Encouraging voluntary donation of citizens' organ is the best institutional solution for the severe shortage of organ transplantation.The policy incentives should allow donors to rescind their donation of their organ anytime before the organ is removed from their body.As long as the donor does not commit subjective offence,he/she shall be released from any legal responsibilities.This arrangement is highly significant legally and practically.

Objective To evaluate the clinical effects of sinus tarsi approach and eight-shape approach in the treatment of calcaneal fractures.Methods Analyzed the outcomes of 23 patients(21 males and 2 females)with calcaneal fractures(25 feet)treated with plate via sinus tarsi approach and eight-shape approach.The mean age of patients was 38 years old(ranged from 24 to 55 years).According to Sanders classification:16 feet in type Ⅱ,9 feet in type Ⅲ.Results The average operation time was 85 min(ranged from 70 min to 100 min),and no wound compli-cations occurred.X-ray review showed that bony healing,and healing time was 3-6 months.The average duration of follow-up was 13 months(ranged from 12 to 18 months).The result was excellent in sixthteen cases,good in six cases and fair in one case according to Maryland score.The satisfactory rate was 95 .6%.Conclusion Open reduction and internal fixation via the sinus tarsi approach and eight -shape approach provides not only reliable fixation,but also less complications.

Objective To explore the value of predicting ovarian response using the antral follicle count in in vitro fertilization(IVF) cycle. Methods 54 patients in our infertility treatment center were observed, in which 6 patients had poor ovarian response and the other 48 patients had good ovarian response. The clinical data, duration and efficacy of treatment were compared between the two groups. Results The mean number of antral follicles and retrieved oocytes in the third day of menstruation in good ovarian response group was significantly higher than that in poor ovarian response group. The clinical pregnancy rate of the good ovarian response group was better than that of the poor one. Conclusions Monitoring the antral follicle count in both ovaries using vaginal ultrasound may predict ovarian response in IVF in the third day of menstruation.

BACKGROUND: More and more psychiatric problems require liaison consultation in specific clinical departments of general hospital.OBJECTIVE: To enhance the recognition of physicians in non-psychiatric departments on psychiatric illness by carrying on psychiatric liaison consultation in general hospital.DESIGN: Case analysis.SETTING: Department of Psychology in the affiliated hospital to Guangdong Medical College.PARTICIPANTS: Totally 154 inpatients for the consultation in Department of Psychology were selected in the Affiliated Hospital of Guangdong Medical College from April 2003 to April 2004, of either sex and different age and educational backgrounds.METHODS: It was to investigate the distributions of departments and diseases with consultation-liaison psychiatry (CLP) in general hospital in 154 cases based on statistics.RESULTS: Totally 154 cases were employed and were all in result analydepartments applying for consultation, the department of internal nedicine occupies the top, 57 cases (37.0%) involved, followed by department of emergency, with 26 cases (16.8%), department of infection, with 17 cases illness: The most common diseases in consultation were neurotic disorders due to brain disease (31.1%), psychiatric disorder (25.3%) and psychiatric disorder due to body disease (13.6%).CONCLUSION: Psychiatric problem happens in every clinical department of general hospital. It is necessary to enhance liaison psychiatric consultation in general hospital.

BACKGROUND:At present,most general hospitals in China treat patients with neurosis and mental diseases merely by means of clinical psychological consultation,which cannot meet the requirements of social service for metal disorders. Is it feasible to establish open psychology wards?OBJECTIVE:To investigate the feasibility of establishing open psychology ward in general hospitals for patients with neurosis and mental diseases.DESIGN:Case analysis based on patients.SETTING:Department of Psychology of Guangdong Medical College Affiliated Hospital.PARTICIPANTS:Totally 900 patients with various types of neurosis were admitted to the Department of Psychology of Guangdong Medical College Affiliated Hospital between July 2000 and March 2003.There were 688 patients with different kinds of psychoneurosis and112 cases of mental diseases. Of them,there were 523 men and 377women aged from 11 to 80 years.with the mean age of (42±8) years and hospitalization duration of(17.0±6.5) days.METHODS:Open management consisting of open ward,supporting system,humanized restriction,collective physical exercise and psychological support was adopted.Symptom checklist (SCL-90) was used by trained psychological doctors to assess the therapeutic effects in the 900 patients with neurosis and mental diseases after two-month rehabilitation.Meanwhile,169 patients with depression were examined with Hamilton rating scale for depression(HAMD) at 2,4,8 weeks of treatment.patients.RESULTS:Open psychology ward could provide an environment for patients to live and make free contact with the outside world. Of the 900patients with various neurosis and metal diseases,531 (59.0%) had recovery to normal,264(29.4%) had obvious improvement,81(9.0%) had improvement,and 24 (2.6%) had no therapeutic effect,with the total effective rate of 97.4% .None of the patients had any accident. HAMD score of the 169 patients with depression was (32.3±3.6) before treatment,was obviously lower at 2,4 and 8 weeks of treatment [(17.4±4.2),(11.5±4.8) and(5.8±3.6),respectively](P ＜ 0.01).CONCLUSION:The therapeutic effect of the open psychology ward in the general hospital on various neuropathies and mental diseases was 97.4% in the 900 cases,with no accident occurring during hospitalization.Depression of the 169 patients was obviously improved,indicating that it isfeasible to establish open psychology ward in general hospitals.

