This article analyzes the medical ethical problems which are related to the education,research and therapy of mucosal disease.The author puts forward several countermeasures: ① increase the subsidize on the research of oral mucosal disease;②learn advanced technology to accelerate the developing of the treatment;③reform the education method,foster the collectivistic consciousness;④understand the patients' psychological characteristics,especially the cancerophobia;⑤comply with the principle of medical ethics-the right of patient come before everything else.

Ultrastructural changes of the inner cell mass (ICM) in rabbit blastocysts from 4 to 7 days post coitum (p.c.) were observed with transmission electron microscope. It revealed that ICM of blastocyst on day 5 p.c. began to differentiate after they were arranged into a single layer, and under which the primitive endoderm appeared. It is suggested that the primitive endodermal cells in rabbit blastocysts are derived from the scattered ICM-like cells at the inner surface of the mural trophoblast rather than delaminated from ICM proper. In this paper, disruption and disappearance of polar trophoblast are described and discussed.

Objective To evaluate the effect of different doses of aspirin on the platelet inhibition rate by thremboelastography.Methods One hundred and eighty patients with ischemic stroke or transient cerebral ischemic attack (TIA) were randomly divided into aspirin 100 mg/d group (60 patients),aspirin 200 mg/d group (60 patients) and aspirin 300 mg/d group (60 patients) according to the order of treatment.The platelet inhibition rate which arachidonic acid pathway induced was measured by thromboelastography and compared at different time points (before medication; 7 days,6 months,1 year after medication).Results There were significant differences in the platelet inhibition rate after medication at different time points compared with that before medication in three groups (P ＜ 0.05).After medication at different time points,the platelet inhibition rate of aspirin 100 mg/d group and aspirin 200 mg/d group was gradually decreasing.On the contrary,that of the aspirin 300 mg/d group showed gradually increasing.Cross-sectional comparison of the three groups at different time points showed that there was no significant difference in the platelet inhibition rate among three groups before medication,7 days,6 months after medication (P ＞ 0.05).However,there was significant difference at 1 year after medication (P ＜ 0.05).The platelet inhibition rate inaspirin 300 mg/d group [(93.8 ± 18.6)％] was higher than that in aspirin 200 mg/d group [(83.7 ± 11.2)％]and aspirin 100 mg/d group [(76.6 ± 12.8)％] (P ＜ 0.05).During medication there were 9 patients of less than 50％ platelet inhibition rate in aspirin 100 mg/d group,5 patients in aspirin 200 mg/d group,3 patients in aspirin 300 mg/d group,and 2 patients of peptic ulcer bleeding in aspirin 300 mg/d group.Conclusions The appropriate dose of aspirin (100,200,300 mg/d) can play a very good anti-platelet effect.Increasing the dose on the basis of 100 mg/d,the platelet inhibition rate shows no increase in the short-term (≤6 months),but in the long-term (1 year) there may be differences.It may be associated with less aspirin resistance and the relative increasing bleeding risk.

