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.

LncRNAs( long noncoding RNAs ) can be defined as RNA transcrips longer than 200nt without protein coding capacity , which play vital roles in various aspects of gene expression regulation.Recent investigations showed aberrant expression of many lncRNAs in primary liver cancer , indicating their important roles in tumorigenesis and development of liver cancer.This review focuses on the biological functions of lncRNAs and their involvements in primary liver cancer.

Radiation nephropathy refers to the damage of renal parenchyma and blood vessel caused by sufficient exposure to ionizing radiation.The clinical presentation includes proteinuria,hematuria,anemia,hypertension,and azotemia.Histological features include capillary loop thickening,mesangiolysis,formation of the double contours,subendothelial swelling,tubular atrophy,and tubulointerstitial fibrosis.Similar changes are seen in a variety of experimental animal models.The pathogenesis of radiation nephropathy remained unclear.It is reported that radiation-induced changes in kidney cell phenotype,renin angiotensin system(RAS) and oxidative stress is clearly involved.Multiple experimental studies have shown that antagonism of the RAS is beneficial,even when not initiated until weeks after irradiation.Recent findings suggest a similar benefit in clinical radiation nephropathy.

Objective To analysis newborn stage and long-term physiological and neuropsychological development in children born after assisted reproductive technology(ART),and to evaluate the safety of ART.Methods Eighty-four 6-month-old to 6-year-old children born after ART performed from January 1st,2006 to June 30th,2011 in Reproduction Center of Fuzhou General Hospital were taken as ART group; and 84 matched children born after spontaneous conception were as control group.The physiological and neuropsychological states of these children in their newborn stage and 6-month-old to 6-year-old duration were compared with Chi-square or t test.Results There was no statistical difference in childbearing age of mothers,the prevalence of gestational diabetes mellitus and hypcrtensive disorder complicating pregnancy,delivery mode,living environment,parents' education level,newborn birth length,birth weight,the rate of premature birth,low birth weight,asphyxia and hospitalized to neonatal intensive care unit between two groups (P＞0.05).In ART group,the incidence of growth retardation and abnormal social life skills was 6.0 ％ (5/84) and 1.2 ％ (1/84),and no statistical difference were found comparing with control guoup [4.8％(4/84) and 1.2％(1/84),x2 =0.12 and 0.00,P＞0.05],neither the developmental quotient (95.9±6.1 vs 94.8±5.1,t=1.25,P=0.21).Twins had higher rates of preterm birth [41.8％ (33/79) vs 10.1％(9/89),x2 =22.37,OR=6.38,95％CI:2.81-14.50,P=0.00],low birth weight [51.9％(41/79) vs 6.7％(6/89),x2=42.35,OR=14.93,95％ CI:5.84-38.16,P=0.00],asphyxia [10.1 ％ (8/79) vs 1.1 ％(1/89),x2 =6.69,OR=9.92,95％ CI:1.21～81.15,P=0.01],hospitalized to neonatal intensive care unit [36.7 ％ (29/79) vs 14.6 ％ (13/89),x2 =10.90,OR =3.39,95％CI:1.61-7.14,P=0.00] and growth retardation [11.4％(9/79) vs 0.0％(0/89),x2=10.71,RR=0.11,P=0.00] than singleton.Conclusions ART has no negative effects on children's physical and neuropsychological development.It could increase the incidence of twins,so that it might increase the incidences of preterm labor and low birth weight,which might affect the long-term physical and neuropsychological development of the offspring.

[Summary]_ Severe hypertriglyceridemia is the third common cause of acute pancreatitis following after alcohol abuse and cholelithiasis. Moreover, it is also an important risk factor of cardiovascular events. However, the cases of severe hypertriglyceridemia caused by autoimmune disease were rare in clinical, which would bring the difficulty for diagnosis and treatment. A better understanding of the clinical characteristics, possible pathogenesis, and corresponding therapy of the disease would be helpful, which would reduce the risk of complications, and finally improve both the survival rate as well as quality of life of these patients.

