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

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.

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.

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.

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.

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.

Objective To explore the value of two dimensional and color Doppler flow imaging(2D CDFI)for the diagnosis and differentiation of the carotid body tumor.Methods Retrospective analysis was made on 12 patients with carotid body tumor examined by 2D CDFI,and differentiations were conducted between several similar diseases.All the cases were confirmed by surgical pathology.Results The carotid body tumor in 2D CDFI was shown as follows: Low echoic substantial masses were found in the carotid branch with clearly boundary,and or partly outline.Most in small size were located at the branch of common carotid artery,so the interval between external and internal carotid arteries was enlarged.The masses in big size always grew around common cartid artery internal carotid artery and external carotid artery.More color flow signals were detected in the masses,and most were artery flow.The relationship between the mass and the carotid was shown clearly by 2D CDFI.Conclusions 2D CDFI is a valuable and practical method in diagnosis of carotid body tumors.

Objective: To investigate the effect of Plantago asiatica L. on antioxidation in rats. Methods: The antioxidative enzymes and LPO of serum, heart, and liver tissues were determined. Results: The activities of superoxide (SOD) in serum and heart were significantly lower than that of the control. The lipid peroxide (LPO) level in serum and heart was markedly higher than that of the control. Serum and liver catalase (CAT) activities in rats fed with high fat were decreased. Activities of liver glutathione peroxidase (GSH Px) in high fat rats were decreased significantly. The production of SOD activities in serum and liver and GSH Px in liver were increased significantly in rats maintained on Plantago asiatica L. supplemented diets, meanwhile serum and heart LPO were reduced. Conclusion: 15g/kg Plantago asiatica L. can increase the antioxidation against lipid peroxide in hyperlipidemic rats.