The amended standardization law and its influence to forensic identification / 中国法医学杂志

The Standardization Law carried out almost 30 years, and it is amended recently. The amended Standardization Law mainly focus on following aspects: enlarge the range of application into social undertakings;define the compulsory standards strictly in case of they are overmuch; add the supply effectively to meet the social needs; establish a well-organized and unified standardization system and make sure each standards can be linked up and matched. Also, the Standardization Law requires the development of standards; compulsory standards and with the enforcement of standards must be carried out; relevant organizations should disclose their standards; and some organizations shouldn't utilize their advantage to do unfair competition and so on. Those regulations may effect the forensic appraisal activities. At present, accrediting bodies in China exist many problems. For example, the standards are not scientific and not updated in time. They are unfamiliar with standards, low sense of executing identification standards,not disclose their standards. And their standards are lower with government's standards. Thus, this essay aim to analyze those problems and put forward related solutions.

Challenge and solution to medical damage idntification / 中国法医学杂志

By the end of 2017, the Supreme People's Court issue a judical interpretation called Tort law of China·Medical damage liability. It formulates some new rules about identification. It stipulates qualification of new appraiser; clears requirement of medical fault judgment; clears the requirement of causal relationship; defines procedure of medical damage identification and so on. However, there exist the dual identification model. Under the new rules, medical damage identification will face new challenges, especially some stipulates about qualification of appraisers, and expert assistants' views become the basis of the verdict. Those will effect medical examiners' working directly in China. So, I put forward following suggestions: ①Medical identification must be scientific, public welfare, normative.②It is trend for medical damage identification back to peer review. ③A unified library of clinical expert appraisers should be establised. ④We should reasearch the theorys, principles and methods of medical damege identification.

[Effects of oral interventions on carotid artery in rats with chronic periodontitis for the detection of Porphyromonas gingivalis and the expression of C-reactive protein].

OBJECTIVE: This study aimed to establish a SD rat model of chronic periodontitis (CP) merged with hyperlipidemia (HL), perform periodontal treatment, detect the expression of partial C-reactive protein (CRP) and Porphyromonas gingivalis (P. gingivalis) in the rat carotid artery, and explore the relationship between periodontitis and atherosclerosis. METHODS: SD rats were randomly divided into three groups: control group (A), HL group (B), and CP+HL group (C). Group C rats were divided into natural process group (C1), scaling and root planning group (C2), and tooth extraction group (C3). Group C2 rats were randomly divided into C2-1 (scaling and root planning group) and C2-2 (scaling and root planning+minocyline+systemic antibiotics group). Group C3 rats were randomly divided into C3-1 (tooth extraction group) and C3-2 (tooth extraction+systemic antibiotic group). One rat from group B was randomly selected and sacrificed after 15 weeks. Subsequently, the carotid vascular tissue was collected for oil red O staining. Modeling was successful when foam cell formation was observed. Periodontal treatments were conducted twice, and euthanasia was performed after the experiment. Moreover, double-carotid artery bifurcation was carried out to detect the expression of CRP and P. gingivalis. Immunohistochemical and 16sRNA semiquantitative methods were used to detect the CRP expression and the relative contents of P. gingivalis, respectively. RESULTS: Immunohistochemical results showed that the CRP-positive expression in groups B and C was significantly higher than that in group A (P<0.05). The CRP-positive expression in other group C rats were significantly lower than that in group C1 (P<0.05). The CRP-positive expression in group C2-2 was the lowest among the groups (P<0.05). The relative quantity of P. gingivalis in group C1 was the highest and significantly higher than that in groups A and B (P<0.05). The relative quantities of P. gingivalis in groups C2-1, C2-2, C3-1, and C3-2 were significantly lower than that in group C1 (P<0.05), and the quantity in group C3-2 was the lowest (P<0.05). CONCLUSIONS: Rats with CP associated with HL will increase the CRP expression and oral bacteria quantity on carotid artery, and lesions will gradually aggravate. Interventions, such as periodontal basic treatment and tooth extraction, could improve carotid artery lesions. The basic treatment with local and systemic anti-inflammatory drugs exerts the most satisfactory effect on local CRP expression. Tooth extraction with antibiotics is an effective method on reducing oral bacteria in carotid artery. Periodontal basic treatment associated with local and systemic antiflammatory drugs can obviously improve the effect.
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Analysis and evaluation of the implementation effect on catastrophic disease insurance of the New Rural Cooperative Medical Scheme in Beijing / 中国卫生政策研究

