The tobacco epidemic is a problem with serious consequence for public health in the whole world. Reducing the tobacco harm and protecting public health have become a crucial topic for ethics. This paper, firstly, presents some facts related to the tobacco epidemic. Based on these facts, then, it analyzes the issue from ethical perspectives. And finally, it discusses the moral responsibilities for reducing the tobacco epidemic.

Objective To compare the clinical effects between rivaroxaban and warfarin on preventing deep vein thrombosis (DVT) in elderly hip fracture patients with diabetes mellitus (DM) after operation. Methods One hundred and sixty-eight elderly hip fracture patients with DM were randomly divided into the observation group and the control group. The observation group (88 cases) were treated with rivaroxaban (10mg, po, qd) after surgery, and the control group were treated with warfarin and low molecular weight heparin calcium for 14 days. Respectively after 7, 14, 21 and 28 days, the color doppler ultrasonography was used to examination vein blood flow and the DVT of affected lamb. In addition, the levels of D-dimer and bleeding were observed during treatment. Results The incidence of DVT in observation group (2 cases, 2.23%) was significantly lower than that in control group (7 cases, 8.75%), and DVT of control group was happened on 7th day after surgery. In addition, the level of D-dimer on 7th day post-surgery in observation group significantly decreased, while it significantly decreased on 14th day post-surgery in control group (P<0.05). However, the incidence of bleeding events in observation was less than that in control group (P<0.05). Conclusion Rivaroxaban can be more effective compared with warfarin in preventing diabetes mellitus elderly hip fracture patients with postoperative DVT formation and significantly reduce the bleeding risk, with more safe and convenient.

Objective To investigate the effect of scalp acupuncture plus real-time cognitive training on cerebral blood flow in Alzheimer disease patients with cognitive disorder.Methods One hundred Alzheimer disease patients with cognitive disorder were randomly allocated to treatment and control groups, 50 cases each. Both groups received treatment for the primary disease. In addition, the treatment group received scalp acupuncture plus real-time cognitive training and the control group took Ginkgo leaf extract tablets. Mean flow velocity (Vm) in the left vertebral artery (LVA), right vertebral artery (RVA) and middle cerebral artery (MCA) were measured using transcranial Doppler in the two groups of patients before and after three months of treatment.Results There were statistically significant pre-/post-treatment differences in LVA, RVA and MCA Vm in the two groups (P<0.01). There were statistically significant post-treatment differences in LVA, RVA and MCA Vm between the treatment and control groups (P<0.05).Conclusions Scalp acupuncture plus real-time cognitive training can improve cerebral circulation and increase cerebral blood flow in Alzheimer disease patients with cognitive disorder.

Objective To evaluate the efficacy and safety of holmium laser lithotripsy for the treatment of urinary calculi.Methods A total of 1216 cases of urinary calculi underwent ureteropyeloscopic and cyctocopic holmium laser lithotripsy.There were 1 006 cases of ureteral stones(302 cases of upper ureteral stones,364 cases of middle ureteral stones,and 340 cases of lower ureteral stones) and 210 cases of bladder stones.Results In 1 case of upper ureteral stones,failure to access the ureteral orifice due to enlarged prostate was encountered,and extracorporeal shock wave lithotripsy(ESWL) was employed.In 1006 cases of ureteral stones,the rate of successful fragmentation on single session was 95.5%(961/1 006),with 89.4%(270/302),96.4%(351/364),and 100%(340/340) for upper,middle,and lower ureteral stones,respectively.Ureteral perforation was encountered during lithotripsy in 6 cases.In 210 cases of bladder stones,the rate of successful fragmentation on one session was 100%(210/210).No bleeding or bladder perforation was observed during lithotripsy.Follow-up checkups for 0.5~40 months(mean,18.6 months) in 881 cases of ureteral stones showed that the stone-free rates were 91.1%(224/246),98.5%(318/323),and 100%(312/312) for upper,middle,and lower ureteral stones,respectively.The overall stone-free rate for all levels of ureteral stones achieved 96.9%((854/881)).Ureteral stenosis was found in 6 cases.Follow-up checkups for 0.5~31 months(mean,12.4 months) in 187 cases of bladder stones revealed a stone-free rate of 98.4%(184/187). Conclusions Holmium laser lithotripsy is a highly effective,minimally invasive,and safe therapy for urinary calculi.It is indicated as the first choice of treatment for patients with ureteral stones and bladder stones.

Objective To study the intra- tumor basis of pleural indentation (P I) and find the influential factors correlated with PI in peripheral lung cancer . Methods Eighty-six cases of peripheral lung cancer (includin g experimental gr oup of 34 cases with PI and control group of 52 cases without PI) were subjected to identify the constitution in tumoral interstitium. And 7 variables (includin g intra-tumor fibrosis, tumor-chest wall distance, histological type, diameter o f tumor, differentiated degree, lymphatic metastases, sex, etc.) were investigat ed about PI by single factor analysis and multiple factor analysis of Logistic r egression model. Results(1)Collagenous fibers were the mai n fiber in tumoral interstitium, and were higher in experimental group than that in control group ( t=3074, P005). Conclusion Collagen Ⅰfibers are the main type of interstiti al fibers, and myofibroblasts are the main type of interstitial cells in PI asso ciated peripheral lung cancer. Intra-tumor fibrosis, tumor-chest wall distance , and histological types are the main influential factors in PI formation, and int ra-tumor fibrosis is the basic and inside factor. The histological types affect PI formation. Tumor-chest wall distance plays an important outside role in PI f ormation.

