试论"自甘风险"原则在审理医疗侵权纠纷案件中的应用

公正的、客观的、完善的法律制度,是调整医患法律关系,规范医疗行为,保障医患双方合法权益的客观需要。随着我国法制建设的迅速发展,目前,患者越来越需要懂得依法维护自己的生命健康权利;医生越来越需要懂得依法进行诊疗,依法履行义务,依法维护自己的切身权利和利益;社会越来越需要有公正健全的法律制度。我国卫生法学领域的“新生代”正是在这种情况下应运而生的。各地涌现出一批兼有医学和法学双学历、勤勉好学、勇于探索、热衷于卫生法学研究的年轻人,将来必有建树。本刊《医与法》栏目就是他们及时发表睿见的一个园地,欢迎来稿。     

Comprehensive analysis of key lncRNAs in HCV-positive hepatocellular carcinoma

IntroductionHepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Despite the therapeutic advances in HCC in the past few decades, the mortality rate of HCC is still high. Hepatitis C (HCV) infection is one of the major etiological risk factors of HCCs. However, the underlying mechanisms of HCV-induced hepatocarcinogenesis remain largely unclear.Material and methodsOur study represented the comprehensive analysis of differentially expressed lncRNAs in HCV-positive HCC for the first time by analyzing the public dataset {"type":"entrez-geo","attrs":{"text":"GSE17856","term_id":"17856"}}GSE17856. Co-expression network and gene ontology (GO) analysis revealed the functions of those differentially expressed lncRNAs.ResultsWe identified 256 upregulated lncRNAs and 198 downregulated lncRNAs in HCV- positive HCC compared to the normal liver tissues. Co-expression network and GO analysis showed that these lncRNAs were involved in regulating metabolism, energy pathways, proliferation and the immune response. Seven lncRNAs (LOC341056, CCT6P1, PTTG3P, LOC643387, LOC100133920, C3P1 and C22orf45) were identified as key lncRNAs and co-expressed with more than 100 differentially expressed genes (DEGs) in HCV-related HCC. Kaplan-Meier analysis showed that higher expression levels of LOC643387, PTTG3P, LOC341056, CCT6P1 and lower expression levels of C3P1 and C22orf45 were associated with shorter survival time in the TCGA dataset.ConclusionsWe believe that this study can provide novel potential therapeutic and prognostic biomarkers for HCV-positive HCC.     

Retrograde nerve growth factor signaling modulates tooth mechanical hyperalgesia induced by orthodontic toothmovement via acid-sensing ion channel 3

INTRODUCTION Orofacial pain, with a prevalence of 16％ among general population,1 is a constellation of painful conditions in the orofacial regions and comprises...     

Improving the Mechanical Properties of Fly Ash-Based Geopolymer Composites with PVA Fiber and Powder

In this work, polyvinyl alcohol (PVA) fiber and powder were added to geopolymer composites to toughen fly ash-based geopolymer, and their different toughening mechanisms were revealed. Firstly, different contents of active granulated blast furnace slag (GBFS) were added to the geopolymer to improve the reactivity of the GBFS/fly ash-based geopolymer, and the best ratio of GBFS and fly ash was determined through experiments testing the mechanical properties. Different contents of PVA powders and fibers were utilized to toughen the geopolymer composites. The effect of the addition forms and contents of PVA on the mechanical properties, freeze–thaw cycle resistance, and thermal decomposition properties of geopolymer composites were systematically studied. The results showed that the toughening effect of PVA fiber was better than that of PVA powder. The best compressive strength and flexural strength of geopolymer composites toughened by PVA fiber were 41.11 MPa and 8.43 MPa, respectively. In addition, the composition of geopolymer composites was explored through microstructure analysis, and the toughening mechanisms of different forms of PVA were explained. This study provided a new strategy for the toughening of geopolymer composites, which can promote the low-cost and efficient application of geopolymer composites in the field of building materials.     

