Objective To analyze the reasons of the emergency patients forgoing the invasive rescue therapy and to put forward the corresponding strategy.Methods According to whether the patients accepted the invasive rescue therapy or not,2 673 patients in resuscitation room of Peking Union Medical College Hospital were divided into rescue group (group R) and do not rescue group (group DNR).There were 2 147 cases in group R and 526 case in group DNR.The rescue consent form or do not rescue consent form was required to sign by patient self,patient' s family member or relatives.The patient' s basic information,underlying disease,payment of medical expenses,personnel who signed the consent form,treatment and prognosis in both groups were investigated.Results There was no significant gender deference in both groups (x2 =1.86,P =0.173).The mean age of patients in group DNR was much higher than that in group R (69.5 ±-12.5 vs.58.6 ± 19.2 years,F =28.92,P =0.000).The proportion of patients outside Beijing in group DNR was higher than that of group R (51.90％ vs.44.01％,x2 =10.59,P =0.001).The ratios of chronic heart failure,chronic respiratory failure,chronic hepatic encephalopathy,chronic renal failure,malignant tumor in group DNR were significantly higher than that of group R (8.17％ vs.3.03％,8.17％ vs.2.61％,3.80％ vs.1.16％,5.32％ vs.1.44％,11.98％ vs.2.28％,all P=0.000).The proportion of patients without insurance in group DNR was higher than that of group R (52.09％ vs.41.08％,x2 =20.87,P =0.000).Except the ratio of patients self signing the consent form in group DNR was higher than that of group R (3.04％ vs.0.42％,x2 =64.40,P =0.000),there were no significant deference in other people who signed the consent form such as patient's offspring,spouse,parents,siblings and others.Univariate and multivariate logistic regression analyses showed older age,non Beijing patients,chronic underlying diseases,without insurance and patients self signing the consent form were the major risk factors on refusing the invasive rescue therapy.The mortality rate of group DNR was much higher than that of group R (19.39％ vs.7.68％,x2=64.40,P=0.000).Conclusions Most of patients who refused to accept invasive rescue therapy were elderly people or in condition of end stage of chronic disease.The doctors and nurses in emergency department should continue to take care of these patients and make use of noninvasive methods to treat them or relieve their pain.

Objective To investigate the modulation role of autophagy in radiation-induced cell death by detecting the response of src kinase activity and autophagy in HEK293 cells irradiated with different dose of α-particle.Methods HEK293 cells were irradiated by contral group (0 cGy) a low dose group (10 cGy) and high dose group (300 cGy) α-particles.Molecular probe 2',7'-dichlorofluorescin (DCFHDA) was used to detect the cell ROS.The src kinase activity and endogenous protein level of LC3Ⅰ/Ⅱ were monitored by Western Blot.Cell death rate of irradiated cells pretreated with autophagy inducer of rapamycin was tested by flow cytometry.Results Compared with control group,the ratio of LC3Ⅰ/Ⅱ decreased (t =4.07,P ＜ 0.05) and the percentage of cells with GFP-LC3 punctuate dots increased (t =12.29,P ＜0.05) under 10 cGy irradiation,indicating the induction of autophagy.On the contrary,the ratio of LC3Ⅰ/Ⅱ increased (t =2.93,P ＜ 0.05) and the GFP-LC3 morphology had no obvious change under 300 cGy irradiation.The cellular ROS level reached to the maximum value at 4 h postirradiation.Both 10 cGy and 300 cGy irradiation could elevate the ROS level (t =17.93,22.88,P ＜0.05),whereas the amplitude of elevation of 300 cGy irradiation was higher than that of 10 cGy irradiation (t =15.76,22.66,14.22,P ＜ 0.05).Compared with control group,the 419th site of tyrosine residue in src kinase manifested hyper-phosphorylation (t =5.66,P ＜0.05) under 10 cGy irradiation whereas it had hypo-phosphorylation under 300 cGy irradiation (t =4.67,P ＜ 0.05).Treatment of cells with DMSO could partly restore the impact on src kinase activity under high or low dose irradiation.Pre-treating the cells with autophagy inducer rapamycin could reduce cell death under 300 cGy irradiations (t =12.14,P ＜ 0.05).Conclusions High or low dose of α-particles irradiation could inhibit or activate src kinase and autophagy system,respectively.ROS mediated the response of src kinase activity and autophagy system induced by irradiation.Modulation of autophagy could desensitize cell responses to irradiation.

