Objective:To summarize the notice of informed consent about gene information detection,and to provide a reference for ethical review of informed consent in clinical research involved gene information detection.Methods:We researched domestic and foreign literatures about gene information detection involved informed consent and comprehensively analyzed them.Results:Gene information detection caused the individual,family,and social aspects of privacy issues,and the right not to know gene information detection had been widely recognized.Informed consent was adopted in informed consent,which not only was respect for personal dignity and autonomy,but also was conducive to the effective use of gene resources.It should construct reasonable procedural system in le gal protection,guarantee the voluntary and authenticity of consent,and put it into practice.Based on the establishment of the right not to know,the Chinese law should also prohibit the implementation of gene detection or provision of gene information put forward by employers and insurance companies.In addition,it is strictly prohibited to detect infant incurable disease genes.Conclusion:In the ethical review of clinical research,when the conflict arises,it is necessary to design informed consent to resolve the conflict between the individuals' rights not to know and their personal health benefits,and to establish reasonable procedures in legislation to ensure the implementation of informed consent.

Objective To discuss the procedural problems and solution correlatively of CT-guided percutaneous biopsy of spinal diseases,with simultaneous evaluation of the safety and clinical application.Methods Sixty-eight cases with spinal diseases were taken CT-guided percutaneous biopsy under local anesthesia and CT guidance,including 9 in cervical spine,19 in thoracic spine,28 in lumbar spine and 12 in sacral spine.The program of carrying out the procedure was decided according to the site,approach route of the lesion with the destination of sampling,under CT guidance.Results The successful rate of needle puncture was 100%(68/68)with diagnostic accuracy of 92.6%(63/68),and false-negative rate of 7.4%(5/68),together with complications rate of 5.9%(4/68).Conclusions CT-guided vertebral biopsy is safe,reliable,less complication,high accuracy and together with clear demonstration of the position of puncture needle and the complex anatomic structures nearby,providing basic information for further clinical treatment and worthy to be recommended.

With the constant development of economic globalization and the growth of knowledge economy, hospitals are confronted with severe challenges and are development opportunities. As leaders of their institutions, hospital directors ought to correctly appraise the situation and attach importance to the following five issues: ①scientific and technological innovations; ②development of unique key specialties; ③cultivation of top notch personnel; ④amplification and perfection of market oriented operational mechanisms; and ⑤team building for joint tackling of key problems. Only in this way can the intensional building of hospitals be enhanced and the competitiveness of them strengthened.

Objective The aim of present study was to observe the correlation between flagellin and tumor necrosis factor ?(TNF-?)in rats with sepsis-induced acute lung injury(ALI).Methods A total of 120 male healthy Wistar rats were randomly assigned into 2 groups:sepsis group which was reproduced by cecal ligation and puncture(CLP),and sham operated group which underwent laparotomy only.All the indexes were observed at the time points of 2h,4h,6h,12h,24h and 48h after operation.Changes in partial pressure of oxygen in artery(PaO2)were determined by blood gas analysis.Pathological changes in pulmonary-tissue were observed by light microscopy.The levels of flagellin in serum,bronchoalveolar lavage fluid and pneumono-homogenate,as well as TNF-? of serum,were determined by enzyme linked immunosorbent assay(ELISA).Results Rats with acute lung injury induced by sepsis was successfully reproduced.The PaO2 of sepsis group significantly decreased at 12h after injury and reached the lowest point at 48h after injury.PaO2 of sepsis group was remarkably lower than that of sham operated group at the time points of 12h,24h and 48h after injury(P

20/min,PaCO2 12?109 or 0.10.26 patients with sepsis infected by Gram negative bacilli were categorized as G-group,15 infected by Gram positive coccus as G+ group and 15 healthy persons as control group.All the cases were proved to have infection by body fluid examination under microscope or bacterial culture.The level of flagellin was determined by ELISA.The peripheral blood mononuclear cells(PBMC)were isolated by the density gradient centrifugation,and total RNA of PBMCs was extracted by RNA BIOzol extract.The level of TLR5 mRNA in the peripheral blood was detected by semi-quantitative RT-PCR.The statistic significance among groups was examined by Students' t test.Results Plasma flagellin levels were below the detection limit of the ELISA kit in both G+ and control groups,while the mean level of plasma flagellin amounted to 6.636?5.147ng/ml in G-group.TLR5 mRNA expression in G-group was significantly higher than that in G+ and control groups,and no significant difference was found between G+ group and control group.Conclusion Flagellin may be involved in the development of ALI through interacts with TLR5.

Objective To establish a RP-HPLC method for the determination of gardenoside in Xinxue Tablets and to provide evidence for ameliorating its quality criterion.Methods HPLC conditions were as follows: C18(4.6?250 mm,5 ?m)column with temperature at 25 ℃,acetonitrile-water(15∶85) as mobile phase with flow rate of 1 mL/min,and the detection wavelength at 238 nm.Results Gardenoside was well separated from other components and had good linearity in the range of 0.128～1.024 ?g(r=0.999 2).The average recovery was 98.67 %and RSD=1.57 %.Conclusion The method is accurate,reproducible,and can be used for the quality control of Xinxue Tablets.

