There is an extremely shocking tragedy of a real medical case.The cesarean section couldn't be performed on a full-term in-labor woman because the patient's husband refused to sign the operation validation contract,leading to the death of both the will-be mother and the baby.The above case shows a dilemma between protecting patients' rights of life,being cured and operated and protecting the doctors from being prosecuted in medical treatment.

Ghrelin is involved in the process of feeding behavior and regulation of related energy metabolism,it also modulates the secretion of gonadotropins or transmitters concerning sex hormone releasing.It is considered as the factor connecting the HPG axis and energy metabolism.Body's nutrition has a bearing upon the process of reproductive system's onset and maturation.Adequate body weight is necessary for normal puberty onset.Obese children tend to have an earlier menarche.Ghrelin may pass on the information about nutrition to the hypothamalus in puberty onset.

Objective To evaluate the performance of the MAKER IS1200 automated chemiluminescence analyzer .Methods A series of experiments were designed to evaluate the precision ,reagent open bottle stability ,linearity range and reference interval of the MAKER IS1200 automated chemiluminescence analyzer in 8 items of hepatitis B 5 indexes ,AIDS ,hepatitis C and syphilis ac‐cording to the requirements of CLSI documents ,the detection results were performed the methodological comparison with those de‐tected by Abbott i2000 automated chemiluminescence analyzer .Results Except the total precision of HBEAG low value was slight‐ly higher than 15% of the judgment standard ,other indexes conformed to the requirements ;the open bottle stability of various items of reagent was better ;the quantitative item HBSAB had good linearity within the detection range (r2 >0 .95);in the verification of reference interval ,no outlier was found in each item ;in the methodological comparison ,the other items had good correlation with those detected by the ABBOTT i2000 except anti‐HCV .Conclusion The MAKER IS1200 automated chemiluminescence analyzer has good detection performance and meets the requirements of immunoassay detection in laboratory work .

OBJECTIVE:To observe clinical efficacy and safety of tegafur combined with three dimensional conformal radio-therapy for advanced esophageal carcinoma. METHODS:Totally 88 cases of advanced esophageal carcinoma admitted into Xuchang central hospital during Aug. 2013-Mar. 2016 were selected and divided into control group and observation group according to random number table,with 44 cases in each group. On the basis of anti-inflammatory,relieving asthma and other symptomatic treatment,two groups accepted three dimensional conformal radiotherapy. Control group was given fluorouracil 80 mg/m2,ivgtt,d1+nadeplatin 70 mg/m2,ivgtt,d1-d5. Observation group was given Tegafur capsules 60 mg,bid,continuous use 5 days,rest for 2 days. A treatment course lasted for 3 weeks,and they received 3 courses of treatment. Clinical efficacies of 2 groups were observed as well as serum inflammatory factors(TNF-α,IL-6,IL-8),lab indexes(VEGF,CA125,CA199,CEA),QLQ-C30 scores be-fore and after treatment. The occurrence of ADR was recorded in 2 groups. RESULTS:The total response rate of observation group was 88.64%,which was significantly higher than 68.18%,with statistical significance(P<0.05). Before treatment,there was no statistical significance in serum inflammatory factor levels,lab index levels and QLQ-C30 scores between 2 groups(P>0.05). Af-ter treatment,serum inflammatory factor levels and lab index levels of 2 groups were significantly decreased,while QLQ-C30 scores were decreased significantly;the observation group was significantly better than control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Tegafur combined with three dimensional conformal radiotherapy shows good therapeutic efficacy for advanced esophageal carcinoma,can significantly reduce serum inflammatory factor levels and lab index levels and improve life quality but do not increase the occur-rence of ADR.

