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

BACKGROUND: As demonstrated by recent reports, immediate early genes (IEGs) are rapidly induced and expressed when a songbird is stimulated either by bird-song or by its vocal-behavior. The expression area and level of IEGs in the brain, such as zenk, c-fos and c-jun, are corresponding to where and how the neurons are related as a songbird is stimulated, suggesting that IEGs play important roles in vocal learning and memory.OBJECTIVE: To study the relation between vocal learning of songbird and immediate early gene so as to understand the mechanism of human language and the control of central nervous system.DATA SOURCES: All papers were cited from MEDLINE with the keywords of "songbird, vocal learning, memory, zenk, c-fos and c-jun" in English between January 1990 and December 2001. Meanwhile, we searched the Chinese journals full-text database and Wanfang database with the same keywords in Chinese between January 1990 and November 2001 were also searched.STUDY SELECTION: The papers about immediate early genes and vocal learning and memory in songbirds were selected. Then non-randomly controlled studies were excluded, and the rest full-text papers were looked up.DATA EXTRACTION: Totally 17 papers about immediate early genes and vocal learning and memory in songbirds were found. We choose 11 papers in them and 6 was excluded because of summarization.DATA SYNTHESIS: ① zenk and vocal behavior: Expression of zenk in bird's brain can affect learning and memory through adjusting synthesis of special protein. ② Reaction of c-fos to various songs: The reaction of local neurons in bird's brain to the birdsongs are made by the decision of the numbers of song factor in learning songs. ③ Associations of c-jun and cfos: zenk, fos and jun are the necessaries for maintaining long-term memory, which produce a marked effect through signal transduction, reconstruction, synthesis and transduction of induced synapse.CONCLUSION: Immediate early genes (IEGs) are rapidly induced and expressed when a songbird is stimulated either by bird-song or by its vocal-behavior. The expression area and level of IEGs in the brain, such as zenk, c-fos and c-jun, are corresponding to where and how the neurons are related as a songbird is stimulated, suggesting that IEGs play important roles in vocal learning and memory.

Pituitary adenylate cyclase-activating polypeptide (PA CAP) which belongs to the secretin/glucagon/VIP family has been originally isola ted from the sheep hypothalamus on the basis of its ability to stimulate cAMP fo rmation in culture rat anterior pituitary cells. Post-translational processing of the PACAP precursor generates two biologically active molecular forms, PACAP -38 and PACAP-27. The primary structure of PACAP has been remarkably conserved during evolution. The sequence of PACAP-27 exhibits substantial similarities w ith those of vasoactive intestinal polypeptide (VIP), glucagon and secretin. The gene encoding the PACAP precursor is widely expressed in brain and various peri pheral organs, notably in endocrine glands, gastro-intestinal，uro-genital tra cts and respiratory system. In vivo and in vitro studies have shown that PACAP exhibits multiple activities especially a trophic activity during ontogen esis, notably in the adrenal medulla and the central nervous system. The biologi cal effects of PACAP are mediated through three distinct receptor subtypes which exhibit differential affinities for PACAP and VIP. The PAC1 receptor, which sho ws high selectivity for PACAP, is coupled to several transduction systems. In co ntrast, VPAC1 and VPAC2, which bind with the same affinity for PACAP and VIP, ar e mainly coupled to the adenylyl cyclase pathway. In conclusion, PACAP is neurop eptide, and it functions as a hypothalamic hormone, neurohormone, neuromodulator , vasodilator, neurotransmitter or trophic factor in the brain and the various o rgans.