经三腔胃肠管饲服大承气汤在治疗重症胰腺炎中的作用

[目的]观察经三腔胃肠管饲服大承气汤在治疗重症胰腺炎中的作用。[方法]将48例重症胰腺炎患者随机分为对照组23例和治疗组25例。对照组采用西医常规治疗;治疗组在西医常规治疗的同时经三腔胃肠管饲服大承气汤。[结果]治疗组在临床症状消失、首次排便时间、实验室指标（血尿淀粉酶）恢复正常时间、开始实施肠内营养（EN）时间、住院时间、住院费用方面明显优于对照组。[结论]经三腔胃肠管饲服大承气汤在重症胰腺炎治疗中作用明显。     

桂枝茯苓胶囊辅助治疗未破裂卵泡黄素化综合征的疗效观察

目的观察采用桂枝茯苓胶囊辅助治疗未破裂卵泡黄素化综合征的临床疗效。方法选择68例多囊卵巢综合征经促排卵后发生未破裂卵泡黄素化的患者,将其分为治疗组(35例)和对照组(33例),采用来曲唑+HMG+HCG方案,治疗组加服桂枝茯苓胶囊温阳活血促排卵,对照组不加桂枝茯苓胶囊。两组均治疗6个月经周期,观察患者排卵率及妊娠率、黄体期孕酮(P)及雌二醇(E2)、卵泡周围血流灌注情况。结果治疗组排卵率、妊娠率均高于对照组(P<0.05)。治疗组黄体期E2及P水平高于对照组(P<0.05),治疗组S/D值及RI较对照组均下降,差异有统计学意义(P<0.05)。结论桂枝茯苓胶囊辅助治疗未破裂卵泡黄素化有较好疗效。桂枝茯苓胶囊的促排卵、增加血流灌注、健黄体作用值得在临床推广。     

影响瞬时弹性成像术检测肝纤维化的相关因素分析

Fibroscan是检测肝脏组织弹性程度的一种方法,现已逐渐被广泛应用于临床检测肝纤维化,其与肝活检相比具有无创、可重复性好、简单快速、易于操作等优点。但是它检测肝纤维化测量值的准确性受到一系列相关因素的影响,如肥胖、肝脏炎症、胆汁淤积、进食等,本文就Fibroscan在检测肝纤维化中的影响因素作一概述。     

舒适护理在上消化道出血患者中的应用效果评价

目的探讨舒适护理在上消化道出血患者中的应用效果。方法将102例上消化道出血患者随机分为观察组和对照组,每组51例,两组均给予常规护理,观察组在此基础上采取针对性的舒适护理措施。结果观察组干预后的SAS评分、止血时间和住院时间均明显优于对照组（P〈0.01）;观察组患者对护理服务的满意度也显著高于对照组（P〈0.01）。结论舒适护理能有效缓解上消化道出血患者的焦虑情绪,提高患者对护理工作的满意度,促进患者早日康复。     

两种方法治疗需氧菌阴道炎的临床疗效分析

目的 分析复方氯霉素阴道泡腾片及氧氟沙星阴道泡腾片治疗需氧菌阴道炎（AV）的临床疗效.方法 按AV标准进行诊断AV 85例,按用药不同分成复方氯霉素阴道泡腾片组45例和氧氟沙星阴道泡腾片组40例,对照比较两组的疗效.结果 治疗7 d时,复方氯霉素阴道泡腾片组与氧氟沙星阴道泡腾片组治疗AV的总有效率分别为80.0%与75.3%（χ2=13.27,P ＜ 0.05）;在白带增多、性交痛、外阴灼痛及外阴红肿等症状方面,复方氯霉素阴道泡腾片组比氧氟沙星阴道泡腾片组改善明显,两组治疗白带增多痊愈率分别为50.0%与15.0%（χ2=12.83,P ＜ 0.05）,两组治疗性交痛痊愈率分别为68.6%与25.0%（χ2=15.41,P ＜ 0.05）,两组治疗外阴灼痛症状痊愈率分别为57.5%与20.0%（χ2=14.60,P ＜ 0.05）,两组治疗外阴红肿症状痊愈率分别为62.5%与15.8%（χ2=19.41,P ＜ 0.05）.结论 用复方氯霉素阴道泡腾片治疗AV是一种疗效确切的方法.     

别让拖延毁掉你的人生

拖延是一种非常普遍的行为. 心理学家简·博克的研究调查显示大多数人(超过50％)都有拖延问题,我们会回避那些困难、繁琐的工作,比如夏天来了,要整理衣橱里冬春季节的衣服,或者要整理一个上百个条目的文档时,我们可能就会选择拖着不做,这是很正常的拖延行为,一般不会给生活造成太大的问题.