Two famous historical events which lead to the establishment of the medical ethics committee are presented in this article. We discuss the significance of the medical ethics committee and put forward 5 propositions to enhance the developing of the committee. Firstly, overcome the scruple and accelerate the construction of the medical ethics committee. Secondly, seek for the ethics spirit from the traditional culture, and establish the principles and the conception correspondingly. Thirdly, be creative and try to adapt to the promotion of medicine and society. Fourthly, strengthen the training of bioethics. Finally, promote the communication between ethics review committees.

Objective: To improve the understanding of the clinical feature and early diagnosis of relapsing polychondritis(RP). Method: Eleven patients with RP were analyzed retrospectively and the reported literatures were reviewed. Result: Nine cases had initial involvement of auricular cartilage while two polyarthritis. The treatment of 2RP patients with respiralory tract involvement was invalid and 1 patient died. Nine cases were initially misdiagnosed, with a misdiagnosis rate of 81.82%. Conclusion: RP involves cartilage and connective tissue. The prognosis with respiralory tract involvement is poor. RP is a sort of paroxysmal and progressive inflammation involving cartilages all over the body with a variety of clinical manifestations. Early diagnosis of RP is based on full understanding of its clinical features.

Objective To evaluate the efficacy of minimally invasive percutaneous intervertebral disc approach for treatment of sympathetic cervical spondylosis. Methods Fifty?six patients diagnosed as having sympathetic cervical spondylosis from January 2009 to August 2014, aged 22-64 yr, with the dis?ease course ranged from 6 months to 15 yr and a follow?up period of 6 months, were enrolled in the study. The related minimally invasive approach was selected according to the height of the diseased intervertebral space. When the ratio of the height of diseased intervertebral space∕normal intervertebral space≤1∕3, per?cutaneous radiofrequency ablation was used ( groupⅠ, n=19); when the ratio within the range of 1∕3-2∕3, percutaneous laser disk decompression was used ( groupⅡ, n=12); when the ratio≥2∕3, low?tem?perature plasma radiofrequency ablation was used ( group Ⅲ, n=25) . Before operation, at 2 weeks after operation, and at 1, 3 and 6 months after operation, the sympathetic symptoms were evaluated using the 20?point score. At 2 weeks and 6 months after operation, the patients′ subjective satisfaction was assessed and graded ( excellent, good, medium and poor ) . Results All the patients were followed up for 6 months. The sympathetic symptom scores were significantly lower at each time point after operation in Ⅰand Ⅲ groups and at 2 weeks and 3 and 6 months after operation in group Ⅱ than those before operation
( P<0.05) . The excellent and good rate of patients′subjective satisfaction was 67.9% at 2 weeks after op?eration, and 76.8% in the last follow?up period at 6 months after operation. Conclusion The minimally invasive percutaneous intervertebral disc approach has a marked short?term effect on sympathetic cervical spondylosis.

Objective To explore the risk factors of urolithiasis incidence of migrant workers in Zhongshan,in order to provide the scientific evidence for preventing urolithiasis.Methods 1 630 workshop migrant workers and 1630 office white collar workers were selected as the subjects of this study.The questionnaire was conducted according to the age,gender,genetic factors,occupation,past illness factors,living environment,work environment factors,diet habit,the habit of drinking water survey,B ultrasound examination,the detection of blood uric acid.Results The incidence rate of urolithiasis was 6.53％,the incidence rate of workshop migrant workers was 8.28％,which was significantly higher than that of white collar 4.72％ (x2 =16.972,P ＜0.01).Conclusion Work environment,eating habits,drinking habits,smoking and sweating are related risk factors of urolithiasis.

OBJECTIVE: To improve the understanding of the clinical feature and early diagnosis of relapsing polychondritis (RP). METHOD: Eleven patients with RP were analyzed retrospectively and the reported literatures were reviewed. RESULT: Nine cases had initial involvement of auricular cartilage while two polyarthritis. The treatment of 2RP patients with respiratory tract involvement was invalid and 1 patient died. Nine cases were initially misdiagnosed, with a misdiagnosis rate of 81.82%. CONCLUSION RP involves cartilage and connective tissue. The prognosis with respiratory tract involvement is poor. RP is a sort of paroxysmal and progressive inflammation involving cartilages all over the body with a variety of clinical manifestations. Early diagnosis of RP is based on full understanding of its clinical features.
Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Middle Aged ; Polychondritis, Relapsing ; diagnosis ; therapy ; Prognosis ; Retrospective Studies ; Young Adult