Objective To explore the related risk factors for diabetic nephropathy(DN) and discuss the value of diabetic dermopathy (DD) screening for DN.Methods A total of 188 patients with type 2 diabetes mellitus (T2DM) were studied,which included 78 patients with DN (DN group) and 110 cases without DN (non-DN group).The sex,age,duration of diabetes mellitus,smoking,DD,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose (FBG),2hours postpradial glucose(2 h PG),triglyceride (TG),total cholesterol (TC),glycosylated hemoglobin A1c (HbA1c),fasting C-peptide(FC-P) were recorded.Multiple factor Logistic regression was applied in patients with DN and non-DN.Results The incidence of DD and DN in T2DM patients was 47.34％(89/188) and 41.49％ (78/188) respectively.The ratio of DD in DN group was 79.49％(62/78),in non-DN group was 24.55％ (27/110),and the difference was significant (P ＜ 0.05).The age,duration of diabetes mellitus,SBP,FBG,2 h PG,HbA1c in DN group was higher than that in non-DN group [(52.83 ± 6.43) years old vs.(50.35 ±6.48) years old,(10.51 ±4.36) years vs.(6.48 ±3.25) years,(137.42 ± 14.17) mmHg(1mmHg =0.133 kPa) vs.(132.57 ± 15.38) mmHg,(11.95 ±2.83) mmol/L vs.(10.28 ± 1.98) mmol/L,(15.07 ± 3.16) mmol/L vs.(13.51 ± 2.75) mmol/L,(9.62±2.17)％ vs.(8.63 ± 2.08) ％],FC-P was lower than that in non-DN group [(1.76 ± 0.89) μ g/L vs.(2.01 ± 0.72) μ g/L],and the difference was significant (P ＜ 0.05).Multiple factor Logistic regression analysis showed that duration of diabetes mellitus,DD and FPG were still related to DN in T2DM (OR =4.841,3.209,3.368,P ＜0.01).Conclusions DD is correlated with DN in T2DM.DN should be screened in T2DM patients with DD.

Objective To retrospectively investigate the characteristics of patients with inflammatory bowel disease (IBD)in last 10 years in Kunming city. Methods Four hundred and thirty consecutive patients with IBD, who had hospitalized in 7 hospitals between January 1998 to March 2007, were investigated. Among them, 379 patinets had ulcerative colitis (UC) and 51 had Crohn's disease (CD). The patients who received coloscopy, histopathological and bariam enema examination accunted for 98.2%, 56.2% and 2.6% in UC group,respectively, and 72.5%,78.4% and 31.4% in CD group,respectively. The gender, age, occupation and the clinical manifestation of the patients, and the results of the colonoscopy and pathological examination were analyzed. Results Most of the UC patients were aged 30 to 39 years and 50 to 59 years with average age of (46.9±15.8) years, whereas CD patients were aged 20 to 29 years with average age of (41.6±17.2)years. The male and urban patients were predominat in both UC and CD groups. Mental workers were common in UC group. The symptoms of diarrhea (302,79.7%), abdominal pain (285,75.2%) and bloody stools (290,76.5%) were major events in UC patients, and those of abdominal pain (44,86.3%), diarrhea (28,54.9%) and weight loss (28,54.9%) were major events in CD patients. The coincidence ratio among colonoseopy, histopathology and bariam enema examinations was 88.4 % ( 329/372 ), 24.4 % ( 52/213 ) and 4/10 in UC patients, respectively, and 86.5%(32/37), 27.5%(11/40) and 75%(12/16) in CD patients, respectively. All of the UC patients were in active stage of disease,including 38.3 % in mild,42.2% in moderate and 19.5% in severe. In CD group, 7.8% was in relief stage and 92.2% in active stage,including 15.7% in mild,43.1% in morderate and 41.2% in severe.Conclusion The understanding of prevalence and clinical characteristics of IBD in last 10 years in Kunming city will be helpful in diagnosis and treatment of the disease.

Objective To study the effects of miR-200b on proliferation and migration of sw620 colon cancer cells,and its regulation effect on E-cadherin expression.Methods The expressions of miR-200b in sw620 cells at 24 h and 72 h after pEGP-miR-200b transfection were detected by real-time PCR (RT-PCR).The change of the expression level of E-cadherin after miR-200b transfection was detected using the methods of RT-PCR and Western blot.The proliferation and migration abilities were measured by MTT and scratch test after miR-200b transfection.Results The expressions of miR-200b in sw620 cells at 24 h and 72 h after pEGP-miR-200b transfection raised significantly compared to the control group (t =11.579,P ＜ 0.01 ; t =11.579,P ＜0.01).MiR-200b transfection inhibited the proliferation abilities of sw620 cells.It is the most significant of the inhibitory effect on the third day and the inhibition rate was 55.34％.MiR-200b transfection markedly inhibited the migration abilities of sw620 cells.The two groups had significant difference in the migration distance of 24,48,72 h (t =11.579,P ＜0.01 ; t =10.419,P ＜0.01 ; t =6.955,P ＜0.01).The mRNA and protein expressions of E-cadherin gene increased significantly by transfecting miR-200b gene in sw620 cells (t =10.432,P ＜ 0.01 ; t =8.325,P ＜ 0.O1).Conclusion Up-regulated expression of miR-200b could inhibite the proliferation and migration abilities of sw620 colon cancer cells.The involved molecular mechanism is probably related to the change of E-cadherin expression.

