The accomplishment of voluntary active euthanasia must involve the concept of "the other".The whole autonomy is an Abstract theoretical principle,which meets logic difficulty in real practice."The other" limits autonomy on the attitude towards life,family relationship,social relationship,physicians,and so on,which is also the practical basis for the accomplishment of euthanasia.When an individual chooses the will of performing euthanasia,he or she should abide by the principles of respect,communion and autonomy.These principles should also be followed in the future legislation of euthanasia.

Objective To suty DSA features of the splencin artery which provides blood supply to the tumor in the patients with hepatic carcinoma,to improve the clinical results of interventional therapy.Methods DSA was performed in 3 patients with hepatic carcinoma and the blood supply of tumors by splenic artery was found.The DSA features were analysed and the interventional embolization was carried out at the same time.Results After super-selective embolization of the splenic artery,obvious reduction of the tumor-feeding microvessels and marked shrinking of the lesion were observed in all cases.Conclusion Splenic artery as one of the supply arteria to the tumors in hepatic carcinoma is very important to familiarize that in transcatheter arterial chemoembolization for hepatic carcinoma.

Objective To assess the clinical value of interventional treatment for bone and soft-tissue tumors. Methods Selective angiography, transcatheter intra-arterial chemotherapy and/or embolization were performed in 28 patients with pathologically-proved bone and soft-tissue tumors. After treatment the clinical response and pathological changes were observed, and the results were analyzed. Results After transcatheter intra-arterial chemotherapy and/or embolization, relieving or even disappearing of the pain was seen in 23 patients, subside of soft-tissue swelling together with regression of the tumor was seen in 19 patients. Twenty-two patients underwent surgical resection of the lesion one week afte.r interventional treatment. Pathologically, cellular degeneration, necrosis and various degrees of liquefaction were demonstrated on the tumor specimen, which were more obvious in patients treated with embolization. Limp-sparing resection was adopted in 66.7% of patients (10/15). Conclusion lnterventional therapy is an effective method for bone and soft-tissue tumors and it is worth popularizing this technique in clinical practice.

Objective To investigate the effect of the first surgical treatment on progression-free survival (PFS)time of retroperitoneal liposarcoma and the prognosis.Methods We analyzed the clinical data of 74 cases of retroperitoneal liposarcoma from 1998 to 2016 in He'nan Cancer Hospital (Zhengzhou University Affiliated Tumor Hospital Department of General Surgery).Results The results demonstrated that progression-free survival time of the first surgical resection of retroperitoneal liposarcoma in patients related with tumor necrosis (P ＜ 0.001),lobulated tumor (P ＜ 0.001),symptoms (P =0.013),Ro resection (P =0.003),distant metastasis (P =0.028),postoperative chemotherapy (P =0.006) and tumor differentiation (P ＜ 0.001).Progression-free survival time was not correlated with gender,age of first diagnosis,the invasion of adjacent organs,tumor size,operation time and combined organ resection (all P＞0.05).The rate of 1-year,3-year,5-year survival time attached to PFS≤24 m and PFS ＞24 m were 93.7％ vs.94.7,90.5％ vs.80.9％,58.4％ vs.74.8％(P=0.111).Conclusion The first attempt of radical resection determines progression-free survival of retroperitoneal liposarcoma,however,patients' PFS was not related with their overall survival.

Objective:To investigate the types and treatment methods of easily-missed, misdiagnosed intestinal obstruction after radical radiotherapy of cervical cancer.Methods:The clinical data of 21 patients with intestinal obstruction after radical radiotherapy of cervical cancer in our hospital from May 2013 to May 2019 were collected, including the radiation dose, obstruction symptoms, surgical methods and treatment outcomes. The types and treatment methods of intestinal obstruction after radical radiotherapy of cervical cancer were further investigated.Results:The intestinal obstruction occurred in 21 patients with cervical cancer after radical radiotherapy. All patients were initially diagnosed as rectal obstruction and underwent the transverse colostomy. The obstruction symptoms were successfully resolved in 15 patients while failed in other 6 patients who then underwent the re-operation. Four patients with rectal obstruction accompanied by middle or terminal ileum obstruction underwent ileostomy, the other 2 patients with terminal ileum obstruction underwent the transverse ileal anastomosis and partial intestines exclusion surgery. All of the obstruction symptoms were alleviated.Conclusions:Rectal is the major obstruction site of the cervical cancer patients with intestinal obstruction after radical radiotherapy. However, a possibility of obstruction at the middle or end of the ileum also exists. Therefore, it is very important to avoid misdiagnosis and conduct appropriate operative treatment according to the obstruction site.

Objective:To investigate the types and treatment methods of easily-missed, misdiagnosed intestinal obstruction after radical radiotherapy of cervical cancer.Methods:The clinical data of 21 patients with intestinal obstruction after radical radiotherapy of cervical cancer in our hospital from May 2013 to May 2019 were collected, including the radiation dose, obstruction symptoms, surgical methods and treatment outcomes. The types and treatment methods of intestinal obstruction after radical radiotherapy of cervical cancer were further investigated.Results:The intestinal obstruction occurred in 21 patients with cervical cancer after radical radiotherapy. All patients were initially diagnosed as rectal obstruction and underwent the transverse colostomy. The obstruction symptoms were successfully resolved in 15 patients while failed in other 6 patients who then underwent the re-operation. Four patients with rectal obstruction accompanied by middle or terminal ileum obstruction underwent ileostomy, the other 2 patients with terminal ileum obstruction underwent the transverse ileal anastomosis and partial intestines exclusion surgery. All of the obstruction symptoms were alleviated.Conclusions:Rectal is the major obstruction site of the cervical cancer patients with intestinal obstruction after radical radiotherapy. However, a possibility of obstruction at the middle or end of the ileum also exists. Therefore, it is very important to avoid misdiagnosis and conduct appropriate operative treatment according to the obstruction site.

