As a common issue,information asymmetry has been a hot topic in the micro-economy field.It is also prominent in clinic as well as the medical insurance.The low efficiency and unfairness caused by information asymmetry will lead to a series of ethical problems.To solve the problems,the construction of moral system and rule are needed.

Objective To investigate the application value of sperm nucleoprotein immaturity and sperm DNA damage detection in in vitro fertilization(IVF).Methods From Mar.2015 to Feb.2016,routine sperm analysis,sperm nucleoprotein immaturity and sperm DNA damage detection were performed in 102 patients with infertility,and the correlation between these parameters were analyzed.Results Sperm DNA fragmentation rate was negatively correlated with IVF optimal embryos rate and sperm viability(P<0.05),while was not correlated with IVF fertility rate(P>0.05).Sperm nucleoprotein immaturity rate was not correlated with IVF optimal embryos rate and fertility rate(P>0.05),while was negatively correlated with sperm concentration(P<0.05).Conclusion Sperm DNA fragmentation rate could be closely correlated with IVF optimal embryos rate,which might be with prediction value in IVF treatment.

This paper summarized the nursing experience of one infant with right lower limb ischemia caused by amniotic band syndrome. The nursing key points included:careful observation of the infant condition,exposing the wound,raising the affected limb,wound disinfection,and removing necrotic tissues at the surface skin,applying topical drugs for promoting tissue growth and antibiotics,selecting appropriate dressing to provide suitable environment for tissue regeneration;debridement of inguinal skin,dressing change,assessing pain and providing corresponding care during debridement;infection prevention. After 29 days of treatment and careful nursing care,the skin damage was repaired on the right lower limb,swelling subsided,the necrotic tissues at right inguinal region were completely cleared,granulation tissue was formed,and the infant was discharged smoothly.

Objective To investigate the effects of Xiaotan Sanjie Recipe (XTSJR) on the proliferation and apoptosis of colorectal cancer cell;To study its relevant mechanism. Methods The original XTSJR aqueous solution was lyophilized, weighted, and dissolved in cell culture and stored. HCT116 cell line was treated with different concentrations of XTSJR for 72 h, and the cell proliferation was detected by CCK-8 assay. XTSJR treated HCT116 cell line with the concentration of 0.94 mg/mL and 1.88 mg/mL for 24 h, 48 h, 72 h, and the cell proliferation was detected by CCK-8 assay. HCT116 cell line was treated with different concentrations (0.24, 0.47, 0.94, 1.88 mg/mL) of XTSJR for 72 h. The cell apoptosis was detected by TUNEL assay under the fluorescence microscope, and the post-intervention expression of Caspase3 protein was detected by Western blot. Results The inhibitory effects of XTSJR on the proliferation of HCT116 cell line was concentration-time dependent. The IC50 value at 72 h-time point was 0.94 mg/mL. Medicine concentration and the treated time have interactive contribution to the inhibitory effect. XTSJR induced the cell apoptosis. The apoptosis rate increased with the increasing medicine concentration. There was statistically significant difference compared with the control group ( P<0.01). After treatment the expression of Pro-Caspase3 decreased, while the expression Cleaved Caspase3 protein increased. Conclusion XTSJR inhibits the proliferation of HCT116 cell line and induce apoptosis. Its mechanism might be related to the activity of Caspase3 protein.

Objective To investigate the effects of Morusin on cell line proliferation, cell cycle and cell apoptosis of colorectal cancer HCT116 cell;To discuss its mechanism. Methods HCT116 cells were treated with different concentrations of Morusin for 72 h. Cell proliferation was detected by CCK-8 assay, and cell growth inhibition rate and IC50 value were calculated. HCT116 cells were treated with 25.4, 50.8 μmol/L Morusin for 24 h, 48 h and 72 h. Cell morphology was observed under the microscope, and cell proliferation was detected by CCK-8 assay. After HCT116 cell line was treated with 25.4μmol/L Morusin for 24 h, cell cycle phase distribution was detected by flow cytometry and the cell apoptosis was detected by TUNEL assay under the fluorescence microscope. Post-intervention protein expressions were detected by Western Blot. Results The inhibitory effects of Morusin on the proliferation of HCT116 cell line was concentration/time dependent and IC50 value at 72 h was 25.4μmol/L;Morusin induced the cell cycle arrest at G0/G1 phase and G2/M phase, but there was no induction of cell apoptosis;Morusin significantly decreased the expression ofβ-catenin and its target c-Myc, and downregulated the expressions of cyclinD1 and cyclinB1, which were involved in cell cycle regulation. Conclusion Morusin can inhibit HCT116 cell cycle and the proliferation of colorectal cancer cells. Its mechanism might be realized by suppressing the activity ofβ-catenin pathway and reducing the protein expressions of cyclinD1 and cyclinB1.

Objective To summarize our experience in treating high risk carotid stenosis. Methods We retrospectively analyzed the clinical characteristics, treatment, and outcomes of 24 patients with high risk carotid stenosis in our department from January 2001 with emphasis on the application of carotid stents and shunting tubes. Results All patients were successfully treated, with 11 patients undergoing carotid angioplasty and stenting (CAS) and 13 patients receiving carotid endarterectomy (CEA) and shunting. No death, stroke, and ischemic neurological deficit occurred in 30 days postoperatively. Conclusion Selective application of CAS and shunting in CEA can effectively reduce complications and improve therapeutic effects in patients with high risk carotid stenosis.

Objective To investigate the early risk factors of the formation of pancreatic pseudocysts after severe acute pancreatitis. Methods One hundred patients with severe acute pancreatitis admitted from Jul. 2005 to Mar. 2007 were included. Clinical and laboratory data within 24 hours of admission and radiological tests of chest, abdominal dynamic contrast-enhanced computed tomography and abdominal ultrasound within 3 days after admission were analyzed and multiple stepwise logistic regression analysis was performed. Results 30 patients developed pancreatic pseudocysts and the incidence of pancreatic pseudocysts in the clinical course of severe acute pancreatitis was 30%. There were significant difference between group A (pancreatic pseudocyst group) and group B (non-pancreatic pseudocyst group) in serum albumin[(33.23±4.810g/L vs (36.07±4.92)g/L], CT severity index (CTSI) (3~6 vs 2~4 points) ,length of hospital stay[(26.83±19.760) day vs (14.51±7.71) days, (P<0.05)]. Meanwhile, there were no significant differences between the two groups in age, gender proportion, body temperature, heart rate, breath rate and mean arterial pressure in admission,urine volume within 24 hours, early defaecation within 24 hours after admission, blood routine, liver function, kidney function, electrolytes, blood cholesterol and triglycerol, PT, APTr, arterial blood gas analysis, blood amylase, C-reaction protein, APACHE Ⅱ, RANSON scoring, early ascites and pleural effusion. But multiple stepwise logistic regression analysis showed that the serum albumin and CTSI were associated with the formation of pancreatic pseudocysts after severe acute pancreatids. Conclusions The serum albumin and CTSI were the independent risk factors of the formation of pancreatic pseudocysts after severe acute pancreatitis.

Objective To determine the feasibility and accuracy of velocity propagation within main pulmonary artery(VP)from color M-mode Doppler imaging using custom software on a personal computer for noninvasive estimation of PVR.Methods Color M-mode imaging of pulmonary flow was obtained and then transferred to computer,the velocity propagation of pulmonary flow was automatically obtained.Comparative studies among Doppler echocardiography,personal computer and cardiac catheterization for predicting PVR had been done in 20 children with congenital heart disease and 20 normal children.Results Velocity propagations of children with congenital heart disease were significant lower than those of normal children obtained by color Mmode echocardiography[(38.38±18.89)cm/s VS(80.34±15.65)cms,P＜0.01),and correlated well with invasive PVR measurements(r=-0.69,P＜0.01).The correlation and repeatability of VP obtained by the custom software were better than VP obtained by Doppler echocardiography(r=-0.78,P＜0.01).A VP cutoff value obtained by the custom software of 35.910 had a sensitivity of 92.9% and a specificity of 100% to within pulmonary artery obtained by color M-mode echocardiography using custom software on a personal computer.

Objective To analyze the level of cardiac troponin I (cTnI) in children with left-to-right shunt congenital heart disease (CHD). Methods In this study, 146 children with secundum atrial septal (ASD) defect, 132 children with ventricular septal defect (VSD) and 300 healthy children were recruited. The levels of cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured and their correlation with clinical data was analyzed. Results The serum cTnI and NT-proBNP levels in both ASD and VSD patients were signiifcantly higher than those in normal children (H=3.89 and 5.27, P<0.01). The serum cTnI and NT-proBNP levels in VSD patients were signiifcantly higher than those in ASD patients (P<0.05). The ratio of pulmonary to systemic arterial pressure (Pp/Ps), pulmonary vascular resistance index (PVRI) and standardized left ventricular end diastolic volume in VSD patients were signiifcantly higher than those in ASD patients (P<0.05). Multiple regression analysis showed that Pp/Ps was signiifcantly correlated with cTnI in VSD patients. (β=0.81, SE=0.03, P=0.000). Conclusions Signiifcant volume and pressure overload due to a left-to-right shunt induce myocardial injury and could lead to irreversible myocardial remodeling in children with CHD. The serum cTnI level is a sensitive biomarker for myocardial damage in VSD patients.

Objective To investigated cerebral structural connectivity and its relationship to neuroleptic-na?ve individuals with first episode early-onset schizophrenia using diffusion tensor imaging (DTI) which could demonstrate the white matter integrity . Methods We recruited subjects with first episode DSM-Ⅳearly-onset schizophrenia who had never been exposed to antipsychotic medication(n=19) and sex ,age-matched healthy volunteers (n= 19) .All subjects received DTI and structural magnetic resonance imaging scans .Voxel-based analysis was performed to investigate brain regions fractional anisotropy (FA) values .Results Statistics revealed that schizophrenia patients showed significant FA reduction in left inferior frontal gyrus ,left temporal gyrus ,left occipital lobe and right middle temporal gyrus as compared to healthy subjects .Conclusion Deficits of white matter integrity in widespread brain regions of the first episode neuroleptic-na?ve early-onset schizophrenia patients .The presence of white matter abnormalities in the early-onset patients is suggestive of being related to the etilology of schizophrenia .