The natural process of life and death has been profoundly and widely involved and increasingly manipulated by the fast developed technology of life science,which could change the human beings' state of life as well as the state of death.Thus,human beings are motivated to think multidimensionally on life and death from the perspective of science,such as the weakening of sacredness of life,the technology employed in life,the socialization of lifestyles,the exploration of the nature of death,the pluralism of different ways of death and the systematization in the education of death.These considerations will no doubt contribute to the mutual promotion of the development of morality and the advancement of life science technology.

The lack of organs has been an crucial limiting factor for Chinese organ transplantation,thus it is in urgent need to effectively increase the number of donor organs.This article holds that,besides through publicity and education to promote unpaid voluntary organ donation,some incentive mechanisms are also required to serve as useful complements.Therefore,organs' origin can be expanded to a certain extent,and the intense supply and demand in organ transplantation can also be eased.Unifying organ transplantation practice in China,this paper explains the necessity of organ donation incentive mechanisms from both theoretical and practical significances,reveals the main elements of the incentive mechanisms,and explores the realization means.

Objectives To identify the spectrum of pathogens causing bloodstream infection and their resistance profiles. Methods We examined records with positive blood culture from Jan. 1998 to Mar. 2003 in a teaching hospital in Shanghai. The contaminants were excluded according to the CDC definition of bloodstream infection. Bacteria were collected from April 1, 2002 to March 31, 2003 and MIC to the most commonly used antimicrobial agents was performed. Results 276 episodes occurred during the study period. Of all the BSI episodes, about 74.3% BSI were hospital-acquired and 37.3% were community-acquired. Gram-positive organisms accounted for 38% of isolates, while gram-negative for 44.2% and fungus for 13.8%. The commonest pathogens causing bloodstream infection in hospital-acquired BSI were coagulase-negative staphylococcus (16.9%) and Escherichia coli (16.6%), followed by Candida species (14.1%), Staphylococcus aureus (13.7%) and Klebsiella pneumoniae (13.2%). Streptococcus spp., Escherichia coli, coagulase-negative staphylococcus and Staphylococcus aureus are the leading pathogens causing community-acquired bloodstream infection, which accounted for 16.9%, 15.5%, 15.5%, 11.3% respectively. Susceptibility tests in vitro shows that methicillin resistance in S. aureus was 56%, while in coagulase-negative staphylococcus was 88%. Among the prevalent Gram-negative BSI isolates, resistance rates for most of the antimi-crobial agents were high. However, it is encouraging to note that the carbapenems retained potency against almost all the Enterobacteriaceae, including those resistant to the third-generation cephalosporins and extended-broad-spectrum penicillins. The crude mortality rate of BSI was 24.4%. Conclusion The rate of Coagulase-negative staphylococcus, Klebsiella pneumoniae and fungus in BSI have increased in the past years. Enterobacteriaceae, acinetobacter spp and fungus are more common in hospital-acquired BSI than community-acquired BSI.

