As a public product,contraceptives are freely provided to eligible people by the Chinese government to guarantee the implementation of the family planning policy,the realization of coordinated development of population and economy,and the benefit of descendants,which conforms to ethical principles.In recent years this free public service,delivered in high-quality and through informed consent,has ethically embodied the respect for human rights and concern for reproductive health of the people.However,in the process of free contraceptive supply,some ethical problems still exist.To begin with,the lack of knowledge and skills in conducting informed consent has placed both service providers and eligible people into a dilemma.Besides,the majority of unmarried,single and divorced have been unfairly excluded from free contraceptives and services.Thirdly,the contraceptive management system and some department responsibilities have been contrary to each other.The author suggests it is necessary to define more clearly the nature of management structure,refine the current contraceptive supply policy,reform the management mechanism and standardize the practice of informed consent in an effort to improve the current contraceptive supply service.

Objective To evaluate the curative difference of laparoscopic cholecystectomy (LC)between elder and middle age.Methods Patients with gallbladder disease who underwent LC from 2006 to 2011 were collected and divided into elder group (≥65 years old,35 patients) and middle age group(＜ 65years old,353 patients).The operation time,conversion rate,postoperative complications,time to first oral intake,time to first ambulation and hospitalization time were compared.These patients were divided into simple gallbladder disease group (included recurrent biliary colic,chronic cholecystitis,gallbladder polyps)and the complex gallbladder disease group (included acute cholecystitis,gallbladder empyema,acute cholecystitis perforation).The age,WBC,operation time,postoperative complicantions and hospitalization time were evaluated.Results The operation time,conversion,postoperative complications rate,time to first oral intake,time to first ambulation and hospitalization time had no significant difference between elder group and middle age group (P ＞ 0.05).The age,conversion rate between simple gallbladder disease group and complex gallbladder disease group had no significant difference (P ＞ 0.05).But the WBC,operatian time,postoperative complications,hospitalization time in simple gallbladder disease group had significant difference compared with complex gallbladder disease group [(7.32 ± 2.12) × 109/L vs.(11.35 ± 4.62) × 109/L,(62.3 ±29.5) min vs.(79.5 ±49.2) min,3.1％(10/322) vs.9.8％(5/51),(5.0 ±3.7) d vs.(7.9 ± 6.5) d,P ＜ 0.01 or ＜ 0.05].Conclusions Age is not the risk factor of LC in elderly patients,but the disease type has a significant effect on the choice of LC.

Objective: To establish a quantitative analysis of multi-components by single marker ( QAMS ) for determining the three alkaloids in Jinji capsules. Methods:With the typical composition palmatine as the internal standard, the relative correction fac-tor ( RCF) between the palmatine and berberine or jateorhizine was respectively established, and the content of berberine and jateorhiz-ine was respectively calculated by QAMS. An external standard method was used to determine the three alkaloids, and the calculated values were compared with the estimated values by Pearson correlation coefficient. Results:There was no significant difference between the calculated values in QAMS and the estimated values in the external standard method, and the RCF was credible. Conclusion:The new method is feasible and accurate to evaluate the contents of the three alkaloids in Jinji capsules.

Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients over 80 years old with biliary-pancreatic diseases. Methods One hundred and twenty patients over 80 years old who underwent ERCP between January 2004 and April 2008 were retrospectively analyzed. The clinical efficacy, safety and complication were observed and followed up. Results One hundred and seventeen patients successfully underwent therapeutic ERCP and the success rate was 97.5%. All diseases of the patients included cholangiocarcinoma in 22 cases, duodenal papilla carcinoma in 3 cases, pancreatic carcinoma in 8 cases, acute pancreatitis in 15 cases, chronic pancreatitis in 5 cases, acute suppurative cholangitis in 9 cases and choledocholithiasis in 58 cases. During the procedure of ERCP, 3 cases failed to insert the duodenoscope, 3 cases were found hemobilia and 2 cases were found acute pancreatitis. Conclusions Therapeutic ERCP is effective and safe in elderly patients over 80 years. Age is not the contraindication of therapeutic ERCP.

OBJECTIVETo investigate the mechanism of how curcumin improves pulmonary vascular remodeling associated with chronic pulmonary arterial hypertension.

METHODSThe model of chromic hypoxia hypercapniapulmoary remodeling was made. Twenty-four male rats were randomly divided into 4 groups (n = 6): group I (normoxia control group), group II (hypxia and hypercapnia model group), group II (disodium cromoglycate control group), group IV (curcumin treated group). The last 3 group rats were put in a hypoxia cabin where the concentrate of O2 was 8% - 11% and the concentrate of CO2 was 3% - 5%, for 8 h a day and lasting 4 w in total. Group III rats were intraperitoneally injected with disodium cromoglycate (20 mg/kg) and group IV rats were administrated with curcumin by gavage (150 mg/kg). The morphological changes of pulmonary vessel walls and the ultrastructure of mast cells were observed by the optics microscope and the transmission electron microscope. Mast cells and its degranulation state were measured by toluidine blue staining and immunohistochemistry. Data were expressed as means ± SD (standard deviation) and analyzed with SPSS17.0 software.

RESULTS(1) By optics microscopy observation, the value of WA/TA was significantly higher in II group than other groups (P < 0.05). (2) Electron microscope showed that the endothelial cells of pulmonary arterioles in III and IV group were near to I group and the proliferation of pulmonary arterial media smooth cell layer and collagen fibers in adventitia was much lighter than those in II group. The membrane of mast cells was more intact in I, III, IV group than II group. (3) The number of mast cells, the degranulation rate of master cells and the number of positive tryptase stained cells in II group were significantly more than those in other groups. (P < 0.05).

CONCLUSIONCurcumin may inhibit the remodeling of pulmonary vessel induced by chronic hypoxia hypercapnia by mast cell regulation.

Animals ; Cell Degranulation ; Curcumin ; pharmacology ; Hypercapnia ; physiopathology ; Hypertension, Pulmonary ; drug therapy ; Hypoxia ; physiopathology ; Lung ; pathology ; Male ; Mast Cells ; physiology ; ultrastructure ; Pulmonary Artery ; drug effects ; Rats ; Rats, Sprague-Dawley ; Vascular Remodeling ; drug effects