Operation agreement letter is forced to perform by the law.For the perspective of law,Operation agreement letter is a medical document for medical staff to certify the legitimacy of medical treatment,for hospital to certify that the duty to apprize has been performed,and also an authorization paper by patient to permit medical staffs to operate.However,there is no enforcement to relieve the responsibility of the medical institutions if medical mistake exist.The ethic meaning of operation agreement letter is to cure the sickness,to save the patient,to heal the wounded,and to rescue the dying.When there is conflict between reality and law,or there is no correlated clause in the law,the medical institutions must consider the spirit of legislation and perform medical treatment in time.

Objective To investigate the molecular mechanisms of delayed ischemic preconditioning (IPC) and doxorubicin preconditioning (DPC) to induce ischemic tolerance. Methods The models of sham-operation and orthotopic liver transplantation in the Wistar rats was used. IPC was administered with a 10-min ischemia followed by a 10-min reperfusion. Animals in the DPC group were pretreatd with Doxorubicin (1?mg/kg, iv). The control rats were subjected to saline treatment. The induction of HSP70 and HO-1 protein ( Western blot), the expression of ICAM-1 transcripts (RT-PCR)and ICAM-1 protein (immunohistochemistry), the activities of serum AST, ALT, LDH, and liver myeloperoxidase (MPO) , liver wet-to-dry weight ratios (W/D) were assessed.Results HO-1 expression was maximally induced at 12?h after IPC, and hardly changed until 48?h. A strong induction of HSP70 was detected at about 24 to 72?h after IPC. The levels of HO-1 and HSP70 were obviously elevated at 24?h after IPC or DPC as compared with the control ( P 0.05 ). In the control group, the transcription of ICAM-1 was significantly increased 6?h after reperfusion. Capillary endothelial cells of the livers strongly expressed ICAM-1. Activities of liver MPO were obviously elevated. IPC and DPC could significantly decrease the transcription of ICAM-1 in the livers in concurrence with the expression of ICAM-1 protein as well as the activity of MPO at 6?h after reperfusion ( P

Objective To investigate the effects of chemokine antagonist,Met-RANTES,on the acute rejection of islet allograft in the rat model.Methods According to the different treatments,rats were divided into 2 group: control group,allogeneic islet transplant untreated;experiment group,allogeneic islet transplant treated with Met-RANTES(200 ?g/day, i.p) for 7 days post-operation.The survival time of rat of islet transplant and blood sugar were recorded,and the pathological changes of islet allograft were observed.Scintillation counter was used to count the count per min(cpm) of monocytes.Flow cytometry was used to detect the ratio of CD4~+/CD8~+ phenotypes and CCR5 expression of peripheral blood lymphocytes.Results The mean survival time of islet allograft in experiment group was(23.0)?(10.5) days,obviously longer than in the control group((3.8)?(4.5) days,P

Objective To evaluate the in vitro inhibitive activities of mycophenolic acid against hepatitis B virus in vitro. Methods The different concentrations of the test drugs in DMEM were added to the well with the monolayer growth of HepG2.2.15 cells. The culture medium was refreshed with DMEM containing the appropriate drugs every 3 days. At 3rd, 6th and 9th days, the supernatant was collected for HBsAg quantitative assay, total RNA was isolated from cells for RT-PCR and realtime-PCR assays. Results It was found no significant anti-HBV effect of mycophenolic acid on concentration of 2～250 ?g/ml, and mini inhibitory efficacy of HBV replication on concentration of 1250 ?g/ml. There was significant anti-HBV effect of lamivudine on concentration of 5 ?g/ml. When combined with lamivudine mycophenolic acid can significantly potentiate anti-HBV activities of lamivudine, and it can get maximal inhibition effect on concentration of 10 ?g/ml. Conclusions Mycophenolic acid could inhibit HBV replication and potentiate anti-HBV activities of lamivudine.

Objective To observe the changes of retinal sensitive cellular ultrastructure of rats in critical period of visual development.Methods Ten normal healthy Wistar rats were chosen,eight of which were neonatal rats and two were mature rats.The eight neonatal rats were randomized into four groups(n=2 in each group) and respectively sacrificed on postborn day 0,15,20,25.The eyeballs of the neonatal rats and the mature rats were resected and the retinas were observed by electron microscope.Results The rat retinal sensitive cellular ultrastructure on postborn day 0 was immature and the cellular arrangement was not clear.The organelle of sensitive cell in critical period developed mature gradually and the arrangement of them was very clear.Conclusion The retinal sensitive cell of rats develops and matures gradually in critical period.