Objective To observe the clinical effects of vitrectomy for advanced retinopathy of prematurity (ROP) and evaluate influence factors of anatomical recovery for stage 5 ROP.Methods Fiftyeight eyes of 40 infants with advanced ROP who underwent vitrectomy were retrospectively analyzed.There were 16 eyes of stage 4a,7 eyes of stage 4b,and 35 eyes of stage 5 ROP.Eighteen eyes received laser photocoagulation,2 eyes received cryotherapy,and 11 eyes received intravitreous injection of Bevacizumab (IVB) before surgery.The average follow-up time was 17.01 months.Anatomical outcome of retina after surgery was recorded by indirect ophthalmoscope and RetCam Ⅱ digital camera system.Visual outcome was measured by grating acuity test(lea gratingTM),and was converted to Snellen acuity values for analysis.For those who cannot cooperate to accomplish the test,we use hand move,light perception and non-light perception to record visual outcome. Results All 16 eyes of stage 4a were anatomically recovered (100.00％).5/7 eyes of stage 4b were anatomically recovered (71.43％) and 2/7 eyes were anatomically failed(28.57％).12/35 eyes of stage 5 were anatomically recovered (34.29％); 10/35 eyes were partial anatomically recovered (28.57％); 13 eyes were anatomically failed (37.14％). Anatomical outcome of stage 4a or 4b was better than stage 5 statistically(x2 =22.55,P＜0.05).Of 16 eyes of stage 4a,3 eyes were absent for visual function test.In the rest 13 eyes of stage 4a,VA of 6 eyes (46.15％) was between 0.03 and 0.07; 5 eyes (38.46％) were hand move; 2 eyes (15.39％) were light perception.Of 7 eyes of stage 4b,2 eyes (28.57％) accomplished grating acuity test with VA of 0.008 and 0.017 respectively; 1 eye (14.29％) was hand move; 2 eyes (28.57％) were light perception; 2 eyes (28.57％) were non-light perception.Of 35 eyes of stage 5,5 eyes were absent for visual function test.In the rest 30 eyes of stage 5,VAof2 eyes (6.67％) was 0.004; 4 eyes (13.33％) were hand move; 12 eyes (40.00％) were light perception; 12 eyes (40.00％) were non-light perception.Visual outcome of stage 5 was worse than stage 4a or 4b statistically(x2=15.734,P＜0.05).There was no statistically significant relationship between anatomical outcome and birth weight,gestational weeks,age at surgery,IVB therapy,laser or cryotherapy before surgery.Conclusions Vitrectomy can effectively control the lesions progress of stage 4a ROP,and achieve partially anatomically recovery of some stage 4b/5 patients.There was no statistically significant relationship between anatomical outcome and birth weight,gestational weeks,age at surgery,IVB,laser or cryotherapy before surgery.

Objective To explore the risk factors and imaging features of silent brain infarction (SBI).Methods The patient with SBI from the clinic were enrolled in the study,and the patients with symptomatic non-lacunar infarction served as controls.The risk factors and imaging features of both groups were compared.Results Among 145 patients with SBI,133 (91.72％) had two or more lesions,mainly in the centrum semiovale (73.10％).The proportion of patients with white matter lesions in the group of SBI in a single location was significantly lower than that in the group of SBI in multiple locations (41.67％ vs.73.68％ ;x2 =5.484,P =0.019).Compared to the patients with SBI,the age in patents with symptomatic non-lacunar infarction was older (72.42 ± 11.79 vs.67.03 ± 12.04 years; t =3.545,P =0.000),the proportions of male (63.55％ vs.46.21％ ;x2 =7.447,P =0.006),hypertension (80.37％ vs.64.14％ ; x2 =7.887,P =0.005) and atrial fibrillation (31.78％ vs.8.97％,x2 =21.113,P =0.000),as well as the levels of fasting glucose (6.09 ±1.23 mmol/Lvs.5.65± 1.18 mmol/L; t=2.863,P=0.005),total cholesterol (5.53± 0.74 mmol/Lvs.5.27 ± 0.90 mmol/L; t =2.554,P =0.011),triglycerides (1.89 ± 0.20 mmol/L vs.1.77 ± 0.18 mmol/L; t =4.910,P=0.000) and homocysteine (1 4.88 ±4.97 mmol/L vs.11.94 ±4.61 mmol/L; t =4.432,P =0.000)were higher.However,the lipoprotein (a) level was lower (0.18 ± 0.06 g/L vs.0.27 ± 0.18 g/L; t =-5.489,P =0.000).Among patients with SBI,33.8％ and 43.5％ had lesions in two and three locations,respectively;among patients with symptomatic non-lacunar infarction,66.4％ and 27.1％ had lesions in a single location and two locations,respectively (P ＜ 0.001).Multivariate logistic regression analysis showed that lipoprotein (a)was the independent risk factor for SBI (odds ratio 5.988,95％ confidence interval 2.421-14.706; P =0.000).Conclusions Although they shared a variety of common risk factors,patients with SBI had less atherosclerotic risk factors than those with symptomatic non-lacunar infarction.Most patients with SBI had lesions in multiple locations.

