The tobacco epidemic is a problem with serious consequence for public health in the whole world. Reducing the tobacco harm and protecting public health have become a crucial topic for ethics. This paper, firstly, presents some facts related to the tobacco epidemic. Based on these facts, then, it analyzes the issue from ethical perspectives. And finally, it discusses the moral responsibilities for reducing the tobacco epidemic.

Objective To study the intra- tumor basis of pleural indentation (P I) and find the influential factors correlated with PI in peripheral lung cancer . Methods Eighty-six cases of peripheral lung cancer (includin g experimental gr oup of 34 cases with PI and control group of 52 cases without PI) were subjected to identify the constitution in tumoral interstitium. And 7 variables (includin g intra-tumor fibrosis, tumor-chest wall distance, histological type, diameter o f tumor, differentiated degree, lymphatic metastases, sex, etc.) were investigat ed about PI by single factor analysis and multiple factor analysis of Logistic r egression model. Results(1)Collagenous fibers were the mai n fiber in tumoral interstitium, and were higher in experimental group than that in control group ( t=3074, P005). Conclusion Collagen Ⅰfibers are the main type of interstiti al fibers, and myofibroblasts are the main type of interstitial cells in PI asso ciated peripheral lung cancer. Intra-tumor fibrosis, tumor-chest wall distance , and histological types are the main influential factors in PI formation, and int ra-tumor fibrosis is the basic and inside factor. The histological types affect PI formation. Tumor-chest wall distance plays an important outside role in PI f ormation.

Objective: To explore the value of 4D-CTA based on computed tomography dynamic angiography for preoperative evaluation of meningioma. Methods: Totally 34 patients with intracranial meningioma underwent cranial dynamic volume CT scan. Then 3D-CTA and 4D-CTA related post-processing were performed. The difference of tumor size, tumor feeding artery and the relationship of tumor and skull, passing artery and peripheral venous system showed with 3D-CTA and 4D-CTA were compared. Results: There was no significant difference between 3D-CTA and 4D-CTA in evaluating tumor size and tumor feeding artery (both P> 0.05). The percentage of definite draining veins evaluated with 3D-CTA was 70.59% (24/34), lower than that with 4D-CTA (94.12% [32/34], P< 0.05). The accuracy of 3D-CTA and 4D-CTA for evaluating the relationship between tumor and skull was 91.18% (31/34) and 97.06% (33/34), and the accuracy of for evaluating the relationship between tumor and passing artery was 87.50% (21/24) and 95.83% (23/24), respectively (both P> 0.05). Conclusion: CT dynamic angiography can accurately evaluate the size of meningioma, the feeding artery and relationship with surrounding tissue, therefore providing comprehensive preoperative information of meningioma.

Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy(HCT)compared with chemotherapy (CT)for ovarian cancer. Methods Related literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,CNKI and CBM.Then the meta?analysis was performed by using RevMan 5.3 software. Results A total of 10 RCTs involving 546 patients were included. The results of Meta?analysis showed that the HCT group was superior to the CT group in the effective rate,tumor control rate,effective rate of CA125,ascites control rate and PD,with significant differences(P<0.05). There was no significant difference in the improvement rate of life quality and the incidences of myelosuppression,severe myelosuppression,severe nausea and vomiting,severe constipation and diarrhea,liver and renal damage(P>0.05). Conclusion Compared with CT,HCT can significantly increase short?term curative effect,ameliorate the quality of life,and it does not increase the incidence of adverse reactions. HCT is worthy of clinical applica?tion.

ObjectiveTo study the metastructure volumes of medial temporal lobe in diagnosis the patients with Alzheimer's disease (AD) using 3 dimensional MRI.Methods23 AD patients according to DSM-Ⅳ criteria and 23 normal controls (NC) were examined with 3D-MRI.Hippocampus formation,amygdala,entorhinal cortex ( EC ),perirhinal cortex ( PC),and comu temporale were measured with 3D-MRI.ResultsSensitivity and specificity of diagnosis AD were 73.9％,97％ ( Hippocampus formation) ;39.1％,95.7％ (amygdala) ;73.9％,95.7％ (EC) ;95.7％,87.0％ (PC) and 34.8％,39.1％ ( cornu temporale).Overall discriminate function =cornu temporal × 3.887 + PC × 5.960 - EC × 0.074 + amygdale × 3.489 + hippocampus formation × 6.656- 22.449.Over-all-accuracy was 91.3％.ConclusionThe total volume of PC can better diagnosis the mild to moderate AD than other structure of medial temporal lobe.The changes of the medial temporal lobe volume could be used in diagnosis the patients with Alzheimer's disease.

