Operation agreement letter is forced to perform by the law.For the perspective of law,Operation agreement letter is a medical document for medical staff to certify the legitimacy of medical treatment,for hospital to certify that the duty to apprize has been performed,and also an authorization paper by patient to permit medical staffs to operate.However,there is no enforcement to relieve the responsibility of the medical institutions if medical mistake exist.The ethic meaning of operation agreement letter is to cure the sickness,to save the patient,to heal the wounded,and to rescue the dying.When there is conflict between reality and law,or there is no correlated clause in the law,the medical institutions must consider the spirit of legislation and perform medical treatment in time.

A simple and sensitive method was developed for the detection of mercury ions with quartz crystal microbalance(QCM), based on the specific thymine(T)-Hg2+-T structure and gold nanoparticles. The gold nanoparticles were prepared by the citrate reduction method. In a self-assembled way, the particle surface was modified with the probe oligonucleotides which were partially replaced by 6-Mercaptohexan-1-ol to reduce the steric hindrance of hybridization. The sensitivity was optimized by the oligonucleotide with a strand length of 9bp and a T number of 7. The linear range was 5.0-100 nmol/L with a detection limit of 2.0 nmol/L. And Ca2+, Mg2+ and other metal ions had no significant interferences. This method was successfully applied for the detection of Hg2+in environmental water samples, with RSD less than 2.9% and recoveries of 97.3%-101.2%.

OBJECTIVE: To evaluate the dose-effect relationship of reptilase in hemostasis. METHODS: The effects of different doses of reptilase on bleeding time (BT), Blood coagulation and hemorheology in New Zealand rabbits were examined. RESULTS: Reptilase showed a significant hemostatic effect at the dosages of 0.023, 0.07, 0.21 and 0.63KU?kg-1, respectively, with the hemostatic effect lower in 0.63KU?kg-1 group than in 0.21KU?kg-1 group; and at the 4 different dosages, reptilase showed no significant effect on fibrinolysis system. At a dosage of 1.90 or 5.71KU?kg-1, reptilase showed a significant anticoagulation efficacy and enhanced fibrinolysis function. There was no significance in hemorheology among groups. CONCLUSION: At a dosage range of 0.21～0.63KU?kg-1, reptilase has an optimal hemostatic effect in New Zealand rabbits.

Objective To study a quick and effective assessing method used in the emergency trauma patients in order to prevent delaying treatment for patients from overlook or misdiagnosis during triage. Method From 1 January 2006 to 31 September 2006, there were 4023 patients evaluated with trauma assessment method, which was composed of CRAMS scale and trauma assessment program. Results Of 4023 patients, there were 2430 cases with CRAMS below 1( < 7) ,of whom 1979 cases assessed with trauma assessment program were found to be injuried severely to threaten their lives. And more noticeably,of 1593 patients with CRAMS ≥7 there were 46 patients found to have life-threatening injuries assessed with trauma assessment method. Conclutions CRAMS score can be used for triage, and trauma assessment program can be used to evaluate the injuries anatomically. Trauma assessment program and CRAMS employed conjointly can increase the sensitivity and specificity for the stratification of the severity in the injuried patients in order to get a successful triage and lo take advantage of the resources of e-mergency care appropriately.

OBJECTIVE:To study improvement effect of modified mahuang chanyi decoction on allergic rhinitis(AR)model guinea pigs and its mechanism. METHODS:32 guinea pigs were randomly divided into normal group (0.9% Sodium chloride in-jection),model group (0.9% Sodium chloride injection),experimental [Modified mahuang chanyi decoction,5.18 g (medicinal materials)/kg] group and control [Fluticasone propionate nasal spray,50 μg/(guinea pig·d)] group. Except for normal group,other groups received ovalbumin 30 mg and calmogastrin 30 mg intraperitoneally to induce AR model. Except for control group,other groups were given relevant medicine intragastrically,twice a day for consecutive 15 d. Nasal symptoms of guinea pigs were ob-served and recorded,and then analyzed and scored. The protein expression of nasal mucosa SHP-1 was detected by immunohisto-chemistry,the serum contents of IL-4 and IFN-γ were determined by enzyme-linked immunosorbent assay. RESULTS:Compared with normal group,model group suffered from AR symptom,and nasal symptoms score was increased;and the protein expression of nasal mucosa SHP-1 and the serum content of IL-4 increased,while the content of IFN-γ decreased(P<0.05). Compared with model group,AR symptom of experimental group and control group were improved;nasal symptoms score,the protein expression of nasal mucosa SHP-1 and the serum content of IL-4 decreased while the content of IFN-γ increased(P<0.05). CONCLUSIONS:Modified mahuang chanyi decoction shows certain improvement effect on AR,and its mechanism is associated the decrease of IL-4 content and the increase of IFN-γcontent in serum.

