The public ethics consciousness,with medical ethics included,fundamentally depends on the gradual improvement in the self-identity of human as objective itself.However,the improvement of humanistic consciousness is a long and painful process.Former recognition of historical culture,including the humanistic ideal in traditional Chinese ethical thoughts and systemic rational thoughts in modern western society,mainly employs transcendental test of abstract anthroposophy as its cultural premise,superficially enhancing certain individuals and their thoughts,motives,and objectives to historical ontology,but actually resulting in the absence of human individuals in realistic history.The self-conscious improvement of human-oriented public ethics can only be realized by the subjective humanistic consciousness which undergoes the regression from axiology,epistemology,to existence theory,making human realize that they themselves are the utmost purpose of all values and significances.

Objective To describe the effect of loop diuretic on renal function in patients with chronic heart failure.Methods Data were of 211 impatients diagnosed as HF collected in a nested case-control study.The association of application of loop diuretic with renal function was assessed to identify whether loop diuretic was an independent risk factor of worsening renal function(WRF).To identify WRF,we defined serum creatinine level as a rise ≥26.5 μmol/L compared to the level at admission.Therefore,the subjects were divided into case group(serum creatinine level ≥ 26.5 μmol/L,n =66)and control group(serum creatinine level ＜ 26.5μmol/L,n =145).Results The doses of loop diuretic were higher in the case group([385.17 ± 49.37]mg)than the control group([244.50 ± 34.82]ag)(P ＜ 0.05),but it was not independent risk factor of WRF (P＞0.05).Creatinine level and NYHA class at admission were independent risk factor for WRF,with OR of 2.248(95 ％ CI:1.088-4.647)and 2.485(95 ％ CI:1.385-4.459)respectively(Ps ＜ 0.05).Conclusion The doses ofloop diuretic were not independent risk factor of WRF,creatinine level and severity of HF at admission are the most important predictors of the occurrence of WRF.

Objective To sum up the experience for the treatment of splenic trauma. Methods Data of 129 cases of traumatic splenic rupture from 1984 to 2004 were retrospectively analyzed. Results Conservative management was undertaken in 17 cases, splenorrhaphy in 16 cases, total splenectomy in 86 cases, partial splenectomy in 8 cases, and splenic autotransplantation in 23 cases. The results were all satisfactory. Conclusion In splenic trauma, treatment modality should be on adopted case to case basis according to the types of splenic rupture. Combined splenic salvage can be used on certain conditions.

The ketoreductase (KR) domain in the first extending module of the polyketide synthase (PKS) catalyzes the reductions of both an α-keto group and a β-keto group in the biosynthesis of bacillaene, suggesting the intrinsic substrate promiscuity. In order to further investigate the substrate specificity, the KR domain (BacKR1) was heterologously overexpressed in Escherichia coli. In vitro enzymatic analysis showed that only one of the four diastereomers was formed in the reduction of the racemic (±)-2-methyl-3-oxopentanoyl-N-acetylcysteamine thioester catalyzed by BacKR1. In addition, BacKR1 was revealed to catalyze the reductions of cyclohexanone and p-chloroacetophenone, indicating the potential of KR domians of PKSs as biocatalysts.
Bacterial Proteins ; genetics ; metabolism ; Catalysis ; Cyclohexanones ; metabolism ; Escherichia coli ; enzymology ; Polyketide Synthases ; genetics ; metabolism ; Protein Structure, Tertiary ; Substrate Specificity ; omega-Chloroacetophenone ; metabolism

Objective To investigate the role of NRAGE subcellular localization in the EMT and radioresistance of esophageal cancer cells.Methods EMT model cells were established by the treatment of TE13 cells with TGF-β1.To verify the establishment of EMT model and the phenotype of EMT-like TE13R120 cells,EMT marker mRNA and protein were detected by Real-time PCR and Western blot,respectively.Real-time PCR was also used to detect the expression of NRAGE mRNA in three groups.Total NRAGE protein,cytoplasm protein and nuclear protein were measured by Western blot.Results It was found that TGF-β1 could induce morphological alterations of TE13 cells from epithelial to mesenchymal and change the expressions of EMT maker E-cadherin and vimentin (t =13.56,-232.84,P ＜ 0.05),indicating the successful establishment of EMT model cells.Similar expression trends of EMT makers were observed in TE13R120cells (t=15.84,-54.54,P＜0.05).NRAGE mRNA (t=-8.73,-5.62,P＜ 0.05) and total protein in both EMT model cells and TE13R120 cells were higher than that in TE13 cells,especially for the nuclear proteins.However,no differences in NRAGE cytoplasm protein expression were found among the three groups.In addition,there were also no difference of NRAGE mRNA (t =-0.88,P ＞0.05),cytoplasm and nuclear protein between TE13R120 cells and EMT model cells.Conclusions The radioresistant cell line TE13R120 has the EMT-like phenotype that may cause cell radioresistance by changing the subcelluar localization of NRAGE.

