ABSTRACT
Heilongjiang Provincial Hospital has scored an initial success in dealing with medical disputes since the medical liability insurance and third-party mediation mechanism were introduced into the hospital in 2013.The paper identified problems found in the practice,and recommended the following:rationalizing the cost of insurance coverage,expanding scope of third-party mediation properly,enhancing professional authority in assessment of medical dispute cases,simplifying insurance compensation procedure,and consolidating the legal status of the medical dispute mediation institutions,for better resolution of such disputes.
ABSTRACT
Objective To study the protective effect of tadenan on morphologic and enzymatic changes of the detrusor muscle after bladder outlet obsttuction (BOO).Methods 28 white male rabbits were divided into four groups of 7 rabbits in each group.Control group received operation but not forming obstruction model,while the other three groups received operation forming obstruction model.Two weeks after operation,tadenan group received tadenan orall.y at 100mg · kg-1 · d -1 for three weeks;peanut oil group received vehicle only and the obstruction group did not teceive any drugs for three weeks.After three weeks,the bladder detrusor muscles of each group were collected.Morphologic changes were observed under electron microscope.The MDA concentration and the activity of SOD,NOS and Ca2 + -Mg2+ -ATP ase were measured.Results Eletron microscopy showed lots of abnormities in the detrusor muscles in obstruction group.The diltation and degranulation of rough endoplasmic reticulum were abvious.Dropsy and vecuole denaturalization were found in mitochondria.The mitochondrial crista decreased or disappeared.A plenty of lysosomes were also found in the detrusor muscle cells.The activity of SOD[A group( 86.568 ±4.657),B group(89.218 ±4.430 ),C group ( 33.696 ± 3.010 ),D group ( 32.258 ± 2.001 ) U/ng protein ],NOS [ A ( 12.87 1 ± 1.240 ),R(9.274 ± 1.137),C(2.365 ±0.358 ),D(3.614 ±0.147) U/mg protein) ] and Ca2+ -Mg2+ -ATP ase[ (A(5.231 ±0.329),R( 5.362 ± 0.266),C ( 2.285 ± 0.354 ),D ( 2.654 ± 0.307 ) μmolPi/mg protein ) ],the concentration of MDA[A(8.369 ±0.170 ),B( 10.358 ±0.383 ),C(36.598 ± 3.120),D(42.574 -± 2.009) nmol/mg protein) ].Conclusion Tadenan had the protective effect on ultrastructure of detrusor cell,and it reduce the production of free radical and avoide excessive superoxidation to prevent the process of pathologic changes of the detrusor muscles.