Objective To explore the influence of honokiol on growth,cell cycle and radiosensitivity in nasopharyngeal carcinoma cells,CNE-1 and CNE-2.Methods MTT assay and clonogenic assay were used to detect cell growth and survival respectively.Flow cytometry was employed to analyze cell cycle progression.Annexin V-FITC kit was used to detect cell apoptosis.Western blot assay was applied to examine protein expression.Results Honokiol signficantly inhibited proliferation of CNE-1 and CNE-2 cells in a dose and time dependent manner,the IC50 value was 2.84 and 2.68 μmol/L(24 h)and 2.50 and 2.20 μmol/L (48 h),respectively.After being treated with 2.5 μmol/L honokiol for 24 h,the ratios of early apoptosis,late apoptosis and necrosis were 24.53％,23.05％ and 7.13％ in CNE-1 cells compared with the control group(t =-41.17,-8.18,-6.08,P ＜0.05).The expression levels of pro-apoptotic proteins Caspase-3 and Bax were significantly increased to 2.31 and 1.89 times (t =-15.92,-17.15,P ＜ 0.05),4.43 and 1.85 times (t =-29.39,-13.47,P ＜ 0.05).Simultaneously the expression level of anti-apoptotic protein Bcl-2 was reduced by 2.22 and 2.74 times(t =26.94,66.14,P ＜ 0.05) as compared with controls after being treated with 4 and 3 μmol/L honokiol.Additionally,honokiol at lower doses signicantly enhanced the senstivity of CNE-1 and CNE-2 cells to X-ray irradiation.The SER was 1.41 and 1.88 in CNE-1 and CNE-2 cells.3 Gy irradiation of X-rays increased the proportion at G2/M state in both cell lines (t =-14.96,-19.26,P ＜ 0.05).Honokiol reduced the G2/M cell cycle arrest induced by irradiation significantly (t =7.65,4.98,P ＜ 0.05).Simultaneously,cyclin B1 protein expression obviously elevated (t =-33.07,-73.49,P ＜ 0.05).Conclusions Honokiol is a potent inhibitor of nasopharyngeal carcinoma cell growth by inducing cell apoptosis and necrosis and works as a radiosensitizer by disrupting G2/M cell cycle checkpoint.

Objective To investigate the effect of EGCG on the radiosensitivity of human nasopharyngeal carcinoma CNE-1 cells.Methods CNE-1 cells were divided into four groups:control,EGCG treatment,UVC or X-ray exposure,and EGCG combined with UVC or X-rays.After treatment with different concentrations of EGCG for 24,48 and 72 h and UVC or X-rays,cell growth was determined with MTT assay,cell survival was measured with clonogenic assay,cell cycle was deteeted with flow cytometry,cell apoptosis was detected by the annexin V-FITC cell apoptosis kit,and protein expression was assayed by Westem blot.Results EGCG inhibited cell growth in a dose-and time-dependent manner(r =0.817and 0.364).Compared with UVC or X-ray irradiation alone,the radiosensitivity of CNE-1 cells was enhanced by 2 h pre-treatment of 50 μmol/L EGCG,which disrupted S phase arrest caused by UVC( t =18.68,P ＜ 0.05 ) and increased the population of S and G2/M arrest caused by X-rays ( t =7.11 and 6.99,P ＜0.05 ).UVC could cause a significant increase of sub-G1 population( t =6.67,P ＜ 0.05 ) and Annexin V-FITC assay indicated apoptosis was further elevated by EGCG ( t =10.28,P ＜ 0.05 ).However,no significant induction of apoptosis was observed in the cells either irradiated with X-rays alone or combinationly treated with EGCG and X-rays.The combination treatment of EGCG and UVC significantly increased the expression of Bax and Caspase-3 proteins,but failed to affect Bcl-2 protein expression.Conclusions EGCG enhances the growth inhibition of CNE-1 cells caused by UVC or X-rays,which is relevant to apoptosis induction or cell cycle arrest.

Objective To determinate the heavy metal cadmium content in rice to ensure food safety.Methods Several brands and batch numbers of rice were collected and divided into groups A and B.Group A contained 24 pieces of rice from the canteens,and group B involved in 22 pieces from the farm product markets.Cadmium content in rice was detected quantitatively with X-ray fluorescence spectrometer,and then evaluated according to GB 2762-2012 which determined rice was not qualified in case cadmium content was more than 0.2 mg/kg.Results Group A had cadmium content between 0.00 and 0.477 mg/kg,the times of ultra standard being 2.385 and the disqualification rate being 29.2％ (7/24),and group B had cadmium content between 0.065 and 0.619 mg/kg,the times of ultra standard being 3.095 and the disqualification rate being 68.2％ (15/22).Excessive cadmium content in rice occurred in both canteens and markets,while the canteens was better than the markets.Conclusion X-ray fluorescence spectrometer detects cadmium content in rice rapidly and simply,and is worthy promoting in elementary facilities.

