With director of the hospital's violent debate

The court: October 25, 1999 as a result of Xian Wang Shugang patients with diarrhea, lower limbs can not afford medical workers in a hospital in Xi'an (hereinafter referred to as hospital workers), the treatment, no improvement of symptoms in at 2:15 p.m. on October 27 admitted to the hospital medicine . It was Wang Shugang electrolytes potassium content of 1.4mmol / L, admission diagnosis hypokalemic periodic paralysis, and potassium supplement given to the hospital, anti-infective treatment of symptoms. The night of 27 and 28 patients improved during the day, at 8:00 on the 28th test potassium 4.0mmol / L, but the evening of 28 patients with the disease to increase again, there is a short-twitch muscles, a sense of breathing difficulties. Report of the doctors, nurses, doctors immediately removed the previous transfusion, needle out, "the moment is simply to fight with the same'', family members said later with lawyers, nurses, Wang Shugang to start transfusion, the use of inappropriate treatment, although slightly Wang Shugang Turn for the better, but still very serious condition, was rushed into the night in a well-known large Si-Jun Xijing Hospital, and the next day at 7:00 in the Si-Jun Xu large Xijing Hospital after the tragic death of all rescue measures proved ineffectual. Wang Shugang after the death of his sister Wang Shuxian bitterly to the new Xi'an City Committee of the identification of medical malpractice to apply for identification, but the result of Wang Shuxian than expected, the Commission identified through medical identification that does not constitute a medical. Against Wang Shuxian, Xi'an medical technology to the identification of the Commission made a request to re-identification. During this period in January 2001, Jin Xiaoguang Wang Shuxian to hire a lawyer of their representations, their agents to investigate, and to attend the mediation committee, and other medical identification. After the lawyers accepted, according to the Health Department's recommendations, and repeated visits to the hospital staff mediation, the mediation was now in dialogue with the publication for our readers. (Note, essentially a dialogue of the original, unchanged for the parties to respect the privacy of paper the names of the two parties are assumed name.) Beijing Jin Xiaoguang online network of lawyers in Beijing law firm in Beijing Ding Jin Xiaoguang, chief counsel on May 20, 2006 The first mediation dialogue Time: February 6, 2001 Location: Xian people to participate in a hospital workers: lawyers Jin Xiaoguang, Wang Shuxian, president of the seats Hospital, Medical Services Jiaoke Chang (M) (talks, work out from time to time Jiaoke Chang) Lawyers certificates and lawyers to produce a letter of recommendation stating the identity and malicious, the front yard talks to staff lawyers will copy documents, a copy of the stay in the hospital. Kim: President of the seats in mediation before I take a look at medical records? I: It has already been identified to the Committee. Gold: According to the "medical treatment", who disputes the original medical records kept by the hospital designated person, you is not it? I: (not silent) Kim: I would like to see the medical records, because I do not want to listen to all the parties, you do not want to listen to the whole, want to know is the fact that, in order to correct my agent, to grasp the facts about the situation. I: We have the required identification to the Commission, you have to ask what we can be face-to-face. Kim: "medical treatment" does not require a lawyer can not see the medical records. I: the silent ... ... you have any questions you asked. Kim: I would like to take a look at medical records, and then is not clear on the face-to-face to ask again. I: the silent King: Well, since you do not, I passed the other way. I have a question, Wang Shugang What is the cause of death? I: (a silent, said after the meeting) is not clear that this should be to identify medical committee says. Gold: hyperkalemia was caused by cardiac arrest it? I: Well, the poor, said. Kim: Well, we started to talk it down, before talking about, president of the seats, you say what you say instructions. I: (laughing) no. Kim: Well, I would like to talk about. Life is the most painful loss of loved ones lost loved ones and for some people, the suffering is temporary, while others are life-long, lingering life, suffering, will be accompanied by life-long regret. In this case, my client is Wang Shuxian, she always engraved in remorse, blame themselves: first, if not on the hospital staff, even if it is to spend some money on the Xijing Hospital, she would not have lost loved ones ah! Loved ones have gone, remorse is inevitable, or come back to reality, according to the medical Identification Committee to mediation, understanding the hospital, suffering from. Life is precious, and how much money you have to have gone back to the not-for