LDM, a product of the combination of contemporary information network technology and the traditional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problems, including quality control of LDM, delegation of responsibility in LDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new conternplation and exploration for hospital managers.

LDM, a product of the combination of contemporary information network technology and the tradi tional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problerms, including quality control of LDM, delegation of responsibility in IDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new contemplation and exploration for hospital managers.

The presumed consent principle in organ donation as one of the legal systems to obtain organs has a-chieved some success in practice.However,it is controversial in the ethical and legal aspects.Some Chinese scholars express concern about the implementation of presumed consent in the context of Chinese culture.In order to explicit whether the principle of presumed consent in organ donation is suitable for the Chinese culture,this pa-per considered that there are positive factors in promoting organ donation in Chinese culture through the study of the relationship among the types of presumed consent,the presumed consent and informed consent and the ethical prin-ciple of respect for autonomy.Under the regulation and promotion of state law,the principle of presumed consent can also play the positive role in promoting organ donation in the context of Chinese culture.

To investigate the changes of the activity of telomerase in peripheral blood mononuclear cells (PBMCs) from senile patients with pneumonia, the telomerase activity was examined before and after the stimulation of phytohemagglutinin-M (PHA-M) in PBMCs from 10 control subjects (group A), 12 non-senile patients with pneumonia (group B) and 9 senile patients with pneumonia (group C). Also observed was the proliferative response of these PBMCs to PHA-M. The results showed that, both with or without the stimulation of PHA-M, the values of telomerase activity in PBMCs from group C patients (A values: pre-stimulation, 0.43 +/- 0.04; post-stimulation, 0.63 +/- 0. 03) were significantly lower than those in PBMCs from both group A patients (A values: pre-stimulation, 0.65 +/- 0.05; post-stimulation, 1.26 +/- 0.13; P<0.001, respectively) and group B patients (A values: pre-stimulation, 0.63 +/- 0.03; post-stimulation, 0.93 +/- 0.03; P<0.05, respectively). The results of MTT test showed that the proliferative activity of PBMCs in group C patients (A value: 0.35 +/- 0.03) was also significantly lower than that in group A patients (A value: 0. 55 +/- 0.04; P<0.05) and group B patients (A value: 0.46 +/- 0.03; P<0.05). These results indicate that the telomerase activity decreases in senile patients with pneumonia, which may be one of the mechanisms for the weakened immune function in those patients.

BACKGROUND: Edema and systemic disorder of energy metabolism after spinal cord injury can induce a series of amplifying effect, which can deterio rate the injured level. Matrix metalloproteinase-9 (MMP-9) is able to digest the basal lamina and damage the close joint of capillary vessel by proteolysis,which induces blood-brain barrier breakdown and brain edema formation.OBJECTIVE: To investigate the spatial characteristic of the MMP-9 in acute injured spinal cord so as to investigate the effect of MMP-9 on secondary spinal injury.DESIGN: A completely randomized study.MATERIALS: The study was completed in the Department of Pathology,Medical College of Wuhan University. Totally 40 healthy male Sprague Dawley rats were divided randomly into control group and model group.Five rats in control group were treated with laminectomy. Other 35 rats in model group was used to establish model of spinal cord injury.METHODS: After anesthetized, complete spinal cord tissue was taken out. Tissue of T8.9 spinal cord was cut out and every 3 serial sections of each tissue were taken out randomly for immunochemical analysis of MMP9 expression. Spinal cord tissue at injured segment was taken with 5 rats at each time point. Five visual fields (×400) of every slice were gathered randomly in injured area (sham-operation region in control group), average absorbency was determined then.MAIN OUTCOME MEASURES: Expression of MMP-9 in the acute in jured tissue of spinal cord.RESULTS: Totally 40 rats entered the final analysis. The expression of MMP-9 was observed 1 hour in model group with the peak time of 1 to 2 days and also seen on 7 days. The MMP-9 positive cells were mainly expressed on ischemic neuron, vascular endothelial cells and neutrophilic granulocyte. MMP-9 was not assayed in the control group.CONCLUSION: The early expression of MMP-9 and the characteristics of spatial distribution after spinal cord injury play a key role in tissue edema and inflammatory cell infiltration.