Objective:To explore the effect of Weishenjiang Liquor on immune function in mice.Methods: Feeding mice with 8.5, 17, 50ml/kg Weishenjiang Liquor which contains 10mg/dl polysaccharide continuously for 28d, were determined the spleen index, chest gland index, phagocytosis of monocytes phagocytes, activity of NK cell, hemolysin formation, lymphocyte transformation and DTH test.Results: Phagocytosis of monocytes phagocytes, NK cell activity, hemolysin formation, lymphocyte transformation rate were increased in mice with a dose of 50ml/kg group. Conclusions: Weishenjiang Liquor has the function of strengthening cellular and humoral immunization in high dose.

AIM:To explore the preliminary mechanism of senegenin ( Sen) on inhibiting hypoxia/reoxygenation ( H/R)-induced apoptosis of primary cortical neurons .METHODS:The cultured cortical neurons were randomly divided in-to normal group (control group), model group (H/R group), Sen+H/R group and Sen group.Flow cytometry was used to evaluate the effect of Sen on H/R-induced cell apoptosis .The protein levels of JNK , p-JNK, c-Jun, p-c-Jun, Bcl-2 and Bax were assessed by Western blotting .RESULTS:The apoptotic rate in H/R group was obviously higher than that in control group (P<0.05), while the apoptotic rate in Sen +H/R group was obviously lower than that in H/R group (P<0.05), suggesting that the model of apoptosis was established successfully .The results of Western blotting showed that Sen increased the expression of JNK and c-Jun, inhibited the phosphorylation of JNK and c-Jun (P<0.05), increased the protein level of Bcl-2 and inhibited the protein level of Bax in H/R treated primary cortical neurons (P<0.05).CONCLUSION:Sen has a protective effect against H/R-induced neuronal apoptosis by increasing the expression of JNK and c-Jun, inhibiting the phosphorylation of JNK and c-Jun, increasing the protein level of Bcl-2 and decreasing the protein level of Bax .

Objective To investigate the fear and attitude of the common people to some threatening diseases .Methods Accord-ing to the age and sex structure of the whole nation ,500 common people were randomly enrolled in the public places of Chongqing main urban area .Firstly ,the respondents were asked to name three diseases they feared most .Then their fear degrees to eight im-portant diseases were performed the questionnaire survey .Results The top ten diseases that common people fear most by their own words were cancer ,AIDS ,heart disease ,hypertension ,stroke ,leukemia ,chronic liver diseases ,diabetes mellitus ,dementia and de-pression successively .Meanwhile ,their fear to the eight important diseases ,which was determined by the ratio of people who did fear to all ,were cancer(94 .2% ) ,traffic accidents(89 .2% ) ,heart disease(85 .0% ) ,AIDS(79 .4% ) ,tuberculosis(76 .8% ) ,hepatitis B(76 .6% ) ,Alzheimer′s disease(73 .4% ) and depression(69 .0% ) .Further analysis showed that such fear was significantly influ-enced by age ,sex and education level .Conclusion The knowledge and perception of common people about certain diseases is one-si-ded ,and their health awareness should be improved .

OBJECTIVE: To explore the relationship between hypoxia-inducible foctor-1α (HIF-1α) and neovascularization in early atherosclerosis plaques by establishing rabbit carotid atherosclerosis models, and to observe the value of contrast-enhanced ultrasound in the detection of neovascularization. METHODS: We provided high-fat diet combined with the implantation of silicone rubber ring to establish carotid atherosclerosis in rat models. On the 14th and 28th days, we detected neovascularization in the carotid atherosclerotic plaques by contrast-enhanced ultrasound, obtained the peak intensity (PI) of the contrast agent in the plaques by time-intensity curve (TIC) and analyzed the difference. We also tested the level of HIF-1α, vascular endothelial growth factor (VEGF), cluster of differentiation 31 (CD31), α-actin, and RAM-11 by immunohistochemical method in each group, analyzed their correlation, and the correlation between PI and CD31 expression. RESULTS: On the 14th day, contrast-enhanced ultrasound showed the neovascularization in the carotid atherosclerotic plaques. On the 14th and 28th days, the intensity of contrast-enhanced ultrasound showed significant difference, the mean optical density of HIF-1α, VEGF, CD31, RAM-11, and α-actin within the carotid atherosclerotic plaques also showed statistical difference. The expressions between HIF-1α and VEGF, HIF-1α and CD31, HIF-1α and RAM-11, HIF-1α and α-actin, as well as PI and CD31 showed highly positive correlations. CONCLUSION During the process of atherosclerosis evolution, neovascularization in the atherosclerotic plaques has come into being in the early period, and HIF-1α in early atherosclerosis can promote the formation of neovascularization. Contrast-enhanced ultrasound can detect the dynamic changes of neovascularization within early atherosclerotic plaques.
Animals ; Carotid Artery Diseases ; complications ; metabolism ; pathology ; Disease Models, Animal ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Neovascularization, Pathologic ; etiology ; metabolism ; pathology ; Rabbits

