Three-parent test tube baby technology is important to solve the mitochondrial genetic disease.Once available,it raises greatly ethical controversy such as breaking traditional family values,hitting the religious belief,existing unknown risks,correctly handling the failed embryo,as well as the influence on the social status of the babies.Regarding these controversy,we can discuss it from several aspects.Because the development of ethics is behind the progress of science and technology,we should affirm the value of three-parent test tube baby technology and balance the development of science and technology with respecting the religious beliefs.Strict supervision system and standard application system reflect our respect for life.Incomprehension to the unknown things should become the motivation of our inquiry.We should face up to our fear of three-parent test tube baby technology,and thus to strengthen research and deepen understanding.Based on the above argument,this paper puts forward the ethical principles that should be followed in the development of three-parent test tube baby technology,namely respect,benefit,no harm and justice.

Purpose It is still undetermined about the application of regular ultrasound (US) combined with ultrasonic elastography (UE) in diagnosing superficial lymph nodes disease.Therefore our aim is to evaluate the value of US combined with UE in diagnosing superficial lymph nodes disease.Materials and Methods The ultrasonography and pathological data of 214 patients (with 266 superficial lymph nodes) were analyzed retrospectively.The US and UE data were compared with the pathologic results.Results The elastic classification of reactive hyperplastic and lymphomatous lymph nodes were no greater than grade 3,respectively;that of malignant metastatic lymph nodes was greater than grade 4.The accuracy of UE or US+UE was higher in diagnosing reactive hyperplastic lymph nodes and metastatic lymph nodes' nature compared with US (P＜0.05).The sensitivity and accuracy of US+UE in diagnosing malignant superficial lymph nodes were higher than those of US (90.13％ vs.72.37％;86.09％ vs.68.05％,P＜0.05).Compared with UE alone,those of US+UE were also higher (90.13％ vs.77.63％;86.09％ vs.72.56％,P＜0.05).Conclusion The accuracy of differential diagnosis of benign or malignant superficial lymph nodes can be improved by US+UE method.

Objective To search one ultrasonic method which could evaluate gastric emptying function accurately.Methods The gastric emptying time of 74 normal volunteers were measured by radioisotope scanning and different ultrasonic methods which including gastric antrum area,gastric antrum volume and whole gastric cylinder method.Results The gastric emptying time measured by whole gastric cylinder method related best with those measured by radioisotope scanning (r =0.79).The gastric emptying time was no significant difference between the cylinder method and radionuclide scanning (P ＞0.05).Compared with radionuclide scanning,those measured by gastric antrum area and gastric antrum volume had significant differences.Conclusions The whole gastric cylinder method can accurately reflect the gastric emptying function.

Evacuation of intracerebral hematomas in 38 hypertensive patients was reported. Hematomas were found in the internal capsule in 24 patients, subcortex in 5. cerebellum in 7 and brain stem in 2. The volume of hematoma was less than 2ml (in the brain stem) in 2 patients, 20-50ml in 15, and over 100ml in 6. The fluid hematoma was to tally aspirated with stereotactic technique in 7 patients. In 17 patients, over 80% of hematoma was evacuated, and in 14 about 60-80% of hematoma was evacuated by the same technic. The results of the operation were good in 11 patients (29.0%), while in 29% there was a mild disability, and in 12 (31.5%) there was a marked disability, 4(10.5%) died.

Since CRISPR/Cas9 has been discovered,it opens a new era for gene therapy with its low cast,high efficiency,short cycle,easy operation and other characteristics.In 2015,Huang Junjiu had used the technique to nodify human embryonic cell for the first time,leading to widespread attention at home and abroad.For nearly 50 years,ethical discussion of gene therapy has never stopped.Through reviewing the development of gene therapy,this paper analyzed several key issues of ethical controversy in gene therapy,such as safety,effectiveness,justice,right,interest orientation and so on,and put forward that gene therapy and ethics are not two opposite sides and cannot be treated separately,the development of gene therapy should follow certain ethical norms and technical norms and it should use the bioethical principles to direct gene therapy.

Objective To evaluate the impact of hepatobiliary surgery in a tertiary public hospital on its core medical operation indicators after the implementation of subspecialty reform.Methods The Department of Hepatobiliary Sur-gery,which implemented the subspecialty reform,was the experimental group,and six surgical departments with-out subspecialties were the control group.Seven indicators in the dimensions of medical quality,medical efficiency,and rational use of medication were collected from September to December 2022,and the difference between the experimental group and the control group was analyzed by the differences-in-differences method using the Septem-ber data before the implementation of sub-specialty reform as the baseline value.Results After the subspecialty re-form,the changes of the indicators of the percentage of discharged patients for surgery,intensity of antimicrobial drug use and average hospital stay in hepatobiliary surgery were better than those of the control group;the percentage of discharged patients for minimally invasive surgery and the percentage of medical service revenue were inferior to those of the control group;the intergroup differences of the two indicators of the percentage of discharged patients for level IV surgery and the case-mix index were not significant.Conclusion By setting up similar control departments in the same period and excluding the influence of external confounding factors on the study results,overall,the core medical operation indexes of hepatobiliary surgery were slightly better than those of the control group,but the advantage was not obvious,which might be related to the short observation time after the subspecialty reform,and its long-term effects need to be continuously followed up and analyzed.