Objective To investigate the association of the DYS527a/b and DYF387S1a/b multi-allele pattern with Y-SNP haplogroups.Methods Samples from 295 unrelated males who carrying the DYS527a/b multi-allele pattern were amplified by the YFilerPlus? kit.The genotypes of their frequency distributions,including three multi-copy loci(DYS527a/b,DYF387S1a/b,DYS385a/b)and other single-copy loci were obtained.The DYS527a/b multi-allele pattern and their haplotypes were examined for the associations with Y-chromosome haplogroups using the AIYSNP42 kit,which contains 42 Y-SNP loci.Based on the above results,the association between the DYS527a/b multi-allele patter and its constituent Y-STR haplotypes and related haplogroups was discussed.Results Among the 295 samples,the DYS527a/b tri-allele pattern and tetra-allele pattern accounted for 97.29%and 2.71%respectively,while the DYF387S1a/b tri-allele pattern and tetra-allele encompassed 54.24%and 4.75%.Null allele was detected in DYS448 in 13.22%of the samples.Here,7 Y-SNPs were deticted such as O-M175 and C-M131 which encompassed 45.76%and 45.08%.The haplogroups of R1-M173,N-M231,D1-M174,J-M304 and F-M89 were less than 13 cases,with frequencies ranging from 4.41%～0.34%.There were Y-STR genotypes differences among haplogroups,as haplogroup O-M175 was represented by 4 genotypes of Y-STR profiles characterized by DYS385a/b(12/12,as well as 12/17,12/18,12/19),DYS392(13),DYS593(16)and DYS393(12),and haplogroup C-M130 was characterized by DYS527a/b(19/20/21),DYS385a/b(11),DYS593(17),DYS390(23),Y_GATA_H4(11),and DYS444(13)and so on.Conclusion The DYS527a/b multi-allele pattern is frequently observed in the Kunming population with haplogroup C-M130.In the samples from haplogroups O,C,R1 and N,the DYS527a/b and DYF387S1a/b haplotypes frequently exhibit the multi-allele pattern.Given the frequencies of different haplogroups and the association between Y-SNP haplogroups and Y-STR loci,it could be helpful to look for more details in the paternal lineage search.

Objective To investigate the association between microvariants at locus DYS570 and Y-SNPs haplogroup.Methods 89 Y-SNPs and 34 Y-STRs in AIYSNP42,AIYSNP47 and YfilerTM Platinum kits were used to detect the genotype of 116 microvariants at locus DYS570 in Kunming,and the Set-B kit was used to detect the core repeat sequences of the DYS570 locus.The data were statistically analyzed by direct counting method.Then,a network map was drawn by Network 10.2,in order to visualize the genetic information of the sample.Results The results demonstrated that 111 DYS570/18.3-21.3 samples had a core repeat sequence of TTT[TITC]18-21,belonging to subgroup O2a2b1a1a1a4-F14494.A DYS570/20.3 sample had a core repeat sequence of[TTTC]15TTC[TTTC]5,belonging to O2a1b1a1a1a1e-F1365 subgroup.A DYS570/17.1 sample had a core repeat sequence of[TTTC]17 T,belonging to the O2a1b1a1a1a-F11 subgroup.Three DYS570(19.2)samples had[TTTC]3 TT[TTTC]16,belonging to the D1a1a-M15 haplogroup.Conclusion The results indicated that the microvariant with the same core repeat structure at locus DYS570 was associated with haplogroups,and the ancestry origin of samples can be inferenced from microvariant characteristics during the practice of forensic medicine.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; DNA (Cytosine-5-)-Methyltransferases ; genetics ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Mutation ; Sequence Analysis, DNA ; Young Adult

OBJECTIVETo investigate the clinical features and prognostic factors of primary mediastinal large B-cell lymphoma (PMLBCL).

METHODSThe clinical data of 82 patients with PMLBCL enrolled from January 2000 to January 2008 were retrospectively studied. All these patients were treated in four affiliated hospitals of Central South University,Hunan province. The prognostic factors were investigated.

RESULTSOf the 82 patients, 45 were men and 37 were women, the ratio was 1.22:1. The median age was 29.5 (ranged from 12 to 78) years old. There were 40 (48.78%) patients in stage I/II, 42 (51.22%) in stage III/IV. The complete response (CR) rate was 13.4% (11/82), and the overall response rate 76.83% (63/82). The 5-year overall survival was 58%. The univariate analysis indicated that the poor prognostic factors included stage III/IV(P=0.005), without rituximab (P=0.004), without radiotherapy (P=0.000), LDH ≥ ULN (upper limit of normal) (P=0.000), disease progression (P=0.000), international prognostic index (IPI)≥ 2 (P=0.000) and superior vena cava syndrome (P=0.015). Chemo-therapy alone (P=0.000) predicted poor outcome. Combination therapy (such as chemo-radiotherapy, chemotherapy combined with rituximab) had better prognosis. Compared to second-line treatment, rituximab as the first-line treatment can prolong PFS, but had no effect on the OS. In multivariate analysis, chemo-radiotherapy and IPI were independently related to prognosis.

CONCLUSIONPMLBCL mostly affects young adults, male patients were slightly more than female patients. It presents with a typical bulky mediastinal mass at diagnosis, which constricts surrounding organs. Patients treated with rituximab or radiation therapy had better prognosis. Rituximab is recommended to be used for the first-line treatment.

Adolescent ; Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Child ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; therapy ; Male ; Mediastinal Neoplasms ; diagnosis ; pathology ; therapy ; Middle Aged ; Prognosis ; Radiotherapy ; Retrospective Studies ; Rituximab ; Young Adult