Fu biao who got an advanced liver cancer had undergone liver-transplantation twice and died at last,which raises great ethical concern.With respect to distribution,there are four substantial distributive principles,including the principle of equality,the principle of need,the principle of contribution,the principle of effort.When allocating scarce health-care resouses,medical criteirion should be considered firstly the equality of everyone's life.Furthermore,the principle of utility and equality should be embodied for ensuring distributive justice.

Objective To analyze the pathogeny of acute respiration failure after kidney transplantation on early period and discuss the clinical value of mechanical ventilation.Methods A total of 16 cases of acute respiration failure after kidney transplantation on early period were studied retrospectively.Results The main causes were acute pulmonary edema caused by heart failure and serious pneumonia; patients were divided into two groups according to pathogeny: heart failure group (n=8) and non-heart failure group (n=8). It was found that the patients in heart failure group were older, preoperative blood pressure higher, dialysis duration longer, acute respiratory failure occurred earlier and mechanical ventilation time shorter than in non-heart failure group. The mechanical ventilation could raise oxygen pressure in artery blood and correct hypoxemia quickly. The mechanical ventilation could keep oxygen pressure in artery blood on the ideal level.Conclusion The pathogeny of acute respiration failure after kidney transplantation on early period included acute pulmonary edema caused by heart function failure and serious pneumonia; the mechanical ventilation was important to treat patient with acute respiration failure after kidney transplantation on early period because it could ensure oxygen pressure in artery blood in order to win time to cure heart failure and serious pneumonia. Also, the mechanical ventilation could improve prognosis of the patients.

Twenty eight patients with multiple organ dysfunction syndrome (MODS) underwent continuous venovenous hemofiltration (CVVH)in ICU from June 2003 to June 2008, including 13 cases treated with predilution mode and 15 with postdilution mode. The changes of oxygenate index( PaO2/FiO2 )during CVVH were retrospectively analyzed. The total case fatality rate of this group of patients was 46%(13/28). There was a significant increase in PaO2/FiO2 of 28 cases during the first 48 h of CVVH (P ＜0. 05);the levels of PaO2/FiO2 in predilution group had increased significantly within 48 h during CVVH (P＜0. 05), while those in postdilution group had not significantly changed (P ＞ 0. 05). There was a significant increase in Pa02/FiO2 for the survival patients during the first 48h CVVH( P ＜ 0. 05 ), while no significantly change in the fatal cases(P ＞0. 05 ). In summary, oxygenate function and outcome of patients with MODS can be improved by CVVH, and predilution may be a more effective mode.

OBJECTIVE:To optimize the extraction technology of chlorogenic acid in Prunus armeniaca flos,and compare the contents in P. armeniaca flos from different origins and varieties. METHODS:HPLC was conducted to determine the content of chlorogenic acid in P. armeniaca flos;using the volume fraction of ethanol,the ratio of material to liquid,ultrasonic extraction times and time as factor,the content of chlorogenic acid as index,single factor and orthogonal test were designed to optimize the extraction technology,and verification tests were carried out. The optimized extraction technology was used to extract and compare the contents of chlorogenic acid in Armeniaca sibirica from 7 origins of P. armeniaca flos and 3 origins of Armeniaca sibirica flos. RESULTS:The optimized extraction technology was extracting twice with 12-fold 75% ethanol,30 min each time. Under the con-ditions,the content of chlorogenic acid can reach 77.38 mg/g(RSD=0.58%,n=3);the contents of chlorogenic acid in A. sibiri-ca flos and P. armeniaca flos were 77.38-83.33 mg/g and 63.12-70.22 mg/g,respectively. CONCLUSIONS:The established extrac-tion technology is reasonable,stable and feasible. The contents of chlorogenic acid in A. sibirica are higher than that in P. armenia-ca flos;the contents have no obvious differences in the same variety of A. sibirica from different origins.

