In the teaching process of nursing ethics,there are two issues arousing teachers' attention and worth discussing.The first issue is to lead the students to discuss the identity status of nurse,define a proper orientation of this specific occupation in order to help the nursing students themselves to have a comprehensive knowledge and cognition of the profession they are going to engage in.The second one is to emphasize understanding of the definition of "respect".

Guided by good clinical practice ( GCP) , M hospital cooperated with the Ethics Committee in quali-ty management of clinical trials and took the specific measures including perfecting the institution and standard op-erating procedures, implementing three level quality control institution, strengthening the training of GCP, and closely cooperating with drug and data management of clinical trials, quality control in the clinical trial, ethical re-view and supervision, quality control in the whole process (seamless connection). Seamless connection from the beginning of project acceptance and quality control in the whole process of clinical trials can effectively solve the ex-isting problems in clinical trials and improve the quality of clinical trials.

Objective We compared the new teaching curriculum of evidence-based medicine (EBM) with the traditional one to explore a more effective one of EBM and provide reference for the popularization of EBM in Xinjiang.Methods From the fourteen regions in Xinjiang,we selected randomly four regions,and the trainees of the four regions were allocated randomly to the experimental group (169) and the control group (167).The new teaching curriculum was used in the experimental group and the raditional one in the control group.After training,we investigated all the trainees with questionnaires and compared the differences of the two groups.Results Compared with the control group,trainees of the experimental group were significantly enhanced in the abilities of cognition (χ2 =6.870,P=0.009),literature retrieval (χ2 =22.670,P=0.000),communication (χ2 =6.288,P =0.012)and scientific research (χ2=4.667,P = 0.031).However,the difference in the ability of diagnosis and treatment (χ2 =0.663,P=0.426) was not significant.On the other hand,the total examinational scores and the scores for the chapters of general introduction,etiological factor,diagnosis and system review of the experimental group were significantly higher than those of the control group,but there was not significant difference between the two groups in terms of the scores for the chapters of treatment and prognosis.Conclusion The new teaching curriculum of EBM is beneficial in developing the abilities of cognition,literature retrieval,communication,scientific research and apprehension of EBM theory and is more applicable for the popularization of EBM in Xinjiang.

In this paper,a unique case of organ transplantation was inspected by organ transplant ethics committee,through which we try to investigate the mode of current operation,problems and confusion of organ transplant ethics committee in China by the constitutive principles,inspection scope,process,content,especially the functional authority and other relevant contents of hospital ethics committee.

This paper describes the role,method and experience,and working model of medical ethics in large-scale hospitals,and holds that the modern hospital management mode has transformed from scientific management to humanism-based management,whose essence is the transformation of managing concept,and the embody of management ethics and management culture.Important connotations and primary task including employing virtue in hospital management,obeying legal regulations in medical practice,and conducting humanistic medicine should be emphasized and concerned in hospital management.

Objective To evaluated the feasibility and accuracy of obtaining the myocardial perfusion image and coronary artery image of pig models of acute myocardial infarction by the second generation dual-source CT dual-energy myocardial perfusion one-stop scanning. Methods The pig models of acute myocardial infarction was established by using the interventional gelatin sponge embolism method on 5 pigs. The myocardial perfusion scanning and coronary angiography were respectively used 20 min before and 24-48 h after modeling. The heart were taken out immediately after the inspection for multiple punch biopsy and HE staining, then the heart was sliced for triphenyltetrazolium chloride (TTC) staining. According to the gold standard of coronary angiography and pathological staining, the sensibility and speciifcity of the coronary artery image of acute myocardial infarction of pig reconstructed by myocardial perfusion scanning and the myocardial perfusion image were respectively evaluated, and the consistency of the results was veriifed by Kappa test. Results Compared with the pathologic gold standard, the sensitivity, speciifcity, of myocardial perfusion iodine image obtained by myocardial perfusion scanning were 93%, 91%; and Kappa value was 0.68. Compared with the coronary angiography gold standard, the sensitivity and speciifcity of coronary artery image obtained by myocardial perfusion scanning were 93%, 81%, and Kappa value was 0.71. Conclusions The second generation dual-source CT dual-energy myocardial perfusionone-stopscanning can accurately get the coronary artery and myocardial perfusion images of the pig models of acute myocardial infarction.

BACKGROUND:Numerous studies have confirmed that neovascularization plays an important role in the growth, invasion and metastasis of tumors. OBJECTIVE:To investigate the features of CD133+ ovarian cancer stem-like cels differentiating into vascular endothelial cels. METHODS:CD133+ ovarian cancer stem-like cels were successfuly harvested from A2780 ovarian cancer cel lines using serum-free culture method, and incubatedin vitro onto 96-wel plates with or without Matrigel. Then, we observed the capacity of CD133+ ovarian cancer stem-like cels and human umbilical vein endothelial cels to form tube-like structures at different time points. Through xenograft experiments, the role of CD133+ ovarian cancer stem-like cels in the angiogenesis of ovarian cancer was observed using immunofluorescence staining. RESULTS AND CONCLUSION:CD133+ovarian cancer stem-like cels and human umbilical vein endothelial cels cultured with no Matrigel had no corresponding lumen formation, and could not express CD31. But those cultured with Matrigel had lumen formation and expressed CD31 significantly. After tumor formation, human-derived CD31 expression was observed in the tumors. These findings indicate that CD133+ ovarian cancer stem-like cels can differentiate into vascular endothelial cels, and be involved in tumor revascularization.

