There were some ethical problems in the implementation of certificate of authorization of cancer pa -tients, such as doctors dominate the signing process and show no respect for patients ′rights and interests .It pro-posed to improve rules and regulations , increase transparency , to setup informed consent platform define and verifi-cation, emphasize the licensee to perform the duty of communication , strengthen the construction of the medical staff ethics , in order to safeguard the rights and interests of patients , promote the rational and effective use of medi-cal resources .

ObjectiveTo investigate the therapeutic effect of Xiaoqinglong decoction for supplementary treatment of patients with ventilator-associated pneumonia (VAP).Methods Thirty-three VAP patients with syndrome of traditional Chinese medicine (TCM) as interior retention of phlegm and exopathic cold admitted to Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine (TCM) from July 2011 to December 2014 were enrolled, and their historical data were retrospectively analyzed. According to the difference in treatment methods, the patients were divided into TCM treatment Xiaoqinglong decoction group (observation group, 18 cases) and general treatment group (control group, 15 cases). The patients in both groups were given conventional western medicine treatment, including anti-infection, phlegm elimination and cough relieve, protection of gastric mucosa and organ function, nutritional support, prevention of bedsore and thrombosis, etc. Additionally, the patients in TCM treatment group were given Xiaoqinglong decoction (drug composition: herba ephedrae 15 g, ramulus cinnamomi 15 g, herba asari 15 g, rhizoma zingiberis 15 g, chinese peony 15 g, rhizoma pinelliae 15 g, fructus schisandrae 15 g, radix glycyrrhizae preparata 10 g) for nasal feeding, once 150 mL, twice a day, once every 7 days. The changes in body temperature were observed before and 3 days and 7 days after treatment, and peripheral blood was collected for determination of white blood cell count (WBC) and C-reactive protein (CRP) level in the two groups. Comprehensive therapeutic effects of the patients in both groups were recorded.Results There were no significant differences in body temperature, WBC and CRP before treatment between the two groups. After treatment, the above parameters in both groups were significantly lower than those before treatment, and they showed a decrease tendency with time prolongation. The decrease in body temperature and WBC in observation group was more obvious than those of control group, and the comparisons showed statistical significant differences on 7 days after treatment [body temperature (℃): 36.5±0.6 vs. 37.0±0.8, WBC (×109/L):6.7±3.0 vs. 8.9±2.5, bothP < 0.05], but there was no significant difference in CRP between the observation group and control group (mg/L: 3 d was 73.7±20.5 vs. 61.5±18.4; 7 d was 27.2±10.5 vs. 23.5±9.1, bothP > 0.05). The total effective rate on the 7th day after treatment in observation group was higher than that of control group [83.3% (15/18) vs. 80.0% (12/15)], but no statistical significant difference was seen (P > 0.05).Conclusions The Xiaoqinglong decoction can reduce the inflammatory reaction of patients with VAP, and improve their symptoms.

Objective To investigate the relationship between Oxfordshire community stroke project(OCSP) classification and imaging classification in acute cerebral infarction. Methods Two hundred and thirty-six patients with acute cerebral infarction were retrospectively evaluated with OCSP classification and imaging characteristics. Results According to OCSP classification,of all the 236 patients with acute cerebral infarction,28(11.9%) experienced total anterior circulation infarction(TACI),71(30.1%) partial anterior circulation infarction(PACI),94(39.8%) lacunar infarction(LACI),and 43(18.2%) posterior circulation infarction(POCI).The consistency was found in 171 cases(72.5%) between the OCSP classification and imaging classification,with the accuracy of 76%(25/33) for TACI,81%(34/42) for PACI,71%(81/114) for LACI and 66%(31/47) for POCI. Conclusion OCSP classification can predict the location and size of cerebral infarction with a high accuracy,and is well consisted with the imaging findings.

This article studies the thermostability and the crystal structure of a new anticancer drug dasatinib. The thermostability of dasatinib was analyzed using the differential scanning calorimeter (DSC) and thermo gravimetric analyzer (TGA), and the structural characteristics of polymorphism and crystalline transformation was determined using the X-ray powder diffractometry (XRD) with in-situ high temperature accessories. The results showed that dasatinib has at least two different crystal forms. The form-I has one crystalline water and form-II one and half, and in a heating-up processing both of them would change their crystal structures. After losing their crystalline water, both would change into the same crystalline form with no crystalline water. Their melting points were almost the same: form-I was 285.68 degrees C and form-II was 285.50 degrees C. The results of the study method would provide a comprehensive reference for the quality evaluation of dasatinib.

