Under active exploration and practice of several generations of organ transpant workers,organ transplantation in China has developed rapidly since 2000 and achieved remarkble results.Techniques of transplantation become mature,and liver transplantation and renal transplantation have reached international advanced level,which benefit massive patients.With high attention and promotion of national government and health administrative departments,structural changes have occurred to source of national organ transplantation to form a China Model.The donation after citizen's death has become the new normal in the organ transplantation in China.Human organ donation work promots the rapid development of transplantation in China,but it also faces challenges of the donor organ shortage and quality improvement.Under the new situation,health,family planning and medical reform work of the national13th Five Year Plan puts forward new requirements on human organ donation and transplantation.Combined with practical work,this article gives a few opinions on how to scientifically further improve the quality and quantity of organ donation and transplantation and directions of future works.

Objective To investigate the effects of clod plasma cardioplegia on the function and structure of immature myocardium. Methods Thirty-two new Zealand white rabbits of 17-26 days weighing (512 ?56) g were anesthetized and heparinized. Their hearts were excised and perfused in a Langendorff apparatus with warm (37℃) oxygenated (95%O2, 5%CO2) Krebs-Henseleit buffer(KHB) at 60 cm H2O perfusion pressure. After the isolated heart had been beating regularly for 10 min, the heart was perfused with clod (10℃) St. Thomas cardioplegic solution (group C, n = 16) or cold cardioplegic solution mixed with plasma (St. Thomas solution: plasma = 1:4) (group P, n=16). The K+ concentration of the cardioplegic solution in both groups was the same. After 30 min cardiac arrest the heart was again perfused with KHB. The following observations were made: (1) the interval from the beginning of cardioplegic solution infusion to cardiac arrest and the amount of cardioplegic solution used; (2) the duration from KHB reperfusion after 30 min cardiac arrest to the recovery of regular heart beat; (3) heat rate after recovery from cardioplegia; (4) coronary flow; (5 ) myocardial water content; (6) myocardial structural changes shown by microscopic examination. Results (1) There was no significant difference in the time needed to induce cardiac arrest and for recovery of regular heart beat from cardioplegia. (2) The heart rate was (129 ?5)beat/min in group P and (120?) beat/min in group C, the coronary flow was (5.10?0.20) ml?L-1 in group P and (3 50? 0.50) mi ?L -1 in group C, the differences were statistically significant (P

To explore the value of two dimensional ultrasonography used in gunshot wound, features of gunshot wound in pig thigh were studied by high frequency ultrasound and compared with pathologic examination. The primary wound tract showed remarkable features in ultrasonography with a cured anomalous pipelike image, which changed with time. Tissues around the wound tract also revealed some sonographic characteristics. The results indicate that two dimensional ultrasound can clearly manifest not only the shape and distribution of the wound tract, but also the relation between the tract and its adjacent tissues. Therefore, the method is of important value in treatment of gunshot wound.

Since the current worldwide medical education and clinical practice lay a particular stress on training medical students with scientific knowledge and medical technical skills,enormous medical staffs are shaped into medical technical workers who lack medical morality and emotions,leading to the contradiction between medical morality and technologies.Medical personnel should know that medicine not only observes illness closely,but also attaches importance to the patients themselves who are suffering the pain.Medical students should pay attention to the forming process of medical morality and emotion in their preparative stage,accept the exercise to prepare for medical morality,and recalls their love and concern for life.

Hepatic fibrosis in rat induced by intraperitoneal injection of dimethylnitroamine (DMN) was traeted by RNA (4 mg ? kg-1) and CoQ10(2. 5 mg ? kg-1) ,seperately. Normal and pathological groups were compared. In 30, 60 and 90 days treatment, rats were killed for ul-trastructural examination and measurement of serum enzymology, serum amino acids and the quantity of collagenous fibers. The results indicated that, in RNA-treated and CoQ10 treated groups, Aspartate aminotransferase (AST) and Y-glutamyl-transpeptidase(?-GT) were normal, the ratio of albunm to globulin (A/G) had significantly difference compared with controlgroup. In RNA-treated group,L-Alanine:2-Ox-oglutarate Aminotransferase(ALT), monoamine oxidase (MAO) and N-acetyl-?-glucosaminidase (NAG) decreased evidently, serum amino acids increased slightly. Ultrastructural and microscopical examination showed the degree of hepa-tocytic necrosis degeneration and the quantity of collagenous fibers in RNA-treated group were rather mild. It appeared that there were protection effects of RNA on liver enzymology and hepaticfibrosis.

