The formation of medical ethics sense is affected and restricted by several factors including medical staff's psychological essence of general morality,learning attitude towards medical ethics,recognition process of medical ethics,and social environmental factors.It is the constant motions and interactions of those essential factors that regulate the medical ethics of medical ethics sense.

The Chinese guidelines for the management of women with epilepsy during periconceptional period are formulated to provide effective management and scientific guidance for female epilepsy patients during the periconceptional period by systematically reviewing the existing domestic and foreign evidences of evidence-based medicine and combining with the actual situation of Chinese female epilepsy patients. Through elaborating on the problems troubling women with epilepsy in childbearing age, such as the timing of pregnancy for women with epilepsy, the teratogenic risk of anti-seizure medications, medication adjustment during pregnancy and breastfeeding, a very systematic and comprehensive guidance is given. This paper reviews the contents of the Chinese guidelines for the management of women with epilepsy during periconceptional period.

Objective:To evaluate the alternation of homocysteine (Hcy),folic acid(FA),CA15-3 and vitaminB12(VitB12) in patients with breast cancer and explore the correlation of them.Methods:The levels of FA ,CA15-3 and VitB12 in serum of 55 breast cancer and 35 benign tumor of breast and 50 controls were measured by electro-chemiluminescence immunoassay ( ECLI ) , the Hcy levels were measured by colorimetric method.Results:Compared with the normal controls and benign tumor of breast cancer ,there were some significantly changes in breast cancer patients including Hcy ,CA15-3 increased and FA ,VitB12 reduced ( P＜0.05 ) ,there were no significant differences in Hcy,FA,CA15-3,VitB12 levels between benign breast tumors and normal controls (P>0.05).Companied with TNM stage increased ,the levels of FA breast cancer groups decreased ,the levels of Hcy,CA15-3 increased.The correlation analysis showed that Hcy was negatively correlated with FA and VitB 12,(r=-0.341,r=-0.540),CA15-3 was negatively correlated with FA, CA15-3 was postively correlated with Hcy (r=0.378,r=-0.361).Conclusion: Serum Hcy,CA15-3,FA and VitB12 detection in patients with breast cancer are helpful in the severity judgment and regimen prognosis .

Objective: To study the antibacterial activity in vitro of Sanhuang Shaoshangling on several common bacteria after changing the preparation process. Methods:Using the new technology of ethanol reflux extraction and water extraction, Sanhuang Sha-oshangling was prepared. A micro-broth dilution method was used to determine the minimum inhibitory concentration ( MIC) of San-huang Shaoshangling for escherichia coli, pseudomonas aeruginosa, staphylococcus aureus and type B paratyphoid salmonella after chan-ging the preparation process. The antibacterial effect of Sanhuang Shaoshangling prepared by the new and the old technology was com-pared, and the inhibition zone was detected by a paper strip method. Results:The antibacterial effect of Sanhuang Shaoshangling pre-pared by the new technology on escherichia coli, pseudomonas aeruginosa, staphylococcus aureus and type B paratyphoid salmonella was better than that of the products prepared by the old technology with the minimum inhibitory concentration ( MIC) of 16 μg·ml-1 , 16μg·ml-1 , 8 μg·ml-1 and 16 μg·ml-1 , respectively, while that of the product prepared by the old technology was 32 μg·ml-1 , 64 μg·ml-1 , 16 μg·ml-1 and 64 μg·ml-1 , respectively. Conclusion: The antibacterial effect of Sanhuang Shaoshangling after changing the preparation process is more significant, which shows certain clinical significance.

Objective To construct lentiviral expression vector of rat IP3R1 gene,and identify its silencing effect by using PC12 cell lines. Methods Oligo DNA sequences of 4 pairs of miRNA,named as miRNA1,miRNA2,miRNA3 and miRNA4,were designed according to IP3R1 gene sequence (GenBank:NM_001007235). The single strand of oligo DNA was annealed to form double strand DNA,and then connected with the empty plasmid pcDNA TM 6.2-GW/EmGFP-miR. By using gateway technology,the expression vector pcDNA TM 6.2-GW/EmGFP-miR-IP3R1 was linked into lentiviral destination vector pLenti6/V5-DEST to form the lentiviral expression vector pLenti6/V5-DEST-IP3R1,then it was transformed into infectious lentiviral particles and to infect PC12 cell lines. Silencing effect of gene IP3R1 was detected by Real-time PCR and Western blot. Results The sequence of expression vector pcDNA TM 6.2-GW/EmGFP-miR-IP3R1 was proved correct using sequencing method. After the transfection of letivirus vector pLenti6/V5-DEST-IP3R1 into PC12 cell lines,the IP3R1 mRNA and protein level were down-regulated 48h later,of which miRNA2 and miRNA3 sequence showed the best silencing effect,and the expression of IP3R1 in the blank control and negative control showed no significant changes. Conclusions Lentiviral expression vector pLenti6/V5-DEST-IP3R1 was constructed successfully. pLenti6/V5-DEST-IP3R1 may render the IP3R1 expression in PC12 cell lines down-regulated,and it provides a foundation for studying the function of calcium release channel IP3R1.