Objective To describe the clinical features of invasive fungal disease in Huashan Hospital,Fudan University from January 2004 to December 2006.Methods The medical data were reviewed retrospectively for the patients with fungal infection, which was confirmed by positive fungal culture or microscopic examination with blood,sterile body fluid,deep tissue,sputum specimen or isolation of Aspergillus spp.and Cryptococcus spp.from bronchoalveolar lavage.The proven and probable cases of invasive fungal disease were included in this analysis.Results A total of 111 patients were diagnosed as invasive fungal dis-ease,including 104 proven cases and 7 probable cases.Sixty-one cases were community-acquired and the other 50 were nosoco-mial.The most common site of infection was bloodstream (51,45.9%),followed by central nervous system (44,39.6%)and respiratory system (14,12.6%).The most common pathogens were Candida spp.(50,45%),Cryptococcus (47,42.3%) and Aspergillus spp. (12, 10.8%). The community-acquired fungal infections were mostly found in central nervous system (44,72.1%),and respiratory system (12, 19.7%),mainly caused by Cryptococcus and Aspergillus. The nosocomial fungal infections occurred primarily in blood-stream (96.0%),mainly due to Candida spp.No underlying disease or risk factor was identified in more than half of the pa-tients with community-acquired infection,while almost all the patients with nosocomial fungal infection had underlying disease and predisposing factors.Indwelling venous catheter was closely associated with nosocomial bloodstream infection.Indwelling venous catheter lasted for more than 1 week in 64.7% of the patients with Candida bloodstream infection.The same fungal strain was isolated from both the cather and blood of the same patient in 11 cases.The overall mortality of these invasive fungal diseases was 14.4% (16/111).The mortality rate was 18.0% (9/50)in the patients with nosocomial invasive fungal infection, and 11.5% (7/61)in the patients with community-acquired invasive fungal infection.Conclusions The most common site of in-vasive fungal infection is bloodstream,followed by central nervous system,and respiratory system.Majority of the fungal patho-gens are Candida spp.,Cryptococcus and Aspergillus spp.The community-acquired invasive fungal disease is primarily meningitis caused by Cryptococcus.The nosocomial invasive fungal disease is mainly bloodstream infection caused by Candida spp.

Objective:To study the effects of soybean phospholipids on learning and memory abilities and contents of fatty acids in hippocampus of mice and its mechanism. Method:Mice were randomly divided into four groups:low dose(2.5g/kg) ,middle dose(5.0g/kg) and high dose(10.0g/kg) groups of soybean phospholipids and control group. The treatment groups were fed with soybean phospholipids every day while the control group with distilled water for 30 d.After learning and memory abilities were measured,the mice were killed and contents of fatty acids in hippocampus of mice were determined by high performance liquid chromatography(HPLC) . Results:(1) The learning and memory abilities of mice in middle and high dose groups were significantly improved,but only memory abilities in low dose groups were stronger than control group.(2) The contents of protein in hippocampus in middle and high dose groups were increased extremely.(3) The contents of oleic acid(C18:1) and docosahexaenoic acid(DHA,C22:6 ) were obviously enhanced in hippocampus of high dose group;but decreased in eicosapentaenoic acid(EPA,C20:5) and linoleic acid(C18:2) . The content of DHA was increased and EPA decreased significantly in middle dose group.The increase of arachidonic acid(C20:4) was not significant.Conclusion:Soybean phospholipids may improve learning and memory abilities,which might contribute to change of fatty acids contents in hippocampus of mice.

Objective: To investigate the health literacy and its influencing factors among residents in areas out of poverty in Kunming City, so as to provide insights into formulating health education strategies. Methods: A total of 1 916 permanent residents at ages of 15 to 69 years were sampled in three areas out of poverty in Kunming City using the multi-stage stratified random sampling method and probability proportionate to size sampling method from August to October, 2020. Health literacy was investigated using the Questionnaire on the Health Literacy among Chinese Residents, the level of health literacy was analyzed and weighted by the population of the China's Seventh National Population Census. Factors affecting health literacy among residents in areas out of poverty were identified using a multivariable logistic regression model. Results: A total of 1 916 questionnaires were allocated, and 1 908 valid questionnaires were recovered, with an effective recovery rate of 99.58%. The respondents included 997 men (52.25%) and 911 women (47.75%), and had a mean age of (45.58±14.28) years. The level of health literacy was 21.38%. Multivariable logistic regression analysis identified age (15 to 24 years, OR=5.087, 95%CI: 1.573-16.450; 25 to 34 years, OR=6.016, 95%CI: 1.991-18.183; 35 to 44 years, OR=7.526, 95%CI: 2.541-22.289; 45 to 54 years, OR=4.800, 95%CI: 1.640-14.050), educational level (junior high school, OR=5.333, 95%CI: 3.100-9.175; high school/vocational high school/technical secondary school, OR=19.895, 95%CI: 10.418-37.966; college or above, OR=27.580, 95%CI: 12.349-61.597) as factors affecting health literacy among residents in areas out of poverty in Kunming City. Conclusion The level of health literacy is 21.38% among residents in areas out of poverty in Kunming City, and age and educational level are associated factors.

