In the peacekeeping operations of the United Nations,medical personnel need to have clear legal compliance to solve the ethical problems encountered.The existing laws and regulations are impractical with a nar row cover,which can't meet the actual requirements.Based on the literatures and practical examples,this paper discussed the medical ethical problems involved in peacekeeping operations using the three-step method (empirical investigation,comparative analysis and summarization),and provided suggestions and countermeasures to the construction of medical ethics in peacekeeping medical support.

Hip ; diagnostic imaging ; Histiocytosis, Sinus ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Mesenchymal chondrosarcoma originated in the primitive mesenchymal tissue .It usually devel-ops in the short bones such as hand ,foot and body bone ,while extremeIy rare in the orbit .We report a case of mesenchymal chondrosarcoma of the orbit which is confirmed by pathology .

Objective To discuss the effects of Deming cycle on reducing adverse drug reactions (ADR) induced by injections of traditional Chinese medicine (TCM).Methods The TCM injections which induced much more ADRs in 2013 were selected. The usage of these TCM injections and characteristics of the ADRs were analyzed. Strategies for controlling ADRs were developed according to Deming cycle and put into the recycle implementation in 2014. Results The ADRs induced by TCM injections were all reduced; the number of total cases was reduced by 41.3% compared to 2013, among which Tanshinone IIA Sulfonate injection,Xinmailong injection, Mylabris injection,Shenqi Fuzheng injection andShengmai injection were reduced significantly, and their reduction rates were all more than 50%. The clinical manifestations of ADRs, including rash, itching, chills, fever, phlebitis, chest distress and palpitation, were all reduced in 2014 compared to 2013, among which especially the allergic reactions, including phlebitis, rash and itching, were reduced by 14.9% and 13.4%.Conclusion Application of Deming cycle in the practice of TCM injections for clinical rational medication can effectively reduce the occurrence of ADRs and better ensure the safety of clinical use of TCM injections.

[ ABSTRACT] AIM:To investigate the protective effect of 1, 3-dicyclopentyl-1, 2, 3, 6-tetrahydropyrimidine-4, 5-dicarboxylic acid diethyl ester (ZL-5015) on lethal endotoxin-challenged mice and to explore the underlying mechanism. METHODS:Mouse model of lethal endotoxin challenge and endotoxemia were established by intraperitoneal administration of lipopolysaccharide (LPS) at a dose of 70 mg/kg to the C57BL/6J mice.Mouse peritoneal macrophages stimulated with LPS (10 mg/L) were used as an in vitro inflammatory model.The levels of interleukin-1β( IL-1β) , interleukin-10 ( IL-10) and tumor necrosis factor-α(TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA).Real-time PCR was used to evaluate the mRNA expression of the cytokines.RESULTS:Prophylactic treatment of the mice with ZL-5015 (100 and 200 mg/kg, ig) slightly increased the survival rate, extended the survival time, decreased the serum levels of IL-1βand TNF-α, and increased the serum level of IL-10 in the early stage of endotoxemia as compared with model group.The results of in vitro study demonstrated that treatment of the endotoxin-stimulated mouse peritoneal macrophages with ZL-5015 (10, 20 and 40μmol/L) inhibited the expression of IL-1βand TNF-αat both mRNA and protein levels but promoted the expression of IL-10 at both mRNA and protein levels.CONCLUSION: The tetrahydropyrimidine derivative ZL-5015 shows a moderate anti-endotoxin effect by increasing the survival rate and extending the survival time of the mice challenged by endotoxin, which may result from inhibition of the expression of pro-inflammatory cytokines such as IL-1βand TNF-α, and promotion of the expression of anti-inflammatory cytokine IL-10.

Objective To investigate the expression of transcription factor Oct 4 in gastric carcinoma and its effects on gastric cancer cell proliferation and apoptosis after Oct 4 gene interfered by lentivirus vector.Methods Real time PCR and Western blot were used to observe the expression of Oct 4 in different differentiated gastric cancer cell lines.Gastric cancer cell lines with high expression of Oct 4 was cultured and infected by siRNA-Oct 4-lentivirus vector.Cell proliferation and apoptosis were observed after Oct 4 gene was interfered.Results Oct 4 was highly expressed in poorly and moderately differentiated gastric cancer cells.Gene interfered with siRNA inhibits the expression of Oct 4 in gastric cancer cells and show significant effects on cell proliferation and mobility as well as apoptosis after down-regulation of Oct 4.Condusions Oct 4 expression is in close relationship with gastric cancer cell proliferation and invasive ability.

OBJECTIVEThis study aimed to compare the treatment effects of simultaneous surgical treatment and stage operation for patients with craniomaxillofacial fracture combined with other injuries.

METHODSFifty patients with maxillofacial fractures combined with other injuries were chosen and divided into simultaneous (28 patients) and staging (22 patients) operation groups. In simultaneous operation group, maxillofacial fracture reduction, internal fixation, and other parts of the surgery were simultaneously operated by relevant departments jointly. In the staging operation group, maxillofacial fracture reduction and internal fixation were performed after treatment of other injuries. Data on the treatment efficacy and associated injuries of the two groups were statistically analyzed.

