There were some ethical problems in the implementation of certificate of authorization of cancer pa -tients, such as doctors dominate the signing process and show no respect for patients ′rights and interests .It pro-posed to improve rules and regulations , increase transparency , to setup informed consent platform define and verifi-cation, emphasize the licensee to perform the duty of communication , strengthen the construction of the medical staff ethics , in order to safeguard the rights and interests of patients , promote the rational and effective use of medi-cal resources .

Objective To develop a control program running on the magnetic induction escape decompression control timer. Methods The software was developed by VHDL in a modular style under the environment of Quartus II. Results The control software stores decompression profile and accurately controls the commitment of the decompression process. Conclusion The program can work accurately according to the profile selected and meet our needs perfectly.

About 30%-40% of patients with epilepsy remain medically intractable and may be considered as candidates for surgical treatment. Precise localization of the epileptogenic zone (EZ) through comprehensive presurgical evaluations is crucial for achieving good outcome. However, currently the interpretation of neuroimaging relies immensely on clinicians' experience, which is subjective and time-consuming. In order to improve the accuracy of EZ localization, medical image post-processing techniques have been applied. The results indicated that post-processing techniques have the advantages of identifying subtle abnormalities in brain structure and function objectively and precisely, thus may provide an accurate and effective solution for EZ localization. The advancements of existing medical image post-processing methods used in EZ localization were reviewed in this article.

BACKGROUND:Previous studies have demonstrated that cell transplantation has neuroprotective effect on intracerebral hemorrhage,and some researches have indicated that transplantation of bone marrow stromal cells(BMSCs)can promote neural function recovery after cerebral infarction.OBJECTIVE:To explore whether transplantation of BMSCs-modified by gtial cell line-dedved neurotrophic factor gene(GDNF)gene provides a better therapeutic effect than native BMSCs after stroke.METHODS:Totally 36 SD rats were induced intracerabral hemorrhage models by injecting autologous arterial blood,and then divided into 3 groups(n=6).each group was assigned into 2 sub-groups Rabbits in each group were stereotaxically grafted with 20 μL GDNF/BMSCs,BMSCs or saline respectively.The rats were executed at 1 and 2 weeks after operation,and immunohistochemistry was used to observe the expressions of synaptophysin(Syn)and growth associated protein-43(GAP-43)in the margin of the hemorrhagic focus.RESULTS AND CONCLUSlON:Compared with the BMSCs and control groups.both Syn-immunoreactive and GAP-43-immunoreactive products were significantly increased in the GDNF/BMSCs group(P＜0.05).Present results demonstrate that transplantation of GDNF gene-modified BMSCs provides better neuroprotection than native BMSCs delivery for stroke.

Objective To evaluate the outcome of Titanium Elatic Intramedullary Nail (TEINs) for treatment of lengthunstable femoral shaft fracture of children.Methods Retrospectively analyze the data of total of 21 children with length-unstable femoral shaft fractures,from December 2011 to June 2014,were treated with TEINs and end caps.This study involved 15 boys and 6 girls,with age ranged from 5 years and 6 months to 10 years and 10 months,whose average age was 7 years and 5 months.Firstly children were treated with traction for 3-7 days,with traction weight of 1/4 to 1/6 of the weight.After that,shortening and angular deformity were significantly corrected.Then surgeries of close reduction and internal fixation with TEINs were done in general anesthesia.TEINs were supported with double nail C shape.The lateral tip of TEIN located near the epiphyseal plate of greater trochanter,and the medial tip near the epiphyseal plate of femur head.Cut the tail of TEINs,set and screw the end caps into cortex,keeping the tail of TEINs and fracture fixed.Spica casting was used for 4 weeks after operation.The last follow-up time was 2 years,and the follow up results were analyzed.Results 21 children were followed up ranged from 22 to 26 months,with the mean follow up 23.4 months.Remove the spica casting and bear loading at 4 weeks after operation.All fractures healed,with healing time of 5 to 8 weeks (an average of 6.2 weeks).At the last follow-up,the limb force line was good with no angular deformity.Femur overgrew 4.2-21.1 mm,with an average of 6.1 mm.At the last follow-up,the patients were evaluated with Harris score,and the excellent and good rate was 100％.No case of TEINs push-out,limited hip mobility,fracture nonunion,delayed healing or other complications was found.Only 1 case got a mild lameness.All parents were satisfied with their outcome.Conclution TEINs and end caps are effective methods for the length-unstable femoral shaft fracture in children.These results indicated that the risk of TEINs push-out can be reduced.

