The writers put forward that we should make the construction of ethics the mainstream in the construction of social medical ethics by probing into social medical science from such facets as economics,politics and culture,etc.

Depression is the general symptom of gloomy mind,which could lead to suicide.The objective of this research is to explore the relation among different psychosocial factors of depressed countryside women and the roles of economy,family and health.Methods: Use SAS,SDS,Living Affair and individual status to ask 608 women in the countryside of Shanxi.Results: 33.9% women have depressed symptom,the analysis of logistic shows that the factors which will lead to depress are anxiety,minus life events,and so on.Conclusion: There is consanguineous connection between the depression of women and their living conditions,health,economy,and so on.

AIM　To study whether KB-R7943 has selective inhibitory effect on the inward and outward Na+-Ca2+ exchange current (INa-Ca) in guinea pig ventricular myocytes. METHODS　Through setting up the model of intracellular Na+-overload during myocardial ischemia and reperfusion, the current-voltage relationship of INa-Ca was recorded using whole-cell patch clamp technique under bi-directional ionic conditions. RESULTS Currents were elicited by a declining ramp pulse depolarized immediately from holding potential of -40 mV to +60 mV, then repolarized to -100 mV at a speed of 80 mV*s-1 and returned to the holding potential under bi-directional ionic conditions, while the ［Na+］ was 25 mmol*L-1 in the pipette solution. The currents increased time-dependently and voltage-dependently which reached from (2.51±0.15) pA*pF-1 to (5.94±0.13) pA*pF-1 at +50 mV and from (-1.92±0.13) pA*pF-1 to (-3.17±0.16) pA*pF-1 at -80 mV (n=12) after 3 min and there is no significant run-down of the current. KB-R7943 10-6 mol*L-1 was found to decrease the current to (4.62±0.05) pA*pF-1 by 29.4% at +50 mV and to (-2.30±0.18) pA*pF-1 by 22.1% at -80 mV (n=5) after 5 min. While 10-5 mol*L-1 KB-R7943 was shown to decrease the current to (3.13±0.03) pA*pF-1 by 61.7% at +50 mV and to (-1.62±0.03) pA*pF-1 by 56.9% at -80 mV (n=7). CONCLUSION　KB-R7943 can block INa-Ca in guinea pig ventricular myocytes. But, it did not show selective inhibition effect on inward and outward currents.

A lot of problems have turned up with the development of the urban employee's basic medical system. So we need to establish a set of scientific medical evaluation index system to weigh it. This article discusses the evaluation index of the medical insurance from the respects of fairness, efficiency and development.

Objective To observe the effect of Dachengqi decoction combined with β-aescine on pulmonary function in patients with acute lung injury (ALI) after chest trauma.Methods Ninety-five patients with ALI after chest trauma admitted to the Department of Thoracic Cardiothoracic Surgery of Dingxi People's Hospital of Gansu from April 2013 to May 2016 were enrolled, and they were divided into a Dachengqi decoction group (47 patients) and a control group (48 patients) by random number table. The control group patients were treated with conventional therapy and β-aescine 0.4 mg/kg+ 10% Glucose (250 mL) intravenous drip, while the Dachengqi decoction group patients were additionally treated with Dachengqi decoction on the treatment of the control group (rhubarb 12 g, magnolia officinalis 24 g, fructus aurantii immaturus 12 g, mirabilite 9 g), one dose daily, taken twice in a day, once in the morning and once in the evening orally, both groups were treated for one week. Before and after treatment, the changes of esophageal pressure, respiratory dynamics, the indexes of pulmonary function and blood gas analysis were observed. Results Compared with those before treatment, the levels of plateau pressure (Pplat), mean airway pressure (mPaw), airway resistance (Raw) and arterial partial pressure of carbon dioxide (PaCO2) of the two groups after treatment were significantly reduced, but the levels of lower esophageal sphincter pressure (LESP), peak airway pressure (PIP), the first second forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEF), the mean maximum expiratory flow (MMEF), pulse oxygen saturation (SpO2), arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2) were all increased significantly; the changes of the above indexes in the Dachengqi decoction group were more significant than those in the control group [LESP (mmHg, 1 mmHg = 0.133 kPa):18.64±2.79 vs. 15.46±3.09, Pplat (cmH2O, 1 cmH2O = 0.098 kPa): 14.27±1.68 vs. 16.00±1.87, PIP (cmH2O): 40.23±5.03 vs. 32.19±4.45, mPaw (cmH2O): 8.57±0.67 vs. 9.41±1.23, Raw (cmH2O·L-1·s-1): 6.76±1.01 vs. 9.31±1.43, FEV1 (L): 1.73±0.27 vs. 1.46±0.25, FVC: (3.95±0.51)% vs. (3.30±0.46)%, PEF (L/s): 3.81±0.47 vs. 3.11±0.38, MMEF (L/s): 0.93±0.16 vs. 0.77±0.12, SpO2: 0.96±0.06 vs. 0.91±0.05, PaO2 (mmHg): 97.82±10.13 vs. 74.73±8.02, PaCO2 (mmHg): 36.49±4.28 vs. 47.13±5.46, PaO2/FiO2 (mmHg): 362.47±20.82 vs. 259.79±17.61, allP < 0.05]. Conclusion Dachengqi decoction combined with β-aescine can reduce the respiratory intensity of patients with ALI after chest trauma and improve the lung function and blood oxygen level.

