As a common issue,information asymmetry has been a hot topic in the micro-economy field.It is also prominent in clinic as well as the medical insurance.The low efficiency and unfairness caused by information asymmetry will lead to a series of ethical problems.To solve the problems,the construction of moral system and rule are needed.

Interleukin-6(IL-6)is associated with cancer staging, survival, apoptosis and the sensitivity to chemotherapeutic drugs, and it is overexpressed in the cancer tissue and serum of cancer patient.IL-6 Can regulate proliferation and differentiation of cancer cells through IL-6/STAT3 signaling pathway. Therefore, blocking IL-6/STAT3 signaling pathway has potential therapeutic implications for cancer.

Objective:To explore the effect of targeted nursing with evidence-based support in the treatment of craniopharyngioma via the transsphenoidal approach.Methods:A total of 70 patients with craniopharyngiomas who were admitted to the Department of Oncology of Beijing Tiantan Hospital, Capital Medical University from June 2018 to June 2019 were selected and all received transsphenoidal surgery in the hospital. The patients were divided into 2 groups according to the lottery method, 35 cases in the control group, using conventional nursing; 35 cases in the observation group, using targeted care with evidence-based support; comparing the two groups of patients before and after care, the incidence of complications, and the length of hospital stay.Results:The scores of anxiety and depression (6.05±1.24 and 5.78±1.48) in the observation group 2 weeks after nursing were lower than those in the control group (9.95±1.73 and 10.52±1.87). The difference was statistically significant ( t value was 10.036, 10.886, P<0.05). The postoperative high fever, electrolyte imbalance, diabetes insipidus, epilepsy remission time and hospital stay in the observation group were (5.49±0.84)h, (5.46±0.39)d, (1.03±0.21)h, (6.24±2.78)d, (12.51±1.48)d, which were shorter than those in the control group (8.78±1.05)h, (8.51±0.47)d, (2.49±0.35)h, (8.97±2.80)d, (15.26±1.52)d. The difference was statistically significant ( t value were 4.093-29.545, P<0.05). The incidence of postoperative complications in the observation group was 17.14% (6/35), which was lower than 37.14% (13/35) in the control group, and the difference was statistically significant ( χ2 value was 4.786, P=0.029). Conclusion:Targeted nursing with evidence-based support can reduce the incidence of postoperative complications in patients with craniopharyngioma through the transsphenoidal approach, shorten the length of hospital stay, and achieve significant application results.

Objective:To explore the protective mechanisms of You-gui-wan on hydrocortisone-induced apoptosis of murine thymocytes.Methods:Annexin V/ PI double stain was applied to analyze the apoptotic states of thymocytes after injection with hydrocortisone coupled with or without administration You-gui-wan.The transcriptions of Bcl-2 and Bax were tested by RT-PCR.Results:The apoptotic rate of thymocytes was seriously increased in hydrocortisone-injected mice contrasted to matched control mice(P

Objective To study operative morbidity and mortality of infrarenal abdominal aortic aneurysm (IAAA) and analyze the correlation between the preoperative or intraoperative risk factors and the morbidity or mortality. Methods Between Jan 1993 and Dec 2001, 120 IAAA cases undergoing surgery were analyzed. Preoperative cardiac, pulmonary, hepatic and renal condition, time of intraoperative aortic clamping as well as emergent operation were taken into account to evaluate the independent determinants of operative morbidity and mortality. Results The operative morbidity was 56.7% and mortality was 10.0%, with the mortality of elective surgery of 5.4% and emergent surgery of 66.7%. Conclusion Preoperative coronary heart disease, hypertention, renal dysfunction and massive blood transfution intra- or postoperatively adversely influenced the postoperative outcome significantly.

Objective:To investigate the current situation of network ethics among the college students , to pro-vide evidence for cultivating correct network ethics .Methods:A survey was conducted in 1200 students with a self-designed questionnaire .Results:College students in the network ethics exist conflicts .They eager to trust but face a crisis of confidence , tool enhancements but responsibility fall , network security but network open , virtual but reality.Conclusion:The government should strengthen the network legislation and network credit system , should increase the development of network security technology so as to build networks ethical norms .Colleges should pay attention to culture the social responsibility , and promote the quality level of network ethics among the college students .

Objective To analyze inpatient expenses of percutaneous coronary intervention (PCI) and factors in the department of cardiology of a hospital, in order to provide references for setting the upper expenses limit and keeping expenses within a reasonable control Methods The hospitalization expenses data were collected from inpatients having intracoronary stenting operations in a class 3 grade A hospital in Shanghai from 2004-2006. The study made multi-factor analysis on factors possibly affecting the expenses, and built a model to predict the expense per disease, and estimated the upper limit for medical insurance expense control. These figures were used in an expense appraisal for inpatients from January to June in 2007. Results For the expenses of the 1296 PCI inpatients investigated, the largest share, 84.11%, comes from operation materials. Factors affecting the expenses, as listed by their influence, were in turn the number of stents used, length of stay, age, the status at admission, and rescues made. The study found that the average hospitalization expenses of inpatients from January to June in 2007 fell below the middle control line, and 85% of them lower than the upper control line. Conclusions To lower the medical expenses for the disease, hospitals need to take measures by using less stents, less days of stay, and less medication. Control lines specified per disease can help manage and control medical treatment quality.

