This article looked at the conflicts in depth between the “moral majority” and vulnerable to HIV homosexu-al of “minority”.Both group of the moral and status of social were discussed , and then put forward social justice and in-clusive moral of “moral majority” and“minority”, and take the analysis from the perspective of the “moral majority” and“minority” for the Ethics .

Objective To explore effective methods of organization and early treatment of mass casualties of burn-blast combined injury. Methods Early clinical data of a batch of 16 patients with burn-blast combined injury and experience of organization for early care were summarized and analyzed. Results The plan for emergency care of mass casualties was implemented in time and well organized, as a result all the wounded survived the shock stage. 10 wounded servicemen were safely transported to other hospitals. Cardiac and respiratory arrest occurred in 1 case during transportation by ambulance, but was successfully resuscitated. Conclusions Timely deployment of plan for emergency treatment, with the organization of a task force including the director of the hospital and clinical specialists are pivotal in the success of taking care of mass casualties. Correct understanding of the clinical characteristics of burn-blast combined injury, effective fluid resuscitation in early stage of injury, and measures to prevent multiple organ dysfunction syndrome were essential in the treatment.

Objective To explore effective treatment methods and experience of management and organization in the early period of multiple patients with extensive burns combined with blast injury of the lungs. Methods To summary and analyze the climical date of 16 patients with extensive burns the combined with blast injury and experience of management and organization. Results One patient died of severe blast injury of lung 5 days after,one died of multi-organ dysfunction syndrome, the others recovered well and the burn, healed well. Organization and the course of resuscitating patients were effective, logistic support was strong and all patients were transported and transferred successfully. Conclusion Individualization fluid infusion based on exact clinical observations and increaseing the ratio of colloid fluid would help to prevent shock accompany burst injury of lung. Early and suitable mechanical ventilation mode to improve ventilation/gas exchange function were important measures to manage inhalation injuries. To plan directive salvage schemes for emergency and powerful logistic support,and transporting and transferring patients in time would help to increase treatment efficiency of multiple patients.

Objective To evaluate the reproducibility of the three-dimensional volume measurement and two-dimensional measurement of pulmonary nodule volume with 64-detector computed tomography.Methods Thirty-three patients with pulmonary nodule who underwent the examination with 64-detector spiral CT(Lightspeed VCT,GE) were included,in whom sixty solid nodules with the diameter less than 3 cm were found.There were 18 women and 15 men.CT images were analysed by two radiologists,respectively,the volumes of pulmonary nodules were measured with ALA software continuously,and two-dimensional measurements which were separated a month apart were also done in the GE AW4.2 workstation independently.Intra-and inter-reader agreement were determined by using Bland and Altman method and the Spearman correlation coefficients,the variability between three-dimensional measurements and two-dimensional ones were identified.Results 57 nodules in 60 were successfully segmented and 3 were segmented incorrectly or unsuccessfully,the ratio of successful segmentation was 95%.Three-dimensional measurements between two readers were highly correlated with r of 0.998,and the r was 0.974 in the two-dimensional measurements.The difference between the two correlation coefficients was significant.The three-dimensional measurements between two readers had completely agreed with each other for nodules that of the diameter

The changes of serum apelin in patients with metabolic syndrome were investigated. The level of fasting serum apelin was determined by ELISA assay.The level of serum apelin was raised obviously in patients with metabolic syndrome(MS).Moreover,the level of serum apelin in patients with type 2 diabetes mellitus was higher than those in cases of MS with impaired glucose regulation and the group of subjects with overweight/obesity [ (475.8±37.3 vs 451.5±54.3 and 430.3±52.1 ) ng/L,P＜0.01 ].In a multiple step-wise regression analysis,In homeostasis model assessment of insulin resistance ( HOMA-IR),body mass index,and total cholesterol were independent factors of apelin.The increased serum apelin was closely related to metabolic abnormalities in metabolic syndrome.The increased insulin resistance might cause the raised level of serum apelin in patients with MS.

Objective Implanting surgical meshes to support breast in periareoler mammaplasty shows an excellent prospect.But shrinking of the mesh and the adhesion formation affected the postoperative shape and palpation of the breast.The aim of this study was to compare biocompatible properties of four different polypropylene meshes (Prolene(R) ; Vypro Ⅱ(R) ; Premilene Mesh (R) and Premilene Mesh LP(R)) and to discuss the inclusion criteria of meshes in this technique.Methods The study was carried out in pigs.Four different polypropylene meshes were implanted subcutaneously in belly.90 days after implantation the mesh samples were explanted,and complications,foreign-body reaction,collagen fiber and elastic fiber formation were observed,as well as ultrastructures for the biocompatible properties.Results The biocompatible properties of each mesh were different.The foreign-body reactions determined the biocompatible properties,and affected the postoperative shape greatly.Conclusions Premilene Mesh LP o as a newer low-weight polypropylene mesh,has superior properties to the others.