Objective To investigate the value of diffusion weighted magnetie resonance imaging and apparent diffusion coefficient (ADC) value in the diagnosis of pancreatic cancer.MethodsThe clinical data of 36 patients with pancreatie cancer who were admitted to the Wuxi No.2 People's Hospital from March 2009 to June 2011 were retrospectively analyzed,and the clinical data of 30 healthy volunteers were collected.All candidates received diffusion weighted magnetie resonance imaging examination.The signal intensity ratios ( SIRs ) of the cancer and the pericancerous tissues in the T1 weighted-images (T1WI),T2 weighted-images (T2WI)and diffusion weighted-images (DWI) were compared by using one-way analysis of variance.The ADC values of the cancer and the paricancerous tissues were compared using the paired t test.The differences of the ADC values of the cancer and pericancerous tissues compared with those of healthy individuals were analyzed using an independent sample t test.ResultsThe accuracy rate of preoperative magnetic resonance imaging examination was 92％.The relative SIRs were 0.203 ± 0.190 in the T2 WI,0.399 ± 0.201 in the T1 WI and 0.579 ± 0.291 in the DWI,respectively,with no significant differences across the 3 kinds of images (F=5.92,6.15,6.83,P ＜ 0.05 ),while SIRs of the T1 WI and DWI were significantly higher than that of the T2 WI ( P ＜ 0.05 ).There was no significant difference in SIRs when comparing T1 WI and DWI ( P ＞ 0.05 ).The mean ADC values of the cancer and pericancerous tissues of the pancreatic cancer patients and the pancreatic tissues of healthy individuals were (1.40±0.24) ×10 3 mm2/s,(1.71 ±0.10) ×10-3 mm2/s and (1.73±0.30) ×10-3 mm2/s,respectively,with significant differences across the 3 modes of images (t =10.54,12.08,P ＜ 0.05).ConclusionDWI can show high quality images of the lesions,and ADC value is helpful in the diagnosis of pancreatic cancer.

OBJECTIVETo observe the clinical efficacy on constipation predominant irritable bowel syndrome (IBS-C) treated with acupuncture for regulating the mind and strengthening the spleen and the impacts on the quality of life in the patients.

METHODSSixty patients of IBS-C were randomized into two groups. In the acupuncture group (30 cases), acupuncture was applied to Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Taichong (LR 3), Sanyinjiao (SP 6), Yintang (GV 29) and Baihui (GV 20), once a day, 5 treatments a week and 4 weeks treatment as one session. In the western medication group (30 cases), lactulose oral solution was prescribed, 15 mL each time, three times a day, 4 weeks treatment as one session. The symptom grade scale and the quality of life scale (IBS-QOL) were adopted to observe the changes in clinical symptoms and quality of life before treatment, after treatment and 2-month follow-up after treatment in the patients of the two groups separately.

