Medical ethics in the public health is ignored for a long time,and its main reason is that there is no suitable criterion in this field,however,on-the-spot investigation becomes more impatient for ethics.This article proposes some criteria which should be observed in the field of the use of informed consent especially when some ethical dilemma appears.

Objective:To explore the clinical value of Foley bladder in the treatment of the cesarean scar pregnancy(CSP).Methods: Twenty patients with CSP in Chongqing Health Center for Women and Children from Jan 2006 to Dec 2009 were stutied.All patients were treated with Methotrexate(MTX)and mifepristone.When their?-Serum human chorionic gonadotropin(?-HCG)were under 5000IU /L,they were undertaken curettage guided by ultrasound and hemostasis with Foley bladder.Results:Seventeen patients were cured,and the amount of bleeding was 279.0?63.9 ml in curettage,(65?19.8)ml after performed Foley bladder,The Foley bladder were held in the uterine cavity for(38?11.1)hours.The other cases included one patient of total hysterectomy,one patient of subtotal hysterectomy and one patient of uterine scar excision.Conclusions:The hemostasis with Foley bladder is a valuable treatment for CSP patients with the Primary Hospital of less bleeding,less cost and protecting the pregnancy.

This paper analyses and discusses of the mammary duct ectasia. The review of 51 cases of mammary diagnostic name and pathogenesis duct ectasia shows that mammary duct ectasia and plasma cell mastitis are the two stages of one disease. It is generally caused by disturbance in the secretion of mammary glands. It is difficult to distinguish it from breast neoplasms. Therefor, we also analyse why the disease is more likely to be misdiognosed as breast cancer and also represent its differential diagnosis. The paper involves some measures of treatment.

Objective To investigate the efficacy and risk factors of carotid artery stenting ( CAS) in patients with uni-lateral and bilateral carotid stenosis .Methods We retrospectively studied 312 cases of patients with CAS diagnosed in xinqiao Hospital between January 2005 and January 2011 .According to the carotid artery lesions , patients were divided in-to the unilateral carotid stenosis group .Periprocedural data and those after one-month follow-up and one-year follow-up were collected in two groups and analysed by statistics .Results A total of 312 patients were enrolled in this study , including 136 patients with bilateral lesions and 176 patients with unilateral lesion .303 of these patients were followed up after one month, and 224 cases after one year.All the 312 patients were implanted with 391 stents.The two groups of patients with transient ischemic attack ( TIA) were different in the incidence of perioperative TIA (1.2%for bilateral lesions and 7.6%for unilateral lesions;P<0.01).Compared with bilateral carotid lesions group , the incidence of early postoperative adverse events (death, stroke, perioperative TIA,and perioperative myocardial infarction ) in unilateral carotid lesion group was lower (5.2%vs 11.4%), but of no statistical significance (P>0.05).The incidence of medium-term adverse events (death, stroke, perioperative TIA, perioperative myocardial infarction, and restenosis) in the bilateral carotid lesions group was significantly higher than in the unilateral group (21.8%vs 9.7%, P<0.01), mainly driven by a higher inci-dence of death, periprocedural TIA, and restenosis (P<0.05).Multivariate analysis showed that left ventricular dysfunc-tion, masculinity , bilateral carotid artery disease , renal insufficiency , and cerebral ischemic symptoms within the last 6 months before intervention , and low-density lipoprotein cholesterol ( LDL-C ) levels were the independent risk factors for medium-term adverse events .Conclusion Patients with bilateral carotid artery disease treated by CAS are more prone to adverse events than those with unilateral disease .

Colorectal cancer is one of the most common malignant tumors. Though the development of multidisciplinary therapy has largely improved the therapy effects, many patients still died of local recurrence and metastases after surgery. Circulating tumor cell (CTC) originates from primary tumor tissues and has a close relationship with cancer metastases and prognosis. This review summarizes the CTC detection methods and relevant clinical research on CTC in recent years.

Acute Disease ; Child ; Humans ; Orbital Cellulitis ; therapy ; Sinusitis ; therapy

With the population ageing,increasing health needs and demands,changing family structure and the transformation of general hospital service model,home care as an important part of primary care,has been brought more and more attention.Home healthcare would relieve the pressure caused by increasing needs of elderly care and transformation of hospital functions,so it should have greater development in the future.This article reviews the present situation and the future development direction of home healthcare in China.