loved ones, and Wan Buhui my life-long suffering of the parties. Despite this, she is willing to consult with you to resolve in order to alleviate the suffering of the yard to reduce losses, we can fight for good mediation. I: (has been silent) Kim: Yes, I said this, president of the seats, you have nothing to say. I: (first silent for a moment, then said slowly) that we are not medical, hospital treatment is correct. Kim: We believe that it is a medical incident, the hospital is at fault, in the absence of negligence, we are not here to trouble-making, blackmail is not it? But if there is no fault, why do you also agree with the Board of Health agreed to mediate this? (Note: Mediation is the recommendation of Xi'an Health Bureau) I: We believe that only medical disputes, medical disputes to mediation can be. (Silence followed by the two sides). Kim: Well, we do not talk about those sensitive words, but we feel the need to have a tacit understanding that the hospital is at fault, only on this basis can we talk about, or will not be able to talk about. Gold: Again, that is no mention of the mouth, but thought there must be a tacit agreement. I: (silence) Kim: I President, what is your program? I: You said. Kim: Well, I said that according to the "Law on the Protection of the interests of consumers" and "the rights and interests of the Shaanxi Provincial Regulations on the Protection of the consumer," the hospital should be compensation for Wang Shugang: 1, XX million for medical expenses; 2, funeral XX million; 3, the elderly Wang Shugang And maintenance children XX million; 4, compensation for the death of XX million; 5, Wang Shugang relative loss of working time costs, travel XX million. I: You say that the premise of what? Gold: consumer services in hospitals, the hospital due to the fault of the damage. I: We do not at fault, so we can not say that the compensation. Kim: It depends on, or there should be a prerequisite for, or else we will not be able to talk about. Gold: do you have any principle of the program? I: (laughing) you come up with a reasonable, we can talk about. Gold: You pay a penny, you are also at fault, not the principles, we will not be able to talk about. I: silence. Kim: Well, we can not talk about it (clean up the volume, into the bag), on whether a medical incident, we think it is, otherwise we will not find you, if the City was not identified, that we referred to the province , If the province is still not on, we discussed through the media, the experts expressed the view that if you cause to the reputation, economic loss, I am sorry, we are not doing it deliberately. I: silence. Gold: Again, insist medical is, adhere to the hospital at fault because in less than two days, Wang Shugang potassium from 1.3mmol / L rose to 7.1mmol / L, in any case, the hospital is Away from this responsibility. I: (silent for a moment, smiled) we have to talk about the harvest, harmonious atmosphere. Gold: on the mediation, Wang Shuxian you have feelings of the hospital, come on the road, she urged me to talk about the best achievements of the talks, do not harden, and she was in the hospital to understand the mood. If the identification must, I fight her in the end. I: (Laughter) We both calm and then consider the fact that the time to get back. Wang Shuxian: We are all busy, busy you are, do not be too long. I: not long, you next Monday, a phone call. Gold: All right, it is so (and I shook hands, I Wo Zheshou the other hand patting the shoulder of the gold, there is a little joke and said "much worse"). And the third time I talk about Time: February 23, 2001 Location: hospital workers who participated in: Jin Xiaoguang, president of the seats Gold: Wang Shugang hyperkalemia is the cause of death, he was in a hospital that you care, tin rose to 1.3 from 7.1, you can not have responsibility for the hospital it? I: he is not dead in our hospital. Gold: potassium increased to 7.1 is in your hospital? I: She is the sister of his drinking, she Jieshui that good medicine. Kim: Is your medicine hospitals. I: Yes, but we did not let him drink so much. Kim: how you let him drink? I: Yes, according to his doctor's advice. Kim: How much is the doctor? You said. I: The medical records of all. Kim: Yes, history is 20ml, but you have to explain how the patient is 20ml explain it? 20ml To me, I understand that the patient understand? I: The experts also asked to identify the problem, we use the feeding cup to him. Kim: There are no medical records reflect that you are feeding him drugs to the Cup and can not be found, you can not say that. I: The Cup is the use of feeding him. Kim: That you give him a big bottle of potassium chloride to do? What is the drug potassium chloride, you do not know it? I: We have on the table, do not let him drink his sister gave him to drink, we did not ask. Gold: This place where drugs? I: We explain how the drugs did not let him drink, we have so many patients, sometimes two bottles of