How case law impacts risk management

Published decisions by federal and state appellate courts impact health care risk management in a number of ways, including overruling precedents, explaining and clarifying new laws and regulations, describing new and novel rules, describing new performance standards, and describing new civil rights.     

维生素D受体基因多态性与特发性癫痫的相关性

目的：探讨维生素D受体基因多态性与特发性癫痫的相关性。方法：通过病例对照研究方法，选取91例特发性癫痫患者作为病例组，另选取同期105例健康者作为对照组，抽取所有研究对象外周静脉血提取DNA，采用PCR直接测序法进行维生素D受体基因BsmI（rs1544410）、FokI（rs2228570）、Cdx2（rs11568820）位点多态性检测。结果：病例组与对照组的BsmI与FokI位点基因型频率和等位基因频率无显著差异（P>0.05）；Cdx2位点基因型频率存在显著差异（χ²=6.67，P=0.036），等位基因频率无显著差异，该位点发生A/G变异，分布不处于Hardy-Weinberg遗传平衡。在Cdx2位点基因型与特发性癫痫关联性分析中，病例组中Cdx2位点AG基因型是特发性癫痫发病的危险因素（OR=2.222，95% CI：1.190~4.150，P=0.027）。结论：维生素D受体基因Cdx2位点多态性与特发性癫痫具有关联性。     

Second Victim Experience and Perception Discordance of the Colonoscopic Perforation

Digestive Diseases and Sciences - Perforation is the most serious adverse event of colonoscopy, but rarely considered from the view of colonoscopists’ second victim experience and perception...     

RIP3/MLKL-mediated neuronal necroptosis induced by methamphetamine at 39℃

Methamphetamine is one of the most prevalent drugs abused in the world.Methamphetamine abusers usually present with hyperpyrexia (39℃),hallucination and other psychiatric symptoms.However,the detailed mechanism underlying its neurotoxic action remains elusive.This study investigated the effects of methamphetamine + 39℃ on primary cortical neurons from the cortex of embryonic Sprague-Dawley rats.Primary cortex neurons were exposed to 1 mM methamphetamine + 39℃.Propidium iodide staining and lactate dehydrogenase release detection showed that methamphetamine + 39℃ triggered obvious necrosis-like death in cultured primary cortical neurons,which could be partially inhibited by receptor-interacting protein-1 (RIP1) inhibitor Necrostatin-1 partially.Western blot assay results showed that there were increases in the expressions of receptor-interacting protein-3 (RIP3) and mixed lineage kinase domain-like protein (MLKL) in the primary cortical neurons treated with 1 mM methamphetamine + 39℃ for 3 hours.After pre-treatment with RIP3 inhibitor GSK’872,propidium iodide staining and lactate dehydrogenase release detection showed that neuronal necrosis rate was significantly decreased;RIP3 and MLKL protein expression significantly decreased.Immunohistochemistry staining results also showed that the expressions of RIP3 and MLKL were up-regulated in brain specimens from humans who had died of methamphetamine abuse.Taken together,the above results suggest that methamphetamine + 39℃ can induce RIP3/MLKL regulated necroptosis,thereby resulting in neurotoxicity.The study protocol was approved by the Medical Ethics Committee of the Third Xiangya Hospital of Central South University,China (approval numbers: 2017-S026 and 2017-S033) on March 7,2017.     

The RAS-RAL axis in cancer: evidence for mutation-specific selectivity in non-small cell lung cancer

Activating RAS mutations are common in human tumors. These mutations are often markers for resistance to therapy and subsequent poor prognosis. So far, targeting the RAF-MEK-ERK and PI3K-AKT signaling pathways downstream of RAS is the only promising approach in the treatment of cancer patients harboring RAS mutations. RAL GTPase, another downstream effector of RAS, is also considered as a therapeutic option for the treatment of RAS-mutant cancers. The RAL GTPase family comprises RALA and RALB, which can have either divergent or similar functions in different tumor models. Recent studies on non-small cell lung cancer (NSCLC) have showed that different RAS mutations selectively activate specific effector pathways. This observation requires broader validation in other tumor tissue types, but if true, will provide a new approach to the treatment of RAS-mutant cancer patients by targeting specific downstream RAS effectors according to the type of RAS mutation. It also suggests that RAL GTPase inhibition will be an important treatment strategy for tumors harboring RAS glycine to cysteine (G12C) or glycien to valine (G12V) mutations, which are commonly found in NSCLC and pancreatic cancer.     

The Role of Tissue Resection Length in the Determination of Post-Operative Eyelid Position for Muller’s Muscle-Conjunctival Resection Surgery

Purpose: To investigate the relationships between pre-operative marginal reflex distance (MRD), tissue resection length, phenylephrine response, and change in MRD with surgery for a cohort of individuals undergoing Muller’s muscle conjunctival resection (MMCR) surgery.

Methods: All cases of MMCR surgery performed over a 13-year period at a single institution were screened for entry. Individuals with adequate photographic documentation and follow up were included. Patients with previous or concurrent upper eyelid, orbital or eyebrow disease of surgery were excluded. Marginal reflex distance (MRD) was calculated based on photographs utilizing public domain software. Data was plotted for inspection and appropriate statistical tests were performed.

Results: During the study period 198 eyes fit criteria for analysis. A loose association between tissue resection length and change in MRD with surgery was found (r?=?0.176, p?p?=?0.367). There was a strong association between MRD change with surgery and pre-operative MRD (r?=?0.498, p?r?=??0.441, p?2?mm and pre-operative MRD as variables revealed a model with pre-operative MRD as the only significant predictor (p?Conclusion: Tissue resection length and phenylephrine response play small roles relative to pre-operative MRD in the determination of change in MRD with MMCR surgery.