Objective To determine the expression of Toll-like receptor 5(TLR5) mRNA in the lung tissues of rats with acute lung injury induced by flagellin, and to investigate its potential role in the pathogenesis of the disease. Methods Flagellin was isolated and purified from Escherichia coli ATCC25922, subsequently identified by monoclonal antibody to flagellin. One hundred and eight SD rats were randomly divided into control group (n=36), flagellin challenged 1 group (n=36) and flagellin challenged 2 group (n=36). Rat model of ALI was reproduced by injecting flagellin. The expression of TLR5 mRNA in the lung tissues of rats was determined with in situ hybridization technique at six time points. Blood gas was monitored and pathological changes in the lung was observed at the same time. Result Flagellin was isolated and purified successfully and its molecular weight was approximately 65kD. Flagellin-induced acute lung injury model was successfully reproduced in rats. From 1h after flagellin injection, TLR5 mRNA expression was found to be increased in the lung tissues of rats with flagellin induced acute lung injury, and the expression was on the increase with the elapse of time and increase of the dose of flagellin. The PaO_2 levels in flagellin challenged 1 and 2 groups decreased. Interstitial edema, alveolar edema and inflammatory cells infiltration were also observed in flagellin challenged groups. Conclusion Flagellin can induce ALI in rats; the development of flagellin induced ALI in rats is related with TLR5 expression in the lung tissues of rats.

To investigate the expression of TNF ?, IL 1?, IL 6 and IL 8 mRNA in the lung,and the levels of TNF ?, IL 1, IL 6 and IL 8 in serum of rats with sepsis induced acute lung injury(ALI), and to examine the effect of pentoxifylline on the production of these cytokines. The expressions of TNF ?, IL 1?, IL 6 and IL 8 mRNA were detected with dot blot.The levels of TNF ?, IL 1?, IL 6 and IL 8 were examined with ELISA. Compared to the sham operation group, TNF ?, IL 1?, IL 6 and IL 8 mRNA expression in sepsis group were increased evidently( P

OBJECTIVE:To investigate the variance of antimicrobial resistance of Klebsiella.spp isolated in our hospital during the recent 5 years.METHODS:Disk diffusion test was used to study the anti microbial resistance.The results were evaluated based on the criteria recommended by American Clinical and Laboratory Standards Institute.The data analysis was performed using WHONET-5software.RESULTS:Atotal of 840 strains of Klebsiella.spp were collected fromour hospital during2003～2007,of which,59.3% were fromrespiratory secretion speci men,12.0%fromblood speci men,and10.1% from secretions.The detection rate of ESBLs-producing Klebsiella.spp was from51.0% to65.1%.No I mipenem-and Meropenem-resistant Klebsiella.spp strain was detected.Susceptibility test showed that Klebsiella.spp-producing ESBLs was multiple resistant,and the anti microbial resistance of Klebsiella.spp has increased year on year.CONCLUSION:Monitoring of the drug resistance of Klebsiella.spp should be strengthened.The variation of the anti microbial resistance of Klebsiella.spp should be noted so as to direct rational drug use in the clinic and prevent spreading of drug resistant strains.

Objective To investigate the characteristics of intestinal microflora and its effect on fecal secretory immunoglobulin A (sIgA) in the elderly. Methods All 104 cases were assigned to two groups: the control group (healthy adults, age<60 years ,n=36) and the elderly group (healthy elderly persons, age ≥60 years, n=68). Feces samples of all cases were cultured under both aerobic and anaerobic conditions for the 6 bacteria (4 kinds of anaerobes and 2 kinds of aerobes) and the yeasts. The ratio of bifidobaeterium to Enterobacteria (the ratio of B/E) was calculated, which reflected personal colonization resistance. The fecal sIgA was also measured. Results Compared with control group, the number of fecal bifidobacterium and the ratio of B/E were significantly decreased in elderly group[(9.1±1.1)vs. (10.2±0.8)lgCFU/g,P<0. 01 ;(1. 02±0.14) vs. (1.24± 0. 18), P < 0. 01], and the number of enterobacteria and peptostreptococcus was significantly increased in elderly group [(9.2±1.3) vs. (8. 2±0.7) lgCFU/g, P < 0. 05 ; (8. 5 ±1.4) vs. (7.1 ± 1.6)lgCFU/g, P<0. 05]. The fecal slgA was much lower than that in control group [(652.9± 184.3) vs. (793. 5±150. 3)μg/ml, P<0. 05]. Moreover, the quantity change of bifidobacterium was correlated with the concentration of fecal sIgA(r=0. 562, P<0. 01). Conclusions The number of fecal bifidobacterium is significantly decreased, while the number of enterobacteria and peptostreptococcus is significantly increased in elderly persons. The colonization resistance is significantly decreased and the intestinal immuno-barrier function is injuried in elderly persons, which have influenced the intestinal microflora.