It is of great significance to maintain personal dignity of human organ donors.There are three problems that may exist in the human organ donation.At the stage of registration,the potential donors may face family kidnapping;at the terminal stage,living with dignity for the donors is difficult to guarantee;at the post-donation stage,there is lack of humane care for the remains of donors and their close relatives.Aiming at the above problems,this paper made an analysis from the theoretical aspect and put forward three ethical principles:the principle of autonomy,respect and humanitarianism.

Objective To summarize the magnetic resonance imaging/ 1 H-magnetic resonance spectroscopy (MRI/1 H-MRS) features of tumor-like inflammatory demyelinating diseases (TIDD),and investigate the clinical value of MRI/1 H-MRS.Methods MRI features of 10 cases of TIDD in brain confirmed by pathology were retrospectively analyzed and compared with pathology.Results The lesions mainly located in the white matter with mild mass effect.MRI scan all showed low T1 high T2 signal,and 7 cases showed high signal,3 cases showed slightly high or mixed signals on DWI.Enhanced MRI showed 5 cases with significant enhancement withopen loop sign,4 cases with significant patchy or nodular enhancement,1 case with mild flakes or linear enhancement.Three cases showed expanded blood vessels and plumbed to the lateral wall inside the edge of the lesions.1H-MRS performance showed 4 cases all with significantly increased Lac and Lip; 3 cases with rised glutamate and glutamine complex β,γ-Glx peaks,reduced N-acetylaspartate acid (NAA),increased Cho to varying degrees.All pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis,hypertrophy and abnormal mitotic figure.Seven cases could be seen obesity glial cells.Conclusions TIDD had its salient MRI features:lesion had obvious edema and mild mass effect,MRI enhancement showed open loop sign and small veins expansed,on perfusion-weighted imaging it showed low perfusion.1H-MRS showed β,γ-Glx peaks,Lac and Lip peaks significantly increased,NAA slightly reduced,Cho mildly elevated.Comprehensively analyzing the MRI and 1H-MRS features,combined with clinical manifestations,contribute to the diagnosis of the disease.

Off-label drug use to some extent meets the clinical medication,achieves the most needed treat-ment of patients and promotes the development of medicine,but there exists certain risks at the same time.Through the analysis of the phenomenon of off-label drug use,from the perspective of medical ethics,this paper proposed that it should adhere to the principles of beneficence and respect,specifically,correcting the motives of off-label drug use,strict review of supporting evidence,ensuring patient's informed consent,strengthening ethical review andintroducing the insurance sharing mechanism,so as to achieve both the guarantee of patient's medication safety and the aversion of medical personnel's practice risks.

OBJECTIVETo establish a simple high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS) system for determination of capsaicin in rat plasma.

METHODSRat plasma (100 µl) was extracted with mixed solvent (ethyl acetate:acetone 85:15) after addition of 50 ng/ml internal standard, and analyzed by Agilent 6460 Triple Quadrupole LC/MS system. The detection was performed with multiple reactions monitoring using electrospray ionization. The precursor/product ion transitions were monitored at m/z 306→137 (+Ion mode) for capsaicin. Verapamil was used as the internal standard at m/z455→165.

RESULTSThe analysis time was only 1.5 min in the positive mode; the calibration curve was linear in the concentration range of 1.85-370 ng/ml. The lowest limit of quantification reached 1.85 ng/ml. The extraction recoveries were 77.34%, 70.64% and 78.02% for the three quality control concentration levels (3.7, 37, and 370 ng/ml), respectively.

CONCLUSIONThe LC-MS/MS system is simple, accurate, reliable and time-saving for determination of trace amount of capsaicin in plasma.

Objective To investigate the heterogeneity of the left ventricular reference value in echocardiography mesurements by Meta analysis. Methods A literature retrieval in PubMed,Embase, Medline and other databases from January 2005 to September 2017 related to left ventricular normal reference value in healthy adults was performed. Cohrane′s Q test was used to test the heterogeneity,and I2 was used as a statistic for the description of heterogeneity. Subgroup analysis,sensitivity analysis and Meta regression were used to analyze the sources of heterogeneity. Results The Meta analysis enrolled 9 studies including 5 933 normal cases. The heterogeneity test showed that the left ventricular normal reference value of echocardiography was highly heterogeneous among the studies. In subgroup analysis, some measurements′ heterogeneity were significantly reduced. Meta regression analysis showed that the contribution of racial specificity to heterogeneity was relatively high in some measurements. Conclusions The heterogeneity of left ventricle is mainly related to racial specificity,but it cannot fully explain the heterogeneity between studies. Further studies are needed to demonstrate the involved factors of heterogeneity of left ventricular normal reference values.