Norepinephrine transporter (NET) transfection leads to significant uptake of iodine-131-1abeled metaiodobenzylguanidine (131I-MIBG) in non-neuroendocrine tumors.However,the use of 131I-MIBG is limited by its short retention time in target cells.To prolong the retention of 131I-MIBG in target cells,we infected hepatocarcinoma (HepG2) cells with Lentivirus-encoding human NET and vesicular monoamine transporter 2 (VMAT2) genes to obtain NET-expressing,NET-VMAT2-coexpressing,and negative-control cell lines.We evaluated the uptake and efflux of 131I-MIBG both in vitro and in vivo in mice bearing transfected tumors.NET-expressing and NET-VMAT2-coexpressing cells respectively showed 2.24 and 2.22 times higher 131I-MIBG uptake than controls.Two hours after removal of 131I-MIBG-containing medium,25.4％ efflux was observed in NET-VMAT2-coexpressing cells and 38.6％ in NET-expressing cells.In vivo experiments were performed in nude mice bearing transfected tumors;results revealed that NET-VMAT2-coexpressing tumors had longer 131I-MIBG retention time than NET-expressing tumors.Meanwhile,NET-VMAT2-coexpressing and NET-expressing tumors displayed 0.54％ and 0.19％,respectively,of the injected dose per gram of tissue 24 h after 131I-MIBG administration.Cotransfection of HepG2 cells with NET and VMAT2 resulted in increased 131I-MIBG uptake and retention.However,the degree of increase was insufficient to be therapeutically effective in target cells.

Objective To explore the incidence and associated factors of aortic artery calcification (AAC) by lateral lumbar X-ray score in maintenance hemodialysis (MHD) patients.Mehtods A total of 155 MHD patients with complete clinical data in our hospital were enrolled in the study.Lateral lumbar X-ray score of the abdominal aorta was used to determine AAC in MHD patients.Results Aortic calcification was most severe in front of the fourth lumbar segment and ameliorated in higher lumbar levels.63.63％ of MHD patients presented visible calcification in the abdominal aorta,and 28.39％ had severe calcification with more than three segments.Age (OR=1.094,P＜0.01),dialysis vintage (OR=1.013,P=0.022),triglyceride (OR=1.261,P=0.030) and phosphate level (OR=1.324,P=0.023) were risk factors of abdominal aorta calcification,however serum albumin level (OR =0.239,P=0.013) was protect factor of aortic calcification.Conclusions Incidence of AAC is quite high in MHD patients and associated with increasing of age,duration of hemodialysis,serum triglyceride,phosphate level and plasma albumin.The semi-quantitative X-ray method of determining vascular calcification is less expensive and may be widely available clinically.

OBJECTIVE: To describe tne regional different factors which impact on early cochlear implantation in prelingual deaf children between eastern and western regions of China. METHOD: The charts of 113 children who received the cochlear implantation after 24 months old were reviewed and analyzed. Forty-five of them came from the eastern region (Jiangsu, Zhejiang or Shanghai) while 68 of them came from the western region (Ningxia or Guizhou). Parental interviews were conducted to collect information regarding the factors that impact on early cochlear implantation. Result:Based on the univariate logistic regression analysis, the odds ratio (OR) value of universal newborn hearing screening (UNHS) was 5. 481, which indicated the correlation of UNHS with early cochlear implantation is significant. There was statistical difference between the 2 groups (P<0. 01). For the financial burden, the OR value was 3. 521(strong correlation) and there was statistical difference between the 2 groups (P<0. 01). For the communication barriers and community location, the OR value was 0. 566 and 1. 128 respectively, and there was no statistical difference between the 2 groups (P>0. 05). The multivariate analysis indicated that the UNHS and financial burden are statistically different between the eastern and western regions (P=0. 00 and 0. 040 respectively). CONCLUSION The UNHS and financial burden are statistically different between the eastern reinforced in the western region. In addition, the government and society should provide powerful policy and more financial support in the western region of China. The innovation of management system is also helpful to the early cochlear implantation.
Child ; China ; Cochlear Implantation ; statistics & numerical data ; Geography ; Hearing Tests ; statistics & numerical data ; Humans ; Infant, Newborn ; Neonatal Screening

