The test concludes the existing prominent problems and main damages on medical morality recently in China,and it also discusses the necessity and feasible ways to reinforce the medical moral construction from the two aspects of theory and practice under social market economical condition.

Staphylococcus epidermidis(SE)is the main opportunistic pathogen in nosocomial infections.It usually enter the body along with biomedical materials and adheres to the surface of biomaterials to form bacterial bi06lm.SE bi06lm bears high organized multi.cell colony structure.Bacterial biofilm iS the key reason for refractoriness of biomaterial originated infection.This paper gives an overview of the research progresses in biomaterial related infection,including SE ica operon,formation of biofilm,biofilm treatment,and SO on.Our review shows that studies of SE biofilm were COnfined to the mutated strain from laboratory and growth pattern of plankton and thus the natural clinical pathogenic procedure of SE can't be fully described.Further study should be carried out on formation of SE biofilm and treatment of infections related to the clinical application of biomaterials.

Mangiferin also called Chinonin or mango, is mainly extracted from the Anacardiaceae and Gentianaceae plants. As polyphenol compounds, Mangiferin shows a strong antioxidant activity and a variety of pharmacological effects. In recent years, laboratory study has identified a variety of pharmacological effects associated with Mangiferin including preventing diabetes and its complications, regulating lipid metabolism abnormalities, antitumor, cardiovascular protection,anti hyperuricemia, neuro-protection, anti oxidation, anti-inflammation, antipyresis and analgesia, anti-bacteria and antivirus, antiradiation, liver pro-tection, promoting skeletal growth, anti allergy and immune reg-ulation,etc. In this paper, the research progress of pharmacolog-ical effects of Mangiferin is reviewed, analyzed and summarized in order to provide reference for further research and develop-ment.

Objective To establish case database of critical illness and explore the effect of critical case-based learning in the anesthesia teaching program as well as its influence on clinical thinking ability of students. Methods Case database of critical illness was built with foxtable software and ASAⅢ~Ⅴpatients undergoing anesthesia were included in the case database. Patients' information were recorded according to the sequence of pre-operative evaluation,intra-operative management and post-operative recovery. We designed a student questionnaire to investigate the effect of critical case-based learning. And we also compared the effect of critical case-based learning and traditional teaching on undergraduate interns, residents, and graduate students by scores of case analysis test. Data analysis used t test. Results The critical cases database is characterized by authenticity, hierarchy and for-wardness. Survey result of questionnaire shows that the proportions of students who believe critical case-based learning helps to strengthen the links of theory and clinical practice, to improve expression skills, and to promote active classroom atmosphere, solidarity and cooperation are 80%, 71.6% and 68.3%respectively. Compared with those who received traditional teaching, the residents and graduate students who received critical case-based learning get significantly higher scores in case analysis test. However, the difference of scores between undergraduate interns receiving traditional teaching or criti-cal case-based learning has no significance. Conclusion The establishment of critical cases database and its application in anesthesia teaching program have effectively improved clinical thinking ability of anesthesia residents and graduate students.

AIM: To study the role of c-myc oncogene in L6565 leukemia oncogenesis and the effects of therapy by inhibition of its expression with antisense c-myc. METHODS: A recombinant retroviral vector containing antisense c-myc of the murine (pGNCas)was constructed and then transfected into PA317 cells by the method of calcium phosphate precipitation. L6565 clone cells were infected with retrovirus particles. Stable integretion of antisense c-myc was shown by PCR. The change of the malignance and phenotype of L6565as were detected by the examination of the growth, morphology, cells cycle, agar assay and expression of c-myc. RESULTS: The shape of most L6565as cells became spherical. The growth of L6565as was inhibited compared to control cells. The analysis of cells cycle: L6565as cells were arrest in G 0/G 1 phase, decreased in S phase. The ability of L6565as cells to form colony in soft agarose was significantly suppressed. c-myc in L6565as cells was lowly expressed. CONCLUSION: (1)c-myc plays a critical role in L6565 leukemia oncogenesis; (2)Inhibition of expression of c-myc makes partly reversion of malignant phenotype of L6565 murine leukemia clone cells.

