The event of “diagnosing mental disorder but actually not” violates patients′right of informed con-sent and refused to health , showing some problems of “diagnosing mental disorder but actually not” and mandatory admission process and psychiatric judicial authentication , and also have some ethical problems .Therefore, relevant departments should perfect the laws and regulation , establish a hospitalized psychiatric patients appeal , the appeal channels , at the same time , physicians should follow a correct understanding , respect patients rights , disinterest-ed, the ethical principles of self -supervision and also use constraints should be regulated .

OBJECTIVE:To evaluate the effect of temozolomide(TMZ)in combination with dexamethasone(DXM)on the proliferation of human gliocytoma U251 cells in vitro.METHODS:Human U251 cells were assigned to 1 of the 3 groups: TMZ(10,25,50,100,200,400?mol?L~(-1),respectively)alone or in combination with 40?mol?L~(-1)DXM(TMZ+DXM group)or control group(none drug).After treatment for 72 hours,the cell morphology,cell inhibition ratio,cell cycle and the apoptotic rate were detected.RESULTS:When TMZ concentration was greater than 100?mol?L~(-1)the cell inhibition ratio was higher in TMZ-treated group than in TMZ+DXM-treated group(P

Pituitary adenylate cyclase-activating polypeptide (PA CAP) which belongs to the secretin/glucagon/VIP family has been originally isola ted from the sheep hypothalamus on the basis of its ability to stimulate cAMP fo rmation in culture rat anterior pituitary cells. Post-translational processing of the PACAP precursor generates two biologically active molecular forms, PACAP -38 and PACAP-27. The primary structure of PACAP has been remarkably conserved during evolution. The sequence of PACAP-27 exhibits substantial similarities w ith those of vasoactive intestinal polypeptide (VIP), glucagon and secretin. The gene encoding the PACAP precursor is widely expressed in brain and various peri pheral organs, notably in endocrine glands, gastro-intestinal，uro-genital tra cts and respiratory system. In vivo and in vitro studies have shown that PACAP exhibits multiple activities especially a trophic activity during ontogen esis, notably in the adrenal medulla and the central nervous system. The biologi cal effects of PACAP are mediated through three distinct receptor subtypes which exhibit differential affinities for PACAP and VIP. The PAC1 receptor, which sho ws high selectivity for PACAP, is coupled to several transduction systems. In co ntrast, VPAC1 and VPAC2, which bind with the same affinity for PACAP and VIP, ar e mainly coupled to the adenylyl cyclase pathway. In conclusion, PACAP is neurop eptide, and it functions as a hypothalamic hormone, neurohormone, neuromodulator , vasodilator, neurotransmitter or trophic factor in the brain and the various o rgans.

Through the review on the 2 months visit to College of Nursing of Michigan State University,I'd like to share the ideas with others.The conten of nursing education,clinical nursing,nursing research and patient safety to improve quality of nursing education.

Ongoing improvement of the laws, rules and regulations are putting the diagnosis and verification of occupational diseases in China onto a legal and standard track. A case study of the "Pneumouconiosis event" of migrant worker Z in 2009 analyzed the challenges and causes of such system.In addition, the authors probed into the fundamental principles to follow in the diagnosis and verification,and raised recommendations for a better diagnosis and verification system in China.

Mesenchymal stem cells(MSCs) can directly act on tumor cells to inhibit their growth,and could also migrate to the tissue lesions and tumor tissues to transfer and express many kinds of anti-cancer factors.Numerous researches have applied MSCs as carriers of drugs to induce apoptosis,inhibit differentiation of tumor cells and inhibit tumor angiogenesis,and have got outstanding antitumor results.

ObjectiveTo assess the sepsis score used for detecting the mortality of patients with sepsis in emergency department, and to compare with APACHE Ⅱ score, simplified acute physiology Ⅱ score ( SAPS Ⅱ ) and modified early warning score (MEWS) in terms of 28-day mortality of patients. Methods A total of 613 patients with sepsis were enrolled from the emergency department for a prospective study from September 2009 to September 2010. The sepsis score, APACHE Ⅱ score, SAPS Ⅱ score and MEWS score all were recorded and compared. The patients with sepsis were followed up for 28 days. Based on the sepsis score, patients with sepsis were stratified into 5 mortality risk groups, namely very low risk group (0～4 points), low risk group (5 ～7 paints), moderate risk group (8 ～ 12 points), high risk group ( 13 ～ 15points) and very high risk group (more than 15 points). The actual mortality rates were compared among all 5 groups by using Chi square test. Then, comparison between survivors and non-survivors carried out with logistic regression analysis to determine the independent risk factors of mortality.Receiver operating characteristic curve (ROC curve) was used to compare the sepsis score with APACHE Ⅱ score, SAPS Ⅱscore and MEWS in respect of the prognosis validity. ResultsTen patients were out of the follow-up and the data of 603 patients followed up were completely documented. The actual mortality rates of 5 risk groups were 0％, 7.7％, 18.5％, 46. 7％ and 63％, respectively. There were significant differences in age and four scoring systems between survivors ( n = 440) and non-survivors ( n = 163 ) ( P ＜ 0. 01 ). Sepsis score,APACHE Ⅱ score, SAPS Ⅱ and MEWS all were valid and eligible for detecting the risk of mortality in patients with sepsis. The ROC areas under the curve (AUC) of these 4 scoring systems were 0. 767, 0. 743,0. 741 and 0. 636, respectively. ConclusionsThe sepsis score can be used to stratify patients with sepsis according to mortality risk with better sensitivity to predict 28-day mortality. It is rational for evaluation in prediction of patients with sepsis in Emergency Department.

Objective To investigate the risk factors and the characteristic patterns of development changes of macrosomia.Methods 208 cases of macrosoroia were collected.Then the risk factors related to macrosomia by use of Logistic regression analysis were researched.208 infants of normal birth weight were selected as control group.The weight and length in 8 growth development monitoring time according to their health care manual were recorded.Mental development index(MDI)and physical development index(PDI)were tested and calculated by CDCC method when macrosomia and normal birth weight infants were 30 months.The characteristic patterns of development changes of macrosomia wre analyzed statistically.Results The risk factors of macrosomia contain age and height of the pregnant women,weight before pregnancy,weight increasing during pregnancy,nutriture,physical activity,family history of obesity and father's weight.Macrosomia was weighter than normal birth weight infants in the 8 growth development monitoring time and was longer than normal birth weight infants from 3 to 30 months(P ＜0.05).However,the length of macrosomia was not significantly different with that of control group when they were 36 months(P ＞ 0.05).MDI and PDI in macrosomia group were(107.33 ± 7.29)and(104.71 ± 6.93)respectively.MDI and PDI of normal birth weight infants group were(112.58 ± 7.61)and(109.09 ± 7.14)respectively.The differences were statistically significant(t =4.28,5.33;both P ＜ 0.01).Conclusion There were several risk factors for macrosomia such as environment and heredity.At the period of infants and young children,macrosomia were weighter than normal birth weight infants.The mental development and psycho-moter development of macrosomia were behind normal birth weight infants.

Mechanical ventilation plays an important role in the treatment of preterm infants,especially respiratory problems.With improvement in both antenatal and neonatal care and therapeutic strategies,premature babies are surviving more than ever.However,the incidence of bronchpulmonary dysplasia remains high which affects the clihical outcomes of premature infants.Non-invasive respiratory support techniques have been used in attempts to decrease lung injury and the complications of preterm infants.This review will focus on various ventilation modalities for managing preterm infants with respiratory failure and lung protective ventilation strategies to minimize lung injury in preterm infants.