During medical activity,there are theory and realism spring of that the right of emergency treatment is in conflict with the right of informed consent.Simply investigating responsibilities is of no avail to solve the conflicts.To Interpret the real reasons of the conflict through legal and ethical aspects.To avoid and reduce conflict,the effective measures are that perfecting the rules of relevant law,elucidating the rights and obligations of hospital and medical staff;regulating the contents of informed consent form and strengthening medical ethics education.

Excitatory amino acid toxicity is one of the mechanisms of vascular dementia. Gluta-mate is the major excitatory neurotransmitter in brain. Memantine, a moderate affinity, uncom-petitive and voltage-dependent N-methyl-D-aspartate (NMDA) receptor blocker, can block NMDA receptor-induced intracellular calcium overload and prevent excitotoxicity. It can be used in the treatment of vascular dementia.

This article explains four cases of professor REN Ji-xue,including anasarca,serious blepharoptosis,head cold,summer diarrhea,from which we can find the laws of syndrome differentiation by him. In which,the key point of the pathogenesis of anasarca is spleen-qi deficiency, so replenishing qi and invigorating the spleen, warming yang for diuresis are the treatment nethod for anasarca. Sinking of qi due to deficiency of spleen leads to serious blepharoptosis and Invigorating Spleen and Replenishing Qi Decoction is the main prescription. The key pathogenesis of head cold is disharmony of nutrient qi with defensive qi, so regulating ying and wei, dispersing lung qi for resuscitation are the treatment methods, and both inside and outside therapies are in use. Cold-damp invasion of spleen is the main cause of summer diarrhea, so activating qi flowing and warming spleen and stomach, dissipating dampness for stopping diarrhea are used. Professor REN Ji-xue is good at taking different method according to different key point of the pathogenesis, so the efficiency is good. This is one feature of Professor REN in treating miscellaneous diseases.

Objective To investigate the relationship of hypoxia inducible factor-1 α(HIF-1α),tumor necrosis factor-α (TNF-α),hepatocyte growth factor (HGF) and cerebral infarction.Method Two hundred and twelve cases with acute cerebral infarction in the Fourth People's Hospital of Langfang from Jun.to Dec.2013 were divided into progressive cerebral infarction(PCI) group(n =105) and the stability of cerebral infarction (SCI) group (n =107).Meanwhile 100 healthy people were served as control group.Enzyme-linked immunosorbent assay(ELISA) was applied to detect the levels of HIF-1 α,TNF-α and HGF.The PCI group were divided into small groups according to nerve function or infarction lesion size,and the levels of HIF-1 α,TNF-α and HGF of each group.Result The levels of HIF-1 α,TNF-α,HGF in PCI group were (2.3 ± 1.3) ng/L,(4.0 ± 0.5) mg/L and (1.4 ± 0.3) μg/L,significantly higher than those in SCI group ((1.1 ± 0.5) ng/L,(3.1 ±1.3) mg/L and (0.7 ±0.4) μg/L;F=5.42) and control group((0.5 ±0.1) ng/L,(1.8 ±0.4) mg/L and (0.4 ±0.1) μg/L;F =3.14).Meanwhile,the levels of HIF-1 α,TNF-α,HGF in SCI group was significantly higher than that of the control group (F =1.32,P ＜ 0.05).The levels of HIF-1α,TNF-α,HGF in mild PCI group were significantly lower than those in moderate group and severe group,and those in moderate group was lower than those in severe group (F =0.93,4.32,2.31 ; P ＜ 0.01).The levels of HIF-1 α,TNF-α,HGF in small infarction group were (0.6 ± 0.4) ng/L,(2.7 ± 0.4) mg/L,(0.7 ± 0.4) μg/L,significantly lower than those in infarction group ((1.1 ± 0.5) ng/L,(4.4 ± 0.5) mg/L,(1.1 ± 0.2) μg/L; F =4.71,P＜0.05) and large infarction group((1.4 ± 0.6) ng/L,(4.8 ± 0.6) mg/L,(1.9 ± 0.5) μg/L; F =2.09,P＜0.05).The levels of HIF-1α,TNF-α,HGF in focal infarction group was significantly lower than that in large infarction group and the difference is statistically significant(F =2.45,P ＜0.05).Conclusion HIF-1 α,TNF-α and HGF serum levels in progressive cerebral infarction are significantly increased,which is related to the function defect and size of infarction.

