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.

Animals ; Capsaicin ; blood ; Chromatography, High Pressure Liquid ; Plasma ; chemistry ; Rats ; Tandem Mass Spectrometry

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.

OBJECTIVETo 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).

METHODSMCs 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.

RESULTSMC 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.

CONCLUSIONPTL 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.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; isolation & purification ; pharmacology ; Asteraceae ; chemistry ; Cell Proliferation ; drug effects ; Cells, Cultured ; Chemokine CCL2 ; metabolism ; Dose-Response Relationship, Drug ; Glucose ; administration & dosage ; pharmacology ; I-kappa B Proteins ; metabolism ; Mesangial Cells ; cytology ; metabolism ; NF-KappaB Inhibitor alpha ; NF-kappa B ; antagonists & inhibitors ; metabolism ; Plants, Medicinal ; chemistry ; Rats ; Sesquiterpenes ; isolation & purification ; pharmacology

OBJECTIVETo investigate the effect of the serum of rats fed with Shenkang pill in regulating monocyte chemoattractant protein 1 (MCP-1) expression induced by advanced oxidation protein products (AOPP) in mouse podocyte clone 5 (MPC5) and explore the underlying mechanism.

METHODSMPC5 cultured in vitro were incubated for different time lengths in the presence of different concentrations of serum of rats medicated with Shenkang pill, and the cell proliferation was assessed using MTT assay. In MPC5 treated with AOPP prior to exposure to the rat serum, the changes in the protein expressions of p38MAPK and IκBα were examined with Western blotting, NF-κB p65 nuclear translocation was analyzed with immunofluorescence assay, and MCP-1 expression in the supernatant was determined using ELISA kits.

RESULTSThe medicated rat serum time- and concentration-dependently promoted the proliferation of MPC5, with the optimal serum concentration of 5% and incubation time of 24 h. AOPP significantly increased MCP-1 expression in the cell supernatant in a time-and concentration-dependent manner; pretreatment with SB203580 (a p38 inhibitor) or parthenolide (a NF-κB inhibitor) significantly decreased MCP-1 expression, and treatment with the medicated serum significantly decreased AOPP-induced MCP-1 expression. AOPP concentration-dependently increased the protein expression of P-p38 but decreased that of IκBα. Both the medicated serum and SB203580 increased IκBα protein in AOPP-induced cells, but the effect was more obvious with the medicated serum. The medicated serum also decreased NF-κB p65 nuclear translocation in AOPP-induced MPC5.

CONCLUSIONShenkang pill-medicated serum can decrease AOPP-induced expression of MPC-1 in MPC5 by regulating p38MAPK/NF-κB to mediate its anti-inflammatory effect. This finding provides a new theoretical basis for the application of Shenkang pill to treat diabetic nephropathy.