Objective: To analyze the effects of the catastrophic disease insurance of New Rural Cooperative Med-ical Scheme ( NRCMS) on alleviating the economic burden of patients in Beijing, and evaluate the effect of the policy implementation. Methods: Based on high, middle and low economic development levels and the implementation pro-ceedings of catastrophic disease insurance of NRCMS, this paper selects 3 districts of Beijing, from which it chooses two or three villages and towns with the highest numbers of catastrophic disease patients, in order to understand the opera-tional status quo of the catastrophic disease insurance through in-depth interviews with managers. This paper conducts questionnaire survey among all catastrophic disease patients from the sampled villages and towns, and uses 497 valid questionnaires received to understand patients' subjective feelings and collect relevant data of family income and medical expenditure of catastrophic disease patients in 2013. Then it carries out data docking with the platform of NRCMS man-agement centers and measure the economic burden of catastrophic disease patients. In this paper, quantitative and qualitative data are analyzed using statistical and thematic analyses, respectively. Results: The catastrophic disease in-surance of NRCMS has significantly played an important role in reducing the average medical expenditure of catastroph-ic disease patients and improving the actual compensation ratio in varying degrees. However, the incidence of cata-strophic health expenditures has not significantly improved. Conclusion: This paper suggests to increase deductibles and reimbursement ratios of catastrophic disease insurance in order to broaden reimbursement directory and other initiatives to improve the compensation level and focus on alleviating the economic burden of catastrophic disease patients.

Patients' satisfaction on catastrophic medical insurance of New Rural Cooperative Medical Scheme:Analysis of 484 patients in three districts of B city / 中国卫生政策研究

Objective:To understand the patients'satisfaction on catastrophic medical insurance of New Rural Cooperative Medical Scheme ( NRCMS ) , and provide references for effective management and policy improvement. Methods:According to the principles of representative sampling, a questionnaire survey conducted. 484 patients got compensation for catastrophic insurance in 2013 were surveyed, and information of medical costs was analyzed. Re-sults:The average medical cost accounts for 84. 57% of total household expenditure. Mandatory medical expenditure is still high and economic burden of diseases is heavy. This policy has increased the compensation rate, and the actu-al compensation rate increases 4. 79% in three districts. The average score of patients' attitude toward catastrophic medical insurance is (3.95±1.05) points, 88. 43% of patients continue to participate in medical insurance. Con-clusions and suggestions:Patients' satisfaction on catastrophic medical insurance of NRCMS is high. It is suggested that the existing financing modes should maintain stability in the short term, and the compensatory rate should be im-proved reasonably.

