ICU is a special department for critically ill person.For the reasons of the closed-type of administration and the peculiar psychological state of patient,some ethics issues came out.The patients and their relative can't receive the due respect and humanism care,and the ethics issue hasn't drawn enough attention.The author holds that to solve the ethical problems in the administration,we should pay attention to the basic principle of ethics of life,reinforce the humanistic morals of the medical personnel in ICU,and apply the principle of people first in clinic.

Objective To estimate the success rate of emergency endoscopic treatment in patients with esophagogastric variceal bleeding using self-made gastroscope outer casing and to investigate bow to prevent complications. Methods A total of 11 patients with esophagogastric variceal bleeding underwent endoscopic treatment with self-made gastroscope outer casing, which consisted of a wire reinforced plastic casing (1.05 cm in inner diameter, 1.35 cm in outer diameter and 50 cm in length), a 3.8 cm×3.8 cm balloon fixed on the casing head and its cavity connected to the gas pipeline placed in casing tail, an anti-reflux pad in the insert entrance of the endoscope tail as well.as a flushing hole. The endoscopy was introduced to the esophagus or stomch together with outer casing to wash and pump the hematocele out from the side of flushing hole. In patients with hemorrhagic lesion in esophageal vein, the balloon was used to press bleeding vein and intravascular sclerotherapy was performed simutanously. In those with hemorrhagic lesion in gastric vein, the balloon was pressed on esophageal vein near to the cardia and intravascular sclerotherapy was performed. Results During the process of examination, the hemorrhagic lesion was fully exposed because of flushing, and bleeding was controlted in all patients after sclerotherapy. No complication such as aspiration or perforation was seen. Conclusions For emergency endoscopic treatment of esophagogastric variceal bleeding, gastroscope outer casing is helpful in removing intragastric hematocele and maintaining a clear field of vision. It can be effectively improving the efficacy of sclerot herapy.

Objective To investigate the incidence of left-sided portal hypertension (LSPH) in chronic pancreatitis (CP) and other accompany conditions of CP and explore the diagnostic value of LSPH in chronic pancreatitis.Methods The clinical,pathological and imaging data of 125 CP patients received at least two imaging examination were retrospectively analyzed.The rates of abnormal pathologic findings,abnormal imaging findings and accompanying LSPH in CP were analyzed.The data were analyzed by chi-square test.Results Among 125 CP patients,29.6％ (37/125) received three or more than three kinds of imaging examinations.The pathological detection rates of pancreatic calcification or lithiasis,pancreatic ductal lesion,abnormal pancreatic morphology,pancreatic lesion and LSPH were 58.4％ (73/125),60.8％ (76/125),35.2％ (44/125),48.8％ (61/125) and 24.8％ (31/125),respectively.The sensitivities of imaging examination in those lesions were 68.5 ％(50/73),96.1％ (73/76),95.5％ (42/44),95.1％ (58/61) and 90.3％ (28/31),respectively.The detection rates of pancreatic calcification or lithiasis and pancreatic ductal lesion in pathological examination were significantly higher than those of the others,and differences were statistically significant (x2=33.764 and 37.932,both P＜0.01).The sensitivity of imaging examination in pancreatic calcification or lithiasis was lower than those of the others and the differences were statistically significant (x2 =36.526,P＜0.01).Among 125 CP patients with 223 pancreatic lesions detected by imaging examination,the rates of patients with 0,1,2,3,4 lesions accounted for pancreatic were 5.6％ (7/125),40.0％ (50/125),28.8％ (36/125),21.6％ (27/125) and 4.0％ (5/125),respectively.Of patients with pancreatic calcification or lithiasis,pancreatic ductal lesions,abnormal pancreatic morphology and pancreatic lesions detected by pathological examination,there were 23.7 ％(17/73),20.0％ (15/76),22.6％ (10/44) and 27.9％ (17/61) cases accompanied with LSPH,there was no difference between these groups (x2 =1.262,P=0.738).Conclusion LSPH may be a reference for CP diagnosis by imaging examination.

