The event of “diagnosing mental disorder but actually not” violates patients′right of informed con-sent and refused to health , showing some problems of “diagnosing mental disorder but actually not” and mandatory admission process and psychiatric judicial authentication , and also have some ethical problems .Therefore, relevant departments should perfect the laws and regulation , establish a hospitalized psychiatric patients appeal , the appeal channels , at the same time , physicians should follow a correct understanding , respect patients rights , disinterest-ed, the ethical principles of self -supervision and also use constraints should be regulated .

OBJECTIVE:To evaluate the effect of temozolomide(TMZ)in combination with dexamethasone(DXM)on the proliferation of human gliocytoma U251 cells in vitro.METHODS:Human U251 cells were assigned to 1 of the 3 groups: TMZ(10,25,50,100,200,400?mol?L~(-1),respectively)alone or in combination with 40?mol?L~(-1)DXM(TMZ+DXM group)or control group(none drug).After treatment for 72 hours,the cell morphology,cell inhibition ratio,cell cycle and the apoptotic rate were detected.RESULTS:When TMZ concentration was greater than 100?mol?L~(-1)the cell inhibition ratio was higher in TMZ-treated group than in TMZ+DXM-treated group(P

Objective Though X-ray measurement of metacarpal bones of right hand in children aged 7-12 in Kaschin-Beck disease (KBD) endemic areas in Xinghai County,Qinghai Province,to provide scientific basis for KBD diagnosis and research on growth and development of children in KBD endemic areas.Methods In 2012,277 children aged 7-12 were carried out clinical examination and right hand X-ray photos in KBD endemic areas,Xinghai County,Qinghai Province.Metacarpal bones were measured by electronic digital vernier caliper,and the axis length and width of the metacarpal bones and its metacarpal bone index were calculated.All data were analyzed by SPSS 19.0 software.Results The axis lengths of the metacarpal bones were in an order of 2.metacarpal ＞ 3.metacarpal ＞ 4.metacarpal ＞ 5.metacarpal ＞ 1.metacarpal in 6 different age groups and different genders; the width of 1.metacarpal bone was the widest; the width of 4.metacarpal bone was the smallest,and the rest of metacarpal bones were similar.The metacarpal bone indexes of female [(7.96 ± 0.76),(8.24 ± 0.92),(8.24 ± 0.71),(8.26 ± 0.92),(8.60 ± 1.02),(8.67 ± 0.84)mm] were higher than those of male's[(7.30 ± 0.78),(7.53 ± 0.77),(7.98 ± 0.90),(7.79 ± 0.56),(7.96 ± 0.64),(8.17 ± 0.92)mm,F =4.302,P ＜ 0.05].Conclusion The axis length,width and index of metacarpal bones of right hand in children between KBD endemic areas and no-KBD endemic areas are similar.

Objective To investigate the turnover and factors influencing amniotic membrane transplantation into corneal stroma.Methods Amniotic membrane stained with dichlorotriazinyl aminofluoresclin (DTAF)was implanted into the corneal stroma of 1 5 New Zealand white rabbits.After transplantation,we observed the clinical changes.The tissue samples from grafted area were observed with HE staining and laser confocal microscope to trace amniotic membrane at 4,8,13,1 7 and 22 week after surgery.And the tissue samples at week 22 after surgery from grafted area were also observed by transmission electron microscopy.Results After 4 weeks of operation, amniotic membrane tissue bent with visible multi-layer homogeneous red dye.The structure remained intact;basement membrane and stroma were no dissolved.After 8 weeks, amniotic tissue was a strip structure of homogeneous red dye,and the substance layer was complete.After 13 weeks,amniotic membrane morphology appeared fuzzy,but still took the shape of strips;a small number of corneal cells accumulated around the amniotic membrane.At 1 7 weeks after operation,fragmented amnion was evident.At 22 weeks after operation,small pieces of amnion tissue remained in the corneal stroma.Laser scanning confocal microscopy revealed that amniotic membrane could retain for over 22 weeks in the corneal stroma.After 22 weeks,amnion stroma collagen fibers that were integrated into the corneal stroma were irregular.Corneal stromal ultrastructure surrounding the amniotic membrane did not obviously change.Conclusion Retention time of amniotic membrane transplanted into corneal stroma can be as long as over 22 weeks and amniotic membrane can be merged into the corneal tissue as a substitute, which wins time for corneal transplantation operation.

Objective To evaluate the clinical efficacy of endoscopic esophageal variceal ligation (EVL) for esophageal variceal bleeding (EVB) in elderly patients with hepatic cirrhosis.Methods From July 2007 to July 2013,clinical data of 198 patients who had been diagnosed with liver cirrhosis presenting with EVB were retrospectively analyzed.Among them,167 patients who had received EVL were divided into the elderly EVL group (n=97,age≥60 years) and the non-elderly EVL group (n=70,aged ＜ 60 years).The other 31 cases (aged ≥ 60 years) had received propranolol therapy.Treatment effectiveness,adverse effects,complications and the one-year survival rate of each group were analyzed.Results The efficacy rates and variceal recurrences were 77.3％ (75/97) and 78.6％ (55/70) in the elderly EVL group and 19.6％ (19/97) and 18.6％ (13/70) in the non-elderly EVL group,respectively,with no significant difference between the two groups (each P＞0.05).The re-bleeding rate was higher in the propranolol treatment group than in the elderly and non-elderly EVL groups [58.1％ (18/31) vs.24.7％ (24/97) vs,22.9％ (16/70),x2 =14.76,P =0.00].One-year survival rates in the elderly group,the non-elderly EVL group and the propranolol treatment group were 86.6 (84/97),88.6％ (62/70),64.5％ (20/31),respectively,with statistically significant differences between the three groups (x2 =10.24,P=0.01).Conclusions EVL is effective for the treatment of hepatic cirrhosis with EVB and can be used as a secondary prophylaxis measure for EVB in elderly patients with hepatic cirrhosis.