Objective To study the expression of polycystin1 and polycystin2 in dissection aorta specimens by Real time PCR and immunohistochemisty. Methods Twelve descending dissection aorta specimens from patients of acute Stanford B dissection were taken during surgery; 12 normal descending aorta specimens were taken from multi-organ donors. The G APDH gene was used as control, gene expression of polycystinl and polycystin2 were compared in these two groups with Real time PCR. The expression of polycystinl and polycystin2 protein were showed with immunohistochemisty in the specimen of these two groups. Three high magnify fields were randomly chosen to count the expression of polycystin1 and polycystin2 protein. The counting of polycystin1 and polycystin2 protein were compared between these two groups. Results The gene expression of polycystinl in AD group is 0. 32 fold as that in the control group (P ＜ 0.01 ) and polyeystin2 in AD group is 0.34 fold as that in the control group (P ＜0.01 ); The protein expression of polyeystinl was 0.47 folds as that in the control group ( P ＜ 0.05 ) and polycystin2 in AD group is 0.35 folds as that in the control group ( P ＜ 0.01 ). Conclusions The expression of polycystin1 and polycystin2 on gene and protein level were down regulated in AD group. The down regulation of polycystinl and polycystin2 may play a pivotal role in the development of AD.

Objective To study the effects of siltuximab on the interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (Stat3) signaling pathway in ovarian epithelial carcinoma.Methods (1) Expressions of IL-6 in ovarian cancer patient specimens were assessed by immunohistochemistry.(2) Expression of phosphorylation Stat3 (pStat3) protein in siltuximab and IL-6 treated SKOV3 cell lines was determined by western blot, and expression levels of Stat3-induced bcl-XL,MCL-1, survivin, in siltuximab treated SKOV3/TR and CAOV3/TR cells lines were also determined by western blot.(3) Real-time image analysis was used to study the nuclear translocation of pEGFP-Stat3 fusion protein in ovarian cancer cell line SKOV3-pEGFP-Stat3 treated with siltuximab and IL-6.(4)Paclitaxel sensitivity in siltuximab treated SKOV3/TR and CAOV3/TR cell lines were assessed using the methyl thiazolyl tetrazolium (MTT).The 50% inhibiting concentration ( IC50 ) was defined as the paclitaxel concentration required to decrease the A490 value to 50%.Results ( 1 ) There were significantly difference in IL-6 staining density and the positive rate of IL-6 protein stained among the metastatic, and drug-resistant recurrent tumors,and matched primary tumors [69%(18/26)] vs.77% (20/26)vs.23% (6/26), P＜0.05].(2)A clear increase in Stat3 phosphorylation levels was observed in the IL-6-treated SKOV3 cell lines as compared to the SKOV3 cell lines.When the IL-6-treated SKOV3 cells were incubated with siltuximab with a range of concentrations of 0.001,0.01,0.1, 1.0 and 10 μg/ml, there were trends toward reduced pStat3 expression in the treated cell lines.Compared without treatment with siltuximab, the expression of the anti-apoptotic proteins MCL-1, bcl-XL and survivin in SKOV3/TR and CAOV3/TR cell lines were significantly decreased after treated with siltuximab.(3) In resting cells, the majority of pEGFPStat3 was cytoplasmic until the addition of human IL-6, which promptly induced the translocation of fluorescent Stat3 molecules to the nucleus.Exposure of cells to siltuximab with a range of concentrations of 0.001, 0.01,0.1, 1.0 and 10 μg/ml, followed by an incubation in IL-6 significantly reduced pEGFP-Stat3 nucleocytoplasmic translocation.(4) MTT cytotoxicity assay demonstrated that siltuximab increased paclitaxel-induced cell death and partially overcame paclitaxel resistance.Treated with siltuximab ( 1 and 10 μg/ml) ,the paclitaxel IC50 value of siltuximab in SKOV3/TR (0.49, 0.19 μg/ml) and CAOV3/TR (0.0010, 0.0008 μg/ml) cells were significantly lower than those in untreated cells (0.71,0.0021 μg/ml;all P ＜ 0.05).Conclusions These results demonstrated that siltuximab effectively block the IL-6 signaling pathways, which .Blockage of IL-6 signaling may provide benefits for the treatment of ovarian cancer.

Objective To summarize our experience in treating high risk carotid stenosis. Methods We retrospectively analyzed the clinical characteristics, treatment, and outcomes of 24 patients with high risk carotid stenosis in our department from January 2001 with emphasis on the application of carotid stents and shunting tubes. Results All patients were successfully treated, with 11 patients undergoing carotid angioplasty and stenting (CAS) and 13 patients receiving carotid endarterectomy (CEA) and shunting. No death, stroke, and ischemic neurological deficit occurred in 30 days postoperatively. Conclusion Selective application of CAS and shunting in CEA can effectively reduce complications and improve therapeutic effects in patients with high risk carotid stenosis.