Objectives:To find out factors that influence the public's organ donation willingness,and explore the effect on organ donation of soft culture system.Methods:We conducted a survey towards people from typical cities and counties of Zhejiang Province by using self-made questionnaire.We adopt some data processing methods such like entropy weight method.Results:Factors like education,age,traditional concept all can affect the degree of organ donation willingness.Soft culture system has favorable social effects.It is directive in reality.Conclusions:In the humanistic perspective,the construction of organ-donation soft culture system plays an obvious role in improving the degree of social organ donation willingness.It includes education training,humanitarian assistance model radiation,and incentive method.

Patients often suffered limb dysfunction after stroke. Upper limb and hand function recovered more slowly than lower limb, and became one of the research focuses in rehabilitation medicine. Timely and effective assessments were important to guide the rehabilitation treatment, evaluate the treatment efficacy and predict functional recovery of upper extremity and hand function. The assessment methods of upper limb and hand motor function included subjective evaluations and objective evaluations. The former included different kinds of scales, which involved assessment focusing on muscle, motor pattern, change of upper limb and hand function. While the latter contained biomechanics, neuroelectrophysiology, functional magnetic resonance imaging, upper limb robotic evaluation system and so on. Scales were proved to have good reliability and validity. But they could not show patients' function accurately because of the subjectivity, and the data could not be kept. Evaluation system with computer was applied in clinical practice more and more widely. In this review, we summarized the assessments on upper limb and hand motor function in patients after stroke.

Esophageal carcinoma(EC) is one of the most common malignancies,which is difficult to cure.The median overall survival is less than 1 year,and the 5-year survival rate is less than 10％.Previous reports cited the incidence of brain metastasis (BM) from esophageal cancer to be approximately 0.4％ ～ 5.1％,and most of the reports come from America and Japan.The incidence of BM from EC is increased.However,because of the rarity of BM from EC,there are no established treatment guidelines.This report provides a comprehensive view of the clinical characteristics,treatment and prognosis of brain metastasis from esophageal carcinoma.

Objective:To investigate the influence of Mannan Peptide combined with 5-Fu on the proliferation and apoptosis of HepG2 cells and to explore the related mechanism.Methods:HepG2 cells were divided into four groups:the control group,5-Fu group,Mannan Peptide group and combination group.Cell proliferation was evaluated by MTT assay.Flow cytometry was used to examine the cell cycle,proliferation index(PI)and apoptosis ratio.The expression of Bcl-2 protein in each group was analyzed by immunocytochemical method.Results:The inhibitive effect of 5-Fu plus Mannan Peptide was significantly stronger than that of Mannan Peptide alone,in a time-and dose-dependent manner. Cells were treated with medicine for 48 hours.Compared with cells in the control group and 5-Fu group,the percentage of cells in G_0/G_1 stage and the apoptosis ratio in the combination group were increased(P<0.01).In immunocytochemical analysis,the combination of Mannan Peptide and 5-Fu could significantly decrease Bcl-2 protein level(P<0.01).Conclusion:The combination of Mannan Peptide and 5-Fu can synergistically suppress the proliferation and induce apoptosis of human hepatoma HepG2 cells.The mechanism might be associated with down-regulation of Bcl-2 protein expression.

Objective To study the feasibility of applying extrusion-puffing technique to the preparation of Qingyin Teabag.Methods Extrusion-puffing techique and water decoction were used to prepare the Qingyin Teabag,and thecorresponding products were compared by pharmacodynamic tests .Meanwhile,a dissolution test was carried out for the monarch drug Radix Glycyrrhizae in the teabag before and after pressurizing-expansion,thus to explore the influence of extrusion-puffing technique on the dissolution speed of ammonium glycyrrhetate from Radix Glycyrrhizae.Results With ammonium glycyrrhetate as the index,T50 and Td of Radix Glycyrrhizae before extrusion puffing extraction were 20.25 min and 56.20 min,while were 7.975 min and 18.975 min respectively after extrusion puffing extraction,the difference being very significant.Pharmacodynamic tests showed effects of the products processed by extrusion-puffing technique were slightly superior to those by water decoction.Conclusion It is feasible to adopt extrusion-puffing technique to the preparation of Qingyin Teabag.