OBJECTIVE: As a part of the whole skeleton,oral maxilloficial bone can also be affected by the risk factors of systemic osteoporosis. This paper reviewed literature on the possible correlation of systemic osteoporosis with oral alveolar bone resorption,periodontal disease,healing of implanted denture and temporomandibular joint disease that result from oral maxillofacial osteoporosis.DATA SOURCES: Literature in English between January 1999 and December 2003 were searched with the computer in Medline Database by the following key words: osteoporosis,alveolar trophy,periodontitis,implanted denture and tempororomandibular joint with; meanwhile literature was also searched in Chinese Periodical Database and Wanfang Database of the same period by the same key words in Chinese.STUDY SELECTION: Literature involving treatment group and control group were screened in the first trial. Then those non-randomized clinical trials were excluded and the others were looked up for full text. Inclusion criteria: randomized controlled clinical trial(RTC) . Exclusion criteria: repeated study.DATA EXTRACTION: A total of 27 articles of randomized or non-randomized studies on the possible association of systemic osteoporosis with oral alveolar bone atrophy, implanted denture and temporomandibular joint disease were collected,and 18 trials met the inclusion criteria.DATA SYNTHESIS: All subjects in the 18 studies were confirmed of having osteoporosis according the diagnostic standards. Changes of oral maxillofacial bone in systemic osteoporosis were explored by observing bone density,residual teeth, the height of alveolar ridge so as to make comparative and correlation analysis.CONCLUSION: In systemic osteoporosis, mandible bone may also have rarefaction changes.

OBJECTIVE: Factors that result in systemic osteoporosis will also affect maxillofacial bones for the latter is a component of skeleton. Present studies are being focused on how is the effect of the drugs that are used to treat systemic osteoporosis on maxillofacial bones. In this article we reviewedclinical and experimental studies about the drugs that acts on maxillomandibular and alveolar bone loss in order to find treatment for maxillofacial bone loss.DATA SOURCES: Medline was searched from January 1999 to October 2001 for English literatures with the searching words of "osteoporosis,mandible, bisphosphonates, herb, estradiol." And Chinese journal database was also searched from January 1995 to December 2004 for Chinese literatures with the searching words of "osteoporosis, mandible, bisphosphonates,herb estradiol"DATA SELECTION: The literatures of therapeutic and controlled studies were chosen, from which the non-random trials and repeated ones were excluded. The full texts of the remaining literatures were found and those of random and controlled trials were included in this review.DATA EXTRACTION: Seventeen literatures that were about random trials on the treatment of maxillofacial bone loss were collected. Thirteen of these 17 were included in this review and 4 of repeated trials were excluded.DATA SYNTHESIS: The subjects in the 17 literatures were all patients with osteoporosis that were in compatible with diagnosis standard. Drugs that act by inhibiting bone resorption, increasing bone mass and ameliorating bone quality were used. The effects of the drugs were compared and analyzed in perspective of the density, mass and strength of bone.CONCLUSION: Medicines for systemic osteoporosis are effective in ameliorating maxillomandibular bone structure, delaying alveolar bone resorption and promoting new bone formation.