Objective:To investigate the efficacy of liposomal doxorubicin intensive preconditioning regimen and allogeneic hematopoietic stem cell transplantation (allo-HSCT) in treatment of leukemia.Methods:The data of 20 patients with intensive preconditioning regimen allo-HSCT who were admitted to Shenzhen Second People's Hospital from January 2016 to June 2017 were retrospectively analyzed. The transplantation effect, occurrence of complications and prognosis of patients were analyzed.Results:The median time of granulocyte engraftment was 17 d (13-23 d); the median time of platelet engraftment was 22.5 d (minimum 13 d, maximum >90 d). The acute graft-versus-host disease (GVHD) and chronic GVHD occurred in 2 cases and 1 case, respectively. Eight cases occurred hemorrhagic cystitis, 15 cases occurred Epstein-Barr viremia, 8 cases occurred cytomegaloviremia, 1 case occurred sepsis, 1 case occurred acute liver injury, and 2 cases occurred fungal pneumonia. The median follow-up time was 31.7 months (0.8-53.8 months). One patient died of intracranial infection on the 25th day after transplantation; 3 patients relapsed during the follow-up period, and 2 of them died; the other 16 patients carried 100% donor genes during the follow-up period.Conclusions:The liposomal doxorubicin intensive preconditioning regimen and allo-HSCT have a good effect on leukemia. Increasing the intensity of pretreatment does not increase the treatment-related adverse reactions. The incidence rates of Epstein-Barr viremia and cytomegaloviremia are high, but they are improved after active treatment.

Objective To investigate the effects of WNK3 kinase on the regulation of large-conductance calcium-activated potassium channels (Maxi K channels) on African green monkey kidney fibroblast-like cells (Cos-7 cells) and its mechanisms.Methods (1) Cos-7 cells were transfected with 0,0.6,1.2,1.8 μg WNK3 plasmid+0.5 μg Maxi K plasmid.The total protein expression of Maxi K channel and the phosphorylation of mitogen-activated protein kinase (MAPK) extracellular regulated kinase-1 and-2 (ERK1/2) were detected by Western blotting.(2) Cos-7 cells were divided into the control group (2.5 μg Maxi K plasmid) and the experimental group (2.5 μg WNK3 plasmid+2.5 μg Maxi K plasmid).Cell surface biotinylation was used to investigate the cell surface protein expression of Maxi K channel in Cos-7 cells.Immunoprecipitation and Western blotting were used to detect the ubiquitination of Maxi K channel protein.(3) WNK3 kinase was knocked down by WNK3 siRNA.The lysosomal degradation pathway was blocked by the proton pump inhibitor (Baf-A1).Cos-7 cells were divided into Maxi K+negative control siRNA group,Maxi K+WNK3 siRNA group and Maxi K+WNK3 siRNA+Baf-A1 group.The protein expression of Maxi K channel protein was detected by Western blotting.Results (1) Compared with those in 0 μg WNK3 plasmid groups,in 0.6,1.2,1.8 μg WNK3 plasmid groups the total protein expression of the Maxi K channel increased and the phosphorylation level of MAPK ERK1/2 reduced on a dose-dependent manner (all P ＜ 0.01).(2)Compared with those in the control group,the total protein expression and cell surface membrane protein expression of the Maxi K channel increased in the experimental group (P ＜ 0.01),while the ubiquitination of the Maxi K channel protein reduced (P ＜ 0.01).(3) Compared with the Maxi K +negative control siRNA group,the expression of Maxi K protein reduced in the Maxi K+WNK3 siRNA group (P ＜ 0.01),but did not change in the Maxi K+WNK3 siRNA + Bar-A1 group (P ＞ 0.05).The expression of Maxi K protein in Maxi K+WNK3 siRNA+Baf-A1 group was higher than that in Maxi K+WNK3 siRNA group (P ＜ 0.01).Conclusions WNK3 kinase inhibits the lysosomal degradation pathway of Maxi K channel protein by reducing the ubiquitination of Maxi K channel,and promotes the expression of Maxi K channel protein in cells and on cell membrane.These effects may be achieved by suppressing MAPK ERK1/2 signal transduction pathway.