drugs, no trouble, so are many, to open a second bottle had not happened, the unexpected. Kim: You violated the rules, procedures should be provided for what? Ah inpatient and outpatient drug like it? I: Our duty is only a little bit, you said is not so much (Bi Hua hand). Kim: No, you are the primary responsibility is to direct. Even if you say, is the younger brother of Wang Shuxian her drink, according to the rules and if you do care a patient's potassium to achieve the kind of 7.1 beyond remedy it? I: What is the concept of a care? Kim: What do you say that? I: silent. Gold: Nursing is a long time to inspect? I: You said. Kim: You said. (Silence) Gold: a nursing visits to 30 minutes once you how the inspections? I: We have visited, which have to do so. Gold: should no longer ask you to inspect the contents of what? Why not find a patient medication wrongly situation and 500ml bottles of potassium chloride? I: we do have. Kim: you do it? (Silence) Gold: seven put three pairs of attention to what is one? I: (laughs) What? Kim: how are you doing? If you do, do not be able to avoid that situation? I: We are not the primary responsibility. Kim: You are the primary responsibility, according to the order, if you do, we can avoid potassium reached 7.1 and hopeless. I: medical, you put too high demands. In the absence of a new "medical treatment" before the introduction, implementation is still old. Kim: You refer to the amount of compensation for it. I: (Laughter) Kim: "medical treatment" is the amount of compensation for the executive to deal with, an accident was 3000 yuan, is not it. I: (laughter, nodding his head) Kim: It is based on civil law for compensation, how can pay 3000 yuan, there are more than 10 million in medical compensation, hundreds of thousands, of more than 1,000,000 have, not the letter? Another your employees as a result of Obstetrics and Gynecology Hospital paid a baby more than 1,000,000 have been reported on, you know? I: know that did not pay more than 1,000,000, more than 1,000,000 is the newspaper said. Kim: In that case, the compensation will not be 3000 yuan now. I: (silence) I: Do you requested is too high. Gold: In addition to the law, there were feelings inside, a lawful, fair, reasonable, that is, the judge handed down, if we play well, the judge moved, liable to be much the same, as long as the provisions of the framework, we mediation There is a situation inside. I: (silence) Kim: you can consider a number of good faith. I: Yes, we will discuss the matter. Gold: a more sincerity. I: I am very anxious. Fourth talks with the president of the seats summary Time: Three days later: hospital workers who participated in: Jin Xiaoguang, president of the seats, Medical Services Jiaoke Zhang (female) ... ... Gold: the dual use of potassium supplement you are correct? In patients have normal potassium, potassium should pay attention to what? Coke: This is absolutely correct, you do not understand medicine, you do not want to say this, if not, experts say, is wrong. Gold: a patient to a 500ml bottle of potassium chloride is not? Coke: We use the feeding cup to him, to say the reason is to write 500ml account. Gold: potassium ions in patients with follow-up should the concentration of potassium? Coke: We checked. Gold: 9:00 am on the 28th you search for an 4.0, up to 12 hours did not check, a six-hour search. Coke: We have checked and have a good day and go again. The patient has been a steady increase in follow-up is not a six-hour search. Kim: How long will it last? Coke: We have checked, a good day all go again. Gold: a 20-minute visits once care, why do you not put an end to the patient and found wrongly situation. Coke: We have been very good during the day, the patient potassium steady rise in his sister are not in one day, are accompanying us to do, you ask, he is the sister of Shashi, he is Zeyang to drink? Gold: where are the drugs? Is your hospital? Why should a medicine bottle on the table ward patient? Coke: We did not let him drink. Kim: Why not find a patient wrongly potassium chloride. Coke: his sister at night, we did not ask, said that drugs, and younger brother gave her the drink, which she said was, that on a moment, how can we find that we not follow the patient per minute. Kim: You are sure errors, why do you have 500ml potassium chloride to the patient on the table? What is the drug potassium chloride, you do not know? Well, we do not say that, and I ask you, your attitude? Coke: Do you accept that we can come up with a proposal. Kim: How many of you said you would accept? Coke: Are you a lawyer, do you know than we do. Kim: We talked about it today. By-laws: a summary of views represented by counsel Wang Shugang on the identification of additional medical advice Xi'an medical technology to identify incidents: Wang Shugang in patients with hyperkalemia-induced cardiac arrest deaths, Xi'an City of the new medical technology to identify new medical identification documents