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

With Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9) for instance, the three acupoints used to treat shoulder bi syndrome by needle knife, and through traceability and researching constant structure, the acupoint position, insertion trace, manipulation and clinical significance of needle knife medicine were discussed. Accurate position is one of the characteristics of acupoints selection of needle knife medicine. As for the acupoints selection method, the mean of body surface localization is always used. The phanerous or palpable bone processes, muscles and tendons are taken as positioning marks; pressing areas where appear sour, numb, or distensible and other sensations is considered as the principle of press positioning. So acupoints position method is the combination of observation and palpation. Different insertion methods can effectively relieve the accretive bursae synovialis, tendon, joint capsule and the compressed nerve, so that shoulder bi syndrome is relieved.
Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Humans ; Needles ; Periarthritis ; therapy

Objective To analyze the variation of peripheral blood Th17 cells and Foxp3+CD4+CD25+regulatory T (Treg)cells in patients with ankylosing spondylitis (AS),and to interpret the role of the ratio imbalance of peripheral blood Th17/Treg cells in the pathogenesis of AS.Methods The percentage of peripheral blood Th17 cells and Foxp3 +CD4+CD25+ Treg cells in AS patients and healthy subjects were determined by flow cytometry (FCM).The concentrations of IL-2,IL-10,TGF-β,IL-6,IL-17 and IL-23 in the serum were measured by enzyme linked immunosorbent assay.The correlation between these cytokines and traditional parameters was analyzed.T test,ANOVA,SNK-q and Speannan's analysis were used for statistical analysis.Results Compared with healthy controls,the percentage of Th17 cells in AS patients increased significantly (P＜0.05); Compared with the inactive AS patients,the percentage of Th17 cells in active AS patients increased significantly [(2.10±0.82)％,(2.89±1.77)％,P＜0.05)]; the percentage of Foxp3+CD4+CD25+ Treg cells in active AS patients was markedly lower than healthy controls (P＜0.05).Compared with healthy controls and inactive AS patients,the specific value of Th17/Treg in active AS patients increased significantly(P＜0.05).The concentrations of IL-17 and IL-23 was found significantly higher in patients with AS than that in healthy controls (t=2.203,P=0.032 and t=2.088,P=0.041).The concentrations of IL-17 and IL-23 was found significantly higher in patients with active AS than that in inactive AS (t=2.808,P=0.008 and t=2.242,P=0.020).The correlation analysis revealed that these cytokines and traditional parameters was not relevant except IL-17/BASDAI (r=0.32,P=0.044).Conclusion The increased ratio of Th17 cells and decreased ratio of Foxp3+CD4+CD25+ Treg cells may play a critical role in AS progression.Manipulating the balance of Th17/Treg would provide a new approach for the treatment of AS.

Objective To evaluate the efficacy and safety of dexmedetomidine combined with propofol for gastroscopy in elderly patients.Methods Ninety ASA physical status Ⅰ-Ⅲ patients,aged 65-80 yr,weighing 45-80 kg,scheduled for elective gastroscopy,were randomized to receive either dexmedetomidine combined with propofol (group DP,n =45) or propofol (group P,n =45).In group DP,dexmedetomidine 0.4 μg/kg was infused over 5 min and propofol 1.0 mg/kg was injected intravenously 25 min later.Propofol 2.0 mg/kg was injected intravenously in group P.When body movement occurred during operation,additional propofol 0.2 mg/kg was given intermittently.Mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2) and Narcotrend index were monitored during the whole procedures.The consumption of propofol and vasoactive agents,adverse cardiovascular events,and respiratory depression were recorded.Results Compared with group P,the consumption of propofol,incidences of respiratory depression and tachycardia,and degree of body movement were significantly decreased (P ＜ 0.05),Narcotrend index was increased during operation (P ＜ 0.01),and no significant change in the incidence of circulatory depression was found in group DP (P ＞ 0.05).Conclusion Small dose of dexmedetomidine 0.4 μg/kg combined with small dose of propofol 1.0 mg/kg provides good efficacy and safety for gastroscopy in elderly patients.

Objective To explore the risk factors and imaging features of silent brain infarction (SBI).Methods The patient with SBI from the clinic were enrolled in the study,and the patients with symptomatic non-lacunar infarction served as controls.The risk factors and imaging features of both groups were compared.Results Among 145 patients with SBI,133 (91.72％) had two or more lesions,mainly in the centrum semiovale (73.10％).The proportion of patients with white matter lesions in the group of SBI in a single location was significantly lower than that in the group of SBI in multiple locations (41.67％ vs.73.68％ ;x2 =5.484,P =0.019).Compared to the patients with SBI,the age in patents with symptomatic non-lacunar infarction was older (72.42 ± 11.79 vs.67.03 ± 12.04 years; t =3.545,P =0.000),the proportions of male (63.55％ vs.46.21％ ;x2 =7.447,P =0.006),hypertension (80.37％ vs.64.14％ ; x2 =7.887,P =0.005) and atrial fibrillation (31.78％ vs.8.97％,x2 =21.113,P =0.000),as well as the levels of fasting glucose (6.09 ±1.23 mmol/Lvs.5.65± 1.18 mmol/L; t=2.863,P=0.005),total cholesterol (5.53± 0.74 mmol/Lvs.5.27 ± 0.90 mmol/L; t =2.554,P =0.011),triglycerides (1.89 ± 0.20 mmol/L vs.1.77 ± 0.18 mmol/L; t =4.910,P=0.000) and homocysteine (1 4.88 ±4.97 mmol/L vs.11.94 ±4.61 mmol/L; t =4.432,P =0.000)were higher.However,the lipoprotein (a) level was lower (0.18 ± 0.06 g/L vs.0.27 ± 0.18 g/L; t =-5.489,P =0.000).Among patients with SBI,33.8％ and 43.5％ had lesions in two and three locations,respectively;among patients with symptomatic non-lacunar infarction,66.4％ and 27.1％ had lesions in a single location and two locations,respectively (P ＜ 0.001).Multivariate logistic regression analysis showed that lipoprotein (a)was the independent risk factor for SBI (odds ratio 5.988,95％ confidence interval 2.421-14.706; P =0.000).Conclusions Although they shared a variety of common risk factors,patients with SBI had less atherosclerotic risk factors than those with symptomatic non-lacunar infarction.Most patients with SBI had lesions in multiple locations.