Objective To evaluate the in vitro inhibiting activities of interferon-alpha (INF-?) against hepatitis B virus (HBV). Methods HepG2 2 2 15 cells were treated with INF-?. At 3rd, 6th and 9th days after treatment, the supernatant was collected for HBsAg quantitative assay, and total RNA of the cells was isolated for RT-PCR and realtime-PCR assay of HBV mRNA. Results There were no significant differences in HBsAg titer and virus mRNA level at 3rd and 6th days between the experimental and control groups. At 9th day, HBsAg titer and virus mRNA level in INF-? group were significantly lower than those in control group. And 500IU/ml INF-? could get maximal inhibiting effect against HBV. Conclusion INF-? can inhibit transcription and expression of HBV gene in HepG2 2 2 15 cells, which indicated that INF-? can inhibit HBV replication directly.

Objective To study the significance of cytokine tumor necrosis factor ? (TNF ?) gene promoter 308 position polymorphisms in predicting acute graft rejection following renal transplantation. Methods In 35 preoperative recipients,TNF ? produced by peripheral blood cells was measured by enzyme linked immmunosorbent assay,and their TNF ? gene promoter 308 position polymorphisms were determined by PCR restriction fragment length polymorphisms(PCR RFLP).The association between TNF ? gene promoter polymorphisms and production of them was studied.Furthermore,the correlation between their polymorphisms and acute rejection in the first 3 months after renal transplantation was discussed. Results The recipients with A/A or A/G genotype in TNF ? promoter 308 position secreted more cytokine (624.96?177.78)pg/ml and (544.32?132.42)pg/ml than those with G/G (233.16?25.37)pg/ml, P

Objective To explore the feasibility of tubular model based segmentation method for cystic artery and three-dimensional (3D) reconstruction model of Calot's triangle.Methods A tubular model based 3D region growing algorithm was proposed for the segmentation of cystic arteries and its adjacent vessels from 13 patients' CT images in DICOM format.The data was transferred to 3D visualization workstation based on a set of CalotShow1.0 software for 3D reconstruction.Results The method could effectively segment cystic artery and obtain the 3D model of Calot's triangle.Conclusions The 3D reconstruction model based on tubular model related vessel segmentation method and CalotShow1.0 can accurately display the spatial positions and adjacent relationships of cystic artery and Calot's triangle.

Objective:To investigate the prognostic significance of plasma fibrinogen (FIB) and D-dimer in elderly patients with non-small cell lung cancer (NSCLC) before any anti-cancer treatments.Methods:97 cases of patients with lung cancer (lung cancer group) and 36 healthy subjects (control group) were enrolled;the level of plasma D-dimer and FIB were compared;the relationship between their levels and clinical pathological factors of NSCLC as well as prognosis was analyzed.Results:The levels of plasma FIB and D-dimer in lung cancer group were higher than those in healthy control group (P＜0.05).FIB in lung cancer group was related to TNM stage,and D-dimer was related to lymph node metastasis and TNM stage.Univariate analysis showed that FIB,D-dimer,tumor size,lymph node metastasis and TNM staging were associated with overall survival time (OS) and progression free survival (PFS).Multivariate analysis revealed that only D-dimer and FIB were independent prognostic factors of patients with NSCLC.Conclusion:Detection of fibrinogen and D-dimer in elderly patients with NSCLC before anti-cancer treatment would be useful for prognosis and might provide a certain value for individualized therapy.

Objective To study the security of low dose and half-body irradiation by 60Co ?-rays as a new method of clinical radiotherapy.Methods The simulated manikin was used to simulate human body and two radiation modalities of facing and backing on radioactive source were adopted.Half-body irradiation was done by 60Co ?-rays with doses of 9,10 and 11 cGy.The exposure dose of every layer and important target organs in the simulated manikin were detected,and the security of low dose and half-body irradiation as a therapeutic method was evaluated.Results The exposure dose of every layer and sensitive organs were all within safety margin,when simulated manikin facing or backing on the radioactive source was irradiated by 60Co ?-rays with doses of 9,10 and 11 cGy.Further,the exposure dose of sensitive organs in the simulated manikin backing on the radioactive source was lower than that in those facing the radioacive source.Conclusion The method of low dose and half-body irradiation as a radiotherapeutic method is safe and feasible and the radiation modality of backing on the radioactive source is more safe.