This study analyzes the legal application of a dispute over employer identification in a case of occupational heat illness caused by part-time work to clarifying matters related to employer determination in occupational disease diagnosis using a case analysis method and factual reconstruction. The analysis is based on relevant civil laws and regulations, occupational disease diagnosis laws and regulations, and jurisprudential theories. The occupational disease diagnostic institution identified the part-time employer as responsible for the patient′s heat illness, which was both reasonable and lawful. This attribution safeguarded the rights of the worker, the primary employer, and the part-time entity. In occupational disease diagnosis, attention should be paid to de facto employment relationship, and the principle of "accountability lies with the actual employer at the time of the incident" should be followed to standardize employer identification. The health administrative department has supervisory responsibilities over occupational disease diagnoses. Workers′ compensation rights can be protected through the advance payment mechanism for work-related injury insurance. It is recommended to further improve internal procedures for occupational disease diagnosis, strengthen the dissemination of relevant laws and regulations and enhance the capabilities of occupational disease diagnosis physicians, to further protect workers' occupational health and their associated legal rights.

OBJECTIVE: To analyze the clinical features of a Chinese pedigree affected with tuberculosis sclerosis and explore its molecular pathogenesis. METHODS: Clinical data of the proband and members of his pedigree were collected. Whole exome sequencing was carried out to detect variants of the TSC1 and TSC2 genes. Candidate variants was verified by Sanger sequencing and bioinformatic analysis. RESULTS: The proband and his mother, who also had mild features of tuberous sclerosis, were found to harbor a novel heterozygous c.4183C>T (p.Q1395X) variant of the TSC2 gene, which was absent in the 4 healthy relatives. Bioinformatic analysis suggested the variant to be likely pathogenic. CONCLUSION The heterozygous c.4183C>T (p.Q1395X) variant of the TSC2 gene probably underlay the disease in this pedigree. Above finding has expanded the spectrum of TSC2 gene variants. The more severe symptoms in the proband may be attributed to phenotypic heterogeneity of this disease.
China ; Humans ; Mutation ; Pedigree ; Tuberous Sclerosis/genetics* ; Tuberous Sclerosis Complex 2 Protein/genetics*

Objective To explore the effect of hydrogen sulfide (H2S) on corticosterone (CORT) -induced neuronal and synaptic damages in the hippocampus of depression rat models.Methods Adult male SD rats were randomly divided into 4 groups:control group,CORT group,low-concentration NaHS (30 μmol/kg) treatment group and high-concentration NaHS (100 μmol/kg) treatment group (n=10).CORT (40 mg/kg) was subcutaneously injected into the rats from the later three groups for 28 d to establish depression models.After administration of CORT for 14 d,the control rats and CORT rats were treated with normal saline (5 mL/kg,ip) for 14 d,rats in the later two groups were treated with NaHS (30 and 100 μmol/kg/d,ip) for 14 d.The depressive-like behaviors were evaluated by sucrose preference test,the neuronal pathological changes in the hippocampus CA3 area were observed by HE staining,the neuronal apoptosis in the hippocampus was observed under microscope using Tunel staining,the protein expressions of Bcl-2,Bax and synaptophysin in the hippocampus were quantified by Western blotting,and the content of Caspase-3 was analyzed by ELISA.Results After administration of CORT for 28 d,rats from the CORT group exhibited decreased sucrose preference,disordered arrangement and sparse morphology as well as increased amount of apoptotic neuron in hippocampal CA3 area as compared with those in the control group with significant differences (P＜0.05);in addition,as compared with those in the control group,the expressions of Bcl-2 and SYN in the hippocampus were significantly suppressed,while the activity of Caspase-3 and the expression of Bax in hippocampus were significantly up-regulated in the rats firom the CORT group (P＜0.05).As compared with CORT group,low-concentration NaHS treatment group and high-concentration NaHS treatment group had significantly increased sucrose preference,improved arrangement of neurons,decreased amount of apoptotic neurons in CA3 areas of CORT rats,up-regulated Bcl-2 and Syn expressions,down-regulated Bax expression as well as reduced activity of Caspase-3 in the hippocampus,with statistically significant differences (P＜0.05);but there was no significant difference between low and high concentration NaHS treatment groups (P＞0.05).Conclusion H2S can effectively improve the damage of hippocampal neurons and synapses in CORT rats.

Objectives:To investigate the impact of doctor-attacking on medical students’ occupation atti-tude. Methods: We conducted a sample survey towards different major of Wenzhou Medical University by using self - made questionnaire. Reults: The occupation attitude of interviewee is not so bad, the confidence about the occupation is really deep down and the occupational sense of mission worries a lot of people. Doctor-attacking cases damage the honorable sense of occupation, even threatens basic personal security. The spread passive emotion by Network media , as well as the varied choices of occupations, expand the influence of hospital violence. Conclusions: The fre-quent occurrences of doctor-attacking cases weaken the occupational attitude of medical students and became the obstruc-tion to be a doctor,countermeasures should be taken from multiaspect of society,media,schools and teachers through a va-riety of ways.

Macrophages are a diverse phenotype that has important functions in inherent and adaptive immunity. Macrophage ac-tivation has two distinct states of polarization:the classically activated (M1) and the alternatively activated (M2) macrophage pheno-types in different micro-environments. M2 macrophages exert an immuno-regulatory activity that is associated with the induction of Th2 responses. The macrophages can infiltrate in the tumor micro-environment, and is also known as tumor-associated macrophages (TAMs). TAMs show the M2 macrophage phenotypes that have been associated with tumor neo-vascularization, infiltration, and metas-tasis. This review aims to investigate the importance of the immuno-regulatory activity of TAM in the carcinogenesis of gastric cancers.