of the Committee [2000] on the 13th: a short period of time in patients with increased serum potassium (27 pm 1.4mmol / L, 28 night 7.1mmol / L), as the potassium intake too much about. However, Yi Jian of the new [2000] text on the 13th but found the hospital, "the concentration of potassium, and the rate of correct medication dosage, the case can not constitute a medical." In that case, the new medicine [2000] 13, why not identify the hospital doctor to the patient temporary 500ml KCI has an error? There is no violation of the principles of the medication? There is no breach of oral administration of the rules? There is no violation of a 30-minute visits to each nursing once? Patients wrongly over the responsibility of potassium chloride in the Who? Hospital visits to the content of what? Why not discover and put an end to the situation wrongly? Now, I am the direct cause of the death of Wang Shugang to add the following: I, K has returned to normal, double potassium supplement is correct? In at 23 o'clock on on the 27th for K + identified 3.3mmol / L, 28 for K + morning 4.0mmol / L has been under normal circumstances (the normal value of 3.5 to 5.5mmol / L), the hospital is still on the 28th to give intravenous Potassium chloride injection, oral administration at the same time, double potassium supplement. Hospital treatment is no doubt on the existence of obvious errors and mistakes, and in 28 from 9:00 am to 9:00 pm in patients with no follow-up serum potassium concentration, in violation of potassium should be follow-up, the need to pay attention to. Second, the temporary hospital doctor whether there is an error? Doctor is a doctor to the patient's care, treatment, diet and further write a check written asked. Doctor's orders for temporary or special inspection of the provisional administration, told at the time of treatment. The hospital in the provisional 28 on a one-time doctor to give patients 500mlKCL, much higher than the dose of medicine provisions, and not by written request of the doctor's advice and use that note, the doctor there is a serious mistake! It is the wrong doctor's orders as a direct result of excess patients wrongly KCL, the new Medical City hospital identified the conclusion that the correct medication dosage. In that case, I would like to ask one-time to give patients a letter 500mlKCL, to the amount of orders that correct? The doctor is how it carried out? A hospital for patients 500mlKCL, how to give patients the service? Patient said: "Let the doctor one hour to drink a big mouth." Where does one drink? Hospital initiative is a party, the patient is a passive one, not the doctor asked how the drugs, there is no evidence that hospitals give patients the means by medication and dose, long-term and temporary medical doctor can not replace each other. Hospital patients should be wrongly assume full responsibility. Third, the hospitals are not in violation of rules? 1, the rules A, is the principle of medication use in all the general principles. Medication in the implementation of the work: 1) administration should be based on doctor's orders. 2) operation to be done in three seven-search attention. Richard III: post-check drug Pendulum; medication, injection, before the disposal of search; medication, injection, disposal after the search. 7 pairs: on the bed, name, the name of the drug, dose, concentration, time and usage, but no one drug invisible. A: After the attention of the drug reaction. 3) to be on time delivery. B, oral administration should pay attention to what? 1) The drug made on time. 2) The drug should be made to see the patient before leaving the dose, especially some of the special drug. In the event of did not for some reason or not the patient medication, the drugs should be back and to hand over custody. 3) made drugs, the drug should be aware of the performance, and have taken the attention, a number of special medicines, such as KCL, should closely monitor the condition and effect. C, a principle of care are inspected once every 30 minutes, whether the inspections in strict accordance with medication and medical conditions change. 2, the hospital is a violation of the rules? In this case, the hospital is not in accordance with the provisions of long-term medical hair medicine three times a day on time, but to give a patient 500mlKCL, and do not know what medication, the patient did not look at dose fill up before leaving, did not closely monitor the condition and effect, Did not even finish first, and other drugs the patient will get custody of the remainder of KCL solution. Up to 28 patients at night appear limbs, muscle weakness, difficulty in breathing, health care workers rushed to the remainder of KCL oral and intravenous drip bottle recovery, the practice of serious violations of rules. Care should be a 30-minute visits once a tour is to carefully inspect, rather than muddle through. Hospital to give a 500mlKCL, has been a serious violation of the