Objective To explore the relationship between esophageal carcinoma extensive infiltration and lesion length and 252 Cf intracavitary brachytherapy,and to evaluate its prognostic influence.Methods Thirty-two patients with esophageal carcinoma were treated by external beam and 252Cf intracavitary radiation.The patients were first treated with conventional fractionated radiation to a dose of 38 Gy over 4 weeks,with 5 daily fractions of 2 Gy per week,and then treated with external and intracavitary radiation concomitantly (4.0 Gy per fraction,once a week on every Saturday to 12 Gy in 3 fractions).The total dose of external irradiation was 50 Gy.Results The local control rate (LCR) at 1,3 and 5 years was 93.75％,76.70％ and 65.75％ in the patients with ≤5 cm lesion (NMT5 group),and 60.94％,27.08％ and 27.08％ in the patients with ＞5 cm lesion (MT5 group),respectively (x2 =7.01,P ＜ 0.05).The 1-,3-and 5-year survival rate (SR) was 93.75％,56.25％ and 43.75％ in the NMT5 group,and 75.00％,18.75％,12.50％ in the MT5 group,respectively (x2 =5.96,P ＜ 0.05).The LCR at 1,3 and 5 years was 92.31％,73.85％ and 61.54％ in the patients with ≤1.5 cm infiltration depth (NMT1.5 group),and 67.67％,35.45％ and 35.45％ in the patients with ＞ 1.5 cm infiltration depth (MT1.5 group),respectively (x2 =3.87,P ＜ 0.05).The 1-,3-and 5-year SR was 92.31％,61.54％ and 46.15％ in the NMT1.5 group,and 73.68％,21.05％ and 15.79％ in the MT1.5 group,respectively (x2 =6.24,P ＜ 0.05).LCR and SR in the patients with ≤5 cm lesion and ≤2 cm infiltration depth were significantly better than those with ＞ 5 cm lesion and ＞ 2 cm infiltration depth (x2 =10.09,7.97,P ＜ 0.05).Conclusions The patients with ≤5 cm lesion length or those with ≤ 1.5 cm infiltration depth,might become the most adaptable indication for 252 Cf intracavitary radiation.In addition,those patients with ≤2 cm infiltration depth and ≤5 cm lesion length were also suitable for 252Cf intracavitary radiation.

AIM:To explore the effects of pGRIM-19-si-survivin co-expression plasmid carried by human at-tenuated Salmonella on prostate cancer subcutaneous xenograft growth in nude mice .METHODS: Prostate cancer xeno-graft model was established in nude mice .Co-expression plasmids carried by attenuated Salmonella were introduced by in-traperitoneal injection .The xenograft volumes were monitored timely .Immunohistochemical staining , RT-PCR and TUNEL assay were applied to investigate the related mechanisms that pGRIM-19-si-survivin inhibited tumor growth in vivo.RE-SULTS:Compared with psi-survivin and pGRIM-19 carried by attenuated Salmonella ( control groups ) , the tumor volumes were reduced markedly in pGRIM-19-si-survivin plasmid group .The mean shrinkage rates were 2.36 and 3.02 times. pGRIM-19-si-survivin co-expression plasmid carried by attenuated Salmonella inhibited survivin expression but strengthened GRIM-19 expression obviously (P<0.05).The mRNA expression of apoptosis-related proteins such as Bcl-xL, Stat3, cy-clin D1 and c-Myc was inhibited , and the vascular endothelial growth factor ( VEGF) mRNA and Ki67 protein were also in-hibited, but the caspase-3 mRNA expression was up-regulated ( P<0.05 ) with significant cell apoptosis .CONCLU-SION:pGRIM-19-si-survivin co-expression plasmid carried by human attenuated Salmonella inhibits the growth of prostate cancer subcutaneous xenografts in nude mice by promoting cell apoptosis and inhibiting prostatic cancer proliferation .