Background Replase of uveitis is a primary cause of vision damage.To predict recurrentassociated factors for uveitis is very critical for the prevention and management of uveitis.Objective This study was to explore the risk factors of recurrent uveitis and establish the prediction model of recurrent uveitis.Methods Clinical data of recurrent uveitis patients who were diagnosed in Renhe Hospital of Three Gorges University from July 1,2010 to June 30,2011 were retrospectively reviewed.The demography characteristics of the patients were collected and the disease was followed-up under the informed consent.Kaplan-Meier method was used to estimate the disease recurrence rate and to plot relapse-free survival curve at different levels of predictive factors.Multivariate Cox proportional hazards model was used to select independent risk factors of relapse and establish the prediction model for recurrent uveitis.Results Total 825 cases of recurrent uveitis were included and followed up for 1 month to 38 months,with a median following-up time of 16 months.Relapse of uveitis was identified in 149 cases (18.1％)during the following-up duration.The relapse-free survival time was from 1 month to 38 months,and the 1-,2-and 3-year cumulative recurrence-free survival rates were 87.3％,82.8％ and 80.9％.Multivariate Cox proportional hazards regression analysis showed that immunosuppression withdrawal(X1) (β =0.940,Waldx2 =12.018,P =0.001),oral steroid withdrawal (X2) (β =1.334,Wald x2 =18.450,P ＜ 0.001),colds (X3) (β =0.642,Wald x2 =11.988,P =0.001),work and study stress(X4) (β=0.285,Wald x2 =4.925,P=0.026) and excessive alcohol and tobacco(X5) (3--0.541,Wald x2 =4.718,P =0.030) were the independent risk factors for recurrence of uveitis.The risk of recurrence in patients with uveitis function model expression was h (t)=h0 exp (2.559 X1 +3.797 X2 + 1.901 X3 + 1.331 X4 +1.719 X5).Conclusions Replase of uveitis is an interaction of many factors,and immunosuppression withdrawal,oral steroid withdrawal,colds,work and study stress,excessive alcohol and tobacco are independent risk factors for recurrence of uveitis.An intervention according to the controllable factors is one of the important ways to prevent the recurrence of uveitis.

Objective To investigate the effect of Aidi injection combined with chemotherapy on CD+4CDhi25CDlow127regulatory T (Treg) cells in peripheral blood of advanced non-small-cell lung cancer (NSCLC).Methods Sixty patients with advanced NSCLC were randomly divided into the study group (treated with Aidi injection combined with chemotherapy) and the control group (treated with chemotherapy).The levels of CD+4CDhi25CDlow127Treg cells were detected by flow cytometry (FCM), and TGF-β1 and IL-10 levels were determined by enzyme linked immunosorbent assay (ELISA) before and after chemotherapy. A group consisted of 20 healthy persons was set up meanwhile.Results There was a significantly higher percentage of CD+4CDhi25CDlow127Treg cells in patients with NSCLC (5.77±1.50) % than that(3.84±0.96) % of healthy volunteers (P=0.000).The IL-10 and TGF-β1 levels[(24.09±6.74), (197.76±43.76) ng/ml]in the serum of patients with NSCLC were also significantly higher than that[(19.39±5.73), (141.13±32.17) ng/ml]of healthy volunteers (P =0.006,P =0.002). In control group, levels of CD+4CDhi25CDlow127 Treg cells were obviously lower than that before chemotherapy (P =0.048).Levels of TGF-β1 and IL-10[(22.25±6.79), (184.85±49.11) ng/ml]were slightly decreased, which showed no significant difference contrast to pretherapy[(24.37±8.10), (197.16±44.57) ng/ml](P =0.276, P =0.314).In study group, levels of CD+4CDhi25CDlow127Treg cells and TGF-β1, IL-10[(4.36±1.19) %,(20.16±4.73), (165.42±39.57) ng/ml]were obviously lower than that before chemotherapy[(5.78±1.50) %,(23.81±5.15), (198.35±43.68) ng/ml](P=0.000, P=0.003, P =0.006).Conclusion The CD+4CDhi25CDlow127 Treg cells in the peripheral blood of advanced NSCLC patients is significantly increased. Aidi injection combined with chemotherapy can obviously reduce the level of CD+4CDhi25CDlow127 Treg cells in patients with advanced NSCLC, and the combined therapy could improve the immune function of patients.