RESULTSIn the simultaneous operation group, 26 patients had good occluding relation, the maximum mouth opening was (34.5 +/- 3.7) mm, the symmetry and shape of hard tissues recovered well, and the bone plate of one patient was removed because of internal fixation infection. In the staging operation group, 14 patients had good occluding relation, the maximum mouth opening was (28.5 +/- 3.5) mm, the symmetry and shape of hard tissues poorly recovered, and the bone plates of 5 patients were removed because of internal fixation infection. Statistical significance was determined among occluding relation, maximum mouth opening, postoperative complications, and length of stay of the two groups (P< 0.05). Treatment of the simultaneous operation group was more effective than that of the staging operation group.

CONCLUSIONWhen a patient's condition is relatively stable, simultaneous surgical treatment of multiple specialties should be conducted to treat craniomaxillofacial fracture combined with other injuries.

Objective:To investigate the influencing factors for orthostatic hypotension(OH)in elderly patients with hypertension.Methods:This was a case-control study.A total of 224 patients with hypertension aged over 65 years were included.After resting for more than 5 minutes, subjects had their blood pressures measured in the supine and standing position at 0 min, 1 min, 2 min and 3 min.OH was defined as a fall in systolic BP of more 20 mmHg(1 mmHg=0.133 kPa)and/or diastolic BP below 10 mmHg of baseline within 3 min in the upright position.Subjects were divided into the OH group( n=34)and the non-OH group( n=190). Baseline data, comorbidities and differences in medications were compare between the OH group and the non-OH group, and the influencing factors for OH were analyzed. Results:The proportion of drinkers was higher in the OH group than in the non-OH group(29.4% or 10/34 vs.7.4% or 14/190, χ2=14.649, P<0.01). Both systolic pressure(139.0±22.1 mmHg vs.124.5±16.3 mmHg, t=-3.661, P<0.01)and diastolic pressure(77.6±6.3 mmHg vs.69.2±9.0 mmHg, t=-6.696, P<0.01)in the supine position were higher in the OH group than in the non-OH group.The proportions of patients with diabetes(47.1% or 16/34 vs.25.3% or 48/190, χ2=6.731, P<0.05)and stroke(41.2% or 14/34 vs.24.2% or 46/190, χ2=4.233, P<0.05)were higher in the OH group than in the non-OH group.The proportion of patients receiving α receptor blockers was higher in the OH group than in the non-OH group(23.5% or 8/34 vs.4.2% or 8/190, χ2=16.228, P<0.01). After adjusting for factors such as alcohol consumption, diabetes, stroke and other differences between the OH and non-OH group, logistic regression found patients with alcohol intake( OR=5.274, 95% CI: 1.990~13.982, P<0.01), diabetes( OR=2.744, 95% CI: 1.213~6.208, P<0.05)and using α receptor blockers( OR=8.812, 95% CI: 2.835~27.383, P<0.01)had a higher risk of OH. Conclusions:OH is very common in elderly patients with hypertension.Alcohol consumption, diabetes mellitus and the application of α receptor blockers can increase the risk of OH.

Objective To study the changes of mRNA and protein expressions of Kras gene in thymic lymphomas induced by ionizing radiation,and to detect the methylation of CpG islands in promoter region of Kras gene,then to investigate the mechanisms for the occurrence of radiation carcinogenesis.Methods The thymic lymphoma models of BALB/c mice were made by X-ray irradiation,then the total RNA was extracted,cDNA was synthesized and the total protein was extracted from both thymic lymphoma tissue and normal thymus tissue;the mRNA and protein expressions of Kras gene in thymic lymphoma tissue and normal thymus tissue were detected by RT-PCR and Western blotting method, and the methylation of CpG islands in promoter region of Kras gene was detected by bisulfite sequencing PCR. Results The mRNA expression level of Kras gene in thymic lymphoma tissue was significantly higher than that in normal thymus tissue(P<0.01).The protein expression level in thymic lymphoma tissue was about 1.41 times higher than that in normal thymus tissue;4 CpG sites were methylated detected by bisulfite sequencing PCR in normal thymus tissue, however, 1 CpG site was methylated in thymic lymphoma tissue,the CpG islands in promoter region of Kras gene were demethylation state in thymic lymphoma. Conclusion Ionizing radiation can cause the changes of mRNA and protein expression levels of Kras gene in thymic lymphoma tissue by demethylation state of Kras gene,eventually lead to the occurrence of tumor;it might be one of the mechanisms for the occurrence of radiation carcinogenesis.

Objective To study the potential efficacy of transplanted bone marrow-derived mesenchymal stem cells (MSCs) in treating and repairing the acute lung injury in animal models. Methods MSCs were isolated from mouse bone marrow, cultrued and amplified in vitro. The lipopolysaccharide (LPS) was inhaled through postnasal tract to cause acute lung injury in mice and the MSCs labeled by Brdu were administrated via vein into the mice. The migration and differention of the cells were identified by immunostaining and double immunostaining. The pathological changes, pulmonary edema index and the content of IL-1β in lung homogenate were used to accese the therapeutical effect of MSCs. Results The cultured MSCs dispalyed a positive CD44 and a negative CD34. The Brdu-labeled cells were detected in the lungs of the recipient 4 days after transplantation, indicating its origin of MSCs. Theses cells also exhibited characteristics of aveolar epithelials, expressing the cytokeratin-the marker of epithelium. Compared with the injuried ones, the mice treated with MSCs showed a decreased pulmonary edema in-dex and IL-1β content in the lung homogenate. Conclusion These data suggest a therapeutical effects of MSCs in treating and repairing the mouse acute lung injury.