The event of “diagnosing mental disorder but actually not” violates patients′right of informed con-sent and refused to health , showing some problems of “diagnosing mental disorder but actually not” and mandatory admission process and psychiatric judicial authentication , and also have some ethical problems .Therefore, relevant departments should perfect the laws and regulation , establish a hospitalized psychiatric patients appeal , the appeal channels , at the same time , physicians should follow a correct understanding , respect patients rights , disinterest-ed, the ethical principles of self -supervision and also use constraints should be regulated .

OBJECTIVE:To evaluate the effect of temozolomide(TMZ)in combination with dexamethasone(DXM)on the proliferation of human gliocytoma U251 cells in vitro.METHODS:Human U251 cells were assigned to 1 of the 3 groups: TMZ(10,25,50,100,200,400?mol?L~(-1),respectively)alone or in combination with 40?mol?L~(-1)DXM(TMZ+DXM group)or control group(none drug).After treatment for 72 hours,the cell morphology,cell inhibition ratio,cell cycle and the apoptotic rate were detected.RESULTS:When TMZ concentration was greater than 100?mol?L~(-1)the cell inhibition ratio was higher in TMZ-treated group than in TMZ+DXM-treated group(P

Child ; Humans ; Tachycardia ; physiopathology ; therapy

Objective To determine a combination of biomarkers that assure the diagnosis of sepsis and severe sepsis in patients in emergency department (ED).Methods A total of 652 patients with systemic inflammatory response syndrome (SIRS) were enrolled for this prospective study in the ED of Beijing Chaoyang Hospital of the Capital Medical University between March 2010 and March 2013.Eight biomarkers were determined,including levels of procalcitonin (PCT),interleukin-6 (IL-6),D-dimer,C-reactive protein (CRP),brain natriuretic peptide (BNP),white blood cell count (WBC),percentage of immature neutrophil,and platelet count (PLT).Patients were divided into the sepsis group (452 cases) and non-sepsis group (200 cases) according to the diagnostic criteria of sepsis.Then all these patients were stratified into severe sepsis group (190 cases,including septic shock) and non-severe sepsis group (462 cases) according to the diagnosis of severe sepsis.Logistic regression was performed to identify the independent factors for the diagnosis of sepsis and severe sepsis,and the optimal combination of biomarkers was established.Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic ability of the combination and the biomarkers.Results PCT,IL-6 and D-dimer were independent factors for diagnosis of sepsis and severe sepsis.The area under the ROC curve (AUC) of the combination of three biomarkers was 0.866 for diagnosis of sepsis,and it was higher than the AUC of PCT (0.803),IL-6 (0.770) and D-dimer (0.737) alone,and this new combination showed better sensitivity,specificity,positive predictive (PPV),and negative predictive (NPV) values than that when the three biomarkers was used individually (the results of combination were 81.2％,8 1.0％,90.6％,56.5％ ; that of PCT were 75.2％,80.0％,89.5％,58.8％; that ofIL-6 were 81.0％,61.0％,82.4％,58.7％; and that of D-dimer were 79.9％,59.0％,81.5％,56.5％,respectively).The AUC of the combination was 0.815 for the diagnosis of severe sepsis and was better than the three biomarkers used alone,which was 0.758 for PCT,0.740 for IL-6,and 0.704 for D-dimer respectively.Moreover,the sensitivity,specificity,PPV and NPV of the combination were higher than that of the three biomarkers used singularly (the results of combination were 81.6％,73.6％,56.0％,90.6％; that of PCT were 79.5％,65.0％,48.2％,88.5％; that of IL-6 were 65.8％,70.6％,47.9％,83.4％; and that of D-dimer were 60.5％,73.2％,48.1％,81.8％,respectively).Conclusion The combination of PCT,IL-6 and D-dimer enhances the diagnostic ability for sepsis and severe sepsis.

Objective To investigate the effects of doxycycline on the expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metaloproteinase-1 (TIMP-1) in breast cancer lung metastasis model mice (BCML-TAⅡ99), and the mechanism thereof. Methods The BCML-TAⅡ99 mouse model was established. The immunohistochemical staining was performed to detect the expressions of MMP-9 and TIMP-1 in BCML-TAⅡ99 model mice and controls. Results The metastasis rate was significantly lower in treatment group than that of control group. The expression of MMP-9 was significantly reduced, but the expression of TIMP-1 was significantly increased, in treatment group compared with those of control group (P<0.05). Conclusion Doxycycline can inhibit tumor growth and metastasis in breast cancer with 1ung metastasis model mice by regulating MMP-9 and TIMP-1 expressions.

