In the process of responding to public health emergencies,the conflicts between the principles of management and ethics are constantly revealed.Combining with a unit's practical experiences of participating in several major public health emergencies,this paper put forward that it should take into account both the rescue and notification to achieve the unity of effective rescue and informed consent;take into account both the enforcement and obedience to achieve the unity of the interest of groups and individuals;take into account both the equality and priority to achieve the unity of urgency priority and equal opportunity;take into account both the rescuing and suf-fering to achieve the unity of interest between the rescuers and the victims,and thus to provide references for the reasonable solution of the ethical conflicts in the process of responding to public health emergencies.

OBJECTIVETo explore the relationship between the alteration in GGT mRNA expression and the development of HCC.

METHODSThree GGT mRNA types (F, H, and P) in normal liver tissues, diseased liver tissues without HCC, cancerous and noncancerous tissues from livers with HCC, and noncancerous tissues from livers with metastatic tumor were tested by RT-PCR.

RESULTSIn normal livers, the main type of GGT mRNA was type F. In liver diseases but not HCC, the distribution of the type GGT mRNA was nearly the same as in normal livers. The prevalence of type H was significantly higher in both cancerous and noncancerous tissues of livers with HCC than in livers without HCC (P<0.05). The prevalence of type F in cancerous tissues was significantly lower than that in livers without HCC (P<0.05).

CONCLUSIONSThe GGT mRNA expression in the human liver will shift from type F to type H during the development of HCC. The fragment analysis of GGT genes may be a sensitive assay to detect hepatic cell canceration.

Carcinoma, Hepatocellular ; enzymology ; genetics ; pathology ; Female ; Gene Expression Regulation, Enzymologic ; Humans ; Liver ; enzymology ; metabolism ; pathology ; Liver Diseases ; enzymology ; genetics ; pathology ; Liver Neoplasms ; enzymology ; genetics ; pathology ; Male ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; gamma-Glutamyltransferase ; genetics

Objective To investigate the relationship between surgical timing and outcomes of aneurysmal subarachnoid hemorrhage (aSAH).Methods The patients with aSAH retrospectively received clipping or endovascular embolization.Their demographic and clinical data were collected.The modified Rankin Scale (mRS) was used to evaluate the outcomes at 6 month after procedure.Univariate and multivariate logistic regression analyses were used to determine the risk factors that influencing clinical outcomes of patients.Results A total of 198 patients with aSAH were enrolled,118 had good outcome (mRS score0-2),80 had poor outcome (mRS score ＞2; 20 of them died); 32 were early operation (operated within 2 d after onset) and 166 were late operation.Univariate analysis showed that the proportions of hypertension (29.66％ vs.52.50％ ; x2 =10.464,P =0.001),cerebral infarction (11.86％ vs.35.00％ ;x2 =15.269,P ＜0.001),cerebral hemorrhage (9.32％ vs.31.25％ ;x2 =15.410,P ＜0.001),Fisher grade 3-4 (22.88％ vs.47.50％ ; x2 =13.104,P ＜ 0.001),Hunt-Hess grade Ⅳ to Ⅴ (19.49％ vs.52.50％ ;x2 =23.557,P ＜0.001),cerebral vasospasm (5.93％ vs.25.0％ ;x2 =14.719,P ＜0.001),hydrocephalus (5.08％ vs.17.50％ ;x2 =8.093,P =0.004),and late operation (78.81％ vs.91.25％ ; x2 =5.442,P =0.020) in patients of the good outcome group were significantly higher than those of the poor outcome group.Multivariatelogistic regression analysis showed that Fisher grade 3 to 4 (odds ratio [OR] 9.13,95％confidence interval [CI] 2.98-13.45; P ＜0.001),Hunt-Hess grade Ⅳ to Ⅴ (OR 6.86,95％ CI 1.57-12.34; P＜0.001),accompanied with hydrocephalus (OR 2.59,95％ CI 1.17-4.31; P=0.024),and late operation (OR 2.17,95％ CI 1.12-3.95; P=0.029) were the independent risk factors for patients with poor clinical outcomes.The univariate analysis for both early operation and late operation groups showed that only the good outcome rate of the early operation group was significantly higher than that of the late operation group (78.13％ vs.56.2％ ;x2 =5.442,P =0.020),and there were no significant differences in the incidences of rebleeding (6.25％ vs.13.25％; x2=1.235,P=0.266),cerebral vasospasm (12.50％ vs.19.28％;x2 =0.042,P=0.834),and hydrocephalus (12.50％ vs.9.64％;x2 =0.242,P=0.623).Conclusion Early operation may significantly improve the outcomes in patients with aSAH.