Objective To analyze the prevalence of developmental dysplasia of the hip (DDH) in Tianjin,and to establish early screening of DDH in China.Methods System of health care for maternity and children in Tianjin were used to perform early ultrasound-screening program for DDH during the first 6weeks of life.The infants with abnormal conditions or suspected ultrasound results were transferred to Tianjin hospital.All the infants were clinically examined by experienced pediatric orthopaedic physician.Anteroposterior pelvic X-rays were taken for suspected infants to make a definite diagnosis.Results Hip ultrasound examinations were performed for 94 443 infants between December 26,2009 and December 25,2010.The 136 cases (165 hips) were suspected as DDH and 168 cases (200 hips) were diagnosed as DDH by ultrasound.All of them were transferred to Tianjin hospital.Among suspected patients,the positive signal of Ortolani or Barlow was found in 10 cases (11 hips).The DDH signal on the radiograph was positive in 73 cases (84 hips).Two hundred and fifty-one infants (295 hips) were finally diagnosed as DDH.There were 40 boys and 211 girls.Also,left hips and infants bom in autumn or winter were more often involved.The prevalence of DDH in Tianjin area was 2.66% (251/94 443).Conclusion Accurate early detection and diagnosis of DDH could be expected with the Tianjin pattern of preliminary screening,secondary screening and definite diagnosis.Careful clinical examination and X-ray are important for diagnosis.

Objective To investigate the associations of peripheral CD4+ CD25 + CD127low/-regulatory T cells (Treg) with HBV viral load and liver pathology in hepatitis B virus (HBV) carriers.Methods Forty six chronic HBV carriers admitted in the first hospital of Jiaxing during October 2012 and February 2014,and 23 healthy subjects (controls) were enrolled in the study.CD4+ CD25 + CD127low/-Treg in peripheral blood of the two groups were detected by flow cytometry.Ultrasound-guided liver biopsies were performed in chronic HBV carriers and HBV DNA load was determined by real-time PCR method.Independent samples t test was used for the comparison between groups,and Spearman rank correlation or Pearson linear correlation analyses were performed.Results The frequency of the peripheral CD4+ CD25+CD127low/-Treg in 46 HBV carriers was (5.11 ±1.47)％,which was significantly higher than that in healthy controls [(3.46 ± 1.23) ％,t =4.629,P ＜ 0.01].The HBV DNA load in HBV carriers was (6.21 ±1.98)lg copies/mL,which was positively correlated with the CD4+ CD25+ CD127low/-Treg level (r =0.405,P ＜ 0.01).Among 46 HBV carriers,21 (45.65％) were of inflammation grade 2 or above,and 16 (34.78％) were of fibrosis stage 2 or above.Peripheral CD4+ CD25+ CD127low/-Treg level was negatively correlated with inflammation and fibrosis in HBV carriers (r =-0.343 and-0.452,P ＜ 0.05).Conclusion CD4 + CD25 + CD127low/-Treg may be associated with the chronicity of HBV infection and the degree of liver damage.

