Objective:To explore the significance of ethical issues in emergency medicine.Method:Literature review combined with specific features of emergency department in author's hospital is employed to explore the ethical issues in current emergency medicine,and the necessity to emphasize ethical issues.Related countermeasures are also come up with according to a small sample investigation among emergency residents in author's hospital.Result:Due to the unique characteristics of emergency medicine,there are specific ethical issues arising in emergency department.Conclusion:Enough emphasis should be attached to the reasons for ethical issues in emergency medicine.Relevant regulations and patients triage should be improved in emergency medical treatment.It is also called for to value patients' legal rights,strengthen physician-patient communication,and protect patients' life safety after emergency treatment.Meanwhile,it is also significant to relieve emergency doctors' stress at work,and strengthen sustainable on-job training and team-work of emergency doctors.

Objective:To investigate the current status of periodontal diseases in the population at the age of 12,35~44 and 65~74 years in Chongqing,to provide information for the establishment of oral health care policies in Chongqing. Methods:A stratified equal-sized randomly sampling design was applied to obtain 751 objects aged at 12 years old,723 objects aged at 35~44 years old and 722 objects aged at 65~74 years old of three cities and three rural areas in Chongqing. The status of gingival bleeding,dental calculus,periodontal pocket and loss of attachment were assessed according to "The Guidline for the Third National Oral Health Survey" by using a CPI prode.The detection rates were calculated and were compared in aspect of area and gender. Results:In the group aged 12,the detection rates of gingival bleeding and dental calculus were 79.49% and 86.68% respectively and the detection rates of dental calculus in rural areas were higher than that of urban residents(P

Chronic constipation (CC) is one of the most common digestive diseases with high prevalence and long course.CC patients often suffer from sleep disorders and psychological problems such as anxiety and depression.Somatic and mental symptoms may affect with each other, so a vicious circle will develop to impair patients′ quality of life (QOL) and increase their economic burden.The article reviews the impact of chronic constipation on QOL and economic burden of patients, indicating that clinician should pay sufficient attentions on chronic constipation.

Antithyroid drugs(ATD)is the main treatment for hyperthyroidism and its adverse reactions have been much concerned by physicians. Methimazole(MMI)and propylthiouracil(PTU)are the two common antitithyroid drugs used currently. Generally, the ATD are safe and effective, though their clinical adverse reactions are also relatively common. The toxic effects include liver damage and leukocytopenia, antineutrophil cytoplasmic antibody-associated pulmonary small-vessel vasculitis, hypoglycemia, allergic reactions, muscle impairment,and so on. They are usually reversible and disappear spontaneously when the drug is discontinued. However,the serious rare side effects can also occur and there may have potentially deadly threatening effects which need to be cautious for the clinicians. MMI is usually preferred over PTU because it has significantly fewer side effects. And unlike the dose-dependent side effects of MMI, there has no significant correlation between adverse reaction and drug dosage in using PTU. Moreover, PTU has more severe hepatotoxity than MMI, even fatal liver impairment and liver failure. The risk of liver damage from PTU is an important concern, particularly in children. For this reason, MMI is the first choice for treating children with hyperthyroidism.

Objectives: To compare the efficacy of patient-controlled epidural analgesia and patient-controlled intravenous analgesia in postoperative analgesia after spinal fusion. Methods: The CNKI, Wanfang, CBM, Pubmed, Embase, Ovid, Cochrane library databases were searched by computer. The randomized controlled trails with patient-controlled epidural analgesia or patient-controlled intravenous analgesia after spinal fusion published from May 1985 to July 2013 were selected. All of them were assessed by the standard of Cochrane systematic review. Data of postoperative VAS and the rate of side effects after using the analgesic drugs were extracted into an electrical sheet, which was synthesized by a Meta-analysis with RevMan 5.2 software. Re-sult: Eight randomized controlled trails involving 482 patients met the inclusion criteria. And the quality grade of 3 literatures was A, 5 literatures was B. The result of meta-analysis showed that: ①Visual analogue score(VAS). The postoperative first day′s VAS[WMD=-0.47, 95%CI(-0.74, -0.20)], second day′s VAS[WMD=-0.66, 95%CI(-1.14, -0.19)] showed that the patient-controlled epidural analgesia had a good analgesic effect compared with the patient-controlled intravenous analgesia, and both had statistic differences(P<0.05). No dif-ference in the postoperative third day′s VAS[WMD=-0.58, 95%CI(-1.38, 0.21)] was observed between the two methods, and no statistic difference(P>0.05); ②The side effects. The patient-controlled epidural analgesia had a higher incidence of skin itch[RR=1.53, 95%CI(1.08, 2.16)], paresthesia[RR=3.34, 95%CI(1.12, 9.98)] after surgery than the patient-controlled intravenous analgesia, and both had statistic differences(P<0.05). While two groups had no a significant deviation about nausea [RR=1.05, 95%CI (0.79, 1.40)], vomiting [RR=0.80, 95%CI (0.48, 1.31)], and no statistic difference(P>0.05). Conclusions: The patient-controlled epidural analgesia has better analgesic effects on the postoperative first and second day after spinal fusion, but obviously has a high-er incidence of skin itch and paresthesia than the patient-controlled intravenous analgesia.

