Objective:To investigate the effects of abdominal Tuina(Chinese therapeutic massage)on behavioral function,5-hydroxytryptamine 1A receptor(5-HT1AR),and synapsin-1(Syn1)in neonatal rats with hypoxic-ischemic brain injuries(HIBI). Methods:Forty healthy neonatal rats,born of 5 specific pathogen-free healthy pregnant rats,were randomly divided into a group for modeling(n=28)and a sham operation group(n=12)on the 7th day of birth.In the group for modeling,24 neonatal rats with HIBI successfully established by the Rice method were randomly divided into a model group(n=12)and an abdominal Tuina group(n=12).The abdominal Tuina group was given abdominal Tuina for 28 d from 24 h after modeling,and the other groups were put under the same conditions but without any treatments.Rats in each group were subjected to suspension tests on the 7th,14th,21st,and 28th days of intervention.After the intervention,the rat hippocampal tissue was collected and stained with hematoxylin-eosin to observe the pathological changes in the rat hippocampal CA1 region.The 5-HT1AR expression in rat hippocampal CA1 region was detected by immune-histochemistry.The Syn1 expression in rat hippocampus was measured by Western blotting method. Results:The cells were disordered,and edema and necrosis appeared in the hippocampal CA1 region of the model group.Cell arrangement was clear,and edema was improved obviously in the hippocampal CA1 region of the abdominal Tuina group.Compared with the sham operation group,the suspension test scores,the number of 5-HT1AR positive cells,and Syn1 protein expression in the hippocampus decreased significantly in the model group after 21 d and 28 d of interventions(P<0.05).Compared with the model group,the suspension test scores,the number of 5-HT1AR positive cells,and Syn1 protein expression increased significantly in the abdominal Tuina group after 21 d and 28 d of interventions(P<0.05). Conclusion:Abdominal Tuina improves the behavioral function of upper limbs and up-regulates the expression levels of 5-HT1AR and Syn1 in the hippocampus of neonatal HIBI rats.

Objective:To investigate the feasibility of individualized primary clinical target volume (CTV) delineation in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).Methods:Clinical data of 87 consecutive patients newly diagnosed with lateralized NPC in Jiangsu Cancer Hospital between October 2016 and February 2018 were retrospectively analyzed. Lateralized NPC is defined as tumor invasion not exceeding the contralateral wall. According to the tumor spread, the primary CTV was optimized as follows: CTV2 only covered the medial part of the contralateral pterygopalatine fossa, whereas the contralateral foramen oval was not included; on the level of parapharyngeal space, the contralateral side of CTV only covered the posterior lateral lymph nodes, whereas the contralateral internal jugular vein was not regularly covered. Failure patterns and 5-year survival [local control rate (LCR), progression-free survival (PFS) and overall survival (OS)] were evaluated by Kaplan-Meier method. Paired t-test and rank-sum test were used to analyze the dose variation in the optimized region and adverse reactions. Results:The median follow-up time was 59.5 months. The 5-year LCR, PFS, and OS were 98.9%, 86.5% and 92.1%, respectively. There was no local recurrence in the optimized area of CTV. Dosimetric comparison results showed that the doses of parotid gland, temporal lobe, cochlea and middle ear on the contralateral side were reduced by 13.45%, 9.14%, 38.83%, and 29.36%, respectively. Four cases (4.6%) developed grade 3 hearing loss, all on the ipsilateral side. The optimized scheme significantly alleviated the hearing loss on the contralateral side compared to that on the ipsilateral side ( P<0.001). Other grade 3 late adverse reactions included cranial nerve injury, subcutaneous fibrosis in the neck and visual impairment, with 1 case each. Conclusion:Individualized primary CTV for lateralized NPC is feasible and safe, with obvious dosimetric advantages and reduced adverse reaction rate, which is worthy of clinical promotion.