Objective To investigate the expression of cyclooxgenase 2 (COX-2) and vascular endothelial growth factor (VEGF) in clear cell renal cell carcinoma (CCRCC) and their correlation with Prognosis. Methods EnVision immunohistochemistry was used to determine the expression of COX-2 and VEGF in 80 CCRCC tissues and 20 normal kidney tissues .The relationship between the above marks and prognosis were analyzed. Results The positive rates of COX-2[65.00 % (52/80) vs 10.00 % (2/20), x2= 7.760, P= 0.021]and VEGF[61.25 % (49/20) vs 20.00 (4/80),x2 = 8.870, P= 0.012]were much higher in CCRCC than those in normal kidney. The expression of COX-2 was correlated with TNM stage (x2 = 8.200,P =0.005), histological grade (x2 = 13.860, P = 0.000) and lymph node metastasis (x2 = 6.050, P = 0.001) in CCRCC, but not with age (x2 = 0.560, P = 0.663) and diameter of tumor (x2 = 0.700, P = 0.528). Both COX-2 expression and VEGF expression were associated significantly with prognosis in CCRCC (x2 = 18.280,P = 0.038;x2 = 6.420, P= 0.042, respectively). There was a positive correlation between COX-2 and VEGF in CCRCC (r =0.485, P < 0.01). Conclusion COX-2 is related to prognosis in CCRCC and can be used as prognostic indicators in patients.

Objective To analyze and compare the differences in application of 24-hour dietary recall and dietary balance index (DBI) in dietary survey and evaluation of patients with type 2 diabetes mellitus,meanwhile investigate their nutrition status.Method This was a cross-sectional study.A total of 100 type 2 diabetes inpatients at the age of 19-59 were recruited from Shanghai Jiaotong University Affiliated Sixth People's Hospital from December 2013 to February 2014.They were surveyed and evaluated by 24-hour dietary recall and DBI respectively.Result The micronutrient intake in patients with type 2 diabetes was not sufficient.Compared with RNI,the intake of vitamin B1,B2,and calcium was less than 50％.The average of DBI lower bound score (DBI-LBS) of the 100 patients was 32.1±6.1,65％; the patients were in moderate or severe deficit of food intake.DBI higher bound score (DBI-HBS) was 4.4±2.8.No significant excess intake problem was found.Dietary quality distance was 36.4±6.9.Eighty-seven percent of them had a dietary patterns of mode B.Conclusion Dietary patterns in type 2 diabetes patients were not reasonable.Nutrition education and nutrition intervention for type 2 diabetes should be emphasized.The two methods can be used to evaluate dietary quality independently,but it would be better to evaluate the quality of the patients' diet using two dietary survey methods together.

BACKGROUNDLung cancer is still the most common cause of cancer death. Although it is reported that the 5-year survival rate for lung cancer has been greatly increased, surgical results are controversial. The aim of this study is to investigate and evaluate the improvement of survival of lung cancer surgically intervened in PUMC hospital during the last 15 years.

METHODSFrom January 1989 to December 2003, 1574 cases of lung cancer underwent surgical treatment and obtained follow-up. The results were retrospectively a- nalysed . All cases in this series were divided into two groups according to time, group A (1999-2003) and group B (1989-1998), and the differences of survival rate between group A and group B were compared.

RESULTSThe morbidity and mortality of group A decreased significantly when compared to group B (11.2% vs 19.2%, 1.06% vs 1.93%, respectively, P < 0.01). However, the 3- and 5-year survival rates had been obviously raised from 42.35% to 56.07%, and from 28.46% to 38.99%, respectively (P < 0.05 ). A significant improvement in survival was observed in patients with stageI, stage II and stage IIIA, but not in stage IIIB and stage IV. Also, the patients with lobectomy had better results but those with exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection did not show better results.

CONCLUSIONSLobectomy associated with systematic dissection of mediastinal lymph nodes has become the standard mode for the resectable lung cancer. Combination of complete resection and lymph nodes dissection, with postoperative adjuvant chemotherapy based on platinum/3rd generation medicine, have preliminarily been justified and proved an important approach for effective improvement of long-term survival of lung cancer.