Informed consent is one of the basic rights of patients.Nowadays it is very difficult to implement sufficiently in health care practice.The article analyzes the relative factors affecting the enforcement of the right of informed consent.from the point of law and ethic as well as psychology.

Objective:To simultaneous determine six flavonoids in Shuxuening injection by quantitative analysis of multi-compo-nents by single marker ( QAMS) and examine the durability and system suitability of the analysis. Methods:Shuxuening injection was the study object and rutin was used as the internal material, the relative correction factor ( f) between rutin and narcissus glycosides, quercetin-3-O-β-D-glucosyl (1-2)-α-L- rhamnoside, kaempferol-3-O-β-D-glucose group (1-2)-α-L-rhamnopyranoside, quercetin-3-O-[2-O-(1-O)-p-coumaric acid-β-D-glucose-yl]-α-L-rhamnoside, kaempferol-3-O-[2-O-(6-O)-on coumaroyl-β-D-glucose-based]-α-L-rhamnosides was respectively established. The result differences between the internal standard method and external standard method were compared, and the internal standard method was re-validated. Results: The contents of the six flavonoids in Shuxuening injection were calculated by the correction factors. Compared with those of the external standard method, the differences in the contents of the method were small( RSD<5%) . Conclusion:QAMS can be used as a simple and accurate quantitative quality evaluation meth-od for the determination of a variety of ingredients in Shuxuening injection, which provides reference for the subsequent study on quality standard.

Low birth weight is associated with newborn mortality and adult chronic diseases.Some studies found that naternal caffeine consunption during pregnancy was closely related with low birth weight.Resent research evidence indicates that caffeine may induce low birth weight by blocking adenosine receptors,inhibiting phosphodiesterase(PDE) and enhancing angiotensin Ⅱ (AT2) receptor gene expression to lower the placenta blood flow.We recommend that women should reduce caffeine intake during pregnancy.

[Objective]To investigate the clinic application of the reversed sural neurocutaneous island flap in repairing the soft tissue defect of the foot and ankle.[Method]From June 1997 to December 2007,38 cases of the lower leg,around the ankle and the heel soft tissue defects were treated with the reversed sural neurocutaneous island flap.The average of the patients was 38.3 years(range 5 to 65).The longest medical history was 11 years.The lagest area of flap was 17 cm?12 cm and the smallest was 5 cm?4 cm.[Result]Thirty-three flaps were completely survived,there were 5 cases with distal edge of the flaps partially necrosis and healed after short time dressing change.The patients were followed up for half a year to 10 years and the curative effect was satisfactory.[Conclusion]The reversed sural neurocutaneous flap is simple to harvest and its blood supply is reliable without the sacrifice of a major blood vessel.So it is an ideal method for repairing the soft tissue defect of the foot and ankle.

The Interleukin-2 gene cDNA was cloned into the Pichia pastoris expression vector pPICZB,which is under the control of the alcohol oxidase promoter AOX1. The linearized recombinant plasmid of BoIL2-pPICZB,digested by Sac I ,was transformed into X-33 strains by electroporation. The multi-copy insert transformants were screened by Zeocin-resistance and induced by 1% methanol. The intracellular expression products were tested by SDS-PAGE analysis and Western blotting. Purified recombinant BoIL2 was gained by metal-chelating affinity chromatographic (MCAC). Assay with murine CTLL-2 cells showed that the recombinant BoIL2 exhibited the biological activity.

10.3969/j.issn.2095-4344.2013.24.012

Objective To evaluate the clinical outcomes and correction accuracy of posttraumatic varus and valgus knee deformities using the Taylor Spatial Frame (TSF).Methods From June 2006 to December 2010,26 patients with posttraumatic varus and valgus knee deformities who had been treated with the TSF combined with less invasive high tibial osteotomy (HTO) or supracondylar femur osteotomy (SFO) were retrospectively analyzed,including 19 males and 7 females with an average age of 39 years.There were 20 cases of posttraumatic varus knees and 6 valgus knees.Twenty one patients were treated with HTO and 3 with SFO,2 with HTO and SFO simultaneously.During the operation,the TSF was firstly assembled and then the parameters of the frame were measured followed by less invasive percutaneous osteotomy.Correction was started seven to ten days after the operation following the time schedule provided by the computer program.Correction of the struts were performed 3 times per day,with a total movement of 0-3 mm.Results Through 7-35 days frame adjustments,20 cases of deformities were fully corrected.X-ray showed that the mechanical axis deviations of the tibia and femur all were recovered to normal range,and the deformity of rotation,angulation and crispation were fully corrected.Six cases had residual slight angulation or crispation deformity ( ＜ 4° or ＜ 10 mm).Through the second 4-10 days frame adjustments,these 6 cases of deformities were fully corrected finally.New bone formation and consolidation on the osteotomy site were good.The fixators were removed from 2.5-6.0 months after surgery and the appearance of the limbs and the patients' gait recovered to normal and the keen pain disappeared.All patients were followed up for 12-60 months and without the recurrence of the deformity.Eleven cases occured pin site infection and were controlled by use of the sensitive antibiotics.One case occured refracture of the distal femur osteotomy site 1.5 months after frame removal.Through conservative treatment,the fracture finally healed.Conclusion Posttraumatic varus and valgus knee deformities can be effectively corrected by using TSF and with a high accuracy.

