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.

Objective] Making a discussion on academic features ofYi Lin Kou Pu Liu Zhi Mi Shu. [Method] With the research methods of philology, we collect Qing transcript ofYi Lin Kou Pu Liu Zhi Mi Shuand analyze its academic features. [Result]Yi Lin Kou Pu Liu Zhi Mi Shuwas additionally compiled, supplemented and annotated by Zhou Sheng, a famous doctor of the Qing Dynasty, on the base of Yi Lin Kou Pu which was composed by Lu Qi. Within four volumes, the contents of the book contain Medicine, Surgery, Gynecology, Pediatrics, etc. The diagnosis and treatment based on syndrome differentiation and Chinese herbal prescription in this book have their own characteristics. That is: theories from different schools make arguments on the facts; six treatments of syndrome lucidly expose the essential points; secret prescriptions and Chinese herbs are widely collected; opinions and knowledge from his teacher grasp the essence of the problem and bring out the crucial point. [Conclusion]Yi Lin Kou Pu Liu Zhi Mi Shu is a distinctive and only existing medical book with high academic value and practical significance.

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.

ObjectiveTo investigate the effects of combination of dexmedetomidine and sufentanil preconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts.MethodsForty male SD rats weighing 180-220 g, aged 8-10 weeks, were anesthetized with intraperitoneal 3％pentobarbital 60 mg/kg and heparin 3000 U/kg.The hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％O2-5％CO2 at 36.5-37.5 ℃.Forty isolated rat hearts were randomly divided into 5 groups ( n =8 each):control group (group C),I/R group,dexmedetomidine preconditioning group (group DP),sufentanil preconditioning group (group SP),and dexmedetomidine + sufentanil preconditioning group (group DS).I/R injury was induced by 30 min of ischemia followed by 120 min of reperfusion.Groups DP,SP and DS received 30 min of perfusion with K-H solution containing dexmedetomidine 2.3 ng/ml,sufentanil 3.77 ng/ml and dexmedetomidine 2.3ng/ml + sufentanil 3.77 ng/ml respectively at 30 min before ischemia.Coronary flow (CF),left ventricular developed pressure (LVDP),± dp/dtmax and HR were measured at 15 min of equilibration,immediately before ischemia,at 30 min of ischemia and at 120 min of reperfusion.The superoxide didmutase (SOD) and myeloperoxidase (MPO) activities and the malondialdehyde (MDA) content in myocardial tissues and infarct size were determined at 120 min of reperfusion.Results Compared with group C,CF,LVDP, ± dp/dtmax,HR and SOD activity were significantly decreased,and MPO activity,MDA concent and infarct size were significantly increased in the other 4 groups ( P ＜ 0.05).Compared with group I/R,CF was significantly decreased in groups DP and DS,HR was significantly decreased in groups SP and DS,and LVDP, ± dp/dtmax and SOD activity were significantly increased,and MPO activity,MDA content and infarct size were significantly decreased in groups DP,SP and DS ( P ＜0.05).Compared with group DS,CF was significantly decreased and HR increased in group DP,and SOD activity was significantly decreased,CF,MPO activity,MDA content and infarct size were significantly increased in group SP (P ＜ 0.05 ),and no significant change was found in SOD and MPO activities,MDA content and infarct size in group DP ( P ＞ 0.05).Conclusion Dexmedetomidine combined with sufentanil preconditioning can reduce I/R injury in isolated rat hearts,but the myocardial protection is not further enhanced.

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.

Chemoprevention is the use of natural or synthetic substances to prevent、suppress or to reverse the development of colorectal cancer.Aspirin and cox-2 inhibitor are the most effective preventive agents.However,the gastrointestinal and cardiovascular adverse effects limit the application.Recurrent adenomas can be markedly reduced by a combination of difluoromethylornithine and sulinclac and with few side effects.5-aminosalicylate and ursodeoxycholic acid have become the focus of inflammatory bowel disease.The double roles of folate need further study.Statins and EGFR inhibitors have some effects,which are in early clinical studies.The article reviews the new progress of chemoprevention of colorectal cancer.

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.