Objective To summarize the result of several kinds of flaps treated to first web space contraction. Methods Thirty-two cases of sever contracture of the first web space were treated between September 2000 and March 2009. Ultrathin groin flap, blood vessel pedicle reverse-flow island flap, neurocutaneous flap of the forearm, and free skin flap were used. The area of flaps were 3.0 cm × 5.0 cm-4.5 cm× 8.0 cm.The therapeutic result was observed by 3-12 months follow-up. Results There were partial necrosis at the distal part of flap in 1 case of nerve nutritional vascular pedicle skin flap and 1 case of ultrathin groin flap.The raw surface was healed by free skin grafting. The other flaps were all survived. There was some contraction observed in some patients after the K-wire released. The width of the first web space was augmented to an average of 50 mm (35-60 mm) and account to 80% to the uninjured side. The angle of the first web space was increased to an average of 70°(45°-80°). The contracture was improved significantly. The abduction and opposition function of thumb were restored. There was some degree decrease of grasp strength. The patients can fulfil daily life and partial work. But sensation was not good in some patients. The contour of the flaps:the contour of ultrathin groin flap was good. The contour of flaps in 3 cases of island skin flaps, 1 case of nerve nutritional vascular pedicle skin flap and 2 cases of free flaps were trimmed again in order to be improved. Conclusion The sever contracture of the first web space could be treated by different kinds of flaps, the suitable management should be chosen according to the specific situation.

The development of medical technology draws the doctor-patient relationship ever closer.However,the abundance and complexity of medical knowledge and technology make it a difficult task for medical personnel to grasp medical knowledge and skills,setting up a higher request for handling physician-patient relationship.Besides,medical disputes between doctors and patients caused by the abuse of medical technology in clinical practice also contribute to the contradiction between the advancement of medical technology and the latency of medical morality.Therefore,it is one important part in the study on medical morality from the perspective of medical technology ethics to take a rational view on the development of medical technology and construct a harmonious physician-patient relationship.

BACKGROUND: There is no any mature and complete system to repair nerve tissue after segmental injury due to particularity of nerve tissue regeneration. Using tissue-engineering technique to solve this problem is difficult and challenged.OBJECTIVE: To research an artificial nerve bridging substance in application of repairing nerve injury on clinic and obverse its microcosmic spatial structure at the same time.DESIGN: Open experiment.SETTING: Orthopaedic Research Institute, Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERTALS: The experiment was carried out in the Orthopaedic Research Institute, Xijing Hospital of the Fourth Military Medical University of Chinese PLA from November 2001 to January 2003. CollagenⅠ, collagen Ⅳ and gelatin were provided by Sigma-aldrich Company, USA.METHODS: Establishment of bridging substance: Collagen Ⅰ (65.53%) and collagen Ⅳ (32.77%) were added into 0.05 mol/L acetic acid solution, respectively; and then, two suspensions were mixed together and stirred at 4℃. The suspension of collagen and heparin sulfate was pumped, held still and poured into silica gel tube with bore of 3 mm.Continuously, two ends of tube were enclosed and suffered from cold drench and mold at five various speeds. General observation was done. Composites were intercepted cross section, vertical section and 45° section for observation by optic microscope at different speeds of 10×10-5 m/s, 5×10-5 m/s, 2.5×10-5 m/s, 1.0×10-5 m/s and 1.0×10-6 m/s; meanwhile, interior structure of microtubule was observed with scanning electron microscope. Interior diameter of microtubule was calculated as the following formula: actual aperture = (magnification × area of microtubule) ÷ (length of guage × perimeter of aperture).MAIN OUTCOME MEASURES: ① General observation; ② observation with microscope; ③ observation with scanning electron microscope and interior diameter of microtubule.RESULTS: ① General observation: Models were regular cylinders and had symmetrical features. Flexility was wonderful,texture was well-proportioned, and elasticity was strong. ② Results of optic microscope: Structure of external surface was completely blocking without any poricidal dehiscence. Surface was smooth and had good continuity. ③ Results of electron microscope: External surface shaped like terrace tile; asides, interior structure of microtubule was average and its courser was coincident and parallel to each other. Microtubules with longitudinal courser were independence on each other. The structure was blocking and did not connect to each other. This was as the same as courser of nerve fibrous bands of organis. Cross section of interior microtubule was general round and regular, and the diameter was average. Interior microtubule had groat continuity without breaks or transection. Trabeculae of microtubule also had groat continuity,and its surface was smooth. Interior diameter of microtubule ranged from 197.3 μm to 258.8 μm.CONCLUSION: Nerve bridging substance is made of collagen and gelatin which are characterized by groat compatibility and degradation after mixture, lysis and cold drench, It has singly longitudinal microtubule and microstructure of high imitation by normal nerves, so nerve bridging substance can be used in basic researches and repair nerve injury on clinic.