Advanced Oxidation Protein Products ; pharmacology ; Animals ; Cell Line ; Cell Proliferation ; Chemokine CCL2 ; metabolism ; Down-Regulation ; Drugs, Chinese Herbal ; pharmacology ; I-kappa B Proteins ; metabolism ; Imidazoles ; Mice ; NF-KappaB Inhibitor alpha ; Pyridines ; Rats ; Serum ; chemistry ; Sesquiterpenes ; Transcription Factor RelA ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective To analyze the hemodynamic changes of cerebral arteries in patients with chronic extracranial internal carotid artery occlusion (EICAO).Methods Ninety-six patients with chronic unilateral EICAO who were admitted to Kailuan General Hospital from September 2012 to December 2015 were selected as the case group (EICAO group),and 30 volunteers were selected as the control group.Color transcranial Doppler ultrasonography was used to detect the anterior communicating artery (ACOA) of the grade Ⅰ collateral circulation,the posterior communicating artery (PCOA),the ocular artery of the grade Ⅱ collateral circulation,and the pial collateral branch.Circulation rate and cerebral hemodynamic parameters:(Mean blood flow velocity (Vm) and pulsatility index).Results In the left and right EICAO groups,the opening rates of collateral circulation at grade Ⅰ were 86.96％ (40/46),96.00％ (48/50) and 78.26％ (36/46) and 88.00％ (44/50) respectively.There were significant differences in the opening rates of collateral circulation at grade Ⅰ between the two groups (x2 =4.114,P =0.043).There was no significant difference in the opening rates of collateral circulation at grade Ⅱ between the two groups (x2 =3.544,P =0.060).The left and right sides of EICAO group were compared with the same side of control group.The Vm of the common carotid artery (left side of the EICAO group (24.08 ± 9.25) cm/s),left side of the control group (32.52±3.28) cm/s,P＜0.01);right side of the EICAO group (22.20±5.51) cm/s),right side of the control group(31.58±3.35) cm/s,P＜0.01)) and the end-carotid artery end stage (TICA) The pulsation index (left side of left EICAO group (0.78 ±0.17),left side of control group (0.92±0.08),P ＜0.01);right side of right EICAO group (0.75 ± 0.19),right side of control group (0.91 ± 0.10),P ＜0.01),Vm of middle cerebral artery (MCA) (left side of left EICAO group(40.29 ±20.61) cm/s,left side of control group(55.72 ±5.60) cm/s,right side of EICAO;The right side of group (37.10±19.70) cm/s),the right side of control group (53.70±6.28) cm/s,P＜0.01),the pulsation index of MCA (left side of left EICAO group(0.74±0.19),left side of control group(0.87±0.10),P＜0.01;right side of right EICAO group (0.69±0.23),right side of control group:(0.90 ± 0.08),P ＜ 0.01).There were significant differences.NIHSS score of neurological impairment:normal 17.39％ (8/46),mild 39.13％ (18/46),moderate 30.44％ (14/46),moderate severe 13.04％ (6/46) in left EICAO group,and normal 18.00％ (9/50),mild 54.00％ (27/50),moderate 24.00％ (12/50),moderate severe 4.00％ (2/50) in right EICAO group.There was no significant difference between the two groups (P =0.178).Conclusion The ipsilateral common carotid artery and its distal middle cerebral artery in patients with chronic unilateral internal carotid artery occlusionshow hypoperfusion of hemodynamics,accompanied by neurological impairment.

Objective:To investigate the effect of different blood glucose and BMI levels on the outcome of closed biliary surgery in diabetic patients.Methods:Clinical data of 424 diabetes admitted to Shanxi Provincial People’s Hospital for closed biliary tract surgery from Jan. 2018 to Jun. 2019 were retrospectively analyzed. According to the fasting blood glucose and BMI levels, the subjects were divided into hyperglycemia and non-hyperglycemia groups and obesity and non-obesity subgroups. The differences of clinical data among different groups were compared and analyzed. Multiple regression analysis was used to analyze the factors of postoperative infection, length and cost of hospitalization.Results:①Compared with the non-hyperglycemia group, the hyperglycemia group had higher BMI, serum creatinine, blood urea nitrogen, blood glucose monitoring rate, glycated hemoglobin detection rate, postoperative infection rate, ICU occupancy rate, length and cost of hospitalization, and lower albumin level, all P<0.05.②The age, fasting blood glucose, serum creatinine, low density lipoprotein, length and cost of hospitalization in the hyperglycemic obese subgroup were all lower than those in the non-obese subgroup, all P<0.05; and the serum creatinine in the obese subgroup was higher than those in the non-obese subgroup ( P<0.05) . ③Logistic analysis revealed that hyperglycemia was an independent risk factor for postoperative infection. For every 1mmol/L increase in fasting blood glucose, the risk of postoperative infection increased by 1.158 times, and albumin was a protective factor for postoperative infection. ④Multiple linear regression analysis showed that hyperglycemia and hypoalbumin were the important factors affecting the length of hospital stay and the increase of hospital cost, all P<0.05. Conclusions:Hyperglycemia is an independent risk factor for postoperative infection and a risk factor for longer hospital stay and higher costs. Obesity is not associated with postoperative infection or longer hospital stay, except for increased serum. Patients with diabetes undergoing closed biliary system surgery need to improve the detection rate of glycated hemoglobin and blood glucose monitoring rate, manage blood glucose reasonably, and control body weight appropriately.