Objective:To investigate the ethical significance of the extracorporeal circulation membrane oxy-genation ( ECMO) in the donation organ transplantation .Methods: Analyzing the data of ECMO protected to the organ in 13 donors after brain death , Accounting the rising costs which caused by ECMO and make the interview to the patients and family members .Results:In the period of ECMO flow , the hemodynamic of the DBD donors be-come stable gradually , the medications reduced significantly or stop , the function of organs was restored .There were 38 organs can be used for the transplantation which were proven by the pathological biopsy .Twenty six kid-neys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed .Medical cost of this patients increase 5.3%, all of the family members and patients can accept the intervention of ECMO .Conclusion:ECMO is an effective method to protect and improve the utili-zation rate of the organ .the improvement of the related technical standards , legal, laws and ethics of staff will pro-mote to the development of organ transplantation .

Objective To investigate the alexithymia, mental health condition and their relationship in female rheumatoid arthritis patients. Methods Fifty-four female patients with rheumatoid arthritis and 50 healthy women were enrolled and assessed with Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20) and the symptom checklist-90(SCL-90). Disease duration and DAS28 of the patients were also recorded and calculated. The data were statistical analyzed by t test between the two groups and other block groups. The association between TAS-20, SCL-90, duration and DAS28 was assessed using Spearman corre-lations. Results ① The TAS-20 total score and Tf1, Tf2, Tf3 factors score of female rheumatoid arthritis patients were significantly higher than those of the control group (57±9, 51±7, t=4.15, P<0.01); it was also the same with the total score and factors score of SCL-90 (beside the paranoid factor) between patients and control groups (165±50, 138±41, t=3.06, P<0.05). ② Correlation analysis showed significantly positive correlation between Tf1 factor and all factors of SCL-90, also between Tf3 factor and obsession-compulsion, interpersonal sensitivity, phobias and paranoid factors(P<0.05). ③ Only hostility factor was different between the higher TAS-20 total score group and the lower one. However, the obsession-compulsion, anxiety and phobias factors scores of the higher Tf1 score group were significantly higher than those of the lower one (P<0.05); The higher Tf3 score group was significantly different from the lower one in obsession-compulsion, interpersonal sensitivity, depression, hostility, paranoid and psychoticism factors (P<0.05). The Tf1 factor score of higher SCL-90 total score group was significant higher than that of the lower one (P<0.05). ④ There were significantly positive correlation between duration and depression and paranoid factors, also between
DAS28 and anxiety and paranoid factors (P <0.05). Conclusion There is obvious alexithymia and psychological problems in female rheumatoid arthritis patients; the Tf1 and Tf3 factors of TAS-20, duration and DAS28 are all major factors related to the psychological state.

Objective To study the immunosuppressive mechanism of alkaloid sinomenine (SIN) by observing the effects of SIN on the proliferation and intracellular protein expression levels of nuclear factor of activated T cells (NF-AT) and interferon-gamma (IFN-γ) in CD4+ T lymphocytes of human periphery blood. Methods CD4+ T lymphocytes were isolated from PBMC suspensions with immunomagnetic beads and divided into five groups to culture. (1) Negative control group: no medicine was added to cell culture medium; (2) Positive control group: CsA solution (final concentration: 50ng/ml) was added to cell culture media; (3) Low-concentration SIN group (L-SIN): low-concentration SIN solution (final concentration: 10 μmol/L) was added to cell culture media; (4) Middle-concentration SIN group (M-SIN): middle-concentration SIN solution (final concentration: 200 μmol/L) was added to cell culture media; (5) High-concentration SIN group (H-SIN): high-concentration SIN solution (final concentration: 1000 tmol/L) was added to cell culture media. The proliferations of CD4+ T lymphocytes were observed. Western blotting was performed to detect the protein expression levels of NF-AT. FCM was used to determine the levels of IFN-γ. Results Compared with negative control group, the cell proliferation was significantly inhibited in H- and M-SIN groups (P＜0. 01 ). SIN concentration-dependently inhibited the protein expression levels of NF-AT and IFN-γ in CD4+ T lymphocytes of human periphery blood (P＜0.01). The protein expression levels of NF-AT and IFN-γ were lowest in positive control group. There was a close negative correlation between intracellular levels of NF-AT and cell proliferation inhibition ratio in CD4+ T lymphocytes of human periphery blood (rs = - 0. 969, P = 0. 000). Conclusion SIN can inhibit the protein expression of NF-AT and IFN-γ in CD4+ T lymphocytes of human periphery blood probably by decreasing protein levels of NF-AT to inhibit the activity and proliferation of CD4+ T lymphocytes.

