This article aims to discuss the significance,problems and strategy to develop hospice-care under the realistic conditions of a huge population base,low economic level,indifferent recognition towards hospice-care idea,lack of professionals in hospice-care,and the acceleration of population aging in China.

Objective To investigate the effect of endoscopic treatment of delayed hemorrhage after endoscopic sphincterotomy.Methods Retrospectively analyzed the data of 2 638 patients who underwent endoscopic sphincterotomy.There were 26 patients who delayed hemorrhage after endoscopic sphincterotomy.All the 26 patients underwent duodenoscopy,and endoscopic treatment was underwent for the patients who had active bleeding.Results There were 21 patients had active bleeding,and the other 5 cases had no bleeding.There were 12 patients with capillary hemorrhage and 9 cases with petechial hemorrhage.In the 12 patients with capillary hemorrhage,9 patients had been sprayed tissue glue,and 3 patients had been local injected with 1 10 000 noradrenalin.In the 9 patients with petechial hemorrhage,5 patients were treated with titanium clip,and 4 patients were treated with argon ion.All the 21 patients were crued,and no patient was operated and no patient died.Conclusion There are few patients who delayed hemorrhage after endoscopic sphincterotomy.Tissue glue sprayed,local injection,argon ion and titanium clip can cure the bleeding.

Objective:To investigate the clinical effect of surgical procedures on patients with chronic sinusi-tis. Method: 104 patients with chronic sinusitis were treated by endoscopic and Caldwell-Luc's approaches. Thelesions were cleared away completely. Result:The clinical cure rate was 96.1％ after 6～12 months (average 9months ) follow up. Conclusion:It suggests that patients with severe maxillary sinus diseases might be cured byendoscopic and Caldwell-Luc's procedure.

Objective:To analyze the long-term curative effect of endoscopic sinus surgery (ESS), and to study the factors related to the defeat of endoscopic sinus surgery.Method:201 cases（353 sides）of chronic sinusitis and nasal polyps were treated with ESS，and were treated by taking the nasal cavity as a whole unit.Result:Following up survey from 12 months to 24 months postoperatively，it was found that 108 cases were cured （53.7%），82 cases achieved symptomatic relief（40.8%），11 cases remained failure （5.5%）.Conclusion:It is very important to improve the ESS technique in order to reduce the recurrence of nasal polyps and sinusitis and to improve the curative effect of ESS，in addition，the treatment after operation is also indispensable to successful surgery.

Objective To investigate the significance of administration of ionic contrast media with dexamethasone in preventing side effect during enhanced CT scanning. Methods We prospectively studied 520 patients who had enhanced CT scans and divided them into two groups: 259 patients received ionic contrast medium with dexamethasone (dexamethasone group); 261 patients received ionic contrast medium without dexamethasone (contrpl group). The side effects of the patients in two groups with different ages were compared. Results There were 19 patients with side effects in dexamethasone group (7 3%), 20 patients with side effect in control group(7 7%). The side effect rate in those patients over the aged 20 years and under the aged 60 years was higher than other age groups. The side effect rate was similar between dexamethasone group and control grouop.Conclusion Administration of Ionic contrast media with dexamethasone during CT scanning can not obviously decrease the incidence of side effect.

In this study, we examined the effects of aspirin on the growth rates, subcellar distribution of beta-catenin protein, the expression of beta-catenin/TCF signaling pathway target gene cyclinD1 mRNA, and cell cycle of Jurkat cell line (Human T-acute lymphoblastic leukemia). Our results showed that the treatment with aspirin inhibited the growth of Jurkat cell line. Jurkat cells treated with 3 mmol/L of aspirin could significantly decrease nuclear localization of beta-catenin, and at 5 mmol/L of aspirin, the nuclear localization of beta-catenin was undetectable. QRT-PCR showed that the target gene cyclinD1 mRNA expression was gradually decreased with the dosage of aspirin. Aspirin induced G0/G1 cell cycle arrest in Jurkat cells. We are led to conclude that aspirin acts through beta-catenin-independent mechanisms. The effects of aspirin include down-regulation of beta-catenin nuclear localization and G0/G1 cell cycle arrest, which might serve as a means of growth inhibition in aspirin-treated human Jurkat cell line.