provisions of medical, hospital and not in accordance with the provisions serious inspection and found no patients on the medication 500mlKCL and put an end to) the hospital care is also a serious fault. Four patients wrongly over KCL, who is the responsibility? Due to the hospital in violation of the principles of medication, temporary serious medical error, not the "three check-seven attention," in violation of in-patients on the drug should be made in accordance with the requirements of the violation of the drug from the medical side of the custody of the requirements should be a violation of Follow-up review in patients with serum potassium concentration and the electrocardiogram of the provisions of the operation, the patient did not observe the condition and treatment, care and a violation of the inspected once every 30 minutes of the requirements of the disease were wrongly over-KCL, caused the death of cardiac arrest, the responsibility Entirely in the hospital. Fifth, if the case constitutes a medical? To sum up, according to the Ministry of Health "on that a number of issues" and "medical grade standards" (for trial implementation of the draft), as hospital medical care in violation of rules and regulations and technical procedures, as a direct result of patients with Wang Shugang Hyperkalemia, caused by cardiac arrest, according to which, in this case constitute a complete medical accidents, Yi Jian of the new [2000] 13 is wrong and should be corrected. Identification of these comments, please give serious consideration to the Committee as soon as possible to make a scientific appraisal of the fair. Jin Xiaoguang lawyer Jan 16, 2001 By-laws: medical technical appraisal committee of Xi'an City, Yi Jian word document [2001] 12 Wang Shugang medical conclusions of the technical evaluation Suffering from side: Wang Shuxian (sister of patients) female, 45 years old, teachers, address: the application was a little party identification: a Xi'an hospital workers in general: Wang Shugang, 35-year-old male, address: a little, occupation: the individual. 1999, 1025-10, 28 in Xi'an due to a medical hospital staff, hospital, 05032.99 years on October 29 to the Xijing Hospital after the death. Identification of reasons: City against the new medical identification technology committee "Yi Jian (2000) 13" to identify the book that "does not constitute a medical" to the conclusion that: Wang Shugang in-patient and out-patient treatment, serum potassium from 1.4 to 7.1 , Excessive intake, as a result of doctors to monitor patients closely enough, resulting in delay in time illness, an accident caused by negligence. Abstract medical records and after treatment: Wang Shugang in October 25, 1999 as a result of diarrhea, lower limbs can not afford medical staff in hospitals. According to the out-patient medical records; in patients with watery diarrhea for it, then lower limbs are weak and can not stand. No fever, no convulsions, syncope, no, no drinking water choking. Denied a history of high blood pressure. There is a history of schizophrenia (now taking Lisco30.1, clozapine 75mg). Richard body: a normal heart and lung. Mentally clear, no signs of the nervous system positioning. 2 pairs of lower limb muscle strength, tendon reflexes weakened knees, two-bus's disease (a). Out-patient diagnosis: (1) hypokalemic periodic paralysis; (2) the spirit of acute poisoning? To deal with: 1, blood, 2, potassium test 2.4mmol / L; (3) 10% GS500ml + VitC3.0 + VitB6200mg + potassium aspartate U.S. 30mgX3: (4) 5% GS500ml +10% KcL15mlX3; ( 7) follow-up. After treatment, symptoms improved in at 2:15 p.m. on October 27 admitted to the hospital medicine. In-patient medical records: Patients with "body weakness, the failure of the activities of 2 days," chief hospital. 2 days ago as a result of eating unclean food diarrhea, will dilute water samples, more volume. No fever, dry mouth, no oliguria. Followed by inability to both lower extremities, restricted activities. Gradually add to the upper limbs and activities can not be weak, unable to hold objects. Out by dealing with low potassium, no improvement in symptoms. Cha-admission: temperature 36.5 ℃, pulse 84 beats / min, 20, respiratory / min, blood pressure 105/70 mm Hg, free expression, the clear sense that carried into the wards, passive posture, abdominal heart-lung (a) of the upper limbs muscle Force 3, a pair of lower limb muscle strength, reduce muscle tension, the two-brachial 2 reflex pathological (++), tendon did not bring out the shallow sense of symmetry exists. Check electrolyte: potassium 1.4mmol / L, sodium 125mmol / L, calcium 2.0mmol / L, admission diagnosis; periodic paralysis. To the potassium supplement, anti-infective treatment of symptoms. Of which: 10% of the long-term medical oral potassium chloride solution 20ml three times daily, 10% potassium chloride 15ml +5% GS500ml + Vitamin C2g + Vitamin B6 0.2 grams intravenous drip 1 / day. Oct. 27 patients with 11 o'clock the