Objective To investigate the clinical features and LRRK2 gene mutation in patients with autosomal dominant familial Parkinson's disease (PD). Methods The clinical features of 16 autosomal dominant familial PD probands were analyzed in terms of age at onset, onset symptoms, UPDRS scores, response to the levodopa treatment and drug-induced dyskinesia. The LRRK2 gene exons 5,13,31,32,35,37,41 and 48 of 16 probands were sequenced after polymerase chain reaction. The novel mutation was further screened in 24D sporadic PD patients and 214 controls using PCR-RFLP for the genotypo frequency analysis. Results Clinically, most of 16 probands had late-onset age. Resting tremor (9patients, 56. 25%,t=0.558,P=0.679)and bradykinesia (9 patients,56.25%,t=0.369,P=0.454)were common onset symptoms followed by rigidity(6 patients,37.50%,t=1.324,P=0.735)and postural instability(5 patients,31.25%,t=2.369,P=0.956).Majority of them had good response to levedopa treatment and rare occurrence of drug-induced dyskinesia. Among the 16 autosomal dominant familial PD probands,6 variants were identified:c.457 T＞C(Leu153Leu),c.1432 G＞T(Asp478Tyr),c.5457 T＞C(Gly1819Gly),c.7153 G＞A(Gly2385Arg),IVS31+28 T＞G and IVS37+162 T＞C. The c.1432G＞T(Asp478Tyr)variant was a novel mutation and it was not detected in 240 sporadic PD patients and 214 controls. The reported mutations associated with the PD, such as Arg1441 Cys/Gly/His, Arg1514Gln, Tyr1699Cys, Ile2012Thr, Gly2019Ser and Ile2020Thr,were not found in our study. Conclusions The autosomal dominant familial PD patients present with classical symptoms of PD and bear the LRRK2 variantsAsp478Tyr and Gly2385Arg.

OBJECTIVE To compare two different procedures of blood donation in volunteer donors,which lead to different discard rates of blood,different donation reaction rates and the satisfaction of the donor agency,so as to seek the better procedure bringing less discard of blood and more convenience for the military donor agency and blood center. METHODS In group A,3 667 donors blood was collected before the tests and retests for transfusion transmitted diseases(TTD) were done.While in group B,4 185 donors were taken blood samples for pre-donation test.The blood collection was performed 4 hours later. RESULTS In group A,3 652 units of blood were collected,of which 69 units were discarded on account of positive results in test and retest.Meanwhile,in group B 3 718 units of blood were collected from the donors who passed the pre-donation test for TTD.As a result,34 units of blood were discarded because of the positive results in retest.The discard rates of blood were 1.89% and 0.91% while the donation reaction rates were 2.22% and 3.98%,respectively.in two procedures.The discard rates of blood in group A were higher than those in group B.But the donation reaction rate in group B was higher than that in group A. CONCLUSIONS The discard rate of blood in the procedure collecting before test is higher than that in the procedure testing before collection.But the donation reaction rate is low and the waiting period for donation is short in the former procedure,which is suitable for low TTD infections population of military agencies.

Objective To compare the specificity, sensitivity, titers, and rapidity of four methods including papain technique, anti-globulin technique, polybrene test, and micro-column gel test for determination of IgG red blood cell antibodies. Methods Twelve kinds of IgG red blood cell antibodies such as anti-D, anti-E, anti-C, anti-c, anti-e, anti-Jk a, anti-Jk b, anti-Fy a, anti-Fy b, anti-k, anti-S, and anti-s were checked by the four methods. Results Seven kinds of IgG red blood cell antibodies including anti-D, anti-E, anti-C, anti-c, anti-e, anti-Jk a, and anti-Jk b were detected using papain technique (7/12). All of the 12 kinds of IgG antibodies were detected by anti-globulin technique (12/12). Eleven kinds of IgG red blood cell antibodies except anti-k were examined with polybrene test (11/12) and all the antibodies were also determinated by micro-column gel test (12/12). The titers of the antibodies determination suggested that papain technique was less sensitive than other three methods, while the micro-column gel test was more sensitive than other three methods in examination of all the antibodies. The lasting time of four techniques were: papain technique 45 min, anti-human globulin technique 60 min, polybrene test 5 min, and micro-column gel test 30 min. Conclusion Papain technique has some limitation in determination of IgG antibodies and anti-globulin technique is complicated because of long period incubation and multiple wash of red blood cells. Polybrene test is the most simple and convenient technique for determination of IgG antibodies. Micro-column gel test is the most sensitive method in determination of IgG antibodies.

Objective To analyze the incidence of invasive fungal infection and the risk factor in primary acute leukemia patients.Methods Retrospectively analysis of clinical data from Jan 2007 to Jun 2008 about 80 newly diagnosed patients with acute leukemia primary treated in Peking University People's hospital.Results The incidence of invasive fungal infection is 13.8%,elderly patients、higer WBC counts and longer antibiotics treatment are the risk factor for the fungal infection.Conclusion There are high incidence of invasive fungal infection in induction therapy for primary acute leukemia,the prophylaxis therapy should be consider in high risk patients.

Objective To investigate the factors affecting insufficient blood collection from volunteer donors. Methods Volunteer blood donors in our hospital were divided into two groups: group A (volunteer donors from January 2001 to December 2003) and group B (volunteer donors from January to June in 2004) after improving the environment of blood collection and service quality. The cases and main affecting factors of insufficient blood collection were analysed. Results The percentage of cases with insufficient blood collection in group A and group B was 0.95% and 0.53%, respectively, which had a significant difference between the two groups (P