Objective To establish a thin layer chromatography scanning method for the determination of cinnamaldehyde content in Qianzheng Plaster.Method Cinnamaldehyde was extracted from Qianzheng Plaster by distillation method.Silica G was used as the thin-layer plate;petroleum ether (60～90℃) and acetic ethyl acetate (17 ∶3)served as the mobile phase and the scanning wavelength was 269 nm.Results A good linearity was obtained in the range of 0.81?g～4.05 ?g (r=0.9993).The mean recovery rate was 95.23 %and RSD=1.39 %.Conclusion This method is accurate and sensitive with good reproducibility.

Thirty-six subclinical hypothyroidism patients with different pathogenic background were treated by levothyroxine. After treatment the levels of serum total cholesterol, low density lipoprotein and triglyceride were significantly lower than those before treatment (P

CyberKnife is a newly developed technology in the field of stereotactic radiosurgery/radiotherapy(SRS/SRT).Compared with conventional SRS/SRT,there are many advantages for CyberKnife in terms of being real-time image-guided,frameless,highly accurate,etc.Recently,it has been used to treat different types of malignant carcinoma including intracranial and extracranial tumors.This article summarized the contemporary progress of CyberKnife in the treatment of intracranial and extracranial tumors.

Objective:To observe apical sealing ability of two kinds of nanomaterial. Methods:40 straight human maxillary anterior teeth were randomly divided into four experimental groups of 8 samples each and two control groups of 4 samples each. The root canals were prepared using step-back technique and obturated with gutta-percha and one of the sealers by the lateral condensation technique. Group 1: Filled with zinc oxide-eugenol sealer and gutta-percha (ZOE); group 2: Filled with hydroxyapatite sealer and gutta-percha (HA); group 3: Filled with nano-zinc-oxide sealer and gutta-percha (NZO); group 4: Filled with nanohydroxyapatite sealer and gutta-percha (NHA). The teeth were placed into microleakage model. Glucose leakage from the coronal to apical was measured by the concentration of glucose in apical reservoir at 1, 2, 4, 7, 10, 15, 20, 25 and 30 days with GOD (glucose oxidase ) method. The apical sealing ability of the materials were assessed according to the concentration of glucose leakage. Results:The glucose leakage of four kinds of materials differed significantly (P

Objective To identify and characterize the CD34~+ stem cells of hematopoietic tumor cell lines. Methods Taking CD34 molecule as a marker to identify if there are CD34~+ tumor cells in hematopoietic tumor cell lines(THP-1,MEL,K562,MOLT-4,RAJI,RPMI8226,SP2/0 and DCS) by fluorescence staining and FCM technology. We separated CD34~+ cells from K562 and MOLT-4 for further study.CD34~+ cells were cultured and observed their development.CD34~+ and CD34 +- cells were compared in their functional status(mRNA),cell cycles(G -0/G -1),their degree of differentiation(Id-1 expression) and their multi-drug resistance(gp expression). Results The percentages of CD34~+ cells were 6 ^2%(DCS),5.2%(MEL),1.4%(RAJI),2.5%(THP-1),2.1%(MOLT-4),3.1%(K562),0(SP2/0),and 0(RPMI8226) respectively.After culturing CD34 ++ cells isolated from K562 cells line could proliferate and the percentage of CD34 ++ reminded the same.CD34 ++ tumor cells contained much less RNA,more G0/G1 cells,expressed more Id-1 protein(less differentiated state) and possessed more P-gp(stronger multi-drug resistance).Conclusion There exists a very small portion of CD34 ++ stem cells among hematopoietic tumor cells and these cells are in a more primitive state.

Objective To observe the efficacy of Shuilongjian in treating cerebellar infarction, and compare with the pure western medicine. Methods 67 inpatients with cerebellar infarction enrolled were divided into two groups according to the method of random digits table, 36 cases in the treatment group and 31 cases in the control group. The control group was given 500 mL dextran by venoclysis, once a day. The treatment group was given Shuilongjian as an additional drug. The therapeutic effect was evaluated according to the nerve function and the total capability in dealing with daily activities. Result All the 67 cases of cerebellar infarction were included in the analysis. The effective rate of the treatment group was better than that of control group with 83.3% and 58.1% (P