Effect of tooth extraction and antibiotics on carotid artery wall and serum interleukin 6 in chronic periodontitis rats with or without atherosclerosis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of tooth extraction with antibiotics on atherosclerosis, and to examine the expression of serum interleukin 6(IL-6) and the pathological changes of the carotid artery in chronic periodontitis(CP) rats with or without atherosclerosis(As).</p><p><b>METHODS</b>A total of 44 SD rats were randomly divided into four groups, group A(normal control), group B(As), group C(CP), group D(CP+As). After model establishment, group C and group D were randomly divided into group C1/D1 (tooth extraction) and group C2/D2(tooth extraction with antibiotics) according to random number table and received the corresponding oral intervention treatment respectively. Serum IL-6 levels were determined by enzyme linked immunosorbent assay(ELISA) respectively one week before the intervention, one week after the first intervention, one, three, five weeks after the second intervention. The pathological changes of the carotid artery were accessed under light microscope.</p><p><b>RESULTS</b>At all sampling time points, the levels of serum IL-6 in group B, C, D were higher than that of group A, with group D1 being increased most obviously, significantly higher than that of group A(P< 0.001). One week after the second intervention, the content of IL-6 in group C and group D peaked[C1(127.0 ± 29.9) ng/L, C2: (120.6 ± 23.1) ng/L, D1: (175.1 ± 50.8) ng/L, D2: (160.5 ± 37.7) ng/L], and was significantly higher than that of group B[B: (43.4 ± 7.5) ng/L,P<0.001]. Then they all had varying degrees of decline, 5 weeks after the second intervention, group C1 and D1 were still higher than that of group B, but group C2 and D2 were lower than that of group B. At all sampling time points, the levels of serum IL- 6 in group C2/D2 were lower than those in group C1/D1, 5 weeks after the second intervention the difference was most obvious and statistically significant(P<0.001). Pathology showed that the carotid artery wall in group A was normal. The carotid artery wall was thickened in group B, inflammatory cells and foam cells could be seen, and elastic fibers disordered. The carotid artery wall in group C1 was uneven, foam cells and a small amount of inflammatory cells were visible, and elastic fiber disordered. Obvious thickening was not seen in the carotid artery wall of group C2, a small amount of foam cells and inflammatory cells were found, and elastic fiber mildly disordered. The carotid artery wall in group D1 was obviously uneven, calcium salt deposits were visible in the artery wall, a large amount of inflammatory cells and foam cells could be found, and elastic fiber disordered. Obvious thickening was not seen in the carotid artery wall of group D2, a small amount of inflammatory cells and a large amount of foam cells could be seen, and elastic fiber disordered.</p><p><b>CONCLUSIONS</b>Periodontitis and hyperlipidemia could increase the level of serum IL- 6 and the risk of the As. In chronic periodontitis rats with or without atherosclerosis, when periodontal inflammation was not controlled, tooth extraction may increase the risk of the As. At the time of tooth extraction, giving the anti-inflammatory treatment can reduce the risk to a certain extent.</p>

Study on the methylation status of NDRG-1 gene in breast cancer and its reversion in vitro / 肿瘤

Objective:To investigate the methylation status of N-myc downstream regulated gene-1(NDRG-1) gene in breast cancer and the effects of methylation enzyme inhibitor 5-Aza-2'-deoxycytidine (5-Aza-CdR) on growth and expression of NDRG-1 mRNA in human breast cancer cell line T47D.Methods:Sensitive methylation-specific (MSP)-PCR was used to detect the methylation status in the promoter regions of NDRG-1 gene in 47 samples of breast cancer and tumor adjacent tissues and 15 cases of benign breast disease. The change in expression of the tumor suppressor gene NDRG-1 mRNA in cultured T47D cells was detected by RT-PCR before and after 5-Aza-CdR treatment. Cell proliferation was observed by MTT assay.Results:Hypermethylation frequencies of NDRG-1 gene promoter were 46.8% in breast cancer tissues and 21.3% in tumor adjacent tissues. No hypermethylation of NDRG-1 gene was observed in the tissues of breast benign disease. The growth of T47D cells was suppressed obviously after 5-Aza-CdR treatment compared with the control group. RT-PCR showed that compared with the control group, NDRG-1 mRNA expression was increased at different concentrations in 5-Aza-CdR treatment group. Conclusion:The promoter methylation status of NDRG-1 gene was significantly related with the occurrence of breast carcinoma. 5-Aza-CdR could effectively reverse the methylation of NDRG-1 gene and recover its expression, thereby inhibiting the growth of tumor cells.