OBJECTIVE Topreparealipidderivativeofgemcitabine(Gem)anditspolymericmi-celles to overcome the disadvantages of Gem.METHODS N-benzyl-3′-acetyl-gemcitabine(BAG)was synthesized.A BAG-loaded poloxamer polymeric micelle (BAG∶poloxamer 188 =10∶1 ,mol/mol)was prepared using an injection method.The micelles were characterized with a laser particle size and elec-tric charge instru ment and negatively-stained trans mission electron microscopy.Hu man breast cancer cells MCF-7 were cultured with Gem or BAG polymeric micelles of 5,10,20,30,50,70,90 μmol·L-1 for 24,48 and 72 h,respectively.The inhibitory rate of cells was measured with an MTT method.The MCF-7 cytotoxicity of BAG polymeric micelles was investigated.A pharmacodynamic study was per-formed on the mice bearing mouse hepatocellular cancer cells H22.Intravenous (iv)and oral (ig)ad-ministration was used at the dose of Ge m 40 mg·kg -1 or BAG polymeric micelles 62 mg·kg -1 .The mice were administered on the 1 st,4th and 7th day and sacrificed on the 8th day.Tumor inhibitory rates were measured.RESULTS TheBAGstructurewasidentifiedbythinlayerchromatograph,1Hand13C NMR,infrared ray chromatograph and mass spectrum.The appearance of BAG micelles was a slightly blue suspension.The micelles were spheres according to the electron microscopic observation.Their size was 62.82 nm and the zeta potential was -18.8 mV.The half inhibition concentration (IC50)of Gem and BAG polymeric micelles was 40.6 and 90.0 μmol·L-1 ,5.0 and 14.9 μmol·L-1 ,5.0 and 1 3.6 μmol·L-1 at 24,48 and 72 h,respectively according to the MTT results.According to the in vivo results,compared with the tumor model group,Gem (ig),Gem (iv)and BAG polymeric micelles (iv and ig)had significant effect on the tumor weight of H22 cell xenograft mice (P<0.01 ).As for anti-tumor efficiency,BAG polymeric micelles (ig)were better than Gem (ig)(P<0.05);BAG polymeric micelles (iv)were better than BAG polymeric micelles (ig)(P<0.05),and BAG polymeric micelles (iv)were almostequaltoGem(iv).CONCLUSION ThelipidderivativeofGemcanbeloadedinthepoloxamer 1 88 polymeric micelles.BAG polymeric micelles show in vitro MCF-7 cell inhibition and in vivo inhibition of mouse H22 xerografts;iv or ig.BAG polymeric micelles (ig)show better anti-tumor effect than Gem (ig),indicating that BAG polymeric micelles are a promising novel anti-tumor oral preparation.

Objective To study the expression of transcription factor special protein 1(Sp1) in colorectal cancer tissues and the relationship with the biological behavior .Methods The Sp1 mRNA expressions of 60 colon cancer tissues and their corresponding normal tissues were detected by real-time PCR ,and the level of target gene was calculated by ΔΔCT method .The relationships be-tween the expression of Sp1 mRNA and the different clinical features and pathological characters were determined .Results Com-pared with the matched normal tissues ,Sp1 mRNA was significantly up-regulated in the colon cancer tissues(P<0 .01) .Sp1 mRNA positive expression rate in colon cancer tissues had no significant different with sex ,age and tumors area(P>0 .05) ,but had signifi-cant different with histological grade ,Duke′s stages and lymph node metastasis(P<0 .05) .Conclusion Sp1 plays an important role in the process of occurrence and development in colon cancer .