Objective To explore laboratory diagnosis tests for lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency.Methods We investigated the coagulation factors'activity,coagulation factors'antibodies,anticardiolipin antibodies,lupus anticoagulant and thrombin generation in thirteen patients of lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency,ten hemophilia A patients, forty-eight healthy people. In these thirteen patients,there were five patients with schizophrenia and had been taking chlorderazin for a long time,two patients with antiphospholipid syndrome, one patient with pemphigus, five patients in which causes of disease were unknown.Among these patients,two patients has haemorrhage,eleven patients don't have reduced.The antibodies of these coagulation factors and LA were positive.Six patients in this group were ACA poslhve,and seven patients were ACA negative.The lag time of eleven non-haemorrage patients with LA positive associated by F Ⅷ,F Ⅸ and F Ⅺ deficiency was(5.60±1.18)min,higher than that of control group which was(1.88±0.25)min.This differenee had statistically significant(t=10.05,P＜0.01).The time to peak was(8.11±1.91)min,significantly higher than that of control group which was (4.10±0.36)min(t=8.83,P＜0.01).The endogenous thrombin potential(ETP)was(1 640.87±higher than that of hemophilia A patients which was(38.50±6.20)%(t=9.77,P＜0.01).The time to peak of hemophilia A patients was(8.01±1.81)min,significantly higher than that of control group which Was(4.10±0.36)min(t=8.20,P＜0.01).The lag time of control group and hemophilia A patients was (1.88±0.25)min and(2.01±0.84)min,respectively.There was no significant difierence of the lag time between these two groups(t=1.26,P＞0.05).Conclusions Diseases like lupus anticoagulant associated bv coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency and inherited hemophilia should use APTT,PT,should be used as confirmation tests. LA and ACA may serve as indication test for identifying the causes of these diseases. ETP and ETP percentage are quite good parametem for predicting the bleeding risk of patients with LA positive associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency.

Objective To design a post-peripheral intervention observation form that uses the timepoint and observation project as the framework of contents,and to evaluated its clinical application effect.Methods Non-concurrent patients were used to make a control study.By using the convenient sampling method,101 patients,who received peripheral interventional therapy during the period from June 1,2014 to December 31,2014,were collected and used as the control group;routine nursing care was adopted and the results were documented.A total of 102 patients,who received peripheral interventional therapy during the period from January 1,2015 to June 30,2015,were used as the intervention group,for whom routine nursing care was carried out and self-designed post-peripheral intervention observation form was employed to record the nursing observation.The results of the two groups were statistically analyzed.After using the form,every month 10 patients,5 visiting physicians and 5 responsible nurses were asked to make an evaluation of nursing quality satisfaction.Results The incidence of main postoperative complications in the intervention group was lower than that in the control group,the chi-square test showed that the difference between the two groups was statistically significant (P＜0.05).The average hospitalization days and the mean medical expense of the intervention group were lower than those of the control group,the chi-square test indicated that the difference between the two groups was statistically significant (P＜0.05).After using this form,the nursing quality satisfaction of patients and visiting physicians was improved,the self-rating satisfaction assessed by responsible nurses was also improved,the chi-square test revealed that the difference between the two groups was statistically significant (P＜0.05).Conclusion All the evaluation indexes of the patients in the intervention group are better than those of the patients in the control group,indicating that this observation form is reasonably designed,meets the specialty characteristics,heightening the dynamic observation for patients after peripheral intervention,strengthens the effectiveness of monitoring postoperative complications,and is helpful for the implementation of the observation after peripheral intervention.Therefore,this observation form is worth promoting use.

Objective: To investigate the influence of high-fat diet on glucose metabolism and fatty acid composition of serum phospholipid in OLETF rats, a model of spontaneous type 2 diabetes mellitus. Method: Twenty male OLETF rats of 14 w age were divided into 2 groups randomly. The dietary fat in two groups contained identical percentages of saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids. Oral glucose tolerance test and measurement of insulin level were performed after 10 w treatment. The fatty acid composition of serum phospholipid in rats was observed as well. Results:The food intakes were comparable in 2 groups. The body weight gain in high-fat group was higher than standard group during the experiment. The result of oral glucose tolerance test and measurement of insulin level showed that the glucose metabolism in two groups had no significant difference. Only the percentage of total n-6 polyunsaturated fatty acids, 18:3(n-3) of serum phospholipid were comparable, percentages of other fatty acids were significantly different in two groups. Conclusion:With the comparable fatty acid composition, higher dietary fat lead to more body weight gain, but had no significant influence on glucose metabolism in OLETF rats. The amount of dietary fat had significant effect on fatty acids composition of serum phospholipid in OLETF rats.