Objective To compare the early treatment results of Pavlik harness and closed reduction plus spica cast?ing in treating developmental dislocation of the hips (DDH). Methods The patients with GrafⅢ/Ⅳtype DDH diagnosed by ul?trasound in our hospital were analyzed retrospectively from January 2009 to December 2013. The subjects with intact clinical and radiologic data and more than 2 years follow?up were included. The present study included 257 patients (298 hips), 31 male and 226 female, with the average age of 74.1±39.2 d (from 30 to 159 d). Pavlik harness underwent in 190, while 67 cases were treated with closed reduction plus spica casting. Acetabular index (AI), Wiberg OE angle (point O was the middle point of proximal me?taphyseal border) and Smith instability index (SI, SI?c:the lateral displacement index, SI?h:the vertical displacement index) on the pelvic X?ray film at 2-3 years of age after successful early treatment were recorded. Femoral head avascular necrosis (AVN) was diagnosed according to the Salter criteria. Results The success rate of reduction of closed reduction was significantly higher than Pavlik harness (97.5% vs. 69.9%, χ2=0.353, P=0.000). There was no significant difference in the incidence of AVN be?tween the closed reduction and Pavlik harness (6.6% vs. 4.6%, χ2=0.106, P=0.745). For GrafⅢ type DDH, the success rate of reduction of Pavlik harness and closed reduction were 80.7% and 98.4% respectively (χ2=11.248, P=0.001), while the Pavlik harness group had significantly worse results of AI, OE and SI?c at the age of 2-3 years (Pavlik harness: 22.9°±3.7°, 16.5°± 6.3° and 0.74 ± 0.06; closed reduction: 21.4° ± 3.4° , 18.9° ± 3.6° and 0.72 ± 0.03; P<0.05). For GrafⅣ type DDH, the success rate of reduction of Pavlik harness was much less than closed reduction (25.6% vs. 94.4%, χ2=24.231, P=0.001), with signifi?cantly worse results of OE at the age of 2-3 years (16.0°±4.1° vs. 18.6°±4.5°, t=-2.141, P=0.038). Conclusion Pavlik har?ness has limitations in treating GrafⅢ/Ⅳtype DDH, with lower success rate of reduction for GrafⅣtype DDH. Closed reduction plus spica casting has better clinical results than Pavlik harness in success rate of reduction and subsequent hip development with? out the additional risk of AVN.

Objective To investigate the clinical value of automated breast volume scanner(ABVS) system in detection musculoskeletal system lesions.Methods Totally 49 patients were scanned by Acuson S2000 ABVS system after conventional ultrasound examination.The scanning data of ABVS were stored and automatically reconstructed to obtain coronal and sagittal images.Then the results were analyzed and the occurrence rates of circle sign of different lesions were compared.Results The images of 49 lesions were obtained with ABVS and conventional ultrasound successfully.Statistical difference of the occurrence rate of circle sign was found between benign and malignant lesions (x2 =5.559,P =0.021).However,there was no statistical difference between hemangioma and malignant lesions (x2 =2.098,P =0.156).Meanwhile,a missed lesion in conventional ultrasound examination was found in coronal view by ABVS.Conclusions ABVS system can obtain effective coronal images of musculoskeletal system lesions,which represents a progress.

Objective To evaluate the effect of dexmedetomidine on the tolerance to endotracheal tube, on agitation and other complications of patients undergoing transnasal transsphenoidal pituitary tumor resection.Methods One hundred and twenty-four patients aged 18-65 years, ASA physical status Ⅰ or Ⅱ) were randomly assigned to dexmedetomidine group (group D, n=60) and control group (group C, n=62).Group D were given intravenous infusion of dexmedetomidine during the operation and group C with saline.The extubation time, observation time in the post-anesthesia care unit (PACU), the incidence of emergence agitation, cough, postoperative sore throat and hoarseness were analyzed.Results The extubation time [(29.7±11.5) min vs (22.2±8.5) min] and the length of stay in PACU [(41.5±11.8) min vs (35.3±10.0) min] were significantly longer in group D than those in group C (P<0.05).There was no significant difference of the incidence of emergence agitation (26.3% vs 32.3%), cough (49.1% vs 53.2%), postoperative sore throat (14.0% vs 24.2%) and hoarseness (10.5% vs 19.4%) between two groups.Conclusion Intraoperative intravenous administration of dexmedetomidine can prolong the extubation time and the length of stay in PACU.The incidence of agitation, cough, postoperative sore throat and hoarseness was not affected by dexmedetomidine.