Objective To explore the correlation and role of E2F3 gene,miR-17-5p and miR-20a in the cell lines of transitional cell carcinoma of bladder. Methods The plasmids of pcDNA3.1-HA-E2F3 and pAAV-siRNA-E2F3 were used to overexpress and knockdown E2F3.The mimics of miR-17-5p,miR-20a and their anti-miRNA oligonucleotides were used to overexpress and screen miR-17-5p and miR-20a.The expression levels of E2F3 gene,miR-17-5p and miR-20a were detected by quantitative real-time PCR,and E2F3 protein were detected by Western blot. Results When E2F3 was overexpressed,the 2- △△Ct of miR-17-5p and miR-20a were 2.26 ± 0.30 and 4.04 ± 0.51,it was statistically significant to compared with control (P ＜ 0.05) ; when E2F3 was knockdown,the 2 △△Ct of miR-17-5p and miR-20a were 0.49 ± 0.02and 0.65 ± 0.04 (P ＜ 0.05) ; when miR-17-5p and miR-20a were overexpressed simultaneously,the level of E2F3 mRNA was significantly decreased,the average E2F3 protein gray scale was 55.31 ± 7.89,the control was 103.67 ± 13.61 (P ＜ 0.05 ) ; when miR-17-5p and miR-20a were knockdown simultaneously,the E2F3 mRNA was significantly increased,the E2F3 protein gray scale was 295.68 ± 19.25,the control was 103.67 ± 13.61 ( P ＜ 0.05 ). Conclusions miR-17-5p and miR-20a could be up-regulated by E2F3 gene,and the E2F3 gene could be down-regulated by miR-17-5p and miR-20a.The regulatory feedback loop of E2F3 gene,miR-17-5p and miR-20a exists in transitional cell carcinoma of bladder. The loop maybe plays a key role in the development of bladder cancer.

Objective To study the application of viral load for differentiating diagnosis of early HIV infection. Methods Thirteen indeterminate specimens, which showed early HIV infection of antibody detection, were selected. Viral load of the specimens were detected. People with suspicious infection were followed up and certified infection status through EIA and Western blot. Results Twelve of 13 indeterminate specimens which indicated early HIV infection, had positive viral loads. One antibody-positive infant was confirmed to have been infected by HIV and 11 recent infected (window period) persons were certified during the follow-up. One antibody-positive infant had negative viral load and was certified noninfected per-son during the follow-up. Viral load testing results accorded with HIV infection status. Conclusion Viral load testing can be used to diagnose HIV early infection, including antibody-positive infants (within 18 months) and recent infected persons. Viral load testing could be diagnostic in determinate specimens during early HIV infection.

BACKGROUND:Percutaneous injection of bone cement into the vertebral body can enhance the vertebral strength and vertebral stability, and obtain pain relief. But the bone cement may leakage into the paravertebral vessels during injection, and may back to the right ventricle and flow into the pulmonary artery through vena cave and thus causing pulmonary embolism.
OBJECTIVE:To evaluate the relationship between cement paravertebral vascular leakage and pulmonary cement embolism during percutaneous vertebroplasty.
METHODS:Total y 134 cases of osteoporotic compression fractures treated with vertebroplasty were retrospectively analyzed. Among them, 23 cases of cement paravertebral vascular leakage were considered as the experimental group, and the 43 cases without cement paravertebral vascular leakage and had the complete imaging data were considered as the control group. The spine and chest X-ray films were taken before and after vertebroplasty to detect whether there were cement paravertebral vascular leakage and pulmonary cement embolism in the patients of two groups.
RESULTS AND CONCLUSION:Among the 134 patients, 23 patients had cement paravertebral vascular leakage, and accounted for 17.2%. Among the 23 patients with cement paravertebral vascular leakage, three cases had pulmonary cement embolism without chest symptoms, and accounted for 13%. No pulmonary cement embolism occurred in the 43 patients without paravertebral vascular leakage of the control group, and there was no significant difference between two groups (P=0.039). Although the patients with cement pulmonary embolism remained asymptomatic, pulmonary cement embolism remained possible if cement paravertebral vascular leakage was detected during vertebroplasty.

Objective:To investigate the clinical characteristics of vertebral compression fracture ( VCF) in glucocorticosteroid-induced osteoporosis ( GIOP) and risk of vertebral refracture after percuta-neous vertebroplasty ( PVP) or percutaneous kyphoplasty ( PKP) .Methods:In the study, 570 cases who received PVP or PKP as treatments of VCF from January 2010 to December 2013 were retrospective re-viewed, of which 42 were GIOP and 21 were followed up as GIOP group, and the other 528 were primary osteoporosis and 391 were followed up, of which 84 were selected as Control group based on age and gen-der.The fracture location, ratio of single segment fracture and multiple segments fracture in the two groups were compared.In the final follow up, the reoperation rates for vertebral refractures by the Kap-lan-Meier method in the two groups were compared.Results:The follow up periods were (24.0 ±13.1) months in GIOP group and (25.8 ±14.4) months in control group(P>0.05).In GIOP group, there were 11 cases with one-segment fracture, 2 with two-segments fracture, 3 with three-segments fracture, 2 with four-segments fracture, 2 with five-segments fracture and 1 with eight-segments fracture.In Control group, there were 67 cases with one-segment fracture, 12 with two-segments fracture, 3 with three-seg-ment fracture, and 2 with four-segments fracture.The ratio of single segment fracture in GIOP group was significantly lower than that in Control group(52.4% vs.79.8%,P=0.01).There were 50 fracture segments in GIOP group and 109 fracture segments in Control group.The ratios of fracture segments loca-ted in thoracic segments(T1-T10), thoracolumbar segments(T11-L1)and lumbar segments(L2-L5) were 18%, 46%and 36% in GIOP group and 11.9%, 58.7% and 29.4% in Control group ( P >0.05).The refracture rate in GIOP group was higher than that in control group (23.8%vs.6.0%).The survival rate was lower in GIOP group than that in control group ( P<0.01) .Conclusion:The predilection site of VCF was similar in GIOP and primary osteoporosis ( thoracolumbar segments>thoracic segments>lumbar segments).The risk of multiple segments VCF was higher in GIOP than in primary osteoporosis. The risk of vertebral refractures after PVP or PKP was higher in GIOP than in primary osteoporosis.