Objective:To evaluate the accuracy of diffusion weighted magnetic resonance imaging (DWI-MRI) combined with high resolution temporal bone CT (HRCT) in the location diagnosis of middle ear cholesteatoma and its value in the postoperative follow-up.Methods:134 patients with inital cholesteatoma and 22 patients with suspected recurrent cholesteatoma were selected for HRCT, conventional MRI and DWI examination. Based on the intraoperative and pathological diagnosis, DWI and HRCT images were combined to evaluate the consistency between the lesion location and invasion area of the initial cholesteatoma and intraoperative lesions. The results of HRCT and DWI in the diagnosis of recurrent middle ear cholesteatoma were statistically analyzed to evaluate their diagnostic efficacy.Results:The accuracy rate of DWI combined with HRCT was 90.3%.The sensitivity, specificity, positive predictive value and negative predictive value of HRCT and DWI in the diagnosis of recurrent middle ear cholesteatoma were 27.8%, 75.0%, 83.3%, 18.8% and 100%, 75.0%, 94.7% and 100%, respectively, and the Kappa values consistent with the pathological results were 0.024 and 0.843, respectively. Chi-square test confirmed that there were differences in the diagnosis between groups ( P<0.001). Conclusions:Combined with the high sensitivity of DWI and the high resolution of HRCT, the accuracy of preoperative positioning of the newly diagnosed cholesteatoma can be improved and surgery strategy can be guided. DWI is also of high diagnostic value for recurrent cholesteatoma in the middle ear.

In view of the mistaken concepts and setbacks found in professionalization of hospital directors,the author rejected the absolute professionalization of hospital directors disregard of the social background and different development stages.He recommended a diversified concept to achieve complimentary advantages of expert-based hospital management and professional hospital administrators.Furthermore,such education systems as MBA and MPA should be developed and improved for the purpose of elevating the capacity and management ability of hospital administrators step by step.

Objective To investigate the effects of serum levels of leptin, IGF-1, BDNF and inflammatory markers in patients with post-stroke depression(PSD). Methods By using Hamilton rating scale for depression (HAMD) ,46 patients with post-stroke depression were recruited and 50 patients without depression as the control group. Two weeks after the onset of stroke, serum levels of leptin, insulin growth factor(IGF-1), hs-CRP, intracellular adhesion molecule (ICAM-1) and brain-derived neurotrophic factors (BDNF) were measured by enzymelinked immunosorbent assay(ELISA). Results The levels of leptin and IGF-1 in patients with PSD were significantly higher than that of the control group (( 57.4 ± 14.32) ng/ml vs (17.53 ± 11.62) ng/ml, P = 0. 002;(120.86 ±28.66) ng/ml vs (66.5 ± 17.51) ng/ml, P=0. 004 respectively). The serum levels of leptin and IGFI were positively correlated with the HAMD score(r=0. 724, P＜0. 01; r=0. 641, P＜0. 01 respectively). There was no significant differences in the levels of hs-CRP((2.3 ±0.42) mg/dl vs (2.2 ± 0.28) mg/dl, P= 0. 767),ICAM-1 (( 182.6 ± 50.27) ng/ml vs (178.7 ± 51.14) ng/ml, P = 0. 812) and BDNF(( 25.8 ± 8.35) ng/ml vs (24.2 ±7.48)ng/ml, P = 0.580)in the two groups. Conclusion The serum levels of leptin and IGF-1 may be associated with post-stroke depression and may be the markers of PSD in the old stroke patients.

Objective To determine whether normal-appearing cervical spinal cord in patients with amyotrophic lateral sclerosis (ALS) has abnormal changes based on the quantitative measurement in healthy volunteers. Methods Conventional MRI and axial DTI were obtained in 16 patients with ALS (ALS group) and 16 age-matched control subjects (normal group) . ADC, fractional anisotropy (FA) and relative anisotropy(RA)imagcs were obtained on workstation (AW4. 2). ROIs (5 mm × 5 mm) were placed in anterior funicalus, posterior funiculus, and bilateral lateral corticospinal tracts (LCTs), respectively, at the same slice (C3). Independent-sample t test was used for comparison of parameters between the two groups. Correlations between DTI parameters of ALS and ALS course, Norris score, and ALSFRS were carried out separately by Pearson correlation analysis. Results FA and RA values of bilateral LCTs were decreased significantly. FA/RA values of left LCT were 0.762±0.089 and 0.762±0.107 in ALS group, while they were 0.863±0.098 and 0.890±0.105 in control group, respectively. FA/RA values of right LCT were 0.751±0.065 and 0.772±0.082 in ALS group, and they were 0.843±0.118 and 0.863±0.134 in control group, respectively, they were decreased significantly (t = 2.575、4.195、2.246、2.218, P < 0.05). There were no significant differences (t = - 1.319, - 1.087, P > 0.05) between ADC values of left and right CSTs in ALS group [(0.744±0.162) × 10~(-3), (0.767±0.141) × 10-~(3) mm~2/s] and control group [(0.640±0.149) ×10~(-3), (0.643±0.168) ×10~(-3) mm~2/s)]. FA, RA and ADC values of ALS patients in anterior funiculus were 0.637±0.113, 0.622±0.138, (0.950±0.354)×10~(-3) mm~2/s, in control group they were 0.670±0.117, 0.656±0.136, (0.865±0.238) × 10~(-3) mm~2/s, there were no significant differences (t = 0.854, - 0.704, - 1.155,P > 0.05). FA, RA and ADC values of ALS patients in posterior funieulus were 0.886±0.073, 0.920±0.100, (0.613±0.137)×10~(-3) mm~2/s, in control group they were 0.906±0.078, 0.914±0.135, (0.636±0.224) × 10~(-3) mm~2/s, there were no significant differences (t = 1.655, - 0.148, - 1.360; P > 0.05). No significant correlation existed between FA and RA values and disease course, Norris and ALSFRS score (P > 0.05), in left and right LCTs. Conclusion DTI with SE-EPI technique is simple and sensitive to detect the pathological changes of the cervical spinal cord in ALS patients. DTI can reveal the abnormalities which are "normal appearing" on conventional T_2WI.

