clinical manifestations.By the active anti-shock therapy,17 cases recovered and 1 case died.Conclusion Allergic shock induced by bupleurum injection happens now and then in clinics,so clinical drug using should pay attention to the history of allergies and medication adverse reactions in the process of observation,in order to reduce drug safety hazards.

Objective To comprehensively and objectively understand the current situation in medical student to enhance students' literacy of medical colleges in our country.Methods In 2014,from September to November,13 medical colleges and universities took part in the questionnaire survey on College Students' Ideological and political work.Through the team of counselors,3 000 questionnaires were distributed to the medical students in the school,and the valid questionnaires were recovered.The effective recovery rate was 94.7％.SPSS 20.0.was used for data analysis.Results Medical college students showed the correct three views in the knowledge level.71.1％ of them (2 015) said that its value was reflected in social contribution.Combined with the current status of the medical industry,in the future career choice,64.1％ of the students (1 818) regarded high income,good development as one of the important criteria.The survey of ideological work in colleges and universities showed that only 842 participants (29.7％) were satisfied with ideological and political theory course,and 1 597 participants (56.4％) were satisfied with the counselor work.Conclusion The current medical college students ideological and political education still needs to be strengthened,especially needs to help medical students to achieve the unity of knowledge and social services so as to put the final implementation of the serving community in the actual action level.

Causative factors of multi-drug resistance tuberculosis (MDR-TB) were analyzed from iatrogenic angles, patients themselves, and society. Reviewed was the development of treatment strategies for MDR-TB from directly observed treatment short-course (DOTS) to DOTS-Plus. The history of Chinese medicine (CM) fighting TB and characteristics at the present stage were also analyzed. Authors pointed out that CM pays attention not only to killing pathogens and confirms the necessity of getting rid of pathogens, but also to cascade response caused by pathogens. It also regards the occurrence and development of MDR-TB as a whole by combining patients' conditions, climatic, geographic, psychological, and social factors. Authors believed that therapeutic principles under guidance of CM holistic view are of positive significance and inspiration in treating MDR-TB, and emphasized holistic view as basic strategies for treating MDR-TB, but not a single countermeasure.
Antitubercular Agents ; therapeutic use ; Holistic Health ; Humans ; Medicine, Chinese Traditional ; Tuberculosis, Multidrug-Resistant ; therapy