This study based on an ethical review of the kidney donation from a young man to his elder relative.We discuss the problems existing in present field of intra-vital organ transplantations,as well as its risk and the ethics review mode.It is recommended that ethics review is performed as a complete procedure,which should not only present in certain format,but also emphasize weighing the advantages and disadvantages of both patients and donors;intra-vital organ transplantations between relatives should also follow the principle of "no compensation and non-commercialization";hospitals should give out the judgment under sufficient considerations of both patients' and donors' benefits within the scope of laws,as well as taking into account of other factors such as prospective outcome of the operations,rather than barely basing on the risk probabilities.

Objective To detect the serum level of complement 1q (C1q) and anti-C1q autoantibodies (C1qAb) in systemic lupus erythematosus (SLE) patients to analyze the correlation of serum level of C1q and C1qAb with renal lesion and disease activity in SLE. Methods The serum level of C1q and C1qAb were detected by single radial lmnmnodiffusion and enzyme-linked immunosorbent assay respectively. Results The serum level of C1q in SLE patients was significantly lower than that of the control groups. The serum level of C1qAb in SLE patients was significantly higher than that of the control groups. There was a strong correlation between the serum level of C1q and C1qAb in SLE patients. SLE patients in flare stage showed a significantly higher level of serum C1qAb and a lower level of serum C1q than stable patients. Lupus nephritis(LN) patients showed a significantly higher level of serum C1qAb and a lower level of serum C1q than non-LN patients. Conclusions Low level of serum C1q and the high level of serum C1qAb are correlated with SLE. The serum level of C1q and C1qAb are significantly correlated with renal lesion and disease activity of SLE patients.

Objective To explore the histocompatibility and plasticitity of hydroxyapatite/high-density polyethylene composite (HMPE). Design Experimental study. Participants Forty-five rabbits. Methods Rabbits were randomly devided into HA/PE, HA and PE surgical groups, every group included 15 rabbits. Osteoeetomy of orbital rim and implantation (HA/PE, HA and PE materials were used) were performed on 3 groups of the rabbits. At 1st week, 4th week, 8th week, 12th week and 24th week of postoperation, we took out the samples from the rabbits separately in each group and did histopathologic and electron microscope examinations. Main Outcome Measures Physical signs of the implant combination with the bone. The bone cell appeared in the implants. Results After 12 weeks, the calcium salts deposit like bone plate with some osteoblast inside the HA/PE implants was observed. After 8 weeks, the calci- um salts deposit inside the HA plants was observed. In the PE implants, nothing could be seen but some fibrous connective tissue. Conclusion HMPE is an ideal repair material especially for orbital bone.

Objective To describe the clinical features of convulsive status epileptieus (CSE) in our hospital and to provide a basis for future CSE prevention and treatment. Methods Patients with CSE hospitalized from January 1996 to October 2007 were prospectively observed. Logistic regression was used to identify predictors of prognosis. Results All 220 eases of CSE were prospeetively analyzed, a hundred and two patients(46.4%) originated from rural areas. The primary cause of CSE was central nervous system(CNS)infectian (72cases, 32.7%), followed by discontinuation or reduction of antiepileptie drugs (AEDs, 35 cases,15.5%). The median duration of CSE was 5 hours and median duration of seizures before treatment was 2 hours; both were longer in rural patients (7.0 and3.5 hours respectively) than in urban patients (3.0 and 2.0 hours, Z=-3.433,-1.558,both P<0.05). The fatality rate by the time of discharge was 15.9%. Logistic regression analysis showed that the duration of CSE (χ2=20.941), a history of epilepsy (χ2=4.910), and respiratory depression (χ2=16.086) were independent predictors of CSE prognosis (allP<0.05) . Comparisons between these data of USA and Europe were made. Conclusions CSE occurs mostly in rural population and epilepsy patients. CNS infection and withdrawal or reduction of AEDs in patients with epilepsy were important triggers of CSE. Antiepileptic therapy for status epilepticus in China falls behind that in the European countries.