Mesenchymal stem cells(MSCs) can directly act on tumor cells to inhibit their growth,and could also migrate to the tissue lesions and tumor tissues to transfer and express many kinds of anti-cancer factors.Numerous researches have applied MSCs as carriers of drugs to induce apoptosis,inhibit differentiation of tumor cells and inhibit tumor angiogenesis,and have got outstanding antitumor results.

ObjectiveTo assess the sepsis score used for detecting the mortality of patients with sepsis in emergency department, and to compare with APACHE Ⅱ score, simplified acute physiology Ⅱ score ( SAPS Ⅱ ) and modified early warning score (MEWS) in terms of 28-day mortality of patients. Methods A total of 613 patients with sepsis were enrolled from the emergency department for a prospective study from September 2009 to September 2010. The sepsis score, APACHE Ⅱ score, SAPS Ⅱ score and MEWS score all were recorded and compared. The patients with sepsis were followed up for 28 days. Based on the sepsis score, patients with sepsis were stratified into 5 mortality risk groups, namely very low risk group (0～4 points), low risk group (5 ～7 paints), moderate risk group (8 ～ 12 points), high risk group ( 13 ～ 15points) and very high risk group (more than 15 points). The actual mortality rates were compared among all 5 groups by using Chi square test. Then, comparison between survivors and non-survivors carried out with logistic regression analysis to determine the independent risk factors of mortality.Receiver operating characteristic curve (ROC curve) was used to compare the sepsis score with APACHE Ⅱ score, SAPS Ⅱscore and MEWS in respect of the prognosis validity. ResultsTen patients were out of the follow-up and the data of 603 patients followed up were completely documented. The actual mortality rates of 5 risk groups were 0％, 7.7％, 18.5％, 46. 7％ and 63％, respectively. There were significant differences in age and four scoring systems between survivors ( n = 440) and non-survivors ( n = 163 ) ( P ＜ 0. 01 ). Sepsis score,APACHE Ⅱ score, SAPS Ⅱ and MEWS all were valid and eligible for detecting the risk of mortality in patients with sepsis. The ROC areas under the curve (AUC) of these 4 scoring systems were 0. 767, 0. 743,0. 741 and 0. 636, respectively. ConclusionsThe sepsis score can be used to stratify patients with sepsis according to mortality risk with better sensitivity to predict 28-day mortality. It is rational for evaluation in prediction of patients with sepsis in Emergency Department.

Objective To investigate the risk factors and the characteristic patterns of development changes of macrosomia.Methods 208 cases of macrosoroia were collected.Then the risk factors related to macrosomia by use of Logistic regression analysis were researched.208 infants of normal birth weight were selected as control group.The weight and length in 8 growth development monitoring time according to their health care manual were recorded.Mental development index(MDI)and physical development index(PDI)were tested and calculated by CDCC method when macrosomia and normal birth weight infants were 30 months.The characteristic patterns of development changes of macrosomia wre analyzed statistically.Results The risk factors of macrosomia contain age and height of the pregnant women,weight before pregnancy,weight increasing during pregnancy,nutriture,physical activity,family history of obesity and father's weight.Macrosomia was weighter than normal birth weight infants in the 8 growth development monitoring time and was longer than normal birth weight infants from 3 to 30 months(P ＜0.05).However,the length of macrosomia was not significantly different with that of control group when they were 36 months(P ＞ 0.05).MDI and PDI in macrosomia group were(107.33 ± 7.29)and(104.71 ± 6.93)respectively.MDI and PDI of normal birth weight infants group were(112.58 ± 7.61)and(109.09 ± 7.14)respectively.The differences were statistically significant(t =4.28,5.33;both P ＜ 0.01).Conclusion There were several risk factors for macrosomia such as environment and heredity.At the period of infants and young children,macrosomia were weighter than normal birth weight infants.The mental development and psycho-moter development of macrosomia were behind normal birth weight infants.