Objective To establish a stable and efficient method of culturing imDCs in vitro,and to explore the effect of GW5074, which blocks ERK1/2 signal pathway in the process of imnature dentritic cells (imDCs) on inducing differentiation of the na(i)ve allogeneic CD4+ T cells into Treg cells in vitro. Methods The imDCs and mature DCs (mDCs) were isolated and cultured from the peripheral blood mononuclear cells (PBMC) derived from a healthy adult male volunteer, and they were identified by cell morphology, cell surface marker and cell functions respectively. Na(i)ve CD4+ T cells were isolated from newborn umbilical vein blood and were divided into 5 groups to be cultured: (1) Blank control group: Na(i)ve CD4+ T cells were cultured alone;(2) Positive control group: The irrDCs were Middle-concentration GW5074 group;(5) High-concentration GW5074 group. In the last three groups, imDCs and na(i)ve CD4+ T cells were co-cultured, the same as the positive control group, but these groups were added by GW5074 dilution at the concentrations of 8, 24, and 40μmol/Lrespectively. After co-culture for 5 days, the transformation ratio from naive CD4+T cells to Treg T cells was detected by flow cytometry. Results On the surface of imDCs, there was stronger pression of CD1a, but weaker expression of CD80 and CD83. On the contrary, on the surface of mDCs, there was weaker expression of CD1a, but stronger expression of CD80 and CD83. The stimulation index in imDCs group and mDCs group was 1.12±0.03 and 2.85±0. 07 respectively. The transformation ratio of Treg T cells in blank control group, positive control group, low-concentration GW5074 group, middle-concentration GW5074 group and high-concentration GW5074 group was (5. 81±1.36)%, (35.73±2.07)%, (22.53±2.11)%, (11.55±1.73)%, and (4.97±1.83)%respectively. One-way ANOVA analysis revealed that there was no significant difference between high-concentration GW5074 group and blank control group, P＞0. 05, but significant difference between the remaining groups, P＜0.01. Conclusion High purity of imDCs can be obtained from PBMC by induction with rhGM-CSF and rhIL-4. ERK1/2 signal pathway plays a role in inducing the immune tolerance. GW5074 can inhibit differentiation of na(i)ve CD4+ T cells into Treg T cells.

The objective of this study was to genetically characterize isolates of Giardia duodenalis and to determine if zoonotic potential of G. duodenalis could be found in stray cats from urban and suburban environments in Guangzhou, China. Among 102 fresh fecal samples of stray cats, 30 samples were collected in Baiyun district (urban) and 72 in Conghua district (suburban). G. duodenalis specimens were examined using light microscopy, then the positive specimens were subjected to PCR amplification and subsequent sequencing at 4 loci such as glutamate dehydrogenase (gdh), triose phosphate isomerase (tpi), beta-giardin (bg), and small subunit ribosomal RNA (18S rRNA) genes. The phylogenetic trees were constructed using obtained sequences by MEGA5.2 software. Results show that 9.8% (10/102) feline fecal samples were found to be positive by microscopy, 10% (3/30) in Baiyun district and 9.7% (7/72) in Conghua district. Among the 10 positive samples, 9 were single infection (8 isolates, assemblage A; 1 isolate, assemblage F) and 1 sample was mixed infection with assemblages A and C. Based on tpi, gdh, and bg genes, all sequences of assemblage A showed complete homology with AI except for 1 isolate (CHC83). These findings not only confirmed the occurrence of G. duodenalis in stray cats, but also showed that zoonotic assemblage A was found for the first time in stray cats living in urban and suburban environments in China.
Animals ; Cat Diseases/*parasitology ; Cats ; China ; Cluster Analysis ; DNA, Protozoan/chemistry/genetics ; DNA, Ribosomal/chemistry/genetics ; Feces/parasitology ; Giardia lamblia/*classification/cytology/genetics/*isolation & purification ; Giardiasis/parasitology/*veterinary ; Microscopy ; Molecular Sequence Data ; Phylogeny ; Protozoan Proteins/genetics ; RNA, Ribosomal, 18S/genetics ; Sequence Analysis, DNA