Objective To determine the therapeutic efficacy of curcumine on inflammatory bowel disease(IBD)and its underlying mechanisms.Methods The rat ulcerative colitis model was developed by using 30 g/L dextran sulfate sodium.Twenty-four young rats were divided into 4 groups:normal group,model group,curcumin 100 mg/kg group(curcumin 100 group),and curcumin 300 mg/kg group(curcumin 300 group).Curcumin was given through gastric gavage once a day for 7 days.General condition,disease activity index(DAI)and histopathological score(HPS)were evaluated.The proportions of CD4+ CD25+ Foxp3+ regulatory T cells(Treg)and CD4+ IL-17+ helper T lymphocyte 17(Th17)in CD4+ T cells in rats,and spleen cells were calculated by using flow cytometry.Immunohistochemical method was performed to determine the level of SOCS3 in colon tissues.Results After curcumin administered through gastric gavage for 5 days,compared with the DAI in the model group[(7.50±0.32)scores],HPS in the curcumin 100 group[(4.00±1.10)scores] and the curcumin 300 group [(5.00±0.89)scores] significantly reduced,and the difference was significant(F=12.469,P<0.05).After curcumin administered through gastric gavage for 7 days,compared with the HPS in the model group[(2.69±0.70)scores],histological score in the curcumin 100 group[(1.94±0.68)scores],the curcumin 300 group [(2.00±0.63)scores] and the normal group[(0.50±0.05)scores] significantly reduced,and the difference was significant(F=33.282,P<0.05).Compared with the model group[(0.015 1±0.000 7)D],the expression of SOCS3 in the curcumin 100 group[(0.002 0±0.000 5)D],the curcumin 300 group [(0.002 6±0.006 0)D] and the normal group[(0.002 2±0.001 0)D] was significantly inhibited(F=382.270,P<0.05),but there was no difference among the former 3 groups(F=0.828,P>0.05).Compared with the model group[(6.5±1.5)％],the propotion of CD4+ CD25+ Foxp3+ Treg cells in CD4+ T cells in the curcumin 100 group[(9.9±1.0)％],the curcumin 300 group [(9.3±0.7)％] and the normal group[(9.6±1.1)％]was obviously upregulated(F=16.635,P<0.05),but there was no difference among the former 3 group(F=1.564,P>0.05).Compared with the model group[(3.5±1.4)％],the propotion of CD4+ IL-17+ Th17 cells in CD4+ T cells in the curcumin 100 group[(2.0±0.9)％],the curcumin 300 group [(1.2±0.6)％] and the normal group[(2.0±0.9)％] was downregulated(F=5.155,P<0.05),but there was no difference among the former 3 group(F=2.073,P>0.05).There was no obvious difference between the curcumin 100 group and the curcumin 300 group in these indicators respectively(all P>0.05).Conclusions Curcumin probably attenuates IBD severity,reduces inflammation and regulates the balance of Treg/Th17 through the inhibition of SOCS3 expression.

Objective To investigate the polymorphism of the vitamin D receptor gene (VDR)TaqⅠin relation to diabetic retinopathy. Method Fragment length discrepant allele specific PCR(FLDAS-PCR) were used to determine VDR genetypes in 158 patients with diabetic retinopathy and in 198 normal subjects. Results The frequency distribution of VDR genotypes in diabetic retinopathy patients was 106 (67.1%) in TT, 33(20.9%) in Tt, 19(12.0%) in tt; and in normal persons was 165 (83.3%) in TT, 23(11.6%) in Tt, 10 (5.1%) in tt. There was a significant difference between diabetic retinopathy patients and normal persons in distribution of VDR gene TaqⅠgenotypes(P

The most radiation exposure for children arises from the medical process, and due to their characteristics such as relatively immature,organ development,they are more sensitive to the radiation than a-dults,and have higher risk of radiation related diseases,so medical radiation exposure should not be ignored.