Objective To explore the incidence and severity of cancer-related fatigue (CRF),and to analyze the correlation between CRF and quality of life in lung cancer patients receiving chemotherapy.Methods This was a cross-sectional study.72 lung cancer patients receiving chemotherapy were investigated by the Piper Fatigue Scale (PFS) and the 36-item short form of the Medical Outcomes Study questionnaire (SF-36).Results The rate of fatigue for lung cancer patients receiving chemotherapy was 76.4%.The incidence of moderate and severe fatigue in total fatigue,behavior/severity dimension,affective dimension,sensory dimension was 68.1%,63.9%,76.4% and 65.3% respectively.The incidence of mild and moderate fatigue in coguitive/mood dimension was 41.7%.The fatigue dimension scores ranked in a descending order,affective,behavior/severity,sensory and cognitive/mood.There was significant negative correlation between CRF and quality of life for lung cancer patients receiving chemotherapy.Conclusions In lung cancer patients receiving chemotherapy,the incidence and degree of fatigue was high.CRF and QOL affect each other.The health care providers should take measures to alleviate lung cancer patients' fatigue in order to improve the QOL of them.

Objective To evaluate the feasibility of the three-dimensional brain artery vessel wall imaging technology reverse rotation angle of fast spin echo (T1 W-SPACE)in the diagnosis of ischemic cerebrovascular disease by comparing it with TOF vascular imaging in magnetic resonance. Methods Patients undergoing stroke but stable condition,including 50,patients with transient cerebral ischemia (TIA)or a history of stroke,examined by TOF-MRA and routine MRI sequence first,then followed by T1 W-SPACE.Results In 43 of 50 cases,conventional MRI sequences detectiog was positive,TOF-MRA found the vascular stenosis in 76 branches,T1 W-SPACE found the vascular stenosis in 73 branches,there was no difference between the two groups(χ2 =0.625,P >0.05);Conventional TOF-MRA cannot detect the vascular wall, T1 W-SPACE found that arterial wall thickening,plaque in 48 branches.Conclusion Compared with the TOF-MRA,T1 W-SPACE can not only detect the vessel stenosis,but also the vessel wall and plaque,and can also type on plaque from pathology angle,has im-portant clinical significance for early prevention and treatment of stroke.

Objective To evaluate the efficacy and safety of therapeutic drug monitoring (TDM ) based vancomycin dose adjustment in patients with gram‐positive infections .Methods A cohort study was designed with 128 inpatients undergoing TDM in Huashan Hospital from January 2005 to September 2014 .The clinical data of these patients were used to analyze the efficacy and safety of vancomycin therapy by Cox model and survival analysis .Results The patients undergoing TDM‐based dose adjustment had a higher daily dose and blood trough concentration ,which may lead to better bacteriological efficacy and overall efficacy .Cox proportional hazards model analysis showed that TDM‐based dose adjustment is a protective factor .No safety‐related risk factor was found .Conclusions TDM‐based vancomycin dose adjustment is important for patients to achieve better outcomes in fighting gram‐positive infections .

Objective To investigate the reasons of artifacts in 64-slice spiral CT coronary angiography.Methods One hundred patients with diagnosed or suspected coronary artery disease underwent retrospectively ECG-gated 64-slice spiral CT coronary angiogruphy.Maximum intensity projection(MIP),muhiplanar reformation(MPR)and volume rendering technique(VRT)were reconstructed.The reasons of artifacts were assessed by two experienced radiologists.Results A total of 1347 segments(1347/1500,89.8%)were reviewed,the artifacts were found in 192 segments(14.2%).Breath movement was the moat common artifact(124/192).and the other reasons included fast rate and irregular rhythm of the heart beat (42/192).while the phase mismatch was the third reason(22/192).Conclusions The common artifacts of 64-slice spiral CT coronary angiography includes breath movement,fast rate and irregular rhythm of heart beat and phage mismatch.Breath-holding control,low rate and regular rhythm of heart beat,muhiphage reconstruction are suggested for the accurate diagnosis.