丹参治疗股骨头坏死的分子机制研究

目的 从分子机制角度入手,利用网络药理学方法探讨丹参治疗股骨头坏死的机制。方法 筛选、预测丹参潜在的活性成分与靶点,工具为中药系统药理学数据库和分析平台。利用DrugBank、PharmGKB、HPO、GAD、OMIM、DisGeNET、TTD等数据库检索股骨头坏死相关作用靶点;结合生物信息学手段,明确丹参防治股骨头坏死的特异性靶点;采用ClueGo进行信号通路富集分析,以进一步分析其可能的分子机制。结果 从中药系统药理学数据库和分析平台中检测出的与丹参相关的202个成分中,按照药物口服生物利用度和类药性参数得到65个入血活性成分,利用相关靶点预测技术预测可能的靶点103个;运用上述数据库检测,发现74个已知靶点与股骨头坏死相关。利用Cytoscape软件构建活性成分及疾病的蛋白质-蛋白质相互作用关系网络图,合并网络图并行拓扑分析筛选出关键基因130个;采用ClueGO信号通路富集分析显示,丹参作用于股骨头坏死的关键节点主要涉及75条信号通路,例如促进成骨细胞的骨形成与抑制破骨细胞的骨吸收信号通路。结论 丹参治疗股骨头坏死具有多成分、多靶点的特点;其主要通路不仅是影响成骨细胞与破骨细胞的细胞生理过程,而且通过调节免疫和炎性反应等干扰和影响骨微环境,以控制疾病发展,与目前治疗股骨头坏死的作用机制相符合。     

艾灸督脉组穴对血管性痴呆大鼠海马p38 MAPK信号通路及细胞凋亡的影响

目的 基于p38丝裂原活化蛋白激酶(mitogen-activated protein kinase, MAPK)通路探究艾灸督脉组穴对血管性痴呆(vascular dementia, VD)大鼠的脑保护机制。方法 将60只SPF级健康雄性SD大鼠随机分为假手术组(12只)和实验组(48只);实验组大鼠采用双侧颈总动脉永久结扎法复制VD大鼠模型,随后将模型复制成功的大鼠分为模型组、艾灸组、阻滞剂组、艾灸+阻滞剂组,每组12只;艾灸组大鼠取“百会”“大椎”“风府”穴,采用温和灸法治疗,每次30 min,每日1次,治疗6 d,休息1 d,连续治疗4周;阻滞剂组在模型复制前30 min腹腔注射p38 MAPK阻滞剂(10μmol/L SB203580),模型复制成功后隔日注射1次,每次每只大鼠按1 mL/kg注射10μmol/L SB203580,连续注射4周;艾灸+阻滞剂组大鼠在阻滞剂组干预方法基础上进行艾灸治疗。采用Morris水迷宫实验检测大鼠认知功能,TUNEL法检测大鼠海马组织CA1区神经元凋亡率,Western blot法和RT-qPCR法分别检测大鼠海马组织CA1区p38 MA...     

电针激活Nrf2/HO-1通路抗帕金森病模型小鼠氧化应激的机制研究

目的 观察电针“风府”“太冲”“足三里”穴对帕金森病(Parkinson’s disease, PD)模型小鼠大脑纹状体中酪氨酸羟化酶(tyrosine hydroxylase, TH)、核因子E2相关因子2(nuclear factor-erythroid 2-related factor 2,Nrf2)、血红素加氧酶-1(heme oxygenase-1,HO-1)水平的影响,探讨电针治疗PD的可能机制。方法 将30只小鼠按随机数字表法分为对照组、模型组和电针组,每组10只。模型组、电针组小鼠按照30 mg/kg腹腔注射1-甲基-4-苯基-1,2,3,6-四氢吡啶(1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, MPTP)制备PD小鼠模型。电针组小鼠给予“风府”“太冲”“足三里”穴电针干预,每日1次,每次30 min,连续干预12 d。其余两组小鼠不予任何干预。采用爬杆实验和悬挂实验观察3组小鼠行为学改变,旷场实验观察小鼠自主运动总路程,免疫组织化学法检测小鼠大脑纹状体中TH表达水平,实时荧光定量PCR法检测小鼠大脑纹状体中Nrf2、超氧...     