Objective To realize the value of magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) in diagnosing vertebral arterial insufficiency of cervical spondylosis. Methods From Nov. 2001 to Feb. 2004, 35 vertebral arterial insufficiency of cervical spondylosis was diagnosed clinically. There were 11 males and 24 females with a mean age of 58.3 years(range, 23 to 76 years). All the patients were examined by MRA and DSA to investigate the tracks, diameters, and stenosis locations of vertebral articles. Results DSA was positive in 32 patients with 19 ipsilateral and 13 bilateral. Meanwhile, MRA positive were in 29 patients, 14 ipsilateral and 15 bilateral. Among MRA positive patients, excepted 5 cases, all the others were also positive with DSA. Accordance of both methods in the diagnosis of thin veterbral artery was 100%. DSA was better than MRA in the diagnosis of localized stenosis and unilateral veterbral artery absence. MRA was much more useful than DSA in the diagnosis of veterbral artery twisting caused by vertebral instability and bone spurs. Conclusion 1) DSA had more accuracy in diagnosis and distinguishing the source of veterbral artery localized stenosis. Posture changing didn't disturb the examination. Its disadvantages, however, were invasive detection, side-effect and dose limitation of contrast medium. 2) As a non-invasive method, MRA was a useful tool in diagnosing diffused, long segmental artery stenosis and obstruction, and especially available for diagnosing the cervical spondylosis combinated with other type. MRA can scan vertebral disc, spinal cord and other vessels at the same time. The indication of MRA was indefinite diagnosis, aged patients with bad tolerance to DSA. The disadvantage of MRA was its low sensitivity in detecting mild stenosis, non-obstruction artery disease, and posture demand during examination.

OBJECTIVE:To improve the drug comprehensive management level of peacekeeping medical team,achieve dynam-ic management of drug information and network. METHODS:The design and development of drug management system of peace-keeping medical team were introduced in terms of overall system architecture,technical routes,system function design,etc.,and the application effect was evaluated. RESULTS:The system was designed by referencing military hospital No.1 drug management system,adopting C/S two-tier architecture,which included system settings,drug dictionary management,inventory management and other 8 modules and numbers of sub-modules. It achieved drug getting out and entering warehouse,supplying maintenance man-agement,prescription dispensing,drug withdrawal and inquiries,expendable drug monitoring,rotation transfer export data,the whole English electronic medical instruments generation,data query statistics,timely query of drugs and disease diagnosis knowl-edge base and other functions. The application of system standardized drug management and significantly improved working efficien-cy of physicians and pharmacists. CONCLUSIONS:The application of the system promotes the transform of drug management from extensive management model to elaborating management model,and the data is safe and easy to operate.

Objective To isolate and culture the rabbit mesenchymal stem cells,and explore the biological features in vitro.Methods Two milliliter of bone marrow was extracted from the tibia of juvenile rabbit under anesthesia and sterile conditions,and mesenchymal stem cells were obtained by density gradient centrifugation and inoculated to 100ml culture flask.The morphological changes,adherence rate and ultrastructure of the stem cells were observed.The surface markers and growth cycle of the mesenchymal stem cells were detected by flow cytometry,and biological features were observed by inducing the cells differentiate into osteoblasts.Results The adherence of mesenchymal stem cells started 2 hours after culturing,basically finished 20 hours later,and more than 90% of the cells were fused at the 15th day.Observed with transmission electron microscopy,the cultured cells showed typical ultrastructure of stem cells: numbers of microvillus mainly distributed on one side of the cells,irregular nuclei with indentation,and lots of cell organs.Analysis for the cell surface markers indicated positive expression of CD44 and CD90 and negative expression of CD45 in mesenchymal stem cells.Cell growth cycle assay showed that most mesenchymal stem cells(about 97%) stayed in stage G1 and G2.Three weeks after osteoblastic induction,the mesenchymal stem cells gradually produced small calcium salt crystals,the cells were positive in alkaline phosphatase staining,and Von Kossa staining showed many calcium salts in the cell clone as black reaction deposits.Conclusions The rabbit bone marrow mesenchymal stem cells isolated by density gradient centrifugation are of high purity and stable growth rate,and the cells' characters can be still maintained after serial subcultivation.Since easy to operate on isolation and proliferation,the mesenchymal stem cells could be used as the tissue engineering seed cells in repairing of intervertebral disc degeneration.