Objective :To explore influence of acupuncture combined butylphthalide soft capsule on cognitive function and head MRI imaging in patients with vascular dementia (VD).Methods : A total of 94 VD patients treated in our hospital were randomly and equally divided into butylphthalide group (received butylphthalide soft capsules ) and combined treatment group (received acupuncture pericardial acupoint treatment based on butylphthalide group ) ,both groups received controls of blood pressure and blood lipids ,anti—infection intervention ,and continuously treated for eight weeks .Mini—mental state ex—amination (MMSE) and clinical dementia rating scale (CDR) were used to assess cognitive function ,related head MRI in—dexes ,plasma levels of somatostatin (SS) and arginine vasopressin (AVP ) were measured.Results : Compared with bu—tylphthalide group after treatment ,there was significant rise in total effective rate (78.72% vs.93.62%) , P＝0.036 ;sig—nificant rise in MMSE score [ (19.18 ± 3.24) scores vs.(21.15 ± 4.11) scores] and significant reduction in CDR score [ (1.51 ± 0.26) scores vs.(1.37 ± 0.28) scores] , P＜0.05 both ;MRI indexes :significant reduction in width of three brain ventricles [(1.12 ± 0.13) cm vs.(1.03 ± 0.19) cm] ,and significant rise in anterior angle index [ (3.08 ± 0.96) vs. (3.54 ± 0.85)] and lateral brain ventricle body width index [ (3.19 ± 0.18) vs.(3.32 ± 0.21)] ,P＜0.05 or ＜0.01 ;sig—nificant rise in plasma levels of SS [ (133.59 ± 10.11) pg／ml vs.(139.14 ± 10.56) pg／ml] and AVP [ (35.37 ± 9.12) pg／ml vs.(40.25 ± 8.08) pg／ml] in combined treatment group , P＜0.05 or ＜0.01. There were no severe adverse reactions in either group .Conclusion : Acupuncture combined butylphthalide soft capsule can significantly improve cognitive function , plasma SS and AVP levels ,inhibit brain ventricle dilation ,promote brain function recovery in patients with vascular de—mentia ,and safety is high .

OBJECTIVE: To explore a method for locating the area of lacrimal sac in dacryocystorhinostomy under endoscopy. METHOD: Sixty-eight patients were performed dacryocystorhinostomy under endoscopy. Take light spot of ocular optic fiber as the lacrimal sac projection to the lateral wall of the nasal cavity position. RESULT: With the guiding of ocular optic fiber, lacrimal sac can be located accurately. The operating time of dacryocystorhinostomy under endoscopy was shortened significantly, and the operation procedure was simplified. All patients were followed up for 2 years, only 2 recurrent cases were found. The success rate reach to 97.06% (66/68). CONCLUSION Ocular optical fiber used in locating the lacrimal sac in dacryocystorhinostomy under endoscopy is simple and feasible, and can be widely used.
Adult ; Dacryocystitis ; surgery ; Dacryocystorhinostomy ; methods ; Endoscopy ; Female ; Fiber Optic Technology ; Humans ; Male ; Middle Aged ; Nasolacrimal Duct ; surgery ; Recurrence ; Treatment Outcome

Objective To investigate the effect of berberine chloride on autophagy and β-secretase (BACE) level in mice with traumatic brain injury (TBI).Methods Eighteen female healthy C57BL/6 mice were randomly divided into three groups:control group,model group and berberine group (n=6).TBI models in the later two groups were established by a weight-drop hitting device and mice in berberine group were administered intragastricly with berberine chloride (50 mg/kg) once daily for 21 d.Immunofluorescent staining were used to assess LC3 and BACE expressions in ipsilateral cortex or thalamus,and then,their mean fluorescence intensities were calculated and compared among these three groups.Results LC3 expression in the ipsilateral cortex and thalamus and BACE expression in the ipsilateral cortex (0.02±0.01,0.06±0.02 and 0.04±0.01 in the control group,model group and berberine group) showed significant difference among the three groups (P＜0.05):LC3 expression in ipsilateral cortex and thalamus and BACE expression in the ipsilateral cortex of the model group were significantly increased as compared with those of the control group (P＜0.05);the LC3 expression in the ipsilateral cortex and thalamus and BACE expression in the ipsilateral cortex of the model group were significantly decreased as compared with those of the berberine group (P＜0.05).Conclusion Autophagy is over-activated in the ipsolateral cortex and thalamus and BACE is over-activated in the ipsolateral cortex after TBI,and these changes are significantly suppressed by berberine chloride.

Objective To determine the risk factors for postoperative hyperactive-type delirium (PHTD) in elderly patients undergoing orthopedic surgery.Methods A total of 7 171 elderly patients of both sexes,aged more than or equal to 65 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅳ,who underwent orthopedic surgery from January 2008 to December 2012 in Second Affiliated Hospital of Wenzhou Medical University,were retrospectively analyzed.Data such as gender,age,preoperative electrolytes,blood glucose,hemoglobin,albumin,senile dementia and use of benzodiazepines,type of operation,anesthesia methods,operation time,intraoperative use of anticholinergic agents and benzodiazepines and hypotension (decrease more than 20％ of the baseline),and postoperative electrolyte,hemoglobin,albumin and hypotension were collected.The patients were divided into postoperative PHTD group (group PHTD) and postoperative non-PHTD group (group non-PHTD) according to whether PHTD developed within 7 days after operation.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression to stratify the risk factors for postoperative PHTD.Results Ninety-nine patients developed PHTD,and the incidence was 1.38％.The results of logistic regression analysis showed that age more than or equal to 80 yr,hip surgery and preoperative anemia were independent risk factors for postoperative PHTD (P＜0.05).Conclusion Age more than or equal to 80 yr,hip surgery and preoperative anemia are independent risk factors for postoperative PHTD in elderly patients undergoing orthopedic surgery.