Objective To explore imaging manifestations of hepatic epithelioid hemangioendothelioma (HEH). Methods CT and MR images in 14 patients with HEH proven by histopathology were retrospectively analyzed. Plain and two-phase contrast-enhanced CT scan were performed in 5 cases, non-contrast and multiphase contrast-enhanced MR scan were performed in 7 cases, CT and MRI were both performed in 2 cases. Characteristics of CT and MR T2WI images were classified and analyzed. All lesions were classified into three types:multiple, diffuse and solitary form. Results (1) Multiple form of HEH:228 lesions were found in 11 patients, including 178 lesions on MRI and 50 lesions on CT. On T2WI, three or two layered-target-signs with hyperintensity core were found in 79.2% (141/178) of the lesions. Three layer-target-sign included hyperintensity core, hypointensity rim and slightly high signal halo from the inside out. Two layer-target-sign included hyperintensity core and slightly high signal halo from the inside out. Characteristics of dynamic contrast-enhanced scan included peripheral two or three layered-rim-like enhancement in 66.3%( 118/178) of the lesions;peripheral, gradual rim-like enhancement with enhanced core in 27.0%( 48/178) of the lesions;heterogeneously mild enhancement in 2.2%( 4/178) of the lesions;centripetal enhancement in 4.5%( 8/178) of the lesions. Fifty lesions were found in CT, which showed low density nodules or masses with clear margins. Two-layered-black-target sign were found in 42 lesions in contrast-enhanced images, white-target sign were found in 3 cases, and centripetal enhancement was found in 5 cases. (2) Diffuse form of HEH:in one of the two cases of this type, the lesions could not be separated from normal liver parenchyma, gradual enhancements were found along with the vessels in the center of the lesions. (3) Solitary form of HEH: one case, the lesion showed heterogeneous density in non-contrast CT images and gradual enhancement in contrast-enhanced images. Conclusions We found some imaging characteristics of HEH. Two or three layered-target-sign on T2WI and black-target sign, white-target sign on contrast-enhanced images were unique imaging features of HEH.

Objective To investigate the effects of interleukine-22 ( IL-22 ) on the expression of interleukin-6 (IL-6) by rheumatoid arthritis synovial fibroblasts (RASF), and to analyze their association with IL-17+CD4+T (Th17) cells differentiation.Methods RASF were isolated from six patients with rheu-matoid arthritis ( RA) and cultured in vitro.The expression of IL-6 at mRNA and protein levels by RASF were detected by qRT-PCR analysis and ELISA after treatment with different concentrations of IL -22 for dif-ferent periods of time.Anti-IL-22R1 blocking antibody and inhibitor assay were used to analyze the specific receptor and its downstream signaling pathways associated with IL-6 production.IL-22 pre-treated RASF and CD4+T cells were co-cultured for 3 days in the presence or absence of anti-IL-22R1 or anti-IL-6 to measure the percentage of Th 17 cells by flow cytometry .Results The expression of IL-6 by RASF was increased up-on IL-22 stimulation in a dose and time dependent manner (P<0.05), and that was closely related to IL-22R1 and its downstream signaling pathways of p38 and JAK2 (P<0.05).Co-culturing CD4+T cells with RASF and Transwell system indicated that the percentage of Th 17 cells was increased in IL-22 pre-treated group as compared with that in IL-22 untreated group , but it could be down-regulated by either blocking IL-22R1 or IL-6.Conclusion IL-22 promoted the expression of IL-6 by RASF and further enhanced Th 17 dif-ferentiation.Neutralizing IL-22 in synovium of patients with RA might be an effective therapeutic strategy for RA treatment.

Objective To explore the clinical characteristics and prognosis of acute myeloid leukemia (AML) patients with CCAAT/enhancer binding protein α (CEBPA) mutations.Methods 208 patients with de novo AML were retrospectively analyzed with regard to frequency of CEBPA mutations,clinical characteristics,therapeutic response and long-term outcome.Results CEBPA mutations were detected in 37 patients (17.8 ％),with 29 cases of double mutations and 8 cases of single mutation.In 117 cases of patients with normal karyotype,28 cases (23.9 ％) were detected with CEBPA mutations.As compared with no CEBPA mutation,the following characteristics were observed in patients with CEBPA double mutations.Presented with younger age at diagnosis,82.8 ％ (24/29) of the patients were M1 and M2.Presented with higher peripheral white blood cell count,higher hemoglob in and low platelet count.And increases of CD7,CD34 and HLA-DR expression.Compared with those without mutation,patients with biCEBPA mutations had better overall survival (OS) (2-years OS:100 ％ vs 75.1％,P =0.045).Conclusion BiCEBPA mutation is one of the favorable prognosis indicators.