Objective To achieve primary intervention from early on the analysis concerning correlations between BI-RADS classification and the factors that might influence it was conducted. Methods In this paper, the women involved in the 7204 cases of physical examinations in our hospital(over the past 5 years)were chosen as the subjects investigated. The correlations between their breast ultrasounography results and the factors such as age,BMI,triglycerides,total cholesterol,glucose,and uterine status were analyzed. The breast report used the Breast imaging reporting and data system(also known as BI-RADS)of the American Society of Radiology to inter-pret the results. Chi-square test and logistic multivariate analysis of data were analyzed by SPSS 13 statistical soft-ware. Results The age,triglyceride,total cholesterol,HDL and glucose were not the factors influencing BI-RADS classification(P>0.05);BMI(P=0.004)and uterine status(P=0.000)turned out to be the independent factors. Low body weight[odds ratio(OR)= 0.696,95%Confidence interval(CI)= 0.502 ~ 0.966],overweight (OR=0.217,95%CI=0.142~0.333),and obese(OR=0.123,95%CI=0.066~0.231)were negatively correlat-ed with it. Hysterectomy(OR = 19.189,95%CI = 14.055 ~ 26.198),(OR = 4.384,95%CI = 3.499 ~ 5.492), uterine fibroids ,menopausal uterus were found to be the risk factors(OR = 3.283 ,95%CI = 2.374 ~ 4.541). Conclusion For the premenopausal women,being overweight or underweight can help reduce the risk of getting breast diseases. However,those suffering absence of uterus,or uterine fibroids,or in their menopausal period,are supposed to be among the high-risk group of breast cancer for regular screening.

Objective To investigate the incidence of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) in Chengdu City in 2010 and summarize clinical characteristics of GEP-NEN.Methods The incidence of GEP-NEN was estimated with the data in 2010 from the databases of West China Hospital and Chengdu Health Information Centre.Results A total of 77 cases of GEP-NEN were diagnosed in West China Hospital in 2010.Ten cases from other hospitals or non-Chengdu citizenship were excluded,so a total of 67 cases were included in this study.In 2010,the incidence of GEP-NEN was 1.86/105 in Chengdu City.Among 67 GEP-NEN cases,most lesions were located in pancreas and rectum (38 cases,56.7％),followed by stomach (10 cases),esophagus (seven cases) and duodenum (four cases).Among 57 GEP-NEN cases which had pathotogial grading,26 cases (45.6 ％) had neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas when diagnosed.Conclusions In 2010,the incidence of GEP-NEN in Chengdu City is similar to the reports from other countries.Pancreas,rectum and upper gastrointestinal tract are predilection sites of GEP-NEN.The diagnosis rate of early GEP NEN needs to be raised.

Objective To investigate the recombination events occurring between HLA-A and-C loci discovered in two Chi-nese families.Methods HLA class I (HLA-A and-B)and II (HLA-DRB1)alleles low resolution typing were typed by pol-ymerase chain reaction-sequence specific oligonucleotide,(PCR-SSO)and PCR-sequence specific primer (PCR-SSP).HLA class I and II high resolution typing was done by sequencing-based typing (SBT).Then the recombination sites were ana-lyzed by family study.Results The results indicates that the recombination events occurred in one family between A*30∶01/32∶01-C*06∶02 and another family between A*11∶01/26∶01-C*07∶06 during meiosis.The recombination both came from fathers and resulted in new HLA haplotypes that were inherited by the children.Conclusion Two HLA-A/C re-combination events occurring between HLA-A and-C loci have been found in two Chinese families,which help further study the mechanisms of HLA recombination.

[ ABSTRACT] AIM:To observe the effects of total saponins of Panax ginseng ( TSPG) on the promotion of hema-topoiesis and to explore the underlying mechanism in treating aplastic anemia ( AA) in a mouse model.METHODS:For preparation of AA model, BALB/c mice were exposed to sublethal dose of 5.0 Gyγradiation, followed by transplantation of lymphocytes from DBA/2 donor mice.The experiment was divided into 6 groups, including normal control group, AA model group, TSPG treatment groups with low, medium and high doses, and positive control group with cyclosporine A ( CsA) .Both TSPG and CsA were administered by gastrogavage.After 15 d treatment, the peripheral hemogram was test-ed, the cytokine contents in serum were measured, and bone marrow semisolid culture of colony-forming assay was conduc-ted for determining hematopoietic progenitor cells.The protein levels of extracellular signal-regulated kinase 1/2 ( ERK1/2) and its phosphorylation status in the bone marrow cells were determined.RESULTS:Curative effect of TSPG in trea-ting AA mice was satisfactory.Peripheral counts of white blood cells and platelet, and concentration of hemoglobin in TSPG groups with medium and high doses were significantly higher than those in model control.TSPG increased the colony num-bers of CFU-E, BFU-E, CFU-GM and CFU-MK derived from hematopoietic progenitor cells.Meanwhile, up-regulation of the phosphorylated ERK1/2, decreased contents of Th1 cytokines and increased contents of Th2 cytokines in the serum were observed.CONCLUSION:TSPG possess the dual efficacies on the promotion of hematopoiesis and immunoregulation in AA mice by regulating the expression of Th1/Th2/Th17 cytokines and increasing the phosphorylation of ERK1/2.