ObjectiveTo explore the application of the Structure Equation Model on validity assessment of the evaluation indicator system,we studied Medical Capital Development Fund projects in 2007 to evaluate their construct validity.MethodsPart of the evaluation results (1200 items) were divided into two parts randomly.PART1 was used for Exploratory Factor Analysis (EFA) to explore the Indicator System' structure,and formed model F1.Confirmatory Factor Analysis (CFA) was used to assess the construct validity of model F1.With considerations of Modification Index(MI) and reality,F1 was modified into F3.At last,we take PART2 as the sample to confirm F3.ResultThe results of model F3 fit indices showed a better fit.All the path coefficients,estimated load factors and other parameters were statistically significant.ConclusionStructural Equation Model is professional,reliable and satisfactory for the evaluation of indicator system's contract validity.

BACKGROUND: The spinal instability would accelerate the degeneration of normal disk. The injuries of anterior longitudinal ligament (ALL) and intervertebral disk were usually caused by cervical trauma, which leaded to spinal instability. Currently, there were few animal researches about the degeneration of injured intervertebral disk affected by ALL destruction.OBJECTIVE: To investigate the degeneration of injured intervertebral disk after spinal instability in the rabbit model of different degrees of ALL and disc destruction.METHODS: A total of 24 New-Zealand rabbits were randomly divided into intervertebral disk injury group (Group A, n=6), partial injury of ALL with disc injury group (Group B, n=6), injury of bony attachment point of ALL with disc injury group (Group C, n=6) and entirely injury of ALL with disc injury group (Group D, n=6). The L2-L3 intervertebral disk and ALL were injured through abdominal cavity. Different groups received different treatments. Computed tomography (CT) scans of the injured disc were performed at the postoperative 4 and 8 weeks, and the middle high of injured discs was calculated on CT sagittal reconstruction. Three rabbits were selected from each group. Hematoxylin-eosin staining of injured disc was performed after the animals were killed. Results were examined under the light microscope.RESULTS AND CONCLUSION: (1) At postoperative 4 weeks, the middle height of injured discs in Group D was decreased significantly compared with Group A (P < 0.05). There were hyperosteogeny and calcification in Group C and Group D. There were nucleus pulposus cells reduction and inflammatory reaction in Group C and Group D on histological staining. (2) At postoperative 8 weeks, the middle height of injured discs respective was decreased significantly compared with Group A (P < 0.05). The hyperosteogeny and calcification became clearer in Group C and Group D than before. There were morphologic changes of nucleus pulposus cells and fibrillation by hematoxylin-eosin staining, and the degree of disc degeneration was Group D > Group C > Group B > Group A. (3) In conclusion, the injury of ALL would accelerate the degeneration of correspondingly injured disk, and the degree of injury of ALL was positively correlated with the degeneration of disk.

Objective Postoperative cognitive dysfunction (POCD) is a common complication of cardiac surgery, which seriously affects the prognosis of the patient.This study aimed to explore the risk factors for early POCD in patients undergoing cardiac valve surgery and the correlation between early POCD and the serum S100B protein level.Methods Eighty patients underwent mitral valve replacement surgery in combination with tricuspid plasty.At 1 day before and 5 days after surgery, we assessed the cognitive function of the patients and divided them into a POCD and a non-POCD group.We obtained such data as the age, sex, education, New EuroSCORE Ⅱ, and preoperative NYHA cardiac function grades and left ventricle ejection fraction (LVEF) of the patients, collected the venous blood to determine serum S100B protein concentration by ELISA, and analyzed the independent risk factors of early POCD using single-factor and binary logistic regression analyses.Results POCD was found in 20 (25%) of the patients, , Logistic regression analysis showed the independent risk factors for early POCD to be hyperglycemia (OR=6.038, 95% CI: 1.202-30.337), operation time (OR=6.423, 95% CI: 1.276-32.332), and aspartate aminotransferase (AST, 2 times higher than normal) (OR=12.878, 95% CI: 2.289-72.445).The serum S100B protein concentrations in the POCD group were (1.9±0.3) μg/L and (1.7±0.4) μg/L at 48 and 72 hours after cardiopulmonary bypass, significantly lower than (2.4±0.4) μg/L and (2.1±0.3) μg/L at 30 minutes and 24 hours (P<0.05), and so was it in the non-POCD group at 72 than at 48 hours postoperatively ([1.4±0.4]) vs [1.5±0.4] μg/L, P<0.05).Conclusion Long operation time, perioperative hyperglycemia and high AST are independent predictors and the serum S100B protein level is a significant marker of early POCD.