To investigate the effect of autoimmune regulator (AIRE) on phagocytic clearance of apoptotic cells, a recombinant expression vector containing full-length human AIRE cDNA was transfected into 16HBE cells. After incubation with transfected 16HBE cells, engulfment of apoptotic HL-60 cells induced by camptothecin was detected by myeloperoxidase (MPO) staining. The change in the expression of Rac 1 in transfected 16HBE cells was determined by RT-PCR and Western blotting. The results showed that the phagocytosis percentage of the experimental group, the mock transfection group and the negative control group (non-apoptotic cells) was (25.50+/-3.67)%, (6.25+/-1.58)% and (1.0+/-0.67)%, respectively. Moreover, the expressions of Rac 1 mRNA and protein were up-regulated in AIRE-transfected 16HBE cells, suggesting that AIRE may function as a regulator in the phagocytic clearance of apoptotic cells by promoting the expression of Rac 1.

Objective To investigate the features of non-senile colonic diverticula as diagnosed by coloscopic examination in 47 cases. Methods 47 cases of non-senile colonic diverticula were diagnosed by colonoscopy in the Department of Endoscopy, General Hospital of PLA, from Jan. 1996 to Dec. 2001. Results There were 38 males and 9 females, whose age was under 60, with a mean age of 43.2 years. The incidence and detectable rate for simple and multiple diverticula showed no relationship to patients' age. The detectable rate of colon diverticula was higher in males than in females. Right colon was the predilection site for both simple and multiple colonic diverticula, especially for simple diverticula. The ratio of incidence for right to left colon was 20.5∶1. The ratio was 2.8∶1 in senile patients (aged above 60, detectable rate of colon diverticula was16.9‰). Conclusion The incidence of colonic diverticula in non-senile patients showed no relationship to age. The incidence of diverticulum in right colon was higher in non-senile patients than in seniors. The incidence of diverticulum in the left colon or both sides of colon was lower in non-senile patients was in seniors.

Objective Finding characteristic of senile colon diverticula in 70 cases senile colon diverticula diagnosed by colonoscope through comparing and summarizing. Methods From Jan 1997 to Dec 2001, 70 cases older than 60 years old senile colon diverticula diagnosed by colonoscope in endoscopy department of PLA general hospital. Male 54 cases ,female 16 cases .Age from 60 to 84 years old, average age 68.70?5.39. Results ①With age increased, detectable rate of colon diverticula and multiple colon diverticula rised; ②Detectable rate in male higher than female; ③Whether the single or multiple diverticula ,all predilection site is in the right colon, rate of the right to the left is 2.8∶1(42∶15), and the single diverticula is more obvious. Conclusions ①Occurrence of diverticula have relation to age; ②Incidence in the right colon of senile is lower than of young people; ③The left colon diverticula and bilateral colon diverticula in senile is higher than in young people.

BACKGROUND: Long term taking cyclosporin A(CsA)can inhibit osteoblastic differentiation and induce osteoporosis.Equol,which has greater binding affinity to estrogen receptors,can stimulate the proliferation and osteoblastic differentiation.OBJECTIVE: To investigate whether equol may protect against the proliferation and osteoblastic differentiation inhibited by CsA in mouse bone marrow mesenchymal stem cells(BMSCs)cultures and analyze signal pathway of protection.METHODS: Primary mouse BMSCs were cultured by using attachment method and assigned to five groups,which respectively treated with equol or/and CsA in the presence or absence of ICI182780,an estrogen receptor antagonist,and Nω-nitro-L-arginine methyl ester.Under an inverted microscope,morphological changes and mineralization ability of BMSCs were observed.The cell proliferation was measured by[3H]-thymidine incorporation.The osteoblastic differentiation and mineralization of extracellular matrix in BMSCs was assessed by measuring alkaline phosphatase activity and calcium deposition,respectively.Nitric oxide production in the conditioned media and cyclic guanosine monophosphata(cGMP)content in BMSCs were determined by using commercial nitric oxide and cGMP kit,respectively.RESULTS AND CONCLUSION: Equol reversed the decreased[3H]thymidine incorporation(P < 0.05),alkaline phosphatase activity(P < 0.05)and calcium deposition(P < 0.01)of CsA,which was accompanied with the changes of nitric oxide production(P < 0.01)and cGMP content(P < 0.01).The group by co-treatment with equol and CsA possessed higher cells growth density and small mineralized nodes than CsA group on day 12 under an inverted microscope.Moreover,the equol-reversed effect was abolished by ICI182780 and Nω-nitro-L-arginine methyl ester.These indicated that equol can reverse the inhibition of CsA on the proliferation and osteoblastic differentiation of mouse BMSCs through estrogen receptor/nitric oxide/cGMP signal pathway.