Objective To assess the value of combined detection of enterovirus nucleic acid and antibody in early etiological diagnosis for hand-foot-and-mouth disease ( HFMD).Methods A case-control study was conducted.A total of 1 066 cases of children clinically diagnosed with HFMD from Hangzhou Children′s Hospital were involved into the research group from January to June 2014, consisting of 401 common cases and 665 severe cases; Throat swabs and serum samples from these children underwent combined detection for EV71/CA16/EV of enterovirus nucleic acid by fluorescence quantitative RT-PCR and for EV71/CA16-IgM by ELISA.All data were analyzed with SPSS 16.0.Results The total positive rate of enterovirus nucleic acid EV71/CA16/EV by fluorescence quantitative RT-PCR in the 1 066 cases of children clinically diagnosed with HFMD was 75.52%( 805/1 066 ) ( 95%CI: 72.80%-78.05%).But the total positive rate of combined detection was 91.46%( 975/1 066 ) ( 95%CI:89%.58-93.04%).The total positive rate of combined detection is higher than that of RT-PCR test(χ2 =98.338,P=0.000).The positive rate of EV71 type of combined detection was 64.63%(689/1 066)(95%CI:61.67%-67.49%),which is 15.38%higher than that of RT-PCR test 49.25%(525/1 066)(95%CI:46.21%-52.29%)(χ2 =51.453, P=0.000).In 665 severe cases of HFMD, the total positive rate of combined detection was 96.69%(643/665)(95%CI:94.95%-97.87%), which is higher than that of RT-PCR test 79.25%(527/665)(95%CI:75.92%-82.22%)(χ2 =95.607, P =0.000).In the severe cases, the positive rate of EV71 type of combined detection was 87.52%( 582/665 ) ( 95%CI:84.71%-89.89%) , which is 18.95% higher than that of RT-PCR test 68.57%(456/665) (95%CI:64.87%-72.06%) (χ2 =69.665, P=0.000).In the fatal cases, the positive rate of EV71 type of combined detection was 95.92%(94/98) (95%CI:89.28%-98.68%).Conclusions The combined detection of enterovirus nucleic acid and specific IgM antibody can significantly increase the positive rate of HFMD, especially for severe cases.The combine detection increases both the total positive rate and EV71 positive rate.Thus it has a high potential for becoming a new guidelines for laboratory diagnosis of HFMD.

Objective Improve understanding the clinical features of bladder varices with portal hypertension. Methods A 63-year-old male manifested seven episodes of painless gross hematuria and had a 9-year history of liver cirrhosis. Physical examination was unremarkable. There was thrombocytopenia of 56 × 109/L. Ultrasound showed splenomegaly. Cystoscopy revealed a 3. 0 cm × 5.0 cm sized hemangiomatous on the left lateral and anterior wall of the bladder. Computed tomography angiography revealed the vesical varicose veins flowing into the inferior mesenteric vein and then to the splenic vein. Results The patient was diagnosed vesical varices, liver cirrhosis and portal hypertension. Performed perivesical devascularization and in ultrasound one month after the operation the variees disappears. Conclusion Vesical varices can occur in liver cirrhosis and portal hypertension patients without history of abdominal and pelvic operation, and can be treated by perivesical devascularization.

Objective This study seeks to use a meta-analytical approach to quantitatively assess the results of applying the problem-based learning(PBL) teaching model and the traditional lecture-based learning(LBL)teaching model to basic medical courses in undergraduate medical edu-cation. Methods The CNKI and VIP databases were electronically searched to retrieve randomised controlled trial studies that examined the use of PBL methods for basic medical courses in under-graduate medical education. In these studies PBL teaching model was used in experiment group and LBL teaching model was used in control group. Pass rate or test scores was used to evaluate the effect of learning. The retrieved documents ranged from the time that each database was first constructed to December 2012. After two researchers performed literature screening independently, data extraction, and quality assessment procedures in strict accordance with the inclusion and exclusion criteria of this study, the Stata 11.0 software package was utilized to conduct the meta-analysis. Results This meta-analysis examined 28 studies that included a total of 3703 subjects. The modified Jadad scores of 20 studies(71.4%) were less than 4, and those of 8 studies(28.6%) were more than or equal to 4. The meta-analysis revealed that compared with the traditional teaching model, the PBL teaching model did not produce improved examination passing rates for a course [relative risk(RR):1.05, 95%confidence interval(CI):(0.99, 1.10), P=0.098] but could improve examination scores for a course [standardized mean difference (SMD): 0.73, 95% CI: (0.51, 0.96), P<0.001]. Conclusion For basic medical courses in undergraduate medical education, compared to LBL teaching, PBL teaching can improve students' test scores but cannot improve students' pass rate. PBL used in basic medical courses has di-versified forms and lacks unified criterion, so there is still a long way to go for the appli-cation of PBL.