Objective To investigate the effect of targeted monitoring on the control of central venous catheter associated infection, study the difference of CVC?RI infection rate and the distribution of pathogenic bacteria in the general hospital and the maternal and child hospital, and analyse the main pathogenic bacteria drug resistance characteristics. Methods From January 2013 to December 2014,685 cases patients with central venous catheterization in the Port Hospital of Hebei Port Group Company Limited,and four cooperative hospitals ( Affiliated Hospital of North China University of Science and Technology, People′s Hospital of Tangshan, Tangshan Port Economic Development District Hospital, Maternal and Child Health Care Hospital of Laoting County) were selected as the research objects. The difference of infection rate before and after the targeted monitoring in 2014 was compared. The tip of the catheter and the peripheral blood were cultured in the patients with suspected infection,bacterial identification and drug sensitivity test were carried out using Compact VITEK2 automatic bacteria identification/drug sensitivity analyzer. Results The infection rate of CVC?RI of five hospitals was 18. 75%( 60/320 ) in 2013, 11. 51%( 42/365 ) in 2014, the difference of infection rate was statistically significant before and after the implementation of the target monitoring(χ2=7. 059,P<0. 05) . The CVC?RI infection rate was 15. 52%(81/522) in the general hospital,12. 88%(21/163) in the maternal and child hospital,the difference was not statistically significant(P>0. 05). In 102 cases of CVC?RI,105 bacterial strains were detected in 91 cases,gram positive bacteria accounted for 51. 43%( 54/105) ,gram negative bacilli accounted for 40. 95%( 43/105) ,fungi accounted for 7. 62%( 8/105) . There was no significant difference in the proportion of pathogenic bacteria in the general hospital and the maternal and child hospital(P>0. 05). Grampositive cocci were mainly staphylococcus aureus and coagulase negative staphylococci,they were completelysensitive to linezolid, quinupristin/ dalfopristin, tigecycline, and vancomycin. They were high sensitivity torifampicin,while highly resistant to gentamicin, tetracycline, penicillin; Gram negative bacilli were mainlypseudomonas aeruginosa and escherichia coli,they were high sensitivity to meropenem,imipenem,while resistantto multiple antimicrobia1s. Conclusion Adhere to the implementation of targeted monitoring help to reduce theoccurrence of CVC?RI. The isolation of pathogenic bacteria from multiple drug resistance should be paid moreattention.

This study examined the mechanism by which the gastric cancer cells lead to early peritoneal metastasis. HMrSV5 cells, a human peritoneal mesothelial cell line, were co-incubated with the supernatants of gastric cancer cells. Morphological changes of HMrSV5 cells were observed. The cell damage was quantitatively determined by MTT assay. The apoptosis of HMrSV5 cells was observed under transmission electron microscope. Acridine orange/ethidium bromide-stained condensed nuclei was detected by fluorescent microscopy and flow cytometry. The expressions of Bcl-2 and Bax was immunochemically evaluated. The results showed that conspicuous morphological changes of apoptosis were observed in HMrSV5 cells 24 h after treatment with the supernatants of gastric cancer cells. The supernatants could induce apoptosis of HMrSV5 cells in a time-dependent manner. The supernatants could up-regulate the expression of Bax and suppress that of Bcl-2 in HMrSV5 cells. These findings demonstrated that gastric cancer cells can induce the apoptosis of HPMCs through supernatants in the early peritoneal metastasis. The abnormal expressions of Bcl-2 and Bax may contribute to the apoptosis. Anti-apoptosis drugs promise to be adjuvant chemotherapeutic agents in the treatment of peritoneal metastasis of gastric cancer.
Apoptosis ; Cell Line ; Cell Line, Tumor ; Coculture Techniques ; Epithelial Cells/*cytology ; Epithelium ; Peritoneal Neoplasms/pathology ; Peritoneal Neoplasms/*secondary ; Stomach Neoplasms/*pathology