论医疗事故罪的主观方面

本文从医务人员的注意义务、注意能力以及法学理论与司法实践的冲突三个角度论述了医疗事故罪的主观方面。对医务人员诊疗中注意义务及其程度的制定标准应当综合考量多种因素 ;在认定医务人员的注意能力时 ,应采用客观说 ;并建议在医疗事故罪的主观定性方面 ,应以危害结果的发生不违背行为人的本意作为区分故意与过失的界限     

Long-Term Follow-Up of Young Children Placed in Foster Care: Subsequent Placements and Exposure to Family Violence

This study examined the quality or characteristics of permanent placements at 6 years of age for 254 children who had been removed from their homes prior to attaining 3.5 years of age (mean = 13 months). Although the primary objective when removing children is protection, subsequent permanent placements are prioritized by federal legislation with a stable family environment, especially one with the biological parent(s), being preferred. Three a priori comparisons (i.e., reunified vs. nonreunified, adopted vs. foster care, relative vs. nonrelative foster care) were conducted for caregiver and child reports of exposure to family violence. The results indicate that both reunified children and their parents report more family violence (witnessed and child victimization) than do nonreunified children and their caregivers. Adoptive parents did report that they used more minor violence in disciplining their children than did foster caregivers, but their children reported witnessing significantly less physical violence in the home. Recognizing that the development of children removed from their homes because of maltreatment is likely a function of both the maltreatment as well as the quality of subsequent family experiences (i.e., violence exposure), implications of the findings for determining placements are discussed.     

论小区停车法律责任的认定

由于对小区停车法律关系性质的理解存在巨大差异,无论理论界或实务界对小区停车法律责任的认定始终没有形成统一的意见。文章通过对小区停车法律关系性质的分析,以小区停车场的不同权属为切入点对小区停车法律责任的认定分三个方面进行讨论。     

Distributive justice and willingness to pay for municipality child care

With the aim of investigating factors affecting willingness to pay for municipality child care, a survey was undertaken in Sweden of 1840 parents living in five municipalities of different sizes. On the basis of the greed-efficiency-fairness hypothesis (Wilke, 1991) which is supported by results from experimental social dilemma research, it was hypothesized that perceived fairness of how the quality of child care is distributed (equal, proportional to need, or proportional to payment) as well as of method of payment (collectively by taxes or proportional to use by fees) would be important determinants of willingness to pay. Results showed that perceived fairness of how quality of child care is distributed played some role but that other factors had stronger effects. Perhaps also reflecting fairness considerations, willingness to pay by fees was on average higher than willingness to pay by taxes. Predicted from previous research, willingness to pay by taxes was furthermore found to increase with income and degree of use. However, willingness to pay by taxes showed an increase rather than the predicted decrease with municipality size.     

STRICTLY LIABLE: GOVERNMENTAL USE OF THE PARENT–CHILD RELATIONSHIP AS A BASIS FOR HOLDING VICTIMS LIABLE FOR THEIR CHILD'S WITNESS TO DOMESTIC VIOLENCE

Studies estimate that between three and ten million children in the United States witness domestic violence annually. Although studies have demonstrated a co‐occurrence of domestic violence and child abuse, there is no concrete evidence to support the assumption that a child's exposure to domestic violence increases the risk to the child of abuse or neglect. Recently the New York State Court of Appeals determined that a child's witness to abuse does not suffice, in and of itself, to show that removal of the child is necessary or that removal is in the “best interests” of the child. Programs which have developed alternatives to presumptive removal understand the importance of viewing the interests of the battered parent and children as being in accord with each other rather than in opposition. Private and government sponsored programs have demonstrated some success in protecting the parent‐child relationship, ensuring the safety of both parent and child, and increasing accountability of batterers while reducing the necessity for removals. Alternative programs are less costly to the state than foster care, and emotionally less costly to the families.     

论医疗合同关系

医患法律关系是医事法规在调整医方与患方之间的关系中所形成的权利义务关系.其中医疗合同关系是一种不同于一般合同的特殊的民事法律关系.以民法的基本理论为依据,结合我国现实情况,力求通过对医疗合同的成立、性质、特征、主体、合同效力及其终止等方面的问题进行研究,阐明医患双方当事人各自所应承担的法律责任,归纳出更为公正、合理的解决医患纠纷的对策和理论依据,以服务于建设社会主义法治国家的需要.     

医疗行为过失的判定

界定医疗纠纷民事诉讼中医疗行为过失的概念,并探讨判定医疗行为过失诸多因素。是否构成医疗过失是司法部门处理医疗纠纷的重要依据,认定医疗行为过失的主要途经是通过医疗纠纷技术鉴定,当前对医疗行为过失的认定尚需进一步的完善,以适应目前对医疗过失的判定。