Background and purpose:Actin related protein 2/3 complex subunit 5 (ARPC5) is involved in the packaging of actin, and then affects the mobility of cells. It plays an important role in the formation of invadopodia of cancer cells. This study aimed to investigate the effect of ARPC5 gene-silence on cell proliferation, migration and invasion of lung squamous carcinoma cell line SK-MES-1. Methods:Under the induction of LipofectamineTM RNAiMAX, the recombinant of si-ARPC5 was transfected into SK-MES-1. The experiment set up 3 groups:blank (mock) group, negative control (NC) group and si-ARPC5 transfected group. Cell proliferation, migration and invasion assays were investigated by cell counting kit(CCK-8) method, scratch assay and Transwell Chambers respectively. Results:The result of qRT-PCR and Western blot displayed downregulation of ARPC5 in mRNA and protein level of SK-MES-1 cell. Proliferation rate of SK-MES-1 cells in 72 h after si-ARPC5 transfection was lower than those in mock and NC groups (t=7.993, t=8.681, P<0.05). Compared to the mock and NC groups, the scratch repairing rate of the si-ARPC5 group was lower [(43.32±0.23)%vs (73.11±0.43)%and (76.58±0.88)%] (t=7.348, t=10.614, P<0.05);And the number of penetrating the membrane was signiifcantly reduced [(27±6) vs (101±11) and (92±9)] (t=10.229, t=8.391,P<0.05). Conclusion:Downregulation of ARPC5 gene can inhibit the proliferation, migration, and invasion of SK-MES-1 cell.

Objective:To obtain the morphological data of permanent teeth excavated from the Long County in Shaanxi Province about 2 000 years ago.Methods:Morphological methods were used to measure all teeth of 59 human skulls excavated from the Long County in Shaanxi Province about 2 000 years ago and conserved in Chinese Academy of Science.The information included length of tooth,height of dental crown,length of dental root,breadth of the dental crown,thickness of the dental crown,breadth of the dental neck and thickness of the dental neck.The data were analyzed by SPSS 13.0 software.Results:Length of tooth,height of dental crown,length of dental root,breadth of the dental crown,thickness of the dental crown,breadth of the dental neck and thickness of the dental neck of all teeth of 59 human skulls were reported.Conclusion:It suggests that the measured data may be useful in anthropological research.

Silent cerebral infarction is widely exist in the elderly population.It is considered to be the early clinical stage of symptomatic stroke and cognitive impairment.The incidences of silent cerebral infarction are higher in patients with atrial fibrillation and after atrial fibrillation ablation.It is not clear whether anticoagulant therapy can prevent silent cerebral infarction and improve cognitive function in patients with atrial fibrillation.This article reviews the hot issues related to silent cerebral infarction and atrial fibrillation.

OBJECTIVE:To establish the quality standard of New Tongzhi surunjiang capsule. METHODS:Qualitative identification of Folium Sennae,Crocus sativus and Colchicum autumnale was conducted by TLC method. The content of gallic acid in the formulation was determined by HPLC. RESULTS:The TLC spots of Folium Sennae,Crocus sativus and Colchicum autumnale were clear and well-isolated. The linear range of gallic acid was 0.155 7～1.401 3 ?g(r=0.999 8) with a mean recovery rate of 101%(RSD=1.64%,n=9).CONCLUSION:The established standard is suitable for the quality control of New Tongzhi surunjiang capsule.

Objective To explore indications of the conservative therapy an early operative treatment for severe acute pancreatitis and researching comprehensive therapeutic rule.Methods Retrospective analyze the clinical feature and the result as making a diagnosis and giving treatment of 82 cases of SAP admitted from Aug.1986 to dec.2000.Results Among them,28 cases underwent conservative treatment,with the cure rate of 85.7%,54 cases underwent conservative treatment,with the cure rate of 81.5%,the total cure rate was 82.9%.Conclusions The conservative therapy or early operation of SAP is determined by the patients' clinica feature,while the supportive conservative therapy being on,we should carefully observe the changes of the patient's condition and the response to therapy,when once surgical indication being discovered,early operation should be performed ,the emergency surgery should be performed as soon as possible for the biliary obstruction of SAP.