Objective:To analyze clinicopathological features of thyroid nodules and to assess preoperative diagnostic methods for the nature of nodules.Methods:The clinical and pathological data of 2 132 patients [456 males and 1 676 females with a mean age of (48.7±11.4) year] with thyroid nodules who underwent surgical treatment in our hospital from January 2017 to December 2019 were retrospectively analyzed. Among all patients, 433 nodules had complete fine needle aspiration biopsy cytology (FNAC) and ultrasound results were selected for further assessment. According to preoperative high-resolution ultrasound images, the nodules were classified by Kwak thyroid imaging and reporting data systems (Kwak TI-RADS) and American College of Radiology TI-RADS (ACR TI-RADS). ROC curve was used to assess the diagnostic efficacy of the two ultrasound modes and FNAC.Results:In 2 132 patients with thyroid nodules, 743 were benign and 1 389 were malignant. In all malignant cases 1 119 were females, accounting for 80.56%. In newly diagnosed benign nodules, 67.97% (505/743) were found by examination, and 32.03% (238/743) were self-found. In malignant nodules, 48.67% (676/1 389) were detected by examination, 51.33% (713/1 389) were self-found. The malignant rate of nodule diameter≤1 cm was the lowest in 1 118 patients with complete thyroid ultrasound data. In 628, 722 and 782 patients who underwent surgical treatment in 2017, 2018 and 2019, the proportion of malignant nodules was 56.37% (354/628), 66.48% (480/722) and 70.97% (555/782); the proportion of benign nodules was 43.63% (274/628), 33.52% (242/722) and 29.03% (227/782), respectively. Among all malignant nodules, papillary carcinoma accounted for 95.18% (1 322/1 389), followed by follicular carcinoma 4.32% (60/1 389), myeloid carcinoma 0.43% (60/1 389) and undifferentiated carcinoma 0.07%(1/1 389). Among all benign nodules, the proportion of nodular goiter was the highest (95.56%, 710/743). The proportion of patients undergoing preoperative FNAC in 2017, 2018 and 2019 was 57.96% (364/628), 63.43% (458/722) and 69.44% (543/782), respectively;the coincidence rate of preoperative FNAC and postoperative pathological diagnosis was 46.15% (168/364), 52.18% (239/458) and 62.06% (337/543), respectively. Among 433 nodules with both FNAC and ultrasound data, the areas under the ROC curve(AUC)of FNA, ACR TI-RADS and Kawk TI-RADS were 0.91, 0.74 and 0.59, respectively ( P<0.05). The sensitivity of ACR TI-RADS and Kawk TI-RADS was 84.34%, 37.35% ( P<0.05) and specificity was 56.29% and 79.14% ( P=0.075). Conclusions:The study reveals that from 2017 to 2019, both the number of cases and malignant rate of thyroid nodules shows a rising trend, meanwhile the application rate of preoperative FNAC and its coincidence rate with postoperative pathology shows an increasing trend. FNAC, ACR Ti-RADS and Kawk TI-RADS have certain diagnostic efficacy in differentiating benign and malignant thyroid nodules, and the diagnostic value of FNAC is the highest followed by ACR TI-RADS and Kawk TI-RADS.

Objective To explore the effects of parthenolide (PTL) on high glucose-stimulated cell proliferation, NF-κB activation and monocyte chemoattractant protein-1 (MCP-1) expression in rat mesangial cells (MCs). Methods MCs were cultured in normal glucose (5.6 mmol/L), high glucose (30 mmol/L), or high glucose with PTL. MTT assay was used to detect the cell proliferation. MCP-1 content in the supernatant was measured by ELISA, and the level of IκBα was detected by Western blotting to reflect NF-κB activity. EMSA method was used to measure the activation of NF-κB. Results MC proliferation, MCP-1 expression and NF-κB activation were significantly enhanced and the expression of NF-κB-binding protein IκBα was obviously reduced in cells cultured in high glucose. Application of PTL obviously abolished the effects of high glucose. Conclusion PTL can suppress high glucose-stimulated NF-κB activation and MCP-1 expression in rat MC. These data provide a theoretical basis for the clinical application of PTL in prevention and control of diabetic nephropathy.