Objective To appraise the treatment of percutaneous ethanol injection (PEI) on Graves′ disease in case selecting, puncture locating and treat evaluation. Methods With high frequency color Doppler ultrasonographic examination, 32 cases with Graves′ disease underwent PEI treatment. Twenty four weeks later the patients were reassessed. Results All the patients can endure PEI treatment.Thirteen cases(41%) showed no hyperthyroid symptoms and their relative steriods and antibodies recovered normal.They stopped the drug,then four cases(13%) recurred.The other nineteen cases(59%) showed less symptoms or disappearance,their relative steriods and antibodies basically returned to normal,low dosage of the drug was administered.Conclusions A good outcome can be achieved with PEI treatment. Ultrasonography has important roles in case selecting, puncture locating and treat evaluation.

Objective: To study the expression of CD138 in normal cervical mucosal tissue,cervical intraepithelial neoplasia ( CINⅠ/Ⅱ and CINⅢ) and cervical squamous cell carcinoma.And to investigate the clinical pathologic significance of CD 138 expression with lymph node metastasis , microvascular density ( MVD ) , CD68 expression and clinical stage in cervical squamous cell carcinoma.Methods:To detected the expression of CD 138 in 120 cases of cervical squamous cell carcinoma ,106 cases of CINⅢ,14 cases of CINⅠ/Ⅱand 54 cases of normal cervical mucosa tissues.Results: The expression of CD138 was lowest in cervical cancer tissue,followed by normal cervical mucosal tissue ,CIN I/II and CINIII,that there had significant difference (P<0.001).The expression level of CD138 was higher in without lymph node metastasis group than in lymph node metastasis group ( P<0.05 ).In cervical cancer , the expression level of CD 138 was higher in early stage ( stage 0 andⅠ) than in advanced stage (Ⅱ) ( P<0.001 );and higher in CD68 expression negative group than in positive group (P<0.05).Furthermore,MVD was higher in CD138 expression negative group than in positive group ( P<0.05 ).Conclusion: CD138 play an important role in the process of development of cervical squamous cell carcinoma,especially for the role of lymph node metastasis is more obvious.CD138 could be used as a indicators for determinate the process of progress in cervical squamous cell carcinoma.

Objective To construct a qseC-deleted mutant strain of E.coli by Red recombination and to study the effect of qseC gene on biofilm formation in the mutants.Methods The chloramphenicolresistant gene flanked by homologues of target genes was amplified by PCR and electro-transformed into E.coli MC1000.When induced by L-arabinose,the plasmid pKD46 could express three recombinant proteins of λ-prophage,which led to the replacement of target gene(qseC) with chloramphenicol-resistant gene.Then the chloramphenicol-resistant gene was eliminated by FLP-promoted recombination events.The biofilm formation of wild-type and mutant strain was detected by crystal violet staining.Results The qseC-deleted mutant of E.coli was confirmed by various PCR and DNA sequencing.Gene qseC was completely deleted.There was no significant difference in growth ability between the qseC mutant strain and the wild-type strain MC1000.The biofilm formation of wild-type and mutant strain was quantified by crystal violet staining.The absorbance determined with a plate reader at 570 nm was 1.00±0.15 and 0.47±0.10 respectively.Conclusion The qseC-deleted mutant of E.coli was constructed successfully.And the qseC gene plays an important role in regulation of biofilm formation in E.coli.

Objective To explore the expression and significance of N-cadherin in urothelial bladder cancer and analyse its relation to clinicpathologic and prognosis of bladder cancer.Methods The expression of N-cadherin in 145 urothelial bladder cancer and 25 normal bladder tissues was detected by immunuhistochemisty,and correlations between N-cadherin and clinicopathologic features were analysed.Results The positive rate of N-cadherin protein was significantly higher in bladder cancer than in normal bladder tissue (P＜0.01).The positive rate of N-cadherin protein was 38.6％ in G1 bladder cancer,58.4％ in G2-G3 bladder cancer,and its difference was significant (P =0.028).The expression was significantly lower in non-muscle-invasive bladder cancer than in muscle invasive bladder cancer (45.7％ vs 64.7％,P=0.029).The muscle-invasive bladder cancer patients were followed up 4-103 months.Among those,the overall survival with positive expression of N-cadherin protein was 24.2％ (8/33),and the overall survival with negative expression of N-cadherin protein was 66.7 ％ (12/18).Kaplan-Meier analysis showed the positive expression of N-cadherin was significantly associated with overall survival of patients with muscle-invasive-bladder cancer (P=0.002 2).Multivariate Cox analysis showed that N-cadherin expression was an important prognostic factor.Conclusions The expression of N-cadherin protein was high in bladder cancer.The detection of the expression of N-cadherin protein is associated with the diagnosis and prognosis of bladder cancer.