OBJECTIVE:To observe clinical efficacy and safety of exenatide combined with clomiphene citrate in the treatment of polycystic ovary syndrome with insulin resistance. METHODS:98 patients with polycystic ovary syndrome complicated with in-sulin resistance were randomly divided into control group (49 cases) and observation group (49 cases). Control group was given Clomiphene citrate capsule 50 mg orally,once a day,for 5 d+Metformin enteric-coated tablet with initial dose of 0.25 g orally, twice a day,adjusted to 0.50-0.75 g orally,twice a day,for 3 menstrual cycles. Observation group was given Clomiphene citrate capsule(usage and dosage same as control group)+Exenatide injection 5 μg subcutaneously,twice a day,adjusted to 10 μg subcu-taneously,twice a day,for 2 months. Clinical efficacies of 2 groups were observed as well as the levels of LH,FSH,LH/FSH and IR before and after treatment,ovulation and pregnancy of infertility patients after treatment. The occurrence of ADR was record-ed. RESULTS:Total response rate,ovulation rate and pregnancy rate of observation group were significantly higher than that of con-trol group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in the levels of LH,FSH, LH/FSH and IR between 2 groups (P>0.05). After treatment,the levels of LH,LH/FSH and IR in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,the levels of FSH in 2 groups was sig-nificantly higher than before,and the observation group was significantly higher than the control group,with statistical significance (P<0.05). There was no statistical significance in incidence of ADR between 2 groups(P>0.05). CONCUSIONS:Exenatide com-bined with clomiphene citrate shows significant therapeutic efficacy for polycystic ovary syndrome complicated with insulin resis-tance and can increase ovulation rate and pregnancy rate through improving insulin resistance,but doesn't increase the occurrence of ADR.

Objective To approach potential abnormalities of neuro-chemical compounds in cerebrum of obsessive-compulsive disorder and to analyze the relationship among the abnormalities with duration of illness and symptom severity. Methods 19 patients with obsessive-compulsive disorder and 22 comparison subjects were scanned by 1H magnetic resonance spectroscopy to exam bilateral prefrontal lobe, temporal lobe, parietal lobe, occipital lobe, anterior cingutate and caudate nucleus, hippocampus as well as splenium and genu of corpus callosum,thalamus. The ratios of N-acetylaspartate (NAA) and choline (Cho) to creatine (Cr) were respectively recorded.The severities of obsessive-compulsive symptoms were assessed by Yale-Brown Obsessive-Compulsive Scale. Results ( 1 ) The ratios of NAA/Cr in right caudate nucleus and left hippocampus were higher than those in normal controls (1.23 ±0.37 vs 1.0 ±0.33, t=2.14, P=0.039;1.34 ±0.25 vs 1. 10 ±0.45, t=2.41, P=0.021 ), but NAA/Cr ratios in genu of corpus callosum were lower(0. 97 ±0.30 vs 1.19 ± 0. 26, t = -2.47, P= 0.018 ).(2) The Cho/Cr ratios in right caudate nucleus and left temporal lobe were higher than those in control groups (1.09±0.51 vs0. 67±0.21,t=3.32, P=0.003;2.58±0.62vs0.84±0.17, t=2.21,P=0.03). (3) The duration of illness was negatively correlated with the Cho/Cr ratios of right prefrontal lobe ( r = - 0. 507, P =0. 027 ). (4) The NAA/Cr ratios of genu of corpus callosum as well as the Cho/Cr ratios of left temporal lobe were negatively correlated with YBOCS score ( r 1 = - 0.457, P = 0.049; r 2 = - 0. 585, P = 0.009 ). Conclusion Neuronal functions increase in right caudate nucleus and left hippocampus which are opposite in genu of corpus callosum. These abnormalities may play an important role in pathogenesis of OCD.

Objective To report a newly developed method and procedure to establish a rat model of subarachnoid hemorrhage in detail, and to provide a better model simulating the clinical subarachnoid hemorrhage caused by a ruptured aneurysm for related research.Methods One hundred and twenty healthy SPF 2-3-month old male Sprague-Dawley rats were divided into 4 groups, 30 rats in each group.The three experimental groups were sacrificed at 6, 24 and 72 hours after modeling.Rat models of subarachnoid hemorrhage were established by inserting a fiber core in the internal carotid artery and piercing this artery.Successful establishment of the subarachnoid hemorrhage model was confirmed by observation of breathing, pupil, defecation, urination and inspection at autopsy dissection.The controllability and reproducibility of this model were verified by observation of clinical manifestation and explored by mortality analysis.Results Subarachnoid hemorrhage was successfully induced by fiber core piercing the internal carotid artery at the needed location.Conclusions This method of model preparation is stable and understandable.The operation is nimble, with a good reproducibility.This model can be successfully performed after a short time learning, well simulate the sudden hemorrhage caused by a ruptured aneurysm, and suitable for research on early brain injury and vasospasm after subarachnoid hemorrhage.