Objective: To compare therapeutic effects of clopidogrel and loading dose ticagrelor on aged patients with ST elevation myocardial infarction (STEMI).Methods: A total of 160 aged STEMI patients undergoing emergency percutaneous coronary intervention (PCI) were selected.According to random number table, they were randomly and equally divided into clopidogrel group (received loading dose aspirin and clopidogrel therapy) and ticagrelor group (received loading dose aspirin and ticagrelor therapy).Coronary TIMI flow grade, incidence rate of no-reflow after PCI, and incidence of cardiac adverse events and bleeding events in one month after PCI were compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of coronary TIMI flow grade 3 (71.25% vs.90.00%), and significant reduction in incidence rate of no-reflow (28.75% vs.10.00%) in ticagrelor group,P<0.05 all.Compared with clopidogrel group on one month after PCI, there were significant reductions in incidence rates of cardiogenic death (13.75% vs.3.75%), in-stent thrombosis (6.25% vs.0) and recurrent myocardial infarction (10.00% vs.1.25%), but significant rise in incidence rate of dyspnea (3.75% vs.12.50%) in ticagrelor group, P<0.05 all.There was no significant difference in incidence of bleeding events between two groups, P>0.05 all.Conclusion: Loading dose ticagrelor can effectively improve coronary blood flow, reduce no-reflow and its safety is good in aged patients with ST elevation myocardial infarction, which is worth extending.

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.

The small-for-size syndrome (SFSS) is widely recognized as one of the most serious clinical complications. It substantially contributes to a poor prognosis after adult living donor liver transplantation. Currently, there is still no consensus on the exact definition and pathogenesis of SFSS. We reviewed the progress on research of pathogenesis of SFSS and put forward some relevant preventive and treatment measures, including donor selection, graft assessment, reduction of high portal vein perfusion, dual grafts technology, advanced molecular medicine and other innovative approaches. Also, we offered some relevant insights into the future research directions of SFSS.

BACKGROUND:With the development of AO, the treatment of intercondylar humeral fractures with open reduction has been a trend. However, the methods of fixation become many. There is no conclusion of which method is optimal.
OBJECTIVE:To investigate the clinical effect of two kinds of different fixation methods (Y-type steel plate and double steel plate) for intercondylar humeral fractures via different surgical approaches.
METHODA retrospective analysis of clinical data of 86 cases of fresh intercondylar humeral fractures in the Department of Orthopedics, Sixth Affiliated Hospital, Xinjiang Medical University, between December 2003
and May 2014 were conducted in this study. According to the different fixation materials, patients were divided into two groupdouble steel group (n=44, including the surgical approach of ulna olecranon osteotomy which had 22 cases and the surgical approach of triceps V shaped severance which had 22 cases), Y-type steel group (n=42, including the surgical approach of ulna olecranon osteotomy which had 21 cases and the surgical approach of triceps V shaped severance which had 21 cases). The clinical curative effect and related complications of the two groups after operation were analyzed. During fol ow-up, modified Cassebaum elbow scoring system was used to evaluate the excellent and good rate of therapy.
RESULTS AND CONCLUSION:After fol owed up for 12-36 months, the total excellent and good rate of Y-type steel plate was 76%and the total excellent and good rate of double steel plate was 77%. There were no significant differences between the two groups (P>0.05). But interestingly, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance and the difference was statistical y significant (P<0.05). Above data suggested that Y-type steel plate and double steel plate were effective ways in the repair of intercondylar humeral fractures. However, for different surgical approaches, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance.

Objective To explore the mechanism of nanometer calcium combined with tonifying kidney herbs on osteoporosis by studying the expression of CaBP-D9K mRNA and protein in the intestinal mucosa of osteoporosis rats due to kidney deficiency. Method The rat model of osteoporosis due to kidney deficiency was established by ovariectomy. Applying the nanometer calcium and nanometer calcium combined with tonifying kidney herbs (big, middle and small dosage) to the rats for 12 weeks, choosing Gushukang, E2 and Gai’erqiD600 as the control drugs. The expression of the CaBP-D9K mRNA and protein in the intestinal mucosa of the osteoporosis rats due to kidney deficiency was determined by the method of RT-PCR and western blotting. Result There was CaBP-D9K and protein expression in the normal rats intestinal mucosa tissue, which plays an important role in the process of the intestinal calcium absorption. The episode of the rat osteoporosis due to kidney deficiency is related to the change of the CaBP-D9K and protein expression and has influence on the intestinal calcium absorption. Conclusion The nanometer calcium combined with tonifying kidney Chinese herbs can stimulate the calcium absorption of intestine, prevent and treat the osteoporosis due to kidney deficiency through regulating the expression of CaBP-D9K mRNA and protein in the intestinal mucosa.