SARS is the crisis rolling up the whole country. The crisis means, danger for us and disaster. But an enormous crisis also usually contains many new opportunities. As for us still very low in rate of autopsy, the variety of public motion of crisis of SARS for bringing is a big chance. We should comply with the surrounding the benefit leads, to publicize strongly the importance, necessity of the autopsy that conquer SARS, at the same time to publicize strongly the law guaranteeing perform of autopsy.

The medical staff wanting to acquire the success of managerial career in the hospital must master some basic strategies which means they should work well and keep the visibility and support superiorly and look for tutors and set up the interpersonal network and axquire the control of the hospital resources and understand the power structure of the hospital.

Objective To discuss the meaning of continuous intracranial pressure (ICP) monitoring in patients with severe traumatic craniocerebral injury. Methods One hundred and twenty four patients with severe craniocerebral injury treated from August 2004 to February 2011 in our hospital, were enrolled and divided randomly into ICP monitoring group (n = 62) and routine treatment group (n = 62). The patients of ICP monitoring group had adjusted treatment plan according to the changes of ICP at any time, whereas the patients in routine treatment group underwent routine neurosurgical treatment according to the doctors' experience. Results There were 7 cases of acute kidney function failure,and 11 cases of electrolyte disturbances in the ICP group.There were 15 cases of acute kidney function failure, and 25 cases of electrolyte disturbances in the routine group. The complication rate in the ICP group was lower than that in the routine group (x2 =3. 54 and 7.67 for acute kidney function failure and electrolyte disturbances respectively, Ps <0. 01). The days of mannite using were (6±2)dand (15 ±3)d, respectively; the dosage of mannite using were (749 ± 125) g and (1545 ±250) g,respectively. The good recovery and slight disability were 28 and 16 cases in the ICP group, and 13 and 9 cases in the routine group,respectively. The severe disability,vegetative state and death were 9,4 and 8 cases in the ICP group,and 17,7 and 13 cases in the routine group. The days and dosage of mannite using in the ICP group were much less than those in the routine group (t = 8. 32 and 7.41, Ps < 0. 01). The proportion of good recovery and slight disability in the ICP group were higher than those in the routine group(x2 =5. 07 and 3. 55,Ps <0.01). However, the proportion of severe disability, vegetative state and death in the ICP group were lower than those in the routine group (x2 =0.84,0.89 and 1.43, Ps < 0. 01) . Conclusion Continuous ICP monitoring in severe craniocerebral injury shows benefits in directing treatment plan adjustment, reducing complications and improving the prognosis.

OBJECTIVE:To guarantee the quality of the clinical drug trial and to ensure the interests of the subjects.ME- THODS:The basic principles,procedures and methods of ISO9001quality management standards were applied in the whole construction of clinical drug trial institution.RESULTS&CONCLUSION:The construction of clinical drug trial institution based on the ISO9001quality management standards was in conformity with the principle of Good Clinical Practice,which was helpful for the guarantee of the quality of clinical drug trial and the interests the subjects.

BACKGROUND:Disc functional magnetic resonance imaging studies are mostly carried out under lying and a non-load state, and do not reflect the changes in morphology and function of the upright human body under disc load conditions. Therefore, we need to study characteristics of disc functional magnetic resonance imaging in the upright state. OBJECTIVE: To analyze the effect of axial load on apparent diffusion coefficient and T2 of intervertebral discs. METHODS:The study consisted of 17 patients with low back pain aged 34-65 years. Before and after axial load, T2 weighted MR imaging, T1 weighted MR imaging, diffusion tensor imaging, and T2-mapping imaging of the lumbar spine were performed. Load quality was 40%-50% body weight. At 10 minutes after axial load, another diffusion tensor imaging was performed. After 15-minute load, another T2-mapping sequence was scanned. Diffusion tensor imaging scan parameters: single echo-planar imaging, repetition time 2 500 ms, echo time 89 ms, six diffusion directions, b value of 400 s/mm2, sweep time 4:10 minutes. Raw data of diffusion tensor imaging were used to construct apparent diffusion coefficient map and b0 map. Apparent diffusion coefficient value of intervertebral discs was calculated before and after loading. T2 map was automaticaly constructed using T2-mapping sequence to measure apparent diffusion coefficient and T2 values in the whole intervertebral disc of nucleus pulposus, and the changes of them were analyzed under short-time axial load. RESULTS AND CONCLUSION:Pfirrmann grading results in 17 patients with 85 discs were obtained as folows: 0 in Grade I, 26 in Grade II, 19 in Grade III, 30 in Grade IV, and 10 in Grade V. Al 85 disc T2 relaxation time mapping and 84 disc apparent diffusion coefficient mapping were accepted. Under short-time axial load in 84 discs, apparent diffusion coefficient reduced in the whole disc (reduced 38×10-3 mm2/s,Z=2.567,P < 0.05) and nucleus pulposus (reduced 62×10-3mm2/s,Z=3.461,P < 0.05). Apparent diffusion coefficient changes mainly affected Grade Pfirrmann III discs (reduced 55×10-3mm2/s,Z=2.556,P < 0.05). T2 changes mainly affected normal intervertebral discs (Pfirrmann grade II). Under the load, T2 value of intervertebral discs diminished (reduced 3.17 ms,Z=2.967,P < 0.05). No significant difference in apparent diffusion coefficient and T2 value was detected under the load in other grades of the intervertebral discs (P > 0.05). These results suggest that changes in apparent diffusion coefficient and T2 values were different due to different Pfirrmann grades under short-time axial load. To evaluate magnetic resonance imaging function of intervertebral discs, we should choose different evaluation method according to different degeneration degrees.

