Through the analysis on different development paths of western and Chinese medical ethics, this article proposed to construct the Chinese medical ethical review system. Although the medical ethical review system was originated in western countries, due to different origins of medical ethical thoughts, different cultures and beliefs among races, as well as different medical and science development models, the application of western medical eth-ical review system should not be mechanically used in China. The application should follow the idea of har-monization with differences. This article discussed on current status and significance of the construction of an ethical review platform which is suitable to the national conditions of China. It was also emphasized on the im-portance of ethics training among researchers.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Medicine, Chinese Traditional ; methods ; Ovarian Diseases ; physiopathology ; therapy ; Ovary ; physiopathology ; Phytotherapy ; Young Adult

OBJECTIVETo observe therapeutic effects of locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly.

METHODSFrom June 2011 to May 2013, 72 elderly patients with comminuted proximal humeral- fractures were divided into locking titanium plate group and anatomical plate group, 36 cases in each group. In locking titanium plate group, there were 16 males and 20 females aged from 60 to 79 years old with an average of (69.55±5.62) years old; 10 cases were type Neer II, 18 were type Neer III and 8 cases were type Neer IV in accordance with Neer classification; treated with locking titanium plate. In anatomical plate group, there were 15 males and 21 females aged from 60 to 81 years old with an average of (69.76±5.70) years old; 9 cases were type Neer II, 20 were type Neer III and 7 cases were type Neer IV; and treated with anatomical plate. Clinical effects, preoperative and postoperative Neer scoring, operative time, bone healing time and incidence of complications between two groups were compared.

RESULTSAll patients were followed up from 1 to 3 years with an average of 15 months. The excellent and good rate of locking titanium plate group (91.7%) was significantly higher than anatomical plate group (75.0%). Postoperative Neer score of two groups were improved obviously, but locking titanium plate group (92.51±7.85) was higher than anatomical plate group (83.64±8.56); there was no significant differences between two groups in operative time (P>0.05); bone healing time in locking titanium plate was (18.6±3.4) weeks, and shorter than anatomical plate group (24.3±3.9) weeks; incidence of complications in locking titanium plate was (5.6%) shorter than anatomical plate group (22.2%), and had obviously differences between two groups.

CONCLUSIONLocking titanium plate for the treatment of comminuted proximal humeral fracture in elderly plays an important role in good rate, bone healing time and Neer score. It has advantages of early rehabilitation exercise, less shoulder pain, rapid recovery of shoulder joint, less complications, safe and effective, and be worthy of clinical application, especially for senile osteoporosis patients.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Titanium

As perimenopausal syndrome is a particularly disturbing condition to the patient, it is practical and necessary to establish a program of comprehensive traditional Chinese medicine therapy for women with perimenopausal syndrome.

Objective: To explore the cognitive level and the mental status of the patients suffering from perimenopausal syndrome in Shanghai, and to identify the traditional Chinese medicine syndrome distribution feature of perimenopausal syndrome. Methods: The cognitive level of the perimenopausal women was evaluated by using general living problem questionnaire. The mental status of the perimenopausal women was evaluated by using self-rating depressive scale. The traditional Chinese medicine syndrome distribution feature of perimenopausal syndrome was identified by using traditional Chinese medical symptoms questionnaire. Results: A total of 634 perimenopausal women finished the investigation. There were 74.76% (474/634) patients who knew little about the perimenopausal syndrome; 77.29% (490/634) patients had a depressive tendency; 8.36% (53/634) patients had depressive disorder. There were 72.40% (459/634) patients who had the symptoms such as susceptibility to anger and restlessness, restless sleep at night, thirst with dry throat and bitter taste, and all these symptoms could be classified into hyperactivity of heart and liver fire syndrome. Conclusion: Patients suffering from perimenopausal syndrome know little about this disease and mostly have depressive tendency, and the major traditional Chinese medicine syndrome pattern is hyperactivity of heart and liver fire based on the chief clinical manifestations of the patients.

Objective To retrospectively review the PET/CT imaging features of sarcoidosis and improve the diagnostic accuracy of this benign disease.Methods The PET/CT imaging characteristics and clinical data, including lesion size, distribution, standardized uptake value (SUV) and the ratio of misdiagnosis, of 11 sarcoidosis patients (5 confirmed pathologically and 6 clinically) were retrospectively analyzed.Results (1) Eleven patients had lymph node involvement:mediastinum and hilar lymphadenopathy in 11/11, supraclavicular fossa lymphadenopathy in 8/11, retroperitoneal lymphadenopathy in 8/11, pelvic cavity lymphadenopathy in 3/11.(2) Extrathoracic lesions were found in 7/11 with 4 lung involvement, 2 liver involvement, 1 parotid gland and temporalis involvement and 1 bilateral iliac and sacral bone involvement.(3) The size of the lesions ranged from 1.0 to 4.6 cm and the CT density ranged from 30 to 40 HU.The lesions in the lung are hypodense and in the liver are slightly hypo-or iso-dense.18F-fluorodeoxyglucose (FDG) uptake of all lesions was definitely increased in 6 cases; 18F-FDG uptake of some lesions was moderately or definitely increased in 2 cases, and slightly increased uptake in 3 cases.(4) The PET/CT diagnosis was consistent with the final diagnosis in 6/11.The 5 cases of misdiagnosis were malignant lymphoma (4/11) and lung cancer ( 1/11 ).Conclusions Differentiation between sarcoidosis and lymphoma in patients presenting with hilar lynphadenopathy can be difficult.Whole-body PET/CT may be helpful in the differentiation of the two diseases.

OBJECTIVETo develop a new technique for assessing the risk of birth defects, which are a major cause of infant mortality and disability in many parts of the world.

METHODSThe region of interest in this study was Heshun County, the county in China with the highest rate of neural tube defects (NTDs). A hybrid particle swarm optimization/ant colony optimization (PSO/ACO) algorithm was used to quantify the probability of NTDs occurring at villages with no births. The hