According to the theory of optimization by ???? ??????????????(俄).this essay propounds two ideal about medical ethics of ethics and the clinic practice.The second involves the optimize methodology including self-study.classroom teaching and case discussion;Via multimedia and network.

Doctors face relevant ethical responsibilities in the medical process of organ transplantation in China: fair distribution of organs,adaptive judgment of a surgical operation for patients with medium and advanced stage of liver cancer,avoidance of wasting medical resources,and a responsibility to prevent receivers from the risk of contacting HIV and HCV infection.So doctors in China should be provided with relevant ethical and legal knowledge and conceptions to take responsibilities to minimize the above risks and adverse issues,and then keep organ transplantations developing in a moderately healthy style.

Objective To report the clinical result of island flaps of hand in reparing of hand skin defects Methods According to location of skin defect, thirty eight cases with skin defect in hand were repaired by different types of island flap on hand Results The repair effect was satisfactory, almost all flaps were transplanted successfully, except two flaps The postoperative follow up period was 6 to 18 months, the blood supply, elasticity and texture of flaps were fine Conclusion Transfering of different types of island flap of hand is an easy, safe and reliable method with fewer complication

Objective For analyzing the outcome of toe transplantation Methods From 1992 to 2001, 24 cases of defect of fingers were treated with toe transplantation, including second toe transplantation for thumb in 19 cases, for index finger in 1 case, and for middle finger 2 cases, as well as second toe and third toe transplantation for middle and ring fingers in 2 cases Results The transplantated toe survived in 23 cases The reconstituted fingers and thumbs showed good shape and excellent function Conclusion Careful examination, reasonable design of reconstrction plan, and fine manipulation to protect blood vessels from trauma induced by operation play a key role in the toe transplantation, especially in the presence of abnormal blood vessels

Objective To analyze the associations between alleles of TNF?-308 and myasthenia gravis(MG) and its subgroups. Methods A biallelic polymorphism at position -308 in the promoter region of TNF? was screened by polymerase chain reaction (PCR) amplification and NcoⅠ restricted enzyme. One hundred MG patients and one hundred healthy controls of Chinese were analysed. Results The allele TNF?2(A) was found significantly increased in all patients (0.32 in MG vs 0.21 in healthy controls, P0.05), showing a trend of increase in patients with an late onset of disease (0.34) compared to age matched healthy controls (0.10, P

Objective:To observe the anti-glioma effects of lymphocyte activated by SEC in vivo and probe into therapy effects of SEC combing with operation,radiotherapy and chemotherapy.Methods:Experiment animals were SCID mice.With establishing animal model of glioma xenografted and immunity chimeric model of HuPBL-SCID,we observed the growth curve,survive time.With having operation,radiotherapy and chemotherapy,30 patients suffering from glioma were divided into control group,handle group 1 and 2,and then results were analyzed with MRI.Results:Growth curve shows:A,C and B group produced different suppress against glioma and its suppress rate were 58.5%,46.2% and 36.3%.The first death occurred at the 17th day in control group mice and all mice deaded at the 40th day.Contrasting to this,the first death occurred at the 40th day and 50% mice still were alive in group A until the day that experiment has just finished(60 day).Clinical material showed:The rate of effect(CR and PR) in control group was 40%,while the rate of effects was 50% in handle group 1 and 62.5% in handle group 2.Conclusion:SEC has extramaly potent anti-tumor activity against glioma.SEC combined with operation,radiatherapy and chemotherapy can raise treatment effect in patients with glioma.

Objective To explore the clinical value of combined detection of human epididymis protein 4(HE4) ,carbohydrate an‐tigen 199(CA199) and carbohydrate antigen 125(CA125) in diagnosis of ovarian cancer and benign ovarian cysts .Methods The se‐rum levels of HE4 ,CA125 and CA199 were determined by using chemiluminescent immunoassay in 45 cases of patients with ovarian cancer(ovarian cancer group) ,60 cases of patients with benign ovarian cyst(benign disease group) ,and 30 cases of healthy individu‐al(control group) .Results The serum levels of HE4 ,CA199 and CA125 in the ovarian cancer group were higher than those in the ovarian cancer group and control group ,there were statistically significant differences(P<0 .05) .Compared with the control group , the serum level of CA125 in benign disease group was significantly higher(P<0 .05) ,while no statistically significant differences of serum levels of HE4 and CA199 were observed between the two groups(P>0 .05) .The sensitivity of combined detection of the three indicators increased to 82 .2% ,and the specificity remained at 90 .0% .Conclusion Combined detection of HE4 ,CA125 and CA199 might have clinical significance in early diagnosis and identification of ovarian cancer .

Objective To explore the short and long-term effect of cardiopulmonary resuscitation (CPR) training for agricultural residence registration population with the language education and practice education,in order to establish a more effective method of first-aid training for agriculture population.Methods 989 agricultural residence registration people were divided into group A (721 people)and group B (268 people) randomly.Group A received CPR training with language education and group B adopted practice education.On the time before and after training immediatelythe 3rd and 6th month after training,we checked the training results and analyzed the data with statistical methods.Results The short- term effect of two methods was satisfying (accuracy more then 90％ ) and without statistical significance.The effect of group B was better than group A in the 3rd and 6th month after training.Two groups showed higher forgetting rate and some accuracy were less than 50％.Conclusions Agriculture population is in urgent need of first-aid.It may be a more effective method of first-aid training for agriculture population to transform gradually from language education to practice education.At the same time,we may use 4 hours as CPR practice education training time and 6 months as re-training period.

Objective To evaluated the impact of obesity on surgical site infection (SSI)following colorectal cancer surgery.Methods A total of 215 patients undergoing radical surgery for colorectal cancer in a hospital be-tween January 2008 and December 2013 were investigated retrospectively,100 patients were with body mass index (BMI)≥25 kg/m2 (obesity group)and 115 patients with BMI<25 kg/m2 (normal weight group),the intra-opera-tive and postoperative indicators and surgical complications were compared between two groups.Results In obesity group,72(72.00%)patients had intra-operative blood loss of >60 mL,58(58.00%)patients’duration of surgery was >220 min ,20 (20.00%)of whom developed postoperative SSI;in normal weight group,30(26.09%)patients had intra-operative blood loss of >60 mL,20(17.39%)patients’duration of surgery was >220 min,8(6.96%)of whom developed postoperative SSI.Intra-operative blood loss and incidence of SSI in obesity group were both signif-icantly higher than normal weight group,duration of surgery and postoperative length of hospital stay were both longer than normal weight group(both P <0.05).Conclusion Incidence of SSI in colorectal cancer patients is high. Obesity,long duration of surgery,and more bleeding are high risk factors for SSI in colorectal cancer patients.