RESULTS(1) Clinical symptom score: the difference in the symptom score at each time point was significant statistically in intra-group comparison (P < 0.01). In 1 week, 4 weeks of treatment and 2 months after treatment, the clinical symptom scores in the acupuncture group were lower than those in the western medication group (P < 0.05, P < 0.01). (2) IBS-QOL score after treatment was improved as compared with that before treatment in the two groups (P < 0.01). The improvement of IBS-QOL at 2 months after treatment in the acupuncture group was apparently superior to the western medication group (P < 0.05). (3) The total effective rate was 90.0% (27/30) in the acupuncture group and was 83.3% (25/30) in the western medication group. The overall efficacy in the acupuncture group was better than that in the western medication group (P < 0.01).

CONCLUSIONAcupuncture for regulating the mind and strengthening the spleen significantly relieves the clinical symptoms of IBS-C and improves QOL of patients. The total efficacy is superior to lactulose oral solution and presents a certain of long-term efficacy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Constipation ; physiopathology ; therapy ; Female ; Humans ; Irritable Bowel Syndrome ; physiopathology ; therapy ; Male ; Middle Aged ; Quality of Life ; Spleen ; physiopathology ; Treatment Outcome ; Young Adult

OBJECTIVE To observe and compare the cytotoxicity induced by andrographolide (AD)and its water soluble derivatives:andrographolide sodium bisulfite(ASB),active pharmaceutical ingredients of Chuanhuning and Yanhuning on human renal tubular epithelial cells (HK-2),and to explore the ASB-induced endoplasmic reticulum stress(ERS)mechanism. METHODS HK-2 cells were treated with the above four drugs respectively. The survival rate was examined by methyl thiazolyltetrazolium (MTT) assay and 50% inhibitory concentration (IC50) was calculated. In ASB treated group, Hoechst33342 staining and flow cytometry analysis were used to determine cell apoptosis, intracellular superoxide dismutase(SOD)activity and malondialdehyde(MDA)content were examined, and the protein expressions of binding immunoglobulin protein (Bip),C/EBP-homologous protein (CHOP)and cysteine-containing aspartate-specific protease 4(caspase 4)were detected by Western blotting. RESULTS The four drugs inhibited HK-2 cell growth in a time-dependent and concentration-dependent manner. At 24 h,the IC50 of AD (30.6 μmol · L- 1) was lower than that of others. Active pharmaceutical ingredients of Chuanhuning and Yanhuning (16.2 and 15.6 mmol · L- 1) were very close,ASB was 29.4 mmol · L-1. ASB(0,15,30 and 60 mmol · L-1)increased the apoptotic rate and caused the decrease in SOD activity and the increase in MDA content in a dose-dependent manner. Compared with control group,the protein expression of CHOP increased (P<0.01) at 8 h with ASB (30 and 60 mmol · L-1)treatment,Bip and caspase 4 had no significant change. In addition,at 24 h, ASB(60 mmol·L-1) decreased the expression of Bip(P<0.05),ASB(30 and 60 mmol·L-1)promoted the expression of CHOP(P<0.01),and the protein expression of activated caspase 4 increased in a concentration-dependent manner(P<0.01). CONCLUSION AD and its water soluble derivatives have a toxic effect on HK-2 cells. CHOP and caspase 4 pathway related to ERS is involved in ASB-induced apoptosis.

The recent development and wide application of ultrasonography and ultrasonography-guided fine needle aspiration biopsy have greatly facilitated the detection of papillary thyroid microcarcinoma (PTMC).Currently, the occurrence, development and pathological features of PTMC are not clearly understood.Therefore, no consensus on the diagnosis and treatment has been reached.Patients with PTMC are suggested to be closely observed and periodically examined with ultrasonography in some countries such as Japan, and these patients are to be operated when the tumor enlarged or new lymphatic metastasis are found.Operation is the first choice in the European and American countries, and the long-term survival rates of these patients are nearly 100％.For the PTMC patients with the risk factors such as thyroid capsule invasion, lymphatic metastasis,multi-focal lesion, higher degree of malignancy, thyroid stimulating hormone suppression therapy was given after operation, which may reduce the local recurrence rate.In China, we should hold well thelimitation and choose the best way for different patients according to the personalized principle in clinical practice.

The clinical laboratory equipment on hospital ship was introduced, whose status and common faults were analyzed during Philippines humanitarian medical rescue mission and 3 times of Mission of Harmony. The experience was summarized for the maintenance of the clinical laboratory equipment. The problems and countermeasures were proposed for the clinical laboratory equipment.