The article describes the essence,element,and contents in the new stage of the informed consent,makes discussions on how to effectively implement the principles of informed content in public health practices,and compares the similarities and differences of informed consent in public health ethics,clinical ethics,and biomedical ethics.

ObjectiveTo investigate the correlation between ineffective esophageal motility (IEM)and gastroesophageal reflux disease (GERD).MethodsA total of 90 GERD patients were enrolled in our study,including 62 patients with reflux esophagitis (RE) and 28 with non-erosive reflux disease (NERD).All the patients underwent gastroscopy,24-hour esophageal pH monitoring and esophageal manometry.ResultsIn the RE group 30 (48.4％) patients were diagnosed as having IEM,which was significantly higher than the NERD group (6 patients,21.4％ ) (P＜0.05).Positive esophageal acid exposure was more often seen in patients with IEM than in those with normal esophageal motility (91.7％ v.s.57.2％,P ＜0.01 ).The values of total percentage of time with pH ＜4,percentage of reflux time in supine position,long-duration episodes ( ＞5 min) and the longest reflux time and DeMeester score were significantly higher in the IEM cases than those in the normal esophageal motility cases ( P ＜ 0.01 ),so was the values of number of reflux episodes (P ＜ 0.05).ConclusionIEM is the most common esophageal dysmotility in patients with GERD and closely related to distal esophageal acid exposure and RE.

Objective To develop the software of Management Information System of Medical Materials.Methods Based on the platform of NET,three layers of C/S was applied in equipment & apparatus department for good operation platform,frequent data access and rapid response.Besides,the current HIS was utilized to protect the system to be extensible,easily-updated and easily-maintained.Results The application of Management Information System of Medical Materials could meet the requirement in scientific and standard supply,application and management of medical materials.The software was used in scores of hospitals with good effect.Conclusion Being able to organically integrate with other functional module,the software provides a powerful tool for the scientific management of hospital equipment.

Objective To evaluate the short-term efficacy and safety of combination therapy with amlodipine and terazosin in middle aged and old male patients with essential hypertension.Methods Randomized,prospective,parallel study was carried out in middle aged and old male patients with essential hypertension in Anqing community between August 2005 and February 2006.Antihypertensive efficacy and safety of the combination therapy were evaluated in 508 patient who completed the study.Results After 4 weeks treatment,the average reduction of SBP were 4.0?15.0,17.5?15.8 and 20.0?15.9 mm Hg in Terazosin group,amlodipine group and combination group,respectively(P

Aim To determine the roles of peripheral ? 1 and ? 2 -adrenoceptors (? 1-AR,? 2-AR) in inhibition of carotid sinus barore ceptor reflex(CSR) induced by intracerebroventricular injection (icv) of histami ne (HA).Methods The left and right carotid sinus regions were i solated from the systemic circulation in 22 male Sprague-Dawley rats anesthetiz ed with pentobarbital sodium.The intracarotid sinus pressure (ISP) was altered in a stepwise ma nner in vivo.ISP-mean arterial pressure (MAP) relationship curve and its ch aracteristic parameters were constructed by fitting to the logistic function wit h five parameters.The changes in CSR performance induced by icv HA and the effec ts of pretreatment with ? 1-AR or ? 2-AR selective antagonist into the per ipheral vein on the responses of CSR to HA were examined.Results icv microinjection of HA (60 ?mol?L -1 in 5 ?l) significantly shifted the ISP-MAP relationship curve upwards (P0.05).Conclusion The intracerebroventricular administration of HA results in a rapid resetting of CSR and a decrease in reflex sensitivity, and the functions of both the peripheral ? 1-AR and ? 2-AR may attenuate CSR resetting induced by icv microinjection of HA. Furthermore,the peripheral ? 1-AR might play an important role in mediating the responses of CSR to central HA.

Objective To elucidate the expression and clinical significance of C-erbB-2 in the tissue of lung cancer. Methods Immunohistochemistry method was used to detect the protein expression of C-erbB-2 in lung cancer tissue. Results The positive expression rate of C-erbB-2 protein in 38 cases of lung cancer was 53.3% (21/38),which was higher than those in lung benign control group (P＜0. 001). The significant correlation were found between the protein level and tumor stage(r＝ +0. 64,P＜0.02). The order was stage Ⅳ＞stage Ⅲ ＞stage Ⅱ ＞stage Ⅰ . There was no correlation among protein expression of C-erbB-2 in various histological types of lung cancer (P＞0.05 for all). Conclusion The positive expression rates of C-erbB-2 were significantly higher in lung cancer group than those in benign control group. There is significant correlation between C-erbB-2 expression and lung cancer stage. There is no correlation among protein expression of C-erbB-2 and histological types of lung cancer.