OBJECTIVETo explore the incidence, degree, and pattern of rib cartilage calcification in congenital microtia patients, in order to provide reference for harvesting the rib cartilage, sculpturing cartilage framework.

METHODSFrom Jun. 2013 to Nov. 2014, 383 patients (age range, 6-45 years) underwent CT scans of the chest. 11 patients with bony diseases or traumatic history were excluded. The remaining 372 patients were divided by age into four groups as 6-15, 16-25, 26-35, 36-45 years old. Twenty patients (10 male and 10 female) were selected by the order of patient identification number in each age group, thus selecting a total of 80 patients (40 male and 40 female). Retrospective study of CT scans of the chest in 80 patients and the incidence, degree, and pattern of cartilage calcification of the sixth to eighth ribs were noted. A chi-square test is conducted to test whether there are significant difference between the variables through the SPSS 19.0 software.

RESULTSOverall, 40.4% (194/480) cartilage was calcified; female patients (47.50%, 114/240) showed higher frequency of calcification than male patients (33.33%, 80/240, P = 0. 025). Calcification rates of all age groups are 1.7% (2/120), 46.7% (56/ 120), 49.2% (59/120), 64.2% (77/120). Calcification rate of 6-15 years group is lowest in all groups (P < 0.05) while other three groups have no statistical significance (P > 0.05). Calcification rates of the sixth and sevent rib cartilage were higher than those of the eighth rib cartilage in all age groups except 6-15 years group, who had a similar rate of all three ribs. Calcification rate of all three rib cartilage was significantly increased with age. Calcification rates of the amle's rib cartilage and the female's in all age groups are 3.3% (2/60) and 0.0% (0/60) (6-15 years): 33.3% (20/60) and 60.0% (36/60) (16-25 years): 40.0% (24/60) and 58.3% (35/60) (26-35 years), 56.7% (34/60) and 71.2% (43/60) (36-45 years). In 6-15 years group calcification rates of male and female had a similar rate, while female's rates were higher than male's rates in other three groups. Male and females mainly had the granular type of calcification [70.0% (56/80), 63.2% (72/114)].

CONCLUSIONSFemales who are over 16 years old should pay more attention to the possibility of middle-severe calcification before harvesting rib cartilage. These patients should take CT examination if necessary. In addition, the patients who had previous operation, or traumatic history, rib deformity, or spine deformity should select the CT examination.

Adolescent ; Adult ; Age Factors ; Calcinosis ; diagnostic imaging ; epidemiology ; Cartilage Diseases ; diagnostic imaging ; epidemiology ; Child ; Congenital Microtia ; Costal Cartilage ; diagnostic imaging ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Tomography, X-Ray Computed

OBJECTIVETo explore the clinical effect of the method by using an expanded post-auricular skin flap combined with autologous rib cartilage framework for correction of concha-type microtia.

METHODSThe operation were performed in three stages. The expander was implanted under post-auricular skin at the first stage and expanded skin flap was formed. At the second stage, the expander was taken out and the expanded skin flap was transferred with autologous rib cartilage framework and skin graft for correction of microtia. At the third stage, the reconstructed ear was revised and new concha was formed.

RESULTSFrom August 2008 to August 2011, 108 cases with 113 concha-type microtia were corrected by this method. All patients healed primarily and were followed up for 6 months to 3 years. The reconstructed ears had a good appearance and position, and were symmetric to ear on the healthy sides.

CONCLUSIONSUsing expanded post-auricular skin flap combined with autologous rib cartilage framework is a reliable method for concha-type microtia.

Adolescent ; Adult ; Cartilage ; transplantation ; Child ; Child, Preschool ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

ObjectiveTo investigate the mental state of the heroin addicts' closest relatives. Methods102 first degree relatives of 60 heroin addicts were measured using Symptom Checklist 90(SCL-90). ResultsThe SCL-90 score of somatization (1.73±0.60), depression(1.82±0.65), anxiety (1.80±0.55), mental disorder(1.56±0.49), paranoid(1.60±0.57) and count of positive items (41.41±18.87) were extremely higher than norm. ConclusionHeroin addicts'first degree relatives present some degree of somatization, depression, anxiety, mental disorder and paranoid.