night of testing serum potassium 3.3mmol / L. It has been at 10 o'clock on Oct 28 medical records: the rise could 10:00 last night, upper limbs may be, can be strength, can hold objects to the activities of both lower sales and can not get out of bed, heart rate 84 beats / min, the law Qi, and did not hear noise, double-strength upper-class IV, 3 lower limbs muscle strength, muscle tone on the lower limbs were reduced to the treatment of oral potassium supplement. Reported that the normal blood, excrement, urine routine no abnormalities. At 8 o'clock on Oct. 28 for testing serum potassium 4.0mmol / L. The evening of Oct. 28, body weakness than in patients with influenza as the most important thing in the morning hours, there is a short-twitch muscles, a sense of breathing difficulties, chest tightness, not flustered, late 9:30 Jicha reported electrolyte: potassium 7.1mmol / L, sodium 120mmol / L. Was 10 percent Glucose to 50ml +10 intravenous infusion of calcium gluconate 30ml, furosemide, potassium, such as lowering treatment, the treated patients improved breathing difficulties, is still a sense of body weakness, heart rate 82 beats / min, the law of Qi, blood pressure 90/60mmHg , Was reported seriously ill. 11pm potassium night review, on October 29 days 13:00 potassium return 6.9mmol / L, diuretics can be used after the urine, chest tightness, shortness of breath flustered still can not afford full-body, physical activity can not give up 10% of the static gluconate Calcium 20ml, furosemide 20ml shortness of breath a little nervous after the turn for the better. Potassium is still high, the need for dialysis to reduce serum potassium, to large military treatment. October 1999 29 days 14:45 Xijing patients admitted to the hospital emergency department, diagnosis: 1, 2, hyperkalemia, periodic paralysis. 7:00 Xu, in patients with sudden loss of consciousness, ECG heart that disappeared, no sound auscultation, died. The final diagnosis: 1, 2, hyperkalemia, cardiac arrest, 3, periodic paralysis. With regard to the amount of potassium: 10% of the medical records 15ml intravenous drip potassium chloride, potassium chloride 10% of the once-daily oral 20ml, three times a day Second, the actual amount of oral potassium 1, according to the hospitals: 27 nurses on duty to 10% of the patients placed potassium chloride 200ml, 3:00 pm and 6:30 according to the doctor's advice by the nurses fed twice 20ml; 28 day display of the liquid 300ml, 8:00 am and 12 noon: 30 nurse fed by two per 20ml. 27, 28 on the 2nd day of nurses fed a total of 4, 80ml. 28, the night after the transfer of patients, nurses see when finishing million sheets have left more than 200 ml of potassium solution. 2, according to Wang Shugang Wang Shuxian's sister appeals to provide material: 27 patients on the evening meal delivery, telling his brother: the oral medication good (refers to the solution of potassium), a doctor one hour to allow a large population. Hey this is to give service to the night Wei Wan. 28 dinner when fed twice. When the transfer is taking the left there is liquid in the bottle. Two nights fed total of about 200ml. The actual total amount of potassium in recent oral 300ml. Identification and analysis: Based on the application of Wang Shuxian, Xi'an medical technology to identify the two organizations, experts of the Committee held a meeting in accordance with legal procedures to carry out medical event Wang Shugang of experts held a meeting in accordance with legal procedures for conducting a medical event Wang Shugang identification technology. The experts read the detailed patient medical records related to the two sides to listen to both sides of the statements made on the question, both doctors and patients to be avoided, experts carried out a full analysis of the argument that: I, on the diagnosis and treatment: a history based on tips, in line with the diagnosis of this case, "hypokalemic paralysis," the principle of correct treatment. Second, with regard to the cause of death: patients hyperkalemia leading to cardiac arrest the direct cause of death. Third, hyperkalemia occurred in the reasons for the Department of excessive intake. Lead to excessive intake of the Department of patients and their families in the near future to take the super-dose medication (about three times) of potassium chloride; at the same time as a result of health care in patients with inadequate monitoring of the disease, not found in time, discovered that although the levels given to the To deal with rescue and eventually failed to correct hyperkalemia. Identification: According to the State Council, "medical treatment" in the second and the third paragraph 4 of this case for three incidents of medical technology. The two sides of the patient, such as identification of dissenting conclusions can be received in the conclusion to the book on the 15th Shaanxi Province identified Technical Committee for medical re-identification. OO second year on June 29