Objective:To investigate the correlation of serum tartrate-resistant acid phosphatase 5b (TRAP-5b), β-collagen degradation products (β-CTX), vitamin D levels and rheumatoid arthritis (RA) complicated with osteoporosis (OP) fractures.Methods:A total of 200 RA patients diagnosed and treated in our hospital from Oct. 2022 to Oct. 2023 were selected. Clinical data of patients were collected, and serum TRAP-5b, β-CTX, vitamin D levels, bone mineral density and bone metabolism markers were detected. They were divided into RA group and RA-OP group according to whether OP fracture occurred. The above indexes were compared and their correlation with osteoporotic fractures in rheumatoid arthritis was analyzed.Results:The levels of serum TRAP-5b and β-CTX in RA patients were higher than those in healthy control group, and the levels of vitamin D were lower ( t=12.27, 20.01, 7.35, P<0.05). There was no statistically significant difference in gender, body mass index, diabetes, hypertension, smoking and drinking incidence between the two groups ( t=1.18, 0.96, 0.55, 1.84, 0.13, 0.30, P>0.05), but there was statistically significant difference in gender composition, serum TRAP-5b, β-CTX, vitamin D and bone metabolism markers between the two groups ( t=2.33, 3.72, 4.94, 5.10, 7.72, 4.77, 2.42, 9.30, 4.01, 6.38, 4.79, P<0.05). Logistic regression analysis showed that the levels of serum TRAP-5b, β-CTX, vitamin D and bone metabolism markers were independent risk factors for OP in RA patients ( P<0.05). Serum TRAP-5b and β-CTX were positively correlated with serum PINP, NTx, PTH, BALP and BGP, respectively ( r=0.811, 0.778, 0.747, 0.675, 0.614; 0.685, 0.513, 0.405, 0.612, 0.518), and negatively correlated with lumbar BMD and proximal femoral BMD ( r = -0.488, -0.512; -0.526, -0.502) ; Serum vitamin D was negatively correlated with serum PINP, NTx, PTH, BALP, BGP ( r=-0.728, -0.640, -0.604, -0.622, -0.545), and positively correlated with lumbar BMD and proximal femur BMD ( r=0.519, 0.492) ( P<0.05) . Conclusions:Serum levels of TRAP-5b, β-CTX and vitamin D are closely related to the occurrence of OP in RA patients. Abnormal increase of serum levels of TRAP-5b and β-CTX and abnormal decrease of vitamin D suggest an increasing risk of OP in RA patients.

Objective To explore the effects of parthenolide (PTL) on high glucose-stimulated cell proliferation, NF-κB activation and monocyte chemoattractant protein-1 (MCP-1) expression in rat mesangial cells (MCs). Methods MCs were cultured in normal glucose (5.6 mmol/L), high glucose (30 mmol/L), or high glucose with PTL. MTT assay was used to detect the cell proliferation. MCP-1 content in the supernatant was measured by ELISA, and the level of IκBα was detected by Western blotting to reflect NF-κB activity. EMSA method was used to measure the activation of NF-κB. Results MC proliferation, MCP-1 expression and NF-κB activation were significantly enhanced and the expression of NF-κB-binding protein IκBα was obviously reduced in cells cultured in high glucose. Application of PTL obviously abolished the effects of high glucose. Conclusion PTL can suppress high glucose-stimulated NF-κB activation and MCP-1 expression in rat MC. These data provide a theoretical basis for the clinical application of PTL in prevention and control of diabetic nephropathy.

The superiority of the cumulative outcomes of day 5/6 embryo transfer to those of day 2/3 embryo transfer in infertile couples has been debated.This retrospective study included data collected from 1051 patients from July 2011 to June 2014.Multiple maternal baseline covariates were subjected to propensity score matching analysis,and each day 5/6 group woman was matched to one day 2/3 group woman.A systematic meta-analysis was conducted to validate the results.After matching was completed,217 patients on the day 2/3 group were matched with those on the day 5/6 group,and no significant differences in the baseline characteristics were observed between the two groups.The cumulative pregnancy rate (57.14％ vs.53.46％,OR 1.16,95％ CI 0.79-1.70) and cumulative live birth rate (53.00％ vs.49.77％,OR 1.14,95％ CI 0.78-1.66) of day 5/6 embryo transfers were higher than those of day 2/3 embryo transfers,but this difference was not significant.The mean cycles per live birth and mean days per live birth in the day 5/6 group were significantly lower than those in the day 2/3 group.This study demonstrated that day 5/6 embryo transfer is a more cost-effective and time-efficient policy than day 2/3 embryo transfer to produce a live baby.