The knee osteoarthritis(KOA)is a kind of degenerative disease, which is more common in the elderly.In recent years, according to the Knee Uneven Settlement Theory, a new treatment method for the knee osteoarthritis by using the proximal fibula osteotomy is popularized in many hospitals.In this article, we reported 1 case undergoing the total knee arthroplasty after the proximal fibula osteotomy for the treatment of knee osteoarthritis and reviewed the relevant literatures.

Objective To observe the difference in the effect of chest compression quality between the traditional training (TT) and the standard video training (SVT). Methods A total of 197 graduate students were divided into two groups according to the different training methods: group A (traditional modality, n=98) and group B (video training modality, n=99). After training for 2 hours, all trainees were asked to practice CPR on a resuscitation manikin for 2 minutes under the monitoring of CPR quality by a feedback system with trainee's back towards compute monitor. The data of chest compression rate (times/min), average depth (cm) and chest compression release velocity (CCRV, mm/ s) were collected and analyzed. Results Compared with TT, the mean compression depth in SVT was (5.42 ± 0.07) cm vs. (5.33±0.08) cm; the effective rate of CPR in SVT was (115±1.034) /min vs. (113.6±1.152) times/min; the mean CCRV in SVT was (439.7±7.72) mm/s vs. (417.3±7.64) mm/s in the first minute (P＜0.05) and (403.9±7.22) vs. (384.5±8.48) mm/s in the second minute (P＞0.05). Conclusions There were no significant differences on improving the quality of CPR between the two groups. The video training showed no significant effectivity on improving the quality of CPR compared with the traditional way.

OBJECTIVETo study the immunohistochemical classification and prognosis of diffuse large B-cell lymphoma (DLBCL).

METHODSA total of 148 cases of DLBCL were classified into germinal center B-cell-like (GCB) and non-GCB/activated B-cell-like (ABC) subtypes by Hans, Choi and Tally immunohistochemical stain algorithms. The clinical features and survival data of GCB and non-GCB/ABC subtypes were compared. Multivariate analysis about clinical features and results of immunohistochemical stain algorithms was carried out by using Cox regression, with overall survival as the outcome.

RESULTSThe prevalence of GCB subtype was significantly lower than that of non-GCB/ABC subtype, as classified by whichever algorithms in the 148 DLBCL cases studied. The prevalence of GCB subtype by Tally algorithm was lowest. The prevalence of GCB subtype (19 cases, 16.7%) was also significantly lower than non-GCB/ABC subtype (95 cases, 83.3%; P = 0.000 1) in the 114 (77.0%) concordant cases by the three algorithms. There was no difference between GCB and non-GCB/ABC subtypes by the three algorithms in five-year overall survival rate and survival curve of the 80 DLBCL patients with follow-up data available (P > 0.05). Primary gastric DLBCL tended to show a higher prevalence of GCB subtype, a better five-year overall survival rate and survival curve than the other groups. Multivariate analysis showed that patient age (HR = 1.036, P = 0.001) and tumor stage (HR = 1.997, P = 0) were also significantly adverse predictors of overall survival.

CONCLUSIONThe Hans, Choi and Tally immunohistochemical stain algorithms cannot effectively classify Chinese DLBCL into different prognostic subtypes. Primary gastric DLBCL has different immunophenotype and outcome, as compared with DLCBL in other sites.

B-Lymphocytes ; pathology ; China ; Humans ; Immunophenotyping ; Lymphoma, Large B-Cell, Diffuse ; classification ; diagnosis ; Lymphoma, Non-Hodgkin ; diagnosis ; Prognosis ; Stomach Neoplasms ; diagnosis ; Survival Rate