Objective:To investigate the effect of SU11248 proliferation and apoptosis of multiple myeloma cell line U266 in vitro and analyze its mechanisms.Methods:Effect of SU11248 on proliferation of U266 cells was detected by MTT assay.The ability of SU11248 to induce apoptosis of U266 cells was examined by cell cycle analysis,TUNEL and DNA fragmentation.Expression of c-myc,hTERT,Bcl-2 and Bax mRNA in U266 cells was assessed by RT-PCR analysis.Results:The proliferation of U266 cells was inhibited by SU11248 in dose-and time-dependent manners (P

50.0%.CONCLUSION:The extensive use of antibacterials results in increased drug resistance,while rational use of antibiotics is the key of decreasing drug resistance and multidrug resistance.It is of great importance to analyze the variation of bacterial drug resistance in area hospital.

Objective To investigate the application potentiality of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in showing vascular patterns of hepatic tumors.Methods Total of 65 hepatic tumors were examined with two-dimensional contrast-enhanced ultrasound (2D-CEUS) and dynamic 3D-CEUS and make statistical comparison between two imaging modes in aspects of enhancement patterns,spatial relationships of tumors and vascularity of different hepatic tumors.Results Dynamic 3D-CEUS showed the same enhancement patterns with 2D-CEUS.However,Dynamic 3D-CEUS was superior to 2D-CEUS in the display of spatial relationships of hepatic tumors and vascularity(P ＜0.05).The vascularity between benign and malignant hepatic tumors was statistically significant (P ＜ 0.05).Conclusions Dynamic 3D-CEUS is a useful technique in the differential diagnosis of hepatic tumors as well as 2D-CEUS,and dynamic 3D-CEUS displays the spatial relationship of hepatic tumors and vascularity more visually and comprehensively,which provides additional beneficial information for the diagnosis and therapy of hepatic tumors.

Objective To prepare Integrin αvβ3/CCR2 dual targeted microbubble,test physical-chemical properties,enhancement effect and targeting ability in vitro.Methods The dual targeted microbubbles (MBdual-target )with FITC labled iRGD and PE labled CCR2 were prapared,and non-target microbubbles as control (MBcontrol ) were prapered.Physical and chemical properties of two groups of microbubbles were tested,connectivity of peptides/antibodies and microbubbles were detected by fluorescence microscope and flow cytometry instrument.Enhancement effect and the stability of two groups of microbubbles was observed and compared in vitro.The affinity of MBdual-target and MBcontrol for bEnd.3 cells was investigated with light and fluorescent microscope.Results ①The particle size of MBdual-target was (0.93±0.23)μm,with no statistically significant difference compared with MBcontrol (P >0.05).②MBcontrol showed no fluorescent,while MBdual-target showed both clear green and red light,under fluorescent microscope.③There was no significant difference of gray scale of enhancement between MBdual-target and MBcontrol in vitro.④ It was showed that MBdual-target adhered to bEnd.3 cells in vitro experiment.Conclusions Integrinαvβ3/CCR2 dual targeted targeted microbubbles was successfully prepared and proved having good enhancement effect and targeting ability in vitro.

Objective To detect serum levels of thyroid hormones in patients with thyroid nodules (TN), and investi-gate their relationship with the nature of TN. Methods A total of 245 patients with TN were recruited in the study. Accord-ing to levels of thyroid antibodies and postoperative pathological results, all patients were divided into nodular goiter (NG) group, thyroid adenoma (TA) group and thyroid cancer (TC) group. TC group was further classified as the TC with increased level of thyroid antibodies (TC-AB+group) and the TC with normal level of thyroid antibodies (TC-AB-group). The serum levels of free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH) were detected for all patients before operation, and differences of thyroid hormones were analyzed between different groups. Results The serum level of TSH was signifi-cantly higher in TC group than that of NG group and TA group (P<0.05). The serum level of FT3 was significantly lower in TC-AB+group than that of NG group and TC-AB-group. The serum level of FT4 was significantly lower in TC-AB+group than that of NG group, and the serum TSH level was significantly higher than that of other groups (P<0.05). Conclusion The increased serum levels of TSH were found in some patients with TC, which may partly attribute to their coexistence with autoimmune thyroiditis and subsequent hypothyroidism. The increased serum TSH level may not be the inherent characteris-tics of TC.

Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.