Objective To investigate the effect of cytarabine (Ara-C) on proliferation and apoptosis of human erythroleukemia K562 cell linethrough autophagy pathway and its possible mechanism.Methods The cellular proliferation inhibiting rate after different concentrations of Ara-C acting for 24,48 h was detected by CCK-8;the cell cycle and apoptosis were detected by flow cy tometry(FCM);the chromatin morphological changes in nucleus were observed by Hoechst staining;the cell acidic autophagy vesicles were detected by acridine orange staining;the expression changes of p38 and p-p38 proteins were detected by Western blot.The expressions of autophagy apoptosis related gene and protein were examined by RT-PCR and immunofluorescence.Results The CCK-8 results found that different concentrations of Ara-C could inhibit the proliferation of K562 cells with dose-and time-dependent manners.FCM detecting indicated that Ara-C could increase apoptosis and could arrest the cell cycle at S phase;Hoechest staining showed that K562cells had typical apoptotic morphological changes after Ara-C treating;the Acridine orange staining revealed that Ara-C caused the inclease of the green fluorescene in cells of the Ara-C group,and the cells appeared a great number of acidic autophagy vesicles;RT-PCR results showed that Ara-C up-regulated the expression of autophagy key genes Beclin-1,LC3A and LC3B;Western blot results showed that Ara-C increased the expression of phosphorylated p-p38.Immunofluorescence results showed the expression of LC3B was significantly enhanced.Conclusion Ara-C canactivate p-p38 mediated K562 cells to generate autophagy,then inhibit the cell proliferation and promotes apoptosis.

With the further researches on the immune mechanisms in tumor,more and more scholars notice the phenomenon that radiation activates the immunity,and find that radiotherapy causes immunity suppression is one-sided.Although body's anti-tumor immunity can be enhanced by radiotherapy,in clinical,we observe that patients who receive radiotherapy cannot avoid tumor recurrence and metastasis.Researches show that tumor microenvironment makes the immune checkpoint pathway abnormally activated.Therefore,the combination of radiotherapy and immune checkpoint inhibitor can change the tumor microenvironment,and can improve the therapeutic effect.

Objective: To prepare and identify recombinant human IL 2/GM CSF(rhIL 2/GM CSF) fusion protein antibodies and to study its specificity and its effect on fusion protein biological activity. Methods: rhIL 2 /GM CSF fusion protein was purified by DEAE Sepharose FF ion exchange chromatography. The purified protein was used to immunize rabbits for the preparation of antisera. The titer and specificity of the antisera were detected by ELISA and Dot ELISA and the biological activity by cell proliferation. Results: The antisera not only reacted with the rhIL 2/GM CSF, IL 2 and GM CSF, but also inhibited the biological activity of the rhIL 2/GM CSF, IL 2 and GM CSF. Conclusion: The obtained antisera can be used to study the structure and function of the rhIL 2/GM CSF.

Objective A new field of organ donation after cardiac death (DCD) has been explored to create additional source to clinic transplantation in China.Methods A 33-years old male patient underwent permanent vegetation state for more than 2 years in ICU after severe head injury.His relatives gave writing consent to donate his organs in order to save his renal failure father and others,if possible,in case of cardiac death.On July 27,2005,the patient's heart arrested.Clinic death was announced.The case was immediately referred to transplant team and Maastricht-V DCD organ procurement was emergently performed and two kidneys were harvested. Estimated warm ischemic time was about 40 min followed by 8 h cold ischemic time.Two adults received the grafts.One of recipients was donor's biological father,namely it was the first case of deceased related renal transplantation (DRRTx) in China.Results Both recipients developed delayed graft function postoperatively and eventually recovered after few weeks.By submission of this article,the DRRTx patient has survived with normal renal function for 77 months (6 years and 5 months).Unfortunately,other patient died from fungus pneumonia after 56 months with normal renal function.Conclusion Non-controlled Maastricht-V DCD could be an additional source to transplantation if prompt reaction could be taken.

We have investigated the effects of different exercises on middle-aged and old women's bone mineral density (BMD), on the metabolic indexes of bone, on the levels of serum elements, and on the correlation between body components and the indexes. On the basis of informed consent, 90 cantonal women pursued three types of exercises (Taijiquan, Swimming and brisk walking) in Chengdu City. BMD indexes of calcaneus were tested by Osteospace quantitative ultrasound instruments; The serum levels of Mg, Ca, P elements and alkaline phosphatase (ALP) were determined by full-automatic biochemical analysis instrument; The serum level of osteocalcin (BGP) was determined by radioimmunoassay. There were no obvious differences of anthropometric indexes between Taijiquan, Swimming, Brisk walking and Control groups. In comparison with control, the serum levels of Mg element increased significantly in the three exercise groups, and the serum levels of Ca and P element increased significantly in Swimming group and Brisk walking group. The serum levels of BGP and ALP were lower than those of control group, but no statistically significant differences were observed. Speed of sound (SOS) and stiffness index (STI) of BMD indexes in Brisk walking group were significantly higher than in Taijiquan group, Swimming group and Control group, and the prevalences of osteopenia and osteoporosis were the lowest in the Brisk walking group, but no obvious decreases of osteopenia and osteoporosis were observed in Taijiquan group and Swimming group. Broadband ultrasound attenuation (BLIA), SOS, STI of BMD indexes were positively correlated to serum levels of Mg, Ca, P, and were negatively correlated to the serum levels of BGP and ALP, and were positively correlated to body weight, BMI, lean body mass and body fat percentage. In conclusion, brisk walking is a fitting type of exercise for middle-aged and old cantonal women; it maintaines normal levels of bone metabolism.
Aged ; Alkaline Phosphatase ; blood ; Bone Density ; Exercise ; physiology ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; metabolism ; prevention & control ; Walking ; physiology