Objective:To investigate the diagnostic value of mitochondrial associated protein fumarylacetoacetate domain containing protein 1 (FAHD1) and growth differentiation factor-15 (GDF-15) in sepsis.Methods:Based on the database of the whole process of sepsis early warning, diagnosis and treatment management, which was established on the study of sepsis early warning and standardized diagnosis and treatment system, adult patients with suspected infection admitted to the department of critical care medicine of Zhejiang Hospital, Second Affiliated Hospital of Zhejiang University, the First Affiliated Hospital of Sun Yat-Sen University, West China Hospital of Sichuan University, Ningbo First Hospital from May 2014 to October 2015 were enrolled. The basic vital signs, and the main blood routine results, liver and kidney function, blood gas, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) score at the time of diagnosis of patients with or without sepsis were analyzed. The preserved serum samples were taken, the levels of procalcitonin (PCT), C-reactive protein (CRP) were detected by electrochemiluminescence method, immunoturbidimetry respectively, and FAHD1 and GDF-15 were detected by enzyme linked immunosorbent assay (ELISA). Univariate and multivariate Logistic regression were used to analyze the risk factors for sepsis diagnose. The indexes' diagnostic efficacy in sepsis were analyzed by receiver operating characteristics curve (ROC curve).Results:A total of 132 patients were enrolled, including 76 cases of sepsis and 56 cases of non-sepsis. Compared with the non-sepsis group, the heart rate in the sepsis group was increased (bpm: 116.4±17.8 vs. 97.4±19.1), while the mean arterial pressure (MAP), platelet count (PLT), arterial partial pressure of oxygen (PaO 2) were significantly decreased [MAP (mmHg, 1 mmHg = 0.133 kPa): 65.8±9.7 vs. 74.7±10.3, PLT (×10 9/L): 120 (69, 204) vs. 163 (117, 239), PaO 2 (mmHg): 83.0 (66.6, 108.0) vs. 108.0 (84.4, 130.0), all P < 0.05], direct bilirubin (DBil), serum creatinine (SCr), lactic acid (Lac), APACHEⅡ score and SOFA score were significantly increased [DBil (μmol/L): 13.00 (5.55, 55.31) vs. 6.20 (2.20, 21.90), SCr (μmol/L): 118.00 (70.00, 191.73) vs. 77.20 (59.65, 110.86), Lac (mmol/L): 2.90 (1.50, 4.10) vs. 1.90 (1.20, 2.80), APACHEⅡ score: 20.0 (16.0, 25.0) vs. 16.0 (10.0, 21.0), SOFA score: 12.0 (8.0, 16.0) vs. 8.0 (5.0, 13.0), all P < 0.05]. In addition, the serum levels of FAHD1, GDF-15, PCT and CRP in sepsis group were significantly higher than those in non-sepsis group [FAHD1 (μg/L): 3.96 (2.25, 5.92) vs. 2.47 (1.03, 3.54), GDF-15 (μg/L): 8.46 (4.37, 19.68) vs. 4.32 (1.74, 10.39), PCT (μg/L): 3.79 (1.37, 11.32) vs. 0.42 (0.12, 2.14), CRP (mg/L): 154.43 (61.33, 283.20) vs. 65.95 (28.15, 144.69), all P < 0.01]. Multivariate Logistic regression showed that serum FAHD1 [odds ratio ( OR) = 1.135, 95% confidence interval (95% CI) was 1.045-1.234], GDF-15 ( OR = 1.090, 95% CI was 1.029-1.155) and CRP ( OR = 1.007, 95% CI was 1.002-1.011) were risk factors for sepsis (all P < 0.05). ROC curve analysis of sepsis showed that the areas under ROC curve (AUC) of serum mitochondrial associated proteins FAHD1 and GDF-15 were 0.727 (95% CI was 0.641-0.802) and 0.677 (95% CI was 0.588-0.757), respectively; and the AUC of classical infection indexes PCT and CRP were 0.767 (95% CI was 0.683-0.837) and 0.680 (95% CI was 0.59-0.760), respectively. There was no significant difference between the AUC of mitochondrial associated proteins and classical infection indexes. The combination of FAHD1, GDF-15, PCT and CRP had the largest AUC, which was 0.809 (95% CI was 0.730-0.874), and the sensitivity was 75.00%, and the specificity was 80.00%. Conclusion:Mitochondrial associated protein FAHD1 and GDF-15 are associated with sepsis, and the diagnostic efficiency is improved when combined with PCT and CRP, which might provide experimental basis for screening diagnostic markers of sepsis.

OBJECTIVE To study the effects of levofloxacin on QT correction dispersion(QTcd) interval in elderly patients hospitalized with acute exacerbations of COPD(AECOPD).METHODS Totally 124 patients received IV levofloxacin(500 mg qd) for 10-14 days.Evaluations included of 12-lead ECGs at baseline and blood examination before treatment,day 5 and after treatment.RESULTS QT correction(QTc) interval was no significant changes,but the QTcd interval was with significant prolongation.CONCLUSIONS IV levofloxacin could not cause QTc interval prolongation,but could make QTcd interval prolongation,which is a potential risk of arrhythmia in elderly patients with AECOPD.