Objective To determine a combination of biomarkers that assure the diagnosis of sepsis and severe sepsis in patients in emergency department (ED).Methods A total of 652 patients with systemic inflammatory response syndrome (SIRS) were enrolled for this prospective study in the ED of Beijing Chaoyang Hospital of the Capital Medical University between March 2010 and March 2013.Eight biomarkers were determined,including levels of procalcitonin (PCT),interleukin-6 (IL-6),D-dimer,C-reactive protein (CRP),brain natriuretic peptide (BNP),white blood cell count (WBC),percentage of immature neutrophil,and platelet count (PLT).Patients were divided into the sepsis group (452 cases) and non-sepsis group (200 cases) according to the diagnostic criteria of sepsis.Then all these patients were stratified into severe sepsis group (190 cases,including septic shock) and non-severe sepsis group (462 cases) according to the diagnosis of severe sepsis.Logistic regression was performed to identify the independent factors for the diagnosis of sepsis and severe sepsis,and the optimal combination of biomarkers was established.Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic ability of the combination and the biomarkers.Results PCT,IL-6 and D-dimer were independent factors for diagnosis of sepsis and severe sepsis.The area under the ROC curve (AUC) of the combination of three biomarkers was 0.866 for diagnosis of sepsis,and it was higher than the AUC of PCT (0.803),IL-6 (0.770) and D-dimer (0.737) alone,and this new combination showed better sensitivity,specificity,positive predictive (PPV),and negative predictive (NPV) values than that when the three biomarkers was used individually (the results of combination were 81.2％,8 1.0％,90.6％,56.5％ ; that of PCT were 75.2％,80.0％,89.5％,58.8％; that ofIL-6 were 81.0％,61.0％,82.4％,58.7％; and that of D-dimer were 79.9％,59.0％,81.5％,56.5％,respectively).The AUC of the combination was 0.815 for the diagnosis of severe sepsis and was better than the three biomarkers used alone,which was 0.758 for PCT,0.740 for IL-6,and 0.704 for D-dimer respectively.Moreover,the sensitivity,specificity,PPV and NPV of the combination were higher than that of the three biomarkers used singularly (the results of combination were 81.6％,73.6％,56.0％,90.6％; that of PCT were 79.5％,65.0％,48.2％,88.5％; that of IL-6 were 65.8％,70.6％,47.9％,83.4％; and that of D-dimer were 60.5％,73.2％,48.1％,81.8％,respectively).Conclusion The combination of PCT,IL-6 and D-dimer enhances the diagnostic ability for sepsis and severe sepsis.

Objective To investigate the effects of doxycycline on the expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metaloproteinase-1 (TIMP-1) in breast cancer lung metastasis model mice (BCML-TAⅡ99), and the mechanism thereof. Methods The BCML-TAⅡ99 mouse model was established. The immunohistochemical staining was performed to detect the expressions of MMP-9 and TIMP-1 in BCML-TAⅡ99 model mice and controls. Results The metastasis rate was significantly lower in treatment group than that of control group. The expression of MMP-9 was significantly reduced, but the expression of TIMP-1 was significantly increased, in treatment group compared with those of control group (P<0.05). Conclusion Doxycycline can inhibit tumor growth and metastasis in breast cancer with 1ung metastasis model mice by regulating MMP-9 and TIMP-1 expressions.

Objective Systematically reviewed the standard treatment of primary brain glioma patients high levels,and discussed effective new therapies. Surgery,radiotherapy and chemotherapy are the main methods of treatment of high?grade gliomas, molecular markers supplement clinical prognostic factors under certain circumstances be able to guide treatment decisions. The rapid development of technology using molecular data can improve our understanding of the disease pathogenesis and proliferation. Effectively validate prognostic biomarkers and identification of tumor may improve the outcome.

Objective To construct a new gene delivery system based on atelocollagen (ATE),and explore that modified aptamer (APT),and APT-ATE/miRNA (miRNA-15a and miRNA-16-1) were successfully synthesized to treat bone-metastatic prostatic cancers.Methods Flow cytometry (FCM) analysis was used to characterize APT-ATE complex.The diameter and zeta potential of complexes were measured by Zetasizer Nano-ZS9.The prostatic cancer (PCa) distribution experiments were used to explore its biological characteristics and targeting ability of PCa cells (PC3 and LNCaP).The inhibition of APT-ATE complex on LNCaP cell was determined with the cholecystokinin (CCK)-8 assay.Results FCM results demonstrated the successful synthesis of ATE-APT complex.The cellular uptake of vectors was concentration-dependent.The gene expression in vitro indicated that the modification of APT could increase the efficiency of gene expression and PCa targeting ability of ATE vectors to LNCaP [prostate specific membrane antigen (PSMA) over-expressing prostate cancer cells].The result of biodistribution showed that the bone uptake of APT-ATE was higher than ATE-APT.Conclusions APT-ATE/miRNA might be useful for preclinical and clinical studies on the treatment of bone-metastatic PCa.