Objective To explore the prognosis of elderly patients suffered from hospital-acquired pneumonia (HAP) by T cell subsets and clinical pulmonary infection score (CPIS).Methods A cohort of 125 elderly patients admitted in ICU & ED (Emergency Department) from Aug,2012 to Jul,2013 were enrolled for a prospective and observational study.The patients were divided into 3 groups:HAP survival group (n =50,group A),HAP death group (n =40,group B) and non-HAP group (n =35,control group).The criteria of exclusion were patients with auto-immune diseases,immunodeficiency,allergic disorders,malignancies,diabetes,trauma,surgical diseases,or patients with recent use of immunosuppressive agents or cyclooxygenase-inhibitors (Aspirin etc.).In the control group,patients with nosocomial pneumonia and other diseases afecting the CPIS were excluded.APACHE Ⅱ scores of all patients were recorded.Blood T cell subsets (including values of CD3,CD4 +,CD8 +,and CD4 +/CD8 +)were measured on the admission day,the 1st day of HAP onset and the 5th day after onset of HAP in HAP patients whereas these measurements were tested only on the admission day in controls.Meanwhile,the CPISs were recorded on the admission day,the 1st day of HAP onset and the 5th day after onset of HAP in HAP patients.Flow cytometer (FCM) was used to detect T cell subsets.Data of statistical analysis were represented as Mean ± SD.The significant differences in T cell subsets and CPIS between survival group and death group were analyzed by independent t test.The paired samples t test was employed in survival group and death group.Linear correlation analysis was made between CD4 +/CD8 + ratio and CPIS in survival and death groups,respectively.Results There were no significant differences in demographics and clinical features (including age,sex,length of stay,APACHE Ⅱ scores) of patients in survivors and non-survivors (P ＞ 0.05).The values of CDs (CD3,CD4 + and CD4 +/CD8 + ratio) between patients of control group and patients of HAP groups were not significantly different on the admission day (P ＞ 0.05).The values of CDs on the admission day were much lower than those on the 1 st day of HAP onset in both survivors and nonsurvivors (P ＜ 0.05).The values of CDs on the 5th day after onset of HAP were higher than those on the 1 st day of HAP onset in the survival group (P ＜ 0.05),while there were no significant differences in CDs between different intervals after HAP onset in the death group (P ＞ 0.05).There were no significant changes in values of CD8 + in any group (P ＞ 0.05).Both survivors and non-survivors had much higher CPIS values on the 1st day of HAP onset than those on the admission day (P ＜0.01).The survival group had higher CPIS on the 5th day after onset of HAP compared to the 1st day of HAP onset (P ＜0.01),while there was no significant change in the death group.Linear correlation analysis showed negative correlation between CD4 +/CD8 + ratio and CPIS on both the 1 st day of HAP onset (survival group:R =-0.740,P =0.004 ; death group:R =-0.613,P =0.035) and the 5th day after onset of HAP (survival group:R =-0.639,P =0.009; death group:R=-0.686,P=0.021).Conclusions The hospital-acquired pneumonia appears as an immune imbalance disorder.The difference in CDs is a promising objective tool,aiding in prediction of prognosis of HAP in the elderly,the lower the CDs,the higher severity.The CD4 + / CD8 + ratio showed a negative correlation with CPIS.Monitoring of T cell subsets and CPIS may provide clinical value for the treatment of hospital-acquired pneumonia in the elderly.