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.

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.

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.

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.

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.

Objective To explore the relationship between the serum neuron-specific enolase(NSE) level and stroke region and size,the degree of neurological deficit and prognosis at acute stage of stroke.Methods The level of serum NSE was detected by ELISA in 96 stroke patients at acute stage,including 58 cases of cerebral infarction (CI),27 cases of intracerebral hemorrhage(ICH),11 cases of subarachnoid hemorrhage (SAH) and 25 normal controls(NC group).The relationship between the level of serum NSE and China Stroke Score (CSS),Barthel index(BI),score of Glasgow-Pittsburgh Coma Scale,lesions region and volume were analysed among the various stroke types groups.Results The levels of serum NSE in the stroke patients at acute stage were significantly higher than that in NC group (allP