AIM: To investigate killing effect of herpes simplex virus thymidine kinase/ganciclovior system(HSV-TK/GCV) on osteosarcoma cell and its mechanisms.METHODS: Recombinant retroviral vector (DORHyTK) containing hygromycin phosphotransferase-thymidine kinase fusion gene(HyTK) was constructed and introduced into human osteosarcoma cell line OS732 with DOTAP. DNA and total RNA extracted from HyTK expressing cells (OS732TK) were tested by PCR and RNA dot blot analysis. A chemosensitivity of OS732TK cells to GCV and “bystander effect” were measured by means of MTT colorimetric assay. Hoeschst 332258 staining and flow cytometric analysis were performed for mechanism of HSV-TK/GCV system gene therapy. RESULTS: DORHyTK was constructed successfully; the HyTK gene existed and expressed in OS732TK cells; All OS732TK cells were killed after 5 days of exposure to 5 mg/L GCV. The “bystander effect” was observed in both a high population and a low population, but the former was stronger than the latter. Hoeschst 332258 staining revealed the characteristic hallmarks of apoptosis, however necrosis also existed. Flow cytometric analysis of DNA content showed a G0-G1 phase blockade. CONCLUSION: HSV-TK/GCV gene therapy system showed its strong killing effects on osteosarcoma cells OS732; The phenomenon of “bystander effect” was also very apparent. GCV exposure induced both necrotic and apoptotic death in HSV-TK expressing cells, and perturbed the cell cycle. HSV-TK/GCV gene therapy system may provide a new therapeutic approach for treatment of osteosarcoma.

BACKGROUND: Injury of axillary nerve leads to the inability of abduction in the upper limb which needs surgery treatment. However, which way of operative approach is more preferable is still uncertain. Whether one-stage posterior operation of nerve transfer can achieve better effects remains unclear, the choice of approach method is an argument.OBJECTIVE: To explore the therapeutic effect of the transposition operation of the branch to long head of triceps branchii to recover the anterior branch of axillary nerve that can restore the function of deltoid muscle and refrain from the deprivation of function to extend elbow.METHODS: A total of 13 cases with axillary nerve injury without any recovery sign admitted at the Department of Hand Surgery, China-Japan Union Hospital of Jilin University were selected, including 11 males and 2 females, aged 18-55 years, mean aged 28.4 years; Under 10-times operating microscope, the anterior branch of axillary nerve was chosen to coincide the branch to long head of triceps branchii in use of 11 -0 atraumatic nylon in posterior approach. The standard issued by the Hand Surgery Society of Chinese Medical Association was adopted to assess the upper limb function postoperatively.RESULTS AND CONCLUSION: All patients were followed-up for 6-53 months with an average of 21 months. All incisions after surgery gain primary healing. The function of shoulder abduction had recovered in some degree. Among of total, 7 cases had deltoid strength of M4 or even more; 4 cases had deltoid strength of M3; one had M2 and one had M1. The effective rate was 92%, and excellent rate was 85%. There was no impact on the extension of elbow in all cases. It was a reliable and convenient technique to recover shoulder abduction with the branch to long head of triceps brachii from radial nerve in restoration of the function of deltoid muscle. It was beneficial to the restoration of axillary nerve with partially injured brachial plexus, and severe quadril.