Objective To observe the effects of gossypol on expressions of transforming growth factor-β1 (TGF-β1), fibronectin (FN) and 11β-hydroxysteroid dehydrogenase (11β-HSD) in nephridial tissue in rats with diabetes mellitus. Methods Thirty male Sprague-Dawley rats were randomly divided into three groups: normal control, type 2 diabetes and gossypol treatment group . After high-fat feeding for 4 weeks, the later two groups were injected with low dosage strepozotocin (30 mg/kg) intraperitoneally to induce type 2 diabetic rat model. The rats in gossypol treated group were given gossypol at the dosage of 15 mg/kg once per day for 4 weeks by gavage. And since the 5th week, the times of gavages had been changed into once per week at the same dosage and lasted to the 12th week . The levels of blood glucose, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-c) were measured. Additionally, the morphological changes of the kidney were studied by light microscopy and transmission electron microscopy respectively. The mRNA expressions of TGF-β1, FN, 11β-HSD and 11β-HSD2 in nephridial tissue were assayed by semi-quantity RT-PCR. The protein expressions of TGF-β1 and FN in nephridial tissue were determined by immunohistochemistry. Results The blood levels of glucose, TC and LDL- c were increased significantly in type 2 diabetic group compared with normal control group(P<0. 01). The volume of glomerulus and the deposition of PAS positive substance in the glomerular interstitium were increased under light microscopy, and the glomerular basal membrane was thicker in type 2 diabetic group than those in normal control group under transmission electron microscopy. The mRNA and protein expressions of TGF-β1 and FN were increased(P<0. 01), and the mRNA expression of 11β-HSD2 was decreased(P<0. 05), while the mRNA expression of 11β-HSD1 was unchanged in type 2 diabetic group compared with normal control group. After the treatment of gossypol, the level of the blood glucose was significantly decreased(P< 0. 01), and the levels of TC, LDL-c showed a trend of decrease but had no statistical differences compared with type 2 diabetic group. The morphology of nephridial tissue was ameliorated in gossypol treatment group. The mRNA and protein expressions of TGF-β1 and FN were decreased(0. 16± 0. 02,0. 22±0. 05 ; 0. 24±0. 06,0. 33±0. 07, P< 0. 05), while the mRNA expressions of 11β-HSD1 and 11β-HSD2 were unchanged compared with type 2 diabetic group. Conclusions Gossypol can relieve the pathologic changes of nephridial tissue, inhibit the expressions of TGF-β1 and FN through decreasing blood glucose of rats with diabetes mellitus.

Objective: To compare the diagnostic efficacy of fine needle aspirate cytology (FNAC), fine needle aspirate-thyroglobulin (FNA-Tg) and BRAF genetic testing in diagnosis of suspected cervical metastatic lymph nodes of PTC. Methods: A retrospective analysis was performed on 95 patients who received modified radical thyroidectomy and confirmed as PTC by pathology. Totally 118 suspected cervical metastatic lymph nodes found with ultrasound examination before or after modified radical thyroidectomy were all detected with FNAC, FNA-Tg and BRAF genetic testing. Taken postoperative pathology as gold standard, the sensitivity specificity, positive predictive value, negative predictive value and accuracy of three methods were obtained, and ROC curves were constructed to compare the diagnostic efficacy of three methods. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC was 63.95% (55/86), 100% (32/32), 100% (55/55), 50.79% (32/63) and 73.73% (87/118), respectively, of FNA-Tg was 91.86% (79/86), 100% (32/32), 100% (79/79), 82.05% (32/39) and 94.07% (111/118), respectively, while of BRAF genetic testing was 80.23% (69/86), 100% (32/32), 100% (69/69), 65.31% (32/49), 85.59% (101/118), respectively. AUC of FNAC, FNA-Tg and BRAF genetic testing was 0.820, 0.991 and 0.874, respectively. The differences of AUC between FNAC and FNA-Tg, BRAF genetic testing and FNA-Tg were statistically significant (P<0.001), whereas between FNAC and BRAF genetic testing was not statistically significant (P=0.099). Conclusion: FNA-Tg is more effective than FNAC and BRAF genetic testing in diagnosis of cervical suspected lymph node metastasis of PTC.

Objective:To explore the effect of mild cognitive impairment on the subjective well-being of the elderly and the mediating role of self-efficacy in it. To provide an effective basis for health management and clinical intervention in the elderly with mild cognitive impairment.Methods:A total of 164 patients with mild cognitive impairment from December 2018 to June 2019 were surveyed by the General Self-efficacy Scale, the Montreal Cognitive Assessment Scale, and the Memorial University of Newfoundland Scale of Happiness Scale.Results:The overall score of self-efficacy was 21.41±3.98, and subjective well-being was 26.44±7.35. There was a positive correlation among cognitive function, self-efficacy and subjective well-being, except that there was no significant correlation between self-efficacy and cognitive function( r values were 0.263-0.687, P<0.01). Self-efficacy played a part in mediating between cognitive function and subjective well-being in patients with mild cognitive impairment, accounting for 37.8% of the total effect. Conclusions:Mild cognitive impairment can also have a negative impact on the subjective well-being of the elderly. Among them, self-efficacy plays a particularly important role in mediating. Interventions about self-efficacy on the elderly with mild cognitive impairment may have more significant effects.