Objective To study the association of the serum alanine aminotransferase (ALT) level with cardiovascular risks in patients with type 2 diabetes mellitus (T2DM).Methods A total of 676 patients with T2DM who excluded liver disease due to chronic viral hepatitis,autoimmune,drugs,alcohol,and other hereditary were selected.According to the ALT level,676 patients were assigned into elevated ALT group (ALT ＞40 U/L,126 cases) and normal ALT group (ALT 5-40 U/L,550 cases).And normal ALT group were divided into 4 groups on the interquartile distance:group 1 (ALT 5-11 U/L,108 cases),group 2 (ALT 12-15 U/L,114 cases),group 3 (ALT 16-21 U/L,127 cases),group 4 (ALT 22-40 U/L,201cases).The age,duration of diabetes,body mass index (BMI),waist-to-hip ratio (WHR),blood pressure,triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesferol (HDL-C),low density lipoprotein cholesferol (LDL-C),fasting plasma glucose (FPG),2 h postprandial blood glucose (2 hPG),glycosylated hemoglobin (HbA1c),uric acid (UA),fasting insulin and homeostasis model assessment insulin resistance index (HOMA-IR) was compared among these groups.Results The levels of BMI,WHR,diastolic blood pressure,FPG,2 hPG,HbA1c,fasting insulin,TG,HOMA-IR and UA in elevated ALT group were higher than those in normal ALT group [(26.80 ± 3.60) kg/m2 vs.(23.40 ± 3.50) kg/m2,0.95 ±0.05 vs.0.91 ± 0.05,(75.3 ± 9.3) mm Hg (1 mm Hg =0.133 kPa) vs.(69.2 ± 9.5)mm Hg,(9.24 ± 2.56)mmol/L vs.(8.53 ± 2.78) mmol/L,(15.25 ± 4.62) mmol/L vs.(14.37 ± 5.06) mmoUL,(8.31 ± 1.76)％ vs.(7.78 ± 1.94)％,(10.76 ± 6.78) mU/L vs.(7.85 ± 7.04) mU/L,(2.73 ± 2.40) mmol/L vs.(2.20 ± 2.78)mmol/L,4.13 ± 2.76 vs.3.06 ± 2.63,(332.42 ± 95.12) μ mol/L vs.(285.14 ± 79.53) μ mol/L] (P ＜ 0.05),and HDL-C was lower than that in normal ALT group [(1.06 ± 0.27) mmol/L vs.(1.15 ± 0.57) mmol/L] (P ＜0.05).Compared with that in normal ALT group,the age was younger,and the duration of diabetes was shorter in elevated ALT group [(49.6 ± 10.5) years vs.(57.5 ± 11.3) years,(37.9 ±42.0) months vs.(54.5 ± 57.8) months] (P ＜ 0.05).The levels of FPG,2 hPG,HbA1c and UA in group 4 were higher than those in group 1,2,3 [(9.18 ± 3.01) mmol/L vs.(8.33 ± 2.57),(8.38 ± 2.52),(8.45 ± 2.73) mmol/L;(14.56 ± 4.80) mmol/L vs.(13.15 ± 5.72),(13.42 ± 4.56),(13.50 ± 5.17) mmol/L; (7.81 ± 1.98)％ vs.(6.76 ± 1.84)％,(6.79 ± 2.10)％,(6.88 ± 2.43)％; (288.24 ± 78.26) μ mol/L vs.(271.15 ± 75.43),(273.27 ± 71.25),(275.56 ± 69.57) μ mol/L] (P ＜ 0.05) ; HOMA-IR was lower than that in group 1,2,3(2.67 ± 2.65 vs.2.84 ± 2.53,2.98 ± 3.10,3.12 ± 2.57,P ＜ 0.05).Conclusion TheincreaseofALTlevel is associated with the clustered cardiovascular risk factors and insulin resistance in patients with T2DM.

Objective To analyze the correlation between mutation in JAK2-V617F gene in peripheral blood mononuclear cells and thrombotic events in patients with myeloproliferative.Methods Investigation of thrombosis in 391 patients with MPN,using QRT-PCR to detect JAK2-V617F gene mutation in peripheral blood of patients.Result 105 cases of thrombotic events in 391 MPN patients (26.9％),84 cases of thrombotic events in 273 JAK2-V617F gene mutation positive patients (30.8 ％),however,21 cases of thrombotic events in 118 J AK2-V617F gene mutation negative panents (17.8 ％).The difference between the two groups was statistically significant (x2 =32.30,P＜0.01).In the PV group,45 cases of thrombosis events in JAK2-V617F positive patients (29.2 ％),6 cases of thrombosis events in JAK2-V617F negativepatients (42.9％),there was significant difference between the two groups (x2 =2.13,P＞0.05).In the ET group,18 cases of thrombosis events in JAK2-V617F positive patients (32.2％),9 cases of thrombosis events in JAK2-V617F negative patients (15.8％),there was significant difference between the two groups (x2 =12.32,P＜0.01).In the PMF group,21 cases of thrombosis events in JAK2-V617F posinve patients (33.3 ％),6 cases of thrombosis events in JAK2-V617F negativepatients (12.8 ％),there was significant difference between the two groups (x2 =14.32,P＜0.01).Conclusion JAK2-V617F positive MPN patients were more susceptible to thrombotic events especially in patients with ET and PMF.