The event of “diagnosing mental disorder but actually not” violates patients′right of informed con-sent and refused to health , showing some problems of “diagnosing mental disorder but actually not” and mandatory admission process and psychiatric judicial authentication , and also have some ethical problems .Therefore, relevant departments should perfect the laws and regulation , establish a hospitalized psychiatric patients appeal , the appeal channels , at the same time , physicians should follow a correct understanding , respect patients rights , disinterest-ed, the ethical principles of self -supervision and also use constraints should be regulated .

OBJECTIVE:To evaluate the effect of temozolomide(TMZ)in combination with dexamethasone(DXM)on the proliferation of human gliocytoma U251 cells in vitro.METHODS:Human U251 cells were assigned to 1 of the 3 groups: TMZ(10,25,50,100,200,400?mol?L~(-1),respectively)alone or in combination with 40?mol?L~(-1)DXM(TMZ+DXM group)or control group(none drug).After treatment for 72 hours,the cell morphology,cell inhibition ratio,cell cycle and the apoptotic rate were detected.RESULTS:When TMZ concentration was greater than 100?mol?L~(-1)the cell inhibition ratio was higher in TMZ-treated group than in TMZ+DXM-treated group(P

Child ; Humans ; Tachycardia ; physiopathology ; therapy

AIM: To verify the neuroprotective effect and optimize the therapeutic dose and time window of picroside Ⅱon cerebral ischemic injury in rats .METHODS:The forebrain ischemia model was established by the method of bilateral common carotid artery occlusion ( BCCAO ) .The successful model rats were randomly divided into 16 groups according to orthogonal design and treated by intraperitoneal injection of picroside Ⅱat different ischemic time poinis and different doses .The changes of the nerve fiber myelin were observed by fast green staining .The immunohistochemical assay and Western blotting were used to quantitatively and qualitatively determine the expression of myelin basic protein (MBP). The mRNA level of MBP in the brain tissues was tested by reverse transcription polymerase chain reaction (RT-PCR).RE-SULTS:Picroside Ⅱ increased the expression of MBP and decreased demyelination after cerebral ischemic injury .The best therapeutic time window and dose were:(1) ischemia for 2.0 h with picrosideⅡat dose of 10 mg/kg according to the results of fast green staining;(2) ischemia for 2.0 h with the dose of 10 mg/kg according to the results of immunohisto-chemical assay;(3) ischemia for 2.0 h with the dose of 10 mg/kg according to the analysis of Western blotting;(4) is-chemia for 1.5 h with the dose of 20 mg/kg according to the detection of RT-PCR.CONCLUSION:Given the principle of the lowest therapeutic dose with the longest time window , the optimized therapeutic dose and time window for rat cerebral ischemic injury is intraperitoneal injection of picroside Ⅱat the doses of 10~20 mg/kg and the time window of ischemia for 1.5~2.0 h.

Lapareseopic colectomy is commonly performed,but laparoscopic extended right hemicolectomy with D3 lymphadenectomy for cancer located at hepatic flexure of the colon is a complex procedure,even in the hands of experts.Laparoscopic dissection of the lymph nodes around the middle colonic and right gastroepiploic vessels are so complicated that precise vascular anatomy and surgical plane are essential to complete this procedure safely.We herein describe a standard technique for performing laparoscopic extended right hemicolectomy with D3 lymphadenectomy using a medial-to-lateral approach.The main surgical plane of this procedure is the right Toldt's space.The superior mesenteric vein (SMV) is the most important anatomical landmark of vascular dissection.Medial-to-lateral approach makes it easy to locate the right Toldt's space and the SMV.

10.3969/j.issn.2095-4344.2013.23.017

Objective To analyze the variation of peripheral blood Th17 cells and Foxp3+CD4+CD25+regulatory T (Treg)cells in patients with ankylosing spondylitis (AS),and to interpret the role of the ratio imbalance of peripheral blood Th17/Treg cells in the pathogenesis of AS.Methods The percentage of peripheral blood Th17 cells and Foxp3 +CD4+CD25+ Treg cells in AS patients and healthy subjects were determined by flow cytometry (FCM).The concentrations of IL-2,IL-10,TGF-β,IL-6,IL-17 and IL-23 in the serum were measured by enzyme linked immunosorbent assay.The correlation between these cytokines and traditional parameters was analyzed.T test,ANOVA,SNK-q and Speannan's analysis were used for statistical analysis.Results Compared with healthy controls,the percentage of Th17 cells in AS patients increased significantly (P＜0.05); Compared with the inactive AS patients,the percentage of Th17 cells in active AS patients increased significantly [(2.10±0.82)％,(2.89±1.77)％,P＜0.05)]; the percentage of Foxp3+CD4+CD25+ Treg cells in active AS patients was markedly lower than healthy controls (P＜0.05).Compared with healthy controls and inactive AS patients,the specific value of Th17/Treg in active AS patients increased significantly(P＜0.05).The concentrations of IL-17 and IL-23 was found significantly higher in patients with AS than that in healthy controls (t=2.203,P=0.032 and t=2.088,P=0.041).The concentrations of IL-17 and IL-23 was found significantly higher in patients with active AS than that in inactive AS (t=2.808,P=0.008 and t=2.242,P=0.020).The correlation analysis revealed that these cytokines and traditional parameters was not relevant except IL-17/BASDAI (r=0.32,P=0.044).Conclusion The increased ratio of Th17 cells and decreased ratio of Foxp3+CD4+CD25+ Treg cells may play a critical role in AS progression.Manipulating the balance of Th17/Treg would provide a new approach for the treatment of AS.

Objective To evaluate the efficacy and safety of dexmedetomidine combined with propofol for gastroscopy in elderly patients.Methods Ninety ASA physical status Ⅰ-Ⅲ patients,aged 65-80 yr,weighing 45-80 kg,scheduled for elective gastroscopy,were randomized to receive either dexmedetomidine combined with propofol (group DP,n =45) or propofol (group P,n =45).In group DP,dexmedetomidine 0.4 μg/kg was infused over 5 min and propofol 1.0 mg/kg was injected intravenously 25 min later.Propofol 2.0 mg/kg was injected intravenously in group P.When body movement occurred during operation,additional propofol 0.2 mg/kg was given intermittently.Mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2) and Narcotrend index were monitored during the whole procedures.The consumption of propofol and vasoactive agents,adverse cardiovascular events,and respiratory depression were recorded.Results Compared with group P,the consumption of propofol,incidences of respiratory depression and tachycardia,and degree of body movement were significantly decreased (P ＜ 0.05),Narcotrend index was increased during operation (P ＜ 0.01),and no significant change in the incidence of circulatory depression was found in group DP (P ＞ 0.05).Conclusion Small dose of dexmedetomidine 0.4 μg/kg combined with small dose of propofol 1.0 mg/kg provides good efficacy and safety for gastroscopy in elderly patients.

Mesenchymal stem cells(MSCs) can directly act on tumor cells to inhibit their growth,and could also migrate to the tissue lesions and tumor tissues to transfer and express many kinds of anti-cancer factors.Numerous researches have applied MSCs as carriers of drugs to induce apoptosis,inhibit differentiation of tumor cells and inhibit tumor angiogenesis,and have got outstanding antitumor results.