Objective To investigate short-term hemodynamic changes in selected patients with middle cerebral artery(MCA) stenting by transcranial Doppler sonography(TCD).Methods Stenting was given to 29 cases (31 MCAs) of patients with moderate and severe MCA stenosis if they had recurred symptoms during the standard antiplatelet therapy.TCD was applied to assess the hemodynamic changes in the stenosis segment and stenotic distal segment before stenting, 1 h and 3 d after stenting. Results Angiography showed that the rate of post-procedure residual stenoses of MCA were less than 20%.Compared with the pre-stentinng peak systolic velocity [PSV, (273±77)cm/s], the post-stenting PSV significantly decreased,which was (162±38) cm/s (P＜0.01) at 1 hour and (168±45)cm/s ( P＜0.01)at 3 days, respectively.Three cases (3 MCA) experienced recurrent stenosis-like spectra at stenosis segments 3 d after stenting and brain CT showed that 2 out of 3 cases suffered intracranial hemorrhage,which was potentially induced by hyperperfusion; PSV doubled in the stenotic distal segment in at least 28.6% patients.There was no statistic difference between pre- and post-stenting in the contralateral MCA (P＞0.05).Conclusions Stenting can dramatically improve the hemodynamic compromise of stenosis segments and their distal segments in selected patients with symptomatic MCA stenosis, however, potential hyperperfusion risk might he taken into consideration after MCA stenting.

Objective To discuss the preservation and clinical significance of petrosal vein in microsurgical operation of acoustic neuroma. Methods 147 patients with acoustic neuroma were operated, with internal decompression of the tumor firstly then dissected the tumor with surrounding structures, the petrosal vein were protected well in 143 cases and failed to protect in 4 cases. Results No hemorrhagic infarction in cerebellar was observed in 143 cases with intact petrosal vein. One case occurred with extensive cerebellar edema, which has gait disturbance after 18 months follow-up. The other three cases occurred with vein infarction and hemorrhagic edema after petrosal vein damage. One was dead and the other two were recovered well after decompression of posterior cranial fossa. One has no significant neurological deficit after 33 months follow-up, while the other has difficulty in line walking after 12 months follow-up. Conclusion Petrosal vein should be well protected in the operation of acoustic neuroma, the decompression of posterior cranial fossa should be considered if petrosal vein failed to protect.

Objective To explore the impact of pancreatobiliary reflux (PBR) in normal pancreatobiliary junction on gallbladder.Methods A total of 54 patients receiving cholecystectomy for gallbladder diseases underwent ultrasonography to evaluate the thickness of gallbladder wall,inner layer and gallbladder wall blood flow before operation.The bile juice was sampled during ERCP in 45 patients with common bile duct stone and during cholecystectomy in 9 patients to detect amylase level.All patients with normal pancreatobiliary junction enrolled in the study were assigned into PBR group (n =24) and controlled group (n =30) according to their bile amylase level.Resected gallbladder specimens were examined histopathologically and then tested for expression of COX2,Ki-67 and p53 immunohistochemically.Results PBR group included 20 cases of cholelithiasis and 4 gallbladder polyp,among which 23 were occult PBR (OPBR) and 1 high confluence of pancreatobiliary ducts (HCPBD),which was similar to pancreatobiliary maljunction (PBM) pathologically.The control group recruited 28 cases of cholelithiasis and 2 gallbladder polyp.There were no differences in frequency of inflammation,hyperplasia,metaplasia or expression of p53 between the two groups (p ＞ 0.05),while higher presence of dysplasia and higher expression of COX2 and Ki-67 were seen in PBR group (p ＜ 0.05).Conclusion In patients with OPBR,although hyperplasia and metaplasia in gallbladder epithelium were similar to those induced by cholelithiasis,dysplasia and active proliferation might relate to progress to malignancy.

Objective To explore the different apoptotic gene expressions and apoptotic signaling transduction of human rhabdomyosarcoma (RD) cells infected by enterovirus 71 (EV71) in different stage.Methods The survival of EV71-infected RD cells was observed by trypan blue staining.The apoptotic morphology and rates of RD cells were surveyed and detected by Annexin V-FITC/PI staining and flow cytometry,respectively.PCR array was employed to analyze 88 apoptotic gene expressions from EV71-infected RD cells at 8 h and 20 h postinfection (p.i),respectively.Results After RD cells were infected with EV71 (MOI =5) at 8 h p.i,the viability was significantly decreased.Flow cytometry data demonstrated that the apoptotic rates of EV71-infected RD cells had increased to 18.0％ and 19.1％ at 20 h p.i in early and later stage respectively.RT-PCR array studies revealed significant variations in the expression of apoptotic genes.Among 88 genes,only the expression of IFN-β1 was upregulated 5.22 folds,whereas 47 genes including ACIN1,Akt,Apaf1,caspase and CIDEB were found to be downregulated that were lower than 2 folds at 8 h p.i.However,28 genes including FasL,CD40L,TNF,caspase-10 and caspase-3 were induced more than 2 folds after EV71 infection at 20 h.Conclusion The downregulation of apoptosis-related genes is associated with viral apoptosis-suppressing effect in RD cells in the early stage of EV71 infection.The death receptor signaling pathways including Fas/FasL and TNF/TNFR are activated to induce cell apoptosis in the late stage of EV71 infection.Moreover,host cell can also inhibit apoptosis by regulating signal pathway of CD40/CD40L,NF-κB/RelA and PI3K/Akt activation.