Retrospective Analysis of 291 Cases of Medical Malpractice Involving Death.

ABSTRACT: Objective To study the medical malpractice cases involving death, and discuss the identification ideas and methods of medical malpractice cases. Methods A total of 291 medical malpractice cases involving death accepted and settled from January 2012 to December 2017 at the Judicial Appraisal Center of Southern Medical University were collected. Based on the age, gender, hospital level, clinical department, whether or not autopsy was performed, cause of death, cause of medical mistakes, causality and causative potency of the appraised person, statistical analysis was made. Results There were more males than females in medical malpractice cases involving death. Mostly young adults or children were involved in these cases. The number of cases involving tertiary hospitals was the highest; among the clinical departments, the internal medicine department had the largest number of cases, followed by surgery, obstetrics and gynecology, pediatrics, etc. Autopsy rate has a trend of increasing year by year. Most patients die from the natural outcomes of their disease or ineffective treatment. Most hospitals have certain medical mistakes, and have an indirect correlation with the patient's death, mainly slight factors. Conclusion Judicial appraisal of medical malpractice should follow the principle of "one-effect and multi-cause", and comprehensively consider various factors such as, the diseases and constitution of the patient, natural outcomes of the diseases, the current medical technology and the level of diagnosis and treatment of the hospital, etc.

[Impact of coal workers' pneumoconiosis complicated by lymph node fibrosis in lung cancer on surgical treatment].

OBJECTIVE: To investigate the impact of coal workers' pneumoconiosis complicated by the pathological changes in lymph nodes in lung cancer on surgical treatment. METHODS: A total of 63 patients with non-small cell lung cancer who received pulmonary lobectomy and systemic mediastinal lymph node dissection were enrolled and divided into the group with coal workers' pneumoconiosis complicated by lung cancer (30 patients) and the non-pneumoconiosis liver cancer group (33 patients). The short-term outcome was compared between the two groups and confirmed by lymph node fibrosis shown by postoperative pathological examination. The predictive value of lymphadenectasis on chest CT was analyzed. RESULTS: Compared with the non-pneumoconiosis liver cancer group, the group with coal workers' pneumoconiosis complicated by lung cancer had significant increases in time of operation, intraoperative blood loss, postoperative extubation time, and length of hospital stay (P<0.05). The patients were divided into groups according to the presence or absence of lymph node fibrosis, and the group with lymph node fibrosis had a significantly longer time of operation and greater intraoperative blood loss than the group without lymph node fibrosis (P<0.05). CONCLUSION: When coal workers' pneumoconiosis is complicated by lung cancer, severe lymph node fibrosis often causes difficulties in surgery, and thoracotomy may be a safe and effective therapeutic method.

[Influence of job burnout on sleep quality of oilfield workers].

OBJECTIVE: To investigate the influence of job burnout on sleep quality of oilfield workers. METHODS: In January to August, 2014, the Chinese Maslach Burnout Inventory(CMBI) and Pittsburgh Sleep Quality Index(PSQI) were used to conduct investigation on job burnout and sleep quality in 1180 oilfield workers. RESULTS: The scores on each subscale of CMBI showed significant differences between workers with different characteristics(marital status, working years, educational background, and type of work) (P<0.05). The global PSQI score for oilfield workers was 5.55±3.26, which was significantly higher than the national norm(3.88±2.52) (P<0.05), and the incidence of issues related to sleep quality was 32.54%. The PSQI score showed significant differences between workers with different characteristics(sex and working years)(P<0.05). The multivariate logistic regression analysis showed that working years, sex, emotional exhaustion, and depersonalization were the major factors affecting sleep quality, and the workers with long working years, male workers with job burnout, and oilfield workers with issues related to sleep quality tend to have a high incidence of issues related to sleep quality. CONCLUSION: Job burnout is the major factor influencing the sleep quality of oilfield workers, and reducing job burnout of such workers is an effective way to improve sleep quality.

Molecular genetic analysis for Ax phenotype of the ABO blood group system in Chinese.

BACKGROUND AND OBJECTIVES: To elucidate the molecular genetic background of the Ax phenotype in the Chinese population. MATERIALS AND METHODS: The ABO genes of eight Ax phenotype samples, four Ax and four AxB, were amplified by polymerase chain reaction (PCR) and were cloned, along with those of 10 random A(1) Chinese subjects. We analysed the ABO gene transcript structure and the sequences of two exons and one intron at the ABO locus. RESULTS: Among the four Ax phenotype samples, we identified one Ax02, two Ax03 and one novel Ax allele with the 543G > T mutation in the A102 background. Two of five family members also carry the allele. Of the four AxB phenotypes, one was designated as cis-AB-1/B101; the other three were shown to carry one B allele and one O with the nt261G deletion. The B alleles of the latter three were identical to B101 except for single point mutation at nt700C > G, nt640A > G and nt641T > C, respectively. The novel B101-like alleles were first associated with A(weak)B phenotypes. CONCLUSIONS: Two ABO*B(A) alleles and an Ax allele clearly differ from all previously reported ABO alleles, suggesting that the molecular genetic background of Ax is heterogeneous in the Chinese population.