Objective To evaluate the diagnostic value of virtual touch imaging quantification (VTIQ) technique in the differential diagnosis between benign and malignant breast lesions.Methods From September to December 2015, the imaging data of 115 breast lesions in 100 patients confirmed by pathology on conventional ultrasound (2DUS) and VTIQ were retrospectively analyzed. The breast nodules were examined by 2DUS firstly and then the lesions were classified by breast imaging reporting and data system (BI-RADS). The maximum, minimum and average of shear wave velocity (SWV) values were obtained from multiple SWV measurement under the VTIQ speed mode. According to the pathology results, receiver operating characteristic (ROC) curve were plotted to determine the most accurate SWV value and the cut-off value for differential diagnosis. And the diagnosis efficiency was compared between 2DUS and VTIQ.Results There were 38 malignant nodules and 77 benign nodules in 115 breast nodules. BI-RADS grading≥4b level was set as the malignant nodules and grading≤ 4a level as the benign nodules. The SWVmax, SWVmin, and SWVmean on VTIQ of benign and malignant breast nodules were (5.11±1.61) m/s, (2.90±0.86) m/s, (3.73±1.02) m/s, and (7.22±0.94) m/s, (4.33±1.31) m/s, (5.73±1.11) m/s. There were significant differences between malignant and benign breast nodules in SWVmax, SWVmin, and SWVmean on VTIQ (t=-7.442,-7.047,-9.356, allP<0.001). Based on the area under curve of ROC, the SWVmean value in the nodule was the best value in comparison with other SWV values. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of diagnose malignant lesion conducted by 2DUS were 89.5％, 85.7％, 87.0％, 0.63 and 0.84, respectively. The cut-off value of VTIQ mean was 4.34 m/s. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the diagnosis of malignant lesion conducted by VTIQ were 89.5％, 85.7％, 87.0％, 0.76 and 0.95, respectively. The diagnosis efficiency of VTIQ was better than 2DUS.Conclusion The study proved that the VTIQ SWVmean is the best parameter for differential diagnosis and VTIQ plays an important role in differential diagnosis of breast nodules.

Objective:To analyze the clinical characteristics of patients with de-novo non-alcoholic fatty liver disease (de-novo NAFLD) and patients with de-novo NAFLD combined with metabolic syndrome (MS) after liver transplantation (LT) , and to determine the related risk factors.Methods:Patients who underwent LT at the Organ Transplantation Center, the Affiliated Hospital of Qingdao University, from Jan. 2016 to Oc. 2020 and were monitored until Oct. 2021 were gathered. The recipients were divided into the group with/without de-novo NAFLD, and LT recipients with de-novo NAFLD were divided into the group with/without combined MS. Clinical characteristics of the LT recipients with de-novo NAFLD combined with MS were analyzed. Logistic regression analyses were performed to identify the risk factors for LT recipients with de-novo NAFLD and those with combined MS.Results:A total of 324 LT recipients with a median follow-up of 2.9 years (range: 2.0-4.3 years) were included in the study. De-novo NAFLD was diagnosed in 21.0% (68/324) of the LT recipients, and MS was diagnosed in 44.1% (30/68) of these patients. Compared with LT recipients without de-novo NAFLD, those with de-novo NAFLD had higher preoperative body mass index (BMI) , blood glucose, glycated hemoglobin levels and lower platelet levels, and longer postoperative follow-up, higher BMI, waist circumference, albumin, triglycerides (TG) , low-density lipoprotein (LDL) , blood glucose, glycated hemoglobin levels, and the incidence of MS (all P<0.05) . Preoperative platelets, glucose, postoperative albumin, LDL and BMI were independent risk factors for predicting de-novo NAFLD after LT (all P<0.05) . Preoperative glucose performed well in predicting the occurrence of de-novo NAFLD (threshold: 5.5mmol/L, P<0.001, AUC=0.678) . The differences in Pre-LT blood glucose, post-LT BMI, waist circumference, prevalence of prediabetes or diabetes, fatty liver index (FLI) , and NAFLD fibrosis score (NFS) between de-novo NAFLD LT recipients with and without combined MS were significantly different (all P<0.05) . Conclusions:The incidence of de-novo NAFLD after LT is noteworthy, and LT recipients with de-novo NAFLD are more likely to have a combination with MS. In preoperative treatment, keeping blood glucose to 5.5 mmol/L or below trends helps to lower the risk of de-novo NAFLD following LT. LT recipients’ nutritional state and lipid levels require prompt care. High albumin levels might not be a desirable thing. De-novo NAFLD LT recipients with concomitant prediabetes or diabetes may imply an increased risk of developing comorbid MS during the post-LT follow-up. Controlling FLI levels in LT recipients with de-novo NAFLD may reduce the risk of developing comorbid MS.