ObjectiveToinvestigatetheeffectsofcaveolin1(Cav1)onexpressionsofproinflammatory cytokine interleukin (IL)-1βand IL-6 in the ischemic cortex after permanent middle cerebral artery occlusion in mice. Methods The Cav-1 knockout mice (n=40) and wild-type mice (n=40) were randomly divided into ischemia groups and sham operation groups (n=20 in each group). They w ere also redivided into ischemia or sham operation at 3, 7, 10 and 14 d time points ( n=5 in each time point). A permanent middle cerebral artery occlusion model w as induced by the suture method. Immunohistochemical method w as used to detect the expressions of IL-1βand IL-6 in the ischemic cortex. Results The expression levels of IL-1βand IL-6 in the ischemic cortex at each time point in the ischemia group in Cav1 knockout mice w ere significantly higher than those in the ischemia group in the w ild-type mice ( al P< 0.05 ). Conclusions The upregulations of proinflammatory cytokines IL-1βand IL-6 in the ischemic cortex in Cav1 knockout mice suggests that Cav1 plays an important role in aleviating inflammation after cerebral ischemia.

Objective To investigate the identification and optimal breeding method of caveolin-1 knockout mice, and provide an ideal animal model for further study of the role of caveolin-1 in cerebral ischemic injury and repair. Meth?ods The introduced caveolin-1 gene knockout mice were reared in the SPF laboratory and genomic DNA was extracted from mouse tail tissue by the method of boiling lysis. According to the primer sequences provided by the Jackson Laboratory of America for polymerase chain reaction ( PCR) to detect the genotypes, with the four different ways of mating:caveolin-1 +/ -heterozygote intercrossing, heterozygous and homozygous caveolin-1 -/ -hybrid ( orthogonal and pay) as well as homo-zygous intercrossing. The pregnancy rate, shape characteristics of the filial generation mice and homozygous rate of the pa-rental mice were observed. Results Agarose gel electrophoresis results indicated that the size of molecular weight of the PCR products was about 200 bp and 661 bp, which were consistent with the expected target gene fragment, and identified caveolin-1 gene knockout mice of different genotypes successfully. The results of different mating patterns are basically in a-greement with Mendel rule, and the female and male aveolin-1 -/ -homozygous mice had a certain ability to reproduce, three different genotypes of mice had no significant differences between the shape features. Conclusions PCR can fast and reliably identify the genotypes of caveolin-1 knockout mice using genomic DNA through the method of boiling lysis. Combi- ning the breeding methods of intercrossing of caveolin-1 heterozygous mice and intercrossing of caveolin-1 homozygous mice may be a good way to obtain enough homozygous mice and homologous wild type mice in a short period.

Objective To observe the variation of the blood pressure in patients with persistent vegetative state (PVS) during whirl-pool-bubble bath. Methods 5 PVS patients accepted whirlpool-bubble both therapy, 38℃for 20 minutes. Their blood pressure was recorded 0, 10 and 20 minutes after immersing for 4 weeks. Results The systolic pressure decreased 20 minutes after immersing compared with that just immersing, but all above 60 mmHg. The systolic and diastolic pressure maintained in a satisfactory range during whirlpool-bubble bath. Conclusion Hypotension has not been found in the patients with PVS during whirlpool-bubble bath.