In the educational reform of radiology,the importance of practical skills training has increasingly become the focus of teaching.As a symbol of medical imaging informationization,PACS provides solid material foundation for teaching reform,making it possible to establish a large capacity and stability of a picture library.By making full use of all intemet teaching resources and improveing teaching methods,teachers have more communication with students through PBL and CBL teaching.Therefore,students get deeper understanding and better ability to put the theory of knowledge into practice and the teaching effect is pretty good.

Objective To explore the relation of donor liver's heme oxygenase-1 level to ische-mia/reperfusion injury and the liver function after liver transplantation. Methods Twenty-eight pa-tients receiving orthotopic liver transplantation (OLT) were divided into two groups according to the donor liver's heme oxygenase level of high HO-1 expression group and low HO-1 expression group.The recipients' serum levels of ALT, AST, bile salt output and the expression of HO-1 mRNA were determined and compared between the 2 groups. Results HO-1 mRNA of low expression group in-creased significantly after the reperfusion. Meanwhile, the HO-1 mRNA of high expression group de-creased. The serum levels of ALT and AST of HO-1 in low expression group were much lower but bile salt concentration higher than those in high expression group. Conclusion HO-1 can be further induced in the liver of HO-1 low expression group during the reperfusion period. The I/R injury in the HO-1 low expression group was less severe than that in high expression group, but the liver function was better. The increase of HO-1 during the transplantation seems better for protecting the liver than the initial HO-1 high expression. Kupffer cells are of the main localization for HO-1 protein in human liver.

Objective To investigate clinical effect and safety of ostium secundum atrial septal defect(ASD) treatment via one -stop hybrid and classical surgical procedures.Methods 45 patients were diagnosed ostium secun-dum simple ASD by ultrasound cardiogram and clinical manifestation,they were divided into one -stop hybrid proce-dure group (n =20)and classical surgical procedure (n =25).Age,gender,weight,post operation hospital day,on -pump time,blood transfusion amount,drainage flow,incision length and incidence of complication between the two groups were compared.Results Age and weight had no difference between the two groups(t =0.40 and 1.64,P >0.05),but the proportion of female cases in one -stop hybrid procedure group was higher than post operation(χ2 =9.45,P <0.05).Hospital day was shorter(t =11.11,P <0.05),drainage amount was fewer(t =81.68,P <0.05), incision length(t =22.51,P <0.05)was shorter.Incidence of complication had no statistically significant difference between the two groups(χ2 =0.35,P >0.05).And one -stop hybrid procedure group was off -pump without blood transfusion.Conclusion One -stop hybrid procedure was simple,could make a quick recovery post operation and was an ideal method for ostium secundum ASD treatment.

Objective To evaluate whether or not the 3.0T magnetic resonance (MR) scanner noise has adverse influence on neonatal hearing by using brainstem auditory evoked potentials(BAEP).Methods Forty-nine inpatients who received the MR examination were enrolled in this study from Aug.to Dec.2013,admitted to the Bayi Children's Hospital Affiliated to Beijing Military General Hospital.The Ⅰ,Ⅲ,Ⅴ wave latencies and the inter-peak intervals before and after the MR scan were compared by using SPSS 16.0 software.Results The BAEP results before and after MR examination respectively:(1) The latencies were:left ear Ⅰ wave (1.96 ± 0.22) ms vs (1.95 ± 0.30) ms,right ear Ⅰ wave (1.96 ± 0.22) ms vs (1.97 ± 0.27) ms,respectively; left ear Ⅲ wave (4.79 ± 0.23) ms vs (4.85 ± 0.28) ms,right earlllwave(4.78 ±0.24) ms vs (4.77 ±0.31) ms,respectively;left ear Ⅴ wave (7.10 ±0.24) ms vs (7.12 ±0.33) ms,right ear Ⅴ wave (6.76 ±0.32) ms vs (7.04 ±0.39) ms,respectively(allP ＞0.05).(2) The inter-peak intervals were:left ear Ⅰ-Ⅲ inter-peak interval (2.83 ± 0.23) ms vs (2.86 ± 0.27) ms,right ear Ⅰ-Ⅲ inter-peak interval (2.82 ± 0.24) ms vs (2.80 ± 0.17) ms,respectively ; left ear Ⅲ-Ⅴ inter-peak interval (2.31 ±0.28) ms vs (2.31 ±0.29) ms,right ear Ⅲ-Ⅴ inter-peak interval (2.26 ±0.27) ms vs (2.26 ±0.23) ms,respectively;left ear Ⅰ-Ⅴ inter-peak interval (5.11 ±0.40) ms vs (5.13 ±0.35) ms,right ear Ⅰ-Ⅴ inter-peak interval (5.07 ± 0.39) ms vs (5.07 ± 0.36) ms,respectively(all P ＞ 0.05).Conclusion The 3.0T MR may have no adverse influence on neonatal BAEP.

To intensify the medical students'clinical skills training is the main objective of medical imaging education. In the process of clinical teaching ,we have adopted many means including renewed multimedia courseware,teaching web page,film storage,and integration of various teaching methods. The film-reading skill of medical students has greatly increased.