OBJECTIVE: To investigate the inhibitive role of lentivirus mediated MMP-9 gene silence in the growth of laryngeal cancer xenografts. METHOD: The nude mouse model of laryngeal squamous carcinoma was established and RNA interference (RNAi) technic was used. Recombinant MMP-9-RNAi-Lentivirus was intratumoral injected while the empty vector lentivirus was taken as control. After the treatment, tumor inhibitive effect was observed and western-blot was used to test the expression of MMP-9 in the xenografts. Finally, the PCNA expression in xenografts were examined with immunohistochemistry to evaluate proliferation change of the Hep-2 cells. RESULT: The average tumor weight was (1.484 +/- 0.391) g in group treated with MMP-9-RNAi-Lentivirus which was significantly lower than that (2.618 +/- 0.465) g in the control group (P < 0.05). The average tumor volume was (1.177 +/- 0.270) cm3 in group treated with MMP-9-RNAi-Lentivirus which was significantly lower than that (2.034 +/- 0.366) cm3 in the control group (P < 0.05) and the tumor inhibitive rate was 43.32%. Western-blot showed there were 7 cases of xenografts with MMP-9 protein negative expression and the other 3 cases were tested with weak positive expression in the treated group xenografts. Whereas all the 10 cases of xenografts were tested with MMP-9 positive expression in the control group. Immunohistochemistry showed PCNA index in treated group was (55.41 +/- 8.77)% which was obviously lower than that (77.04 +/- 6.91)% in control group (P < 0.01). CONCLUSION The growth and proliferation of laryngeal cancer could be inhibited by recombinant MMP-9-RNAi-Lentivirus.
Animals ; Cell Line, Tumor ; Gene Silencing ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lentivirus ; genetics ; Matrix Metalloproteinase 9 ; genetics ; metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Proliferating Cell Nuclear Antigen ; metabolism ; RNA, Small Interfering ; Transfection ; Xenograft Model Antitumor Assays

The fast development of life science and technology such as organ transplantation,euthanasia,gene research plan and assisted reproductive technique and so forth brought happiness for human being,and at the same time they also brought lots of ethical dilemmas.System construction is an important approach to these problems and ethic guidance is absolutely necessary in this process.Moreover,the reasonable procedure is the important support for ethical guidance.Lastly,ethical problems are also closely related to scientists′ social responsibiliies of scientists.In conclusion,from the ultimate view,the advancement and balanced development of society is the fundamental factor to solve the negative effects of life science and technology.

Death is the ultimate belonging for life that can never be surpassed.The limitation of life made people generate a natural and instinctive fear towards death.However,the indifference and escape from death can result in human's absence of overall grasp and comprehension of the essence of life.The author reflected on the essence of death through reflecting on the internal significance of death.A reflection on life from death to living will make people treat themselves friendly and spend a meaningful life.

The new phenomena and problems in ethical education in the context of market-oriented economic system and the deviation of theory and practice in the traditional education of medical ethics all demand for the current ethical education being closer to the life world.In order to make medical ethics education closer to the reality and life world,teachers of medical ethics should combine the teaching content and practice more deeply,arouse students' enthusiasm and their ability of understanding the configuration of knowledge,and the ability of analyzing and resolving problems.