ObjectiveTo explore the projections of the long descending propriospinal tracts to lumbar enlargement. Method　Anterograde tracing with cupric-silver staining. 10 animals were injected b biotinylated dextran in the upper cervical cord. Following survival times of 14 days, projections of the long descending propriospinal tracts were immunohistochemically demonstrated in the lumbar enlargement.Results　The degenerated terminals and labeled terminals were found in the bilateral gray matter of the lumbar enlargement, but predominantly ipsilaterally. The terminals were widely distributed in laminal Ⅴ-Ⅸ, heavily Ⅶ and Ⅷ. Conclusion　The long descending propriospinal tract from the upper cervical cord projects to the lumbar enlargement.

OBJECTIVEThis study investigated the influence of different designs and porcelain/glaze firing on the marginal and internal fit of three kinds of computer aided design/computer aided manufacturing (CAD/CAM) zirconia ceramic implant-supported crowns.

METHODSThree groups of zirconia ceramic implant-supported crowns with different designs were produced from copings by using a Cercon CAD/CAM system (n = 8). The first two groups comprised double-layer crowns (zirconia coping + veneer) with regular (Group A) and full circumferential zirconia-collar marginal designs (Group B). The third group was composed of anatomic single-layer zirconia crowns without cores (Group C). Initially, the marginal and internal gaps of the copings and crowns were individually replicated by light-body silicon and then measured by micro-computed tomography scanning before and after porcelain/glaze firing. Five measurements were employed: vertical marginal gap (MG); horizontal marginal discrepancy (HMD); chamfer area (CA); axial wall (AW); and axial-occlusal transition area (AOT). Statistical analyses were performed by SPSS 17.0.

RESULTSHMD measurements in Group A were statistically higher than those in Groups B and C (P < 0.05), regardless of whether the values were obtained before or after porcelain/glaze firing. By contrast, the HIMD measurements in Groups B and C showed no significant difference (P > 0.05). Moreover, no differences were noted in MG, CA, AW, and AOT among the three groups (P > 0.05). All the measurements in the three groups showed no significant change after porcelain/glaze firing (P > 0.05), except for MG in Group A, which significantly decreased (P < 0.05).

CONCLUSIONThe marginal fits of the double-layer crowns with full circumferential zirconia-collar and the anatomic single-layer zirconia crowns were superior to that of the double-layer crowns with regular margins. The MG of the crowns with regular margins was obviously influenced by porcelain firing.

Aquaporin4(AQP4),a member of the aquaporin family,is mainly expressed inastrocytes end-feet in the central nervous system. A large number of experimental studies have show n that AQP4 expression plays an important role in the occurrence, development, and regression of brain edema after different types of stroke. In addition, the AQP4 expression can affect the development process of cerebrovascular disease through the mechanisms such as affecting the integrity of the blood-brain barrier and promoting astrocyte migration, nerve regeneration, and neuroinflammatory response. Investigation of regulation mechanisms of AQP4 in transmembrane transport of substance in brain and intracel ular and extracel ular environmental balance and its expression in model of cerebrovascular disease have an important significance for understanding the occurrence, development, protection, and treatment of clinical cerebrovascular disease.

Spontaneous intracerebral hemorrhage is the most deadly type of stroke.Its 30-day mortality rate is nearly 40％.More than 30％ of patients with spontaneous intracerebral hemorrhage will have hematoma growth,which lead to poor outcomes.In addition to the classic predictors,some inaging signs also have important implications for identifying hematoma growth,such as swirl sign,blend sign,and black hole sign on nonenhanced CT scans,extravasation sign on contrast-enhanced CT scans,spot sign on CT angiography,leak sign revealed by the modified imaging method,as well as the spot sign on CT peffusion imaging.

Objective To investigate the synergism and attenuation effects of Scapharca Subcrenata Extraction on NP chemotherapy in model mice.Methods The models of nude mice were induced with A549 cell line xenograft.The tumor inhibiting rates, body weight, food intake, hematology and blood biochemistry index were determined to evaluate the synergism and attenuation effects of Scapharca Subcrenata Extraction (125、250、500 mg/kg, i.g) on NP chemotherapy. Results Compared with NP chemotherapy group, the tumor inhibiting rates, body weight, food intake, white blood cell number were increased and glutamate pyruvate transaminase, glutamic oxalacetic transaminase and urea nitrogen were decreased markedly in NP chemotherapy plus Scapharca Subcrenata Extraction groups. Conclusion Scapharca Subcrenata Extraction has a remarkable synergism and attenuation effects on NP chemotherapy.