Objective To analyze the mechanism of fentanyl combines midazolam,by comparison with some of the commonly used anesthetic method to determine in the ethical advantages of anesthesia.Methods 45 rats were randomly divided into three groups,Group A:1％ anesthetized by intraperitoneal injection of sodium pentobarbital 40 mg/kg; Group B:5 ％ ketamine 120 mg/kg intraperitoneal injection; Group C:midazolam 5 mg/kg + fentanyl 0.05 mg/kg Last intravenous anesthesia.Observe the effects of anesthesia.Results The rats which are used of fentanyl conbines midazolam anesthesia,the onset of anesthesia time:0.02 ± 0.03 min,maintenance of anesthesia time:89.73 ± 22.59 min,the the narcotic operation time:1.51 ± 0.30 min,the success of anesthesia cases:15 cases.Conclusions Fentanyl combines midazolam compared with the currently used method of anesthesia,the advantages of the more prominent,it has significant improvement and protection about the security,utilization and recovery ethics in experimental rats.

Objective:To study the expression and physiological significance of water channel proteins in human T lymphocytes.Methods:AQP0-9 mRNA and protein in inactivated and activated human T lymphocytes were analyzed using reverse transcriptase-polymerase chain reaction (RT-PCR) analysis and Western blot.Results:No AQP was expressed in inactivated lymphocytes.However,AQP3 mRNA and protein were expressed in PHA activated T lymphocytes.Conclusion:Water and glycerol transport mediated by AQP3 may be important in T lymphocyte activation.

The health system in Shanghai selected 102 prominent middle aged and young health personnel with both political integrity and professional competence as candidates for its program of cultivating 100 outstanding cross century academic leaders. Program starting funds were provided by the Health Bureau of the city and cultivation plans were worked out and contracts signed together with the institutions the candidates work with and competent authorities at higher levels so as to ensure the implementation of the cultivation measures and the whole course follow up and assessment of the candidates actual professional expertise, organizational and managerial capabilities, academic positions, notability enhancement, and actual performance in patient care, teaching and research. Performance analysis indicates that after 5 to 7 years of special training, the candidates have turned into the citys new generation of advantaged academic leaders and have helped to push the development of the health cause and the quality of patient care in Shanghai to a generally higher level.

Background and purpose:It has a signiifcant effect for erlotinib on treatment of patients with epidermal growth factor receptor mutation in advanced non-small cell lung cancer (NSCLC). But almost all patients will eventually progress for the resistance of drug. This study was to evaluate the efifcacy and safety of retreatment of erlotinib in patients with advanced NSCLC. Methods:It was a retrospective analysis of the 46 advanced NSCLC patients who previously treated with erlotinib and had clinical beneift. The patients were given erlotinib 150 mg orally once daily after failure to other medications until disease progression or the occurrence of intolerable toxicity. The clinical features, therapeutic effect and survival were analyzed. Results: The objective response rate of retreatment with erlotinib was 28.3%. The disease control rate was 60.9%. The rate of symptom relief was 45.7%. The median progression-free survival was 3.6 months. The median overall survival was 7.3 months. One-year survival rate was 8.7%. The median progression-free survival was signiifcant longer in the patients who stopped taking erlotinib more than 6 months than those less than 6 months (P=0.002). The median overall survival was signiifcant longer in the patients whose ECOG ≤2 than those ECOG >2 (P=0.038). The most common drug-related adverse events were rash and diarrhea. Conclusion:The retreatment of erlotinib could possibly prolong the survival time of patients who previously treated with erlotinib and had clinical beneift.

Clinical trial is the most direct and the most effective way to test the performance of medical equipments.The Belmont Report is the statement of the basic moral principles and guidelines,used to help solve the moral problems produced in scientific researches involving human subjects.This apaper examines the ethical issues in clinical trials for medical equipments from the perspective of the Belmont report.It first introduces the background and basic concepts of Belmont report,background concept and the concept and the basic process of medical equipment clinical trials.Then the three principles of the Belmont Report is presented and how to apply the Report to solve ethical problems arising in medical equipment trials.Application of informed consent risk and benefits assessment,and selection of subjects participants and the distribution of research results to address the ethical issues arising in clinical trials.

Objective:To introduce recent progress on diagnosis and treatment of benign symmetric lipomatosis(BSL).Method:Detailed clinical data of 6 patients with BSL were reviewed and analyzed.We present a summary of the clinical symptoms,physical sign,diagnosis and therapeutic methods of BSL. And related literatures were discussed together.Result:All of 6 patients have excessive subcutaneous fat deposit predominantly around neck.One patients had upper extremity localizations. Six patients had the complication of left ventricular diastolic function changes,glucose intolerance or diabetes mellitus, chronic hepatopathy, hyperuricemia and sleep apnea syndrome in one or more. One patients with several symptoms occur simultaneously, another one female patient was accompanied by all symptoms but chronic hepatopathy. Five male patient were alcohol abusers. Tatal neck lipentomy and abstinence from alcohol were performed on 5 patients. One patient refused treatment.During a follow-up of 3 months to 4 years, one patients was relapsed again,and no recurrence was seen in another 4 patients. All pathological results were nonencapsulated fat. Conclusion:BSL is a lipodystrophy caused by diffuse fatty tissue, symmetry deposition in the neck and shoulder subcutaneous fascia space or deep fascial space .The highest incidence favors to middle-aged man who is alcoholist. Chronic alcohol addiction and typical clinical symptoms help to diagnosis BSL. Lipectomy represents a successful procedure in treating BSL.