肾脏小肿瘤最大径与良恶性相关性分析

目的:探讨肾脏小肿瘤(SRMs)(≤4cm)最大径(Dmax)与肿瘤性质之间的相关性。方法:回顾性分析协和医院近3年收治78例SRMs患者的临床资料,将肿瘤Dmax与术后病理结果对照分析。结果:78例SRMs患者中恶性肿瘤61例(78.21%),其中肾透明细胞癌59例(96.72%),肾乳头状腺癌1例(1.64%),肾嫌色细胞癌1例(1.64%);良性肿瘤17例(21.79%),均为肾错构瘤。Dmax2cm者4例,良性肿瘤2例(50%),恶性肿瘤2例(50%),均为低分级;2cm≤Dmax3cm者38例,良性肿瘤11例(28.95%),恶性肿瘤27例(71.05%),其中低分级25例(92.59%),高分级2例(7.41%);3cm≤Dmax≤4cm者36例,良性肿瘤4例(11.11%),恶性肿瘤32例(88.89%),其中低分级28例(87.5%),高分级4例(12.5%)。3组之间良性、恶性肿瘤发生率比较差异均有统计学意义(P=0.000),恶性肿瘤核分级中低分级比较差异有统计学意义(P=0.000),高分级比较差异无统计学意义(P=0.067)。结论:随着肾脏小肿瘤Dmax的增加,肿瘤恶性的可能性增加,且核分级多为低分级。     

山龙眼科至蓼科法定药用植物基源考证

目的 厘清由于分类系统和种分类等级的变化、种鉴定等原因引起的药材标准中法定药用植物基源混乱的情况。方法 查询我国国家和各省市自治区的相关药材标准及权威分类学著作，对植物基源存疑的种，从植物系统分类、分类群等级和种鉴定等各方面进行考证。结果 我国国家和地方标准收载的法定药用植物中，来源于恩格勒系统山龙眼科至蓼科的共有105种，其中基源鉴定清晰，分类无问题，中文名和拉丁学名无混淆的63种，基源存疑有5个科共42种，其中由于属名的异名充作正名而引起拉丁名混乱的1种，属分类系统变化而造成种混淆的5种，种等级分类群的鉴定、归并不同而造成混淆的11种，中文名混淆的25种，并对有混淆的种进行考订纠正。结论 檀香科、桑寄生科、马兜铃科、蛇菰科及蓼科法定药用植物基源有一定问题，经过研究考订，这些问题得以厘清解决。     

Getting the C-bit between your teeth

In this article, it is suggested that an important cultural image of intoxication in some Western societies appears to be ‘intoxication as ecstasy’, intoxication as escape from the everyday into a ‘wild’ and ‘natural’ state. The purpose of this article is to discuss this cultural image and its link to gendered ideas about sexuality and, on the basis of this discussion, to develop a hypothesis for further testing. The hypothesis developed proposes that women–via the cultural linking of their sexuality to biological processes of reproduction–are placed closer to nature than men. This makes women's drinking and intoxication seem more dangerous than men's, because drinking and intoxication would seem to make women come even closer to nature. It is suggested that women's ‘dual licentiousness’ threatens the distinction between nature and culture.     

Checking and Balancing New Zealand's Mental Health Review Tribunal: Perspectives of Forensic Patients

The aim of the study was to examine perspectives of forensic patients who applied for Mental Health Review Tribunal (MHRT) hearings regarding their compulsory detention in New Zealand. Ten participants were identified; semistructured interviews were completed; and a thematic analysis was performed. The participants described variable understanding of the process and scope of the MHRT. They explained why they applied for hearings, including to resolve disputes with clinicians regarding aspects of their care and the desire to expedite examination of their compulsory status. In some instances, the participants described feelings of distress and powerlessness regarding the process and outcome of the hearings. They also discussed the impact of the process upon the therapeutic relationships with their treatment teams. It emerged as important for patients to understand the limited functions of the MHRT. Written and other accessible forms of information may be helpful in this regard. For participants, the application process and hearing had variable value and utility, although some participants reported that the MHRT afforded them dignity because they had the right to challenge their compulsory detention.     

A Legal Approach to Cancer Epidemiology in Public Health

The Public Health Act encompasses scientific research and law enforcement as causes, distributions, and preventive factors for diseases and injuries of a particular population. Today, the Public Health Law is growing into a field that expects to cultivate and utilize lawful practitioners who can apply specialized legal skills in health policy development and public health performance. The multidisciplinary approach of the Public Health Act integrates the legal and scientific elements of the field and the workforce, characterized by a more dynamic understanding of the health impact of legislation and the rapid deployment of effective policies. Thus, legal health interventions that manage and treat diverse populations need to be evaluated more rigorously and quickly. In addition, funding for policy surveillance and other legislation and policy mapping needs to be more sophisticated to maximize utility and avoid duplication. This study investigated legal interventions to manage and treat various groups of populations for health and discussed the necessity of public health laws.     

When Artificial Intelligence Models Surpass Physician Performance: Medical Malpractice Liability in an Era of Advanced Artificial Intelligence

It seems inevitable that diagnostic and recommender artificial intelligence models will ultimately reach a point when they outperform human clinicians. Just as antibiotics displaced a host of medicinals for treating infections, the superior performance of such models will force their adoption. This article contemplates certain ethical and legal implications bearing on that adoption, especially because they involve a clinician’s exposure to allegations of malpractice. The article discusses four relevant considerations: (1) the imperative of using explainable artificial intelligence models in clinical care, (2) specific strategies for diminishing liability when a clinician agrees or disagrees with a model’s findings or recommendations but the patient nevertheless experiences a poor outcome, (3) relieving liability through legislation or regulation, and (4) comprehending such models as “persons” and therefore as potential defendants in legal proceedings. We conclude with observations on clinician–vendor relationships and argue that, although advanced artificial intelligence models have not yet arrived, clinicians must begin considering their implications now.     

药品缺陷侵权法律问题与对策研究——以权利救济为视角

目的 解决药品缺陷侵权的权利救济问题，保障用药患者的合法权利。方法 梳理药品缺陷侵权的立法现状与权利救济现状，分析中国药品缺陷侵权权利救济存在的问题，并针对问题提出相应的解决措施。结果 药品缺陷侵权的相关立法不完善，权利救济案件数量少且成功率低，权利救济现实情况堪忧。药品缺陷概念缺失与认定标准不明确、侵权归责原则不明、举证责任分配不合理、救济途径单一以及药品缺陷认定困难是药品缺陷侵权在权利救济方面存在的现实问题。结论 药品缺陷侵权的权利救济问题不容忽视，必须通过明确药品缺陷概念与认定标准、完善药品缺陷的归责原则立法、拓宽救济途径、完善药品鉴定制度以及建立、健全多元救济体系等措施，对药品缺陷侵权问题加以规制，从而提高药品服务的质量，保证用药安全。     

Polychlorinated dibenzo‐p‐dioxins and dibenzofurans levels in piglet liver with various diseases

This study deals with the levels of toxic polychlorinated dibenzo‐p‐dioxin and furan congeners (PCDD/Fs) in the livers of piglets affected by infectious diseases using isotope dilution high‐resolution gas chromatography/high‐resolution mass spectrometry (HRGC/HRMS). Seventeen toxic congeners in the liver samples infected with bacterial and viral diseases were compared. For porcine reproductive and respiratory syndrome virus (PRRSV) samples, the North American‐ and European‐type PRRS diseases were observed. This study shows that there are significantly different levels of PCDD/Fs, present, which vary according to the types of diseases as evidenced by our analysis of the piglet liver samples.