Objective To investigate the risk factors of progressive intracerebral hematoma (PIH) in severe traumatic brain injury (STBI) and provide reference for diagnosis and treatment of STBI.Methods The clinical information of 96 patients of STBI from March 2008 to March 2012 were retrospectively analyzed,the risk factors of PIH were analyzed by the univariate and multivariate Logistic regression analysis.Results Thirty-six patients occurred PIH,the incidence rate of PIH was 37.5％ (36/96).The univariate regression analysis showed that the age,admission GCS scores,injury to the first CT time,brain contusion,subarachnoid hemorrhage,epidural hematoma,subdural hematoma had certain relation with PIH (P ＜ 0.01or ＜ 0.05).Multivariate Logistic regression analysis showed that the age,brain contusion,subarachnoid hemorrhage,epidural hematoma,subdural hematoma were risk factors of PIH (P ＜0.05 or ＜0.01).Conclusion Fully aware of the risk factors of PIH and timely intervention is the key to reduce the morbidity and mortality of STBI.

Objective To evaluate risk factors of restenosis of vertebral artery origin after stenting.Methods A total of 144 continuous cases were collected for this retrospective analysis.More than 50％ of stenosis in the original sites after treatment was defined as restenosis.Patients were divided into restenosis group (39 patients) and none-restenosis group (105 patients).The risk factors associated with restenosis were compared between the two groups by Chi-square test,including sex,age,presence of hypertension,diabetes,coronary heart disease,hyperlipidemia,smoking and drinking,the difference of preoperative neurological symptoms,combination with other vessels,stenosis,as well as stent type and stent size.Logistic regression was used to test the risk factors for restenosis.Results The incidence of restenosis of vertebral artery origin after stenting was 26.4％,and all of them occurred in 5 months.Between the two groups,there was no significant difference of distribution of sex (male 89,female 34,x2 =0.804,P =0.370),age(60 vs 21 patients of more than 60 years old,x2 =2.358,P =0.125),hypertension (67 vs 28 patients,x2 =0.253,P =0.615),diabetes (27 vs 9 patients,x2 =0.914,P =0.91),hyperlipidemia (6 vs 5 patients,x2 =0.478,P =0.489),coronary heart disease(32 vs 6 patients,x2 =2.489,P =0.115),smoking (50 vs 24 patients,x2 =0.129,P =0.719),drinking(20 vs 13 patients,x2 =0.001,P =0.978),diameter of stents (53 vs 18 patients of more than 4 mm,x2 =0.213,P =0.645),length of stents (45 vs 19 patients of more than 15 mm,x2 =0.927,P =0.336),preoperative neurological symptoms (93 vs 29 patients,x2 =0.250,P =0.617).There was significant difference of factors including combination with the bilateral stenosis (43 vs 24 patients,x2 =4.844,P =0.028),combination with the internal carotid artery stenosis(49 vs 26 patients,x2 =4.558,P =0.033) and stent types(59 vs 11 patients of drug eluting stent,x2 =8.916,P =0.003) between the two groups.Bare stents and combination with internal carotid artery stenosis were independent risk factors for restenosis by logistic regression.Conclusions The incidence of restenosis with vertebral artery origin occurs in 5 months after surgery.Bare stents and combination with internal carotid artery stenosis increased the incidence of restenosis,and preoperative neurological symptoms of vertebrobasilar system and presence of the bilateral stenosis may induce restenosis.

Objective To investigate the predictive value of serum histone deacetylase 3(HDAC3) ,cystatin C(CysC) and albu‐min levels on a large area of myocardial infarction .Methods According to whether heart failure and (or) cardiogenic shock occur‐ring during hospitalization ,102 patients with acute myocardial infarction(AMI) were divided into the two groups :the non - compli‐cating heart failure and (or) cardiogenic shock group(n= 63) and the complicating heart failure and (or) cardiogenic shock group(n= 39) .Then according to whether the creatine kinase(CK‐MB) peak value was greater than 200 IU /L ,102 AMI patients were di‐vided into two groups :CK‐MB peak values ≥ 200 IU /L group(n= 58) and the CK‐MB peak values < 200 IU / L group(n= 44) .The serum HDAC3 ,CysC and albumin levels were detected at early morning on 2 d of admission in all patients .Results Compared with the non - complicating heart failure and (or) cardiogenic shock group ,serum HDAC3 and CysC levels in the the complicating heart failure and (or) cardiogenic shock group were significantly increased(P< 0 .01) ,while serum albumin protein level was significantly in the occurrence of heart failure and(or)cardiogenic shock group .Compared with the CK‐MB peak value < 200 IU /L group ,serum HDAC3 and CysC levels in the CK‐MB peak value > 200 IU /L group were significantly increased (P< 0 .01) ,while serum albumin level was significantly decreased(P< 0 .01) .Conclusion Serum HDAC3 ,CysC and albumin levels have certain predictive value on a large area of myocardial infarction and conduce to judge the prognosis of patients .