The objective of this study was to genetically characterize isolates of Giardia duodenalis and to determine if zoonotic potential of G. duodenalis could be found in stray cats from urban and suburban environments in Guangzhou, China. Among 102 fresh fecal samples of stray cats, 30 samples were collected in Baiyun district (urban) and 72 in Conghua district (suburban). G. duodenalis specimens were examined using light microscopy, then the positive specimens were subjected to PCR amplification and subsequent sequencing at 4 loci such as glutamate dehydrogenase (gdh), triose phosphate isomerase (tpi), beta-giardin (bg), and small subunit ribosomal RNA (18S rRNA) genes. The phylogenetic trees were constructed using obtained sequences by MEGA5.2 software. Results show that 9.8% (10/102) feline fecal samples were found to be positive by microscopy, 10% (3/30) in Baiyun district and 9.7% (7/72) in Conghua district. Among the 10 positive samples, 9 were single infection (8 isolates, assemblage A; 1 isolate, assemblage F) and 1 sample was mixed infection with assemblages A and C. Based on tpi, gdh, and bg genes, all sequences of assemblage A showed complete homology with AI except for 1 isolate (CHC83). These findings not only confirmed the occurrence of G. duodenalis in stray cats, but also showed that zoonotic assemblage A was found for the first time in stray cats living in urban and suburban environments in China.
Animals ; Cat Diseases/*parasitology ; Cats ; China ; Cluster Analysis ; DNA, Protozoan/chemistry/genetics ; DNA, Ribosomal/chemistry/genetics ; Feces/parasitology ; Giardia lamblia/*classification/cytology/genetics/*isolation & purification ; Giardiasis/parasitology/*veterinary ; Microscopy ; Molecular Sequence Data ; Phylogeny ; Protozoan Proteins/genetics ; RNA, Ribosomal, 18S/genetics ; Sequence Analysis, DNA

Objective To study the relationship between hepatic arterial buffer response (HABR),recovery of liver function,early biliary complications and small-for-size syndrome (SFSS).Methods Early hepatic hemodynamic parameters (including hepatic arterial flow (HAF),portal venous flow (PVF) were measured using duplex Doppler sonography in 34 patients who received living donor liver transplantation (preoperatively n＝26,intraoperatively n=26) and on postoperative days 1,2,3,and 7.Alanine aminotransferase (ALT),aspartate aminotransferase (AST) and total bilirubin (TBIL) level were measured preoperatively and on postoperative days 1,2,3,7,14,21,and 28.If TBIL level was elevated,we used B ultrasonography or CT and even ERCP to diagnose early biliary complications.The days taken for AST,AI T and TBIL to recover and the number of patients with early (＜60 days) biliary complications (bile leakage or bile stricture) and with small-for-size syndrome (SFSS) were recorded.Results Passive hepatic artery buffer response (HABR) was present in 11 patients early after living donor liver transplantation (group 1) and it disappeared in 23 patients (group 2).The recovery in days taken for normalization of AST (10.6± 8.8),AIT (11.6±9.0) and TBlL (average of 29) in group 1 were shorter than in group 2.However,the differences did not reach statistics difference (P＞0.05).The overall incidences of early biliary complications and small-for-size syndrome (SFSS) in group 1 were significantly lower than in group 2 (P=0.04).The survival rate in group 1 was 82 ％,compared with 74 ％ in group 2.Conclusions Passive hepatic arterial buffer response (HABR) disappeared in some patients early after living donor liver transplantation.There were high incidences of early biliary complications and small-for-size syndrome (SFSS) in these patients.Measurcment of hepatic buffer response in the early stage after living donor liver tranaplanta tion is valuable for predition of early biliary complications and small-for-size syndrome (SFSS),thus helping to prevent failure in transplantation.