OBJECTIVE To study the application value of protein chip technique in detection of Helicobacter pylori(Hp) infection and clinical diagnosis of associated disease. METHODS The antibodies against CagA,Ure and VacA in 300 serum samples were detected by protein chip technique.The biopsy specimens obtained by gastroscopy from 170 patients with digestive system symptom were detected by modified Giemsa staining at the same time.These patients were also accepted with rapid urease test(RUT) and ~(14)C-urease breath test (~(14)C-UBT).Twenty serum samples from Hp infected patients were detected again after treatment. RESULTS The sensitivity of protein chip technique in detection of Hp infection was 92.5%,the specificity was 41.3%,the total consistent rate was 73.5%,the positive predictive value was 72.8%,and the negative one was 76.5%.The disease was serious in CagA~+ Hp.The antibody′s concentration was lower after treatment in patients infected Hp. CONCLUSIONS The method of protein chip for Hp infection detection could be used in judging the type of Hp.It is suitable for guiding of medicine and the monitoring of treatment.

Objective To explore the clinical features of hepatolenticular degeneration (HLD) with hemolytic anemia as the first manifestation, and its relationship with ichthyosis.Method The clinical manifestations, course, diagnosis, and treatment of HLD combined with ichthyosis in one child who presented with hemolytic anemia as the ifrst manifestation, were retrospectively analyzed.Results In ten-year-old girl, the ifrst symptom was fatigue and jaundice, and then progressed to abdominal distension 5 days after admission. The reticulocyte percentage was 8.5%. Coombs test was negative. The K-F rings appeared on the cornea. The CT scan of Abdomen showed pleural and peritoneal effusion, abnormal substance deposition in liver and splenomegaly. There were mutations inATP7B andTGM1 genes, both of which were located on fourteenth of chromosomes. The diagnosis of HLD combined with ichthyosis was conifrmed. After symptomatic and supportive treatments such as removal of copper, prevention of the copper absorption and supplement of vitamin A, the disease was brought to remission.Conclusion HLD with hemolytic anemia as the ifrst manifestation, combined with ichthyosis was extremely rare.

Objective To determine the measurement consistency of diffusion coefficient D, perfusion fraction f and pseudodiffusion coefficient D*in rectal cancers based on different ROIs. Methods Forty-three patients with histologically proven rectal cancers were examined using echo-planar DW-MRI with eight b values (0 to 1 000 s/mm2). Intravoxel incoherent motion parameters were measured on intravoxel
incoherent motion map that contained the largest tumor cross-section, according to two distinct ROI protocols:freehand outline ROI and semi-automatic tumor center ROI. The two protocols were compared for differences in IVIM parameters and the interclass correlation coefficient (ICC) were also calculated. intra-and inter-observer variability using paired t test and Bland-Altman plot. Results The IVIM parameters(D, f and D*) obtained by ROIs for outlined and center analysis were (1.08 ± 0.24) × 10-3mm2/s, (0.16 ± 0.06), (26.59 ± 19.54) × 10-3mm2/s and (1.06 ± 0.27) × 10-3mm2/s, (0.17 ± 0.07), (30.79 ± 20.85) × 10-3mm2/s, respectively. No significant differences were observed between the means of the IVIM parameters (D, f, D*) calculated by the two methods (t=1.113,-0.259,-1.660;P=0.272, 0.797,0.104, respectively),and the relative ICC were 0.863, 0.469, 0.663, respectively. The intra-observer 95% limits of consistency of IVIM parameters were (-0.012—0.038) × 10-3mm2/s, (-0.003—0.007), (-0.923—1.166) × 10-3mm2/s with ROI outline tumor, respectively;(-0.024—0.044)×10-3mm2/s, (-0.005—0.015), (-1.670—4.195)×10-3mm2/s with center ROI, respectively. The inter-observer 95% limits of consistency of perfusion parameters were (-0.047—0.009) × 10-3mm2/s, (-0.015—0.009), (-7.206—3.190) × 10-3mm2/s with ROI outlined tumor, respectively;(-0.068—0.048) × 10-3mm2/s, (-0.005—0.041), (-17.657—0.779) × 10-3mm2/s with center ROI, respectively. Conclusions There was no statistically significant difference between the outlined ROI and tumor center ROI analysis of rectal cancers' IVIM parameters. The tumor analysis by outlined ROI protocol appropriately improves intra-and inter-observer consistency and can provide more reproducible and stable results.