OBJECTIVE: To observe the levels of four hydroxylated metabolites of polycyclic aromatic hydrocarbons(PAHs)in the urine of coke workers and its influencing factors.To explore the feasibility of using PAHs as biomarkers for exposure of coke oven emissions(COEs).METHODS: A cross-sectional survey was used to compare 261 coke oven workers in a coke oven plant as exposure group with 111 workers without COEs exposure in an oxygen making plant as control group.Ultra high liquid chromatography-mass spectrometry was used to detect four hydroxylated metabolites of PAHs,including1-hydroxypyrene(OHP),1-hydroxynaphthalene(OHN),2-OHN and 3-hydroxyphenanthrene,in urine of these two groups.RESULTS: The levels of four hydroxylated metabolites of PAHs in urine in exposure group were higher than that of the control group(P<0.01).The levels of urinary 1-OHP,1-OHN,2-OHN were followed by the sequence of bottomoven,side-oven,and top-oven subgroups among the exposure group(P<0.05).The multiple linear regression results indicated that the levels of urinary 1-OHP,1-OHN,2-OHN were correlated with COEs exposure(P<0.05),after adjusting the confounding factors of gender,age,length of service,smoking status and alcohol drinking status.The levels of urinary 1-OHP,1-OHN,2-OHN of the exposure group increased with the increase of COEs exposure levels showing a dose-effect relationship(P<0.01).The levels of 1-OHN and 2-OHN were associated with smoking apart from COEs exposure(P<0.01).CONCLUSION: The urinary 1-OHP can be used as a reliable biomarker for the evaluation of internal exposure to COEs.The 1-OHN and 2-OHN can be used as adjuvant biomarkers.

Objective: To compare and quantify the differences in size-specific dose estimates (SSDE) obtained by effective diameter and water-equivalent diameter from the central slice of the scan range in head CT examination. Methods: A total of 111 consecutive adult patients who underwent head CT examination were enrolled in this study. All of CTDI_vol values in the dose report were documented. The dataset was assigned into group A and group B, based on the individual size-dependent conversion factors (f) of effective diameter (d_eff) and water-equivalent diameter (d_w) at the central slice multiplied by normalized volume computed tomography dose index (CTDI_vol ) respectively. Body size, f and SSDE were calculated. With SSDE_gross served as the reference level, the performance of SSDE_deff and SSDE_dw was evaluated. Results: Statistically significant differences were found in body size (t=47.587, P<0.05) and f(z=-9.242, P<0.05) between group A and group B. Statistically significant difference also existed in SSDE (t=-46.687, P<0.05), (56.20±2.66) and (53.49±2.48) mGy for group A and group B respectively. Strongly positive correlation was shown in body size (r=0.873, R² =0.761) and SSDE (r=0.974, R² =0.949) between group A and group B(all P<0.05). Positive correlation was also found between SSDE_deff and SSDE_gross(r=0.900, R² =0.809), SSDE_dw and SSDE_gross (r=0.904, R² =0.817, all P<0.05). Mean absolute difference was 2.34 and 0.78 mGy, for SSDE_deff vs. SSDE_gross and SSDE_dw vs. SSDE_gross respectively; mean absolute relative difference was 4.38%, 1.40%; root mean square difference was 1.17 mGy (2.17%), 1.06 mGy (1.91%). Interquartile range and full range of SSDE_deff and SSDE_dw were 3.22 vs. 2.39 mGy, 13.65 vs. 12.48mGy, respectively. A less degree of variation was observed in SSDE_dw than that in SSDE_deff. Conclusions SSDE_dw values based on the water-equivalent diameter at the central slice of the scan range got better agreement with those derived from all slices, which could serve as a simpler and more valid indicator to represent the average value of size-specific dose estimates of the whole scan range in head CT examination.