Objective To explore the molecular mechanism of osteoblast apoptosis mediated by glucocorticoid, provide experimental basis for clinical prevention and treatment of hormonal necrosis of femoral-head.Methods The MC3T3-E1 cells were divided into control group and three treatment group treated with different concentrations of dexamethasone (1, 10, 100μmol/L) for 24 hours.The apoptosis rate detected by TUNEL, the mitochondrial transmembrane electric potential after JC-1 staining by flow cytometry, the expression of Bax, Bcl-2 in mitochondrion and Cyt-C, apoptosis inducing factor ( AIF) in cytoplasm by Western blot.ResuIts With the increasing of Dex concentration, the rate of osteoblast apoptosis was significantly increased(F(3,28) =159.0,P=0.000), the positive cell rate of JC-1 stainning was significantly increased(F(3,28) =499.5,P=0.000), the expression of Bax(F(3,28) =17.4,P=0.000)in mitochondrion and Cyt-C(F(3,28) =22.4,P=0.000), AIF(F(3,28) =42.61,P=0.000)in cytoplasm were significantly increased.There were statistically significant difference of above indexes between control group and each experimental group(P<0.05).But there were no significant differences of Bcl-2 in mitochondrion among five groups(F(3,28) =0.62,P=0.607).ConcIusion Dexamethasone increases expression of Bax in mitochondrion, prompts mitochondrial permeability transition pore ( MPTP ) to be over-openning, induces apoptosis in osteoblast via a mitochondria-mediated pathway.

Anthracycline-based antitumor drugs are one of the highly effective broad-spectrum anti-cancer drugs that are commonly used clinically. However, anthracyclines have the serious side effect of cumulative dose-related cardiotoxicity. Clinically, intake of myocardial protective drugs is one of the most important strategies for the safe use of anthracyclines in chemotherapy. Numerous cancer patients un-dergoing chemotherapy also require surgery, during which general anesthesia is commonly used. Various studies have shown that propofol and sevoflurane, the most commonly used general anesthetics, present a significant protective effect in myocardial ischemia-reperfusion damage. Therefore, for patients who have just undergone chemotherapy with anthracyclines, anthracycline-induced myocardial injury may occur at the acute or chronic phase of surgery. Consequently, if the effect of anesthetics on the cardiotoxicity of anthracyclines is similar to the protective effect of these drugs for myocardial ischemia-reperfusion damage, this protective effect on cardiotoxicity will have significant impact on the recovery of cardiopulmonary function of patients after surgery. Thus, further studies are needed to establish the effect of anesthetics on the cardiotoxicity of anthracyclines.

Objective To investigate the characteristics of children ametropia in the development process ,predict and analyze the refractive state with the measurement data of refractive factors on the children aged from 5 to 13 years old .Methods 461 children (922 eyes) ,aged from 5 to 13 years old ,were selected from outpatients who went to ophthalmology clinic from January 2011 to September 2012 .The static diopter was measured by the optometry with the continuous mydriasis of 5 days using the ophthalmic gel of 1% atropine .And the biological measured values of refractive factors were obtained by the A type ultrasonic and keratome-ter .Meanwhile ,the parameters including the height (H) ,weight and the dominant eye were recorded to analyze the characteristics of children ametropia in the development process ,and then the equation between the diopter and the correlative factors including the measurement data of refractive factors and growth factors was established by the stepwise multiple regression analysis .Results (1) The myopia degree of the right eye static diopter was significantly deeper than the left (P<0 .05) .In the group in which the left eye was dominant ,the difference of the left eye and right eye refractive factors was not statistically significant (P>0 .05) .In the group in which the right eye was dominant ,the difference of the left eye and right eye refractive factors was not statistically significant (P>0 .05) except the instance in which K1 of the right eye was bigger than the left eye(P<0 .05) .(2) In the period of 5 to 13 years old ,the myopia developing trend of girls was earlier than boys .(3) The ocular axis length(AL) and H development had a close relationship ,and the correlation equation of them was AL =16 .135+0 .052H(r=0 .993) .(4) The multiple linear regression equation for the relationship between the static diopter (D) ,ocular AL and mean value of the corneal curvature (K) was D=84 .271-0 .937K -1 .878AL(r=0 .871) .Conclusion The ocular AL and H development of children have a close relationship .The static diopter(D) of the children aged from 5 to 13 years old can be predicted by the ocular axis length(AL) and corneal curvature(K) , w hich can be used to prevent myopia reasonably .

Many tumorigenesis in human are closely linked to the functional loss of P53. The tumor-suppressive functions of P53 are abrogated by mutations, but in 50% of all tumors it remains wild type. In these cases, loss of P53 tumor-suppressive function mainly results from the abnormal methylation of 5' CpG islands of tumor suppressor genes such as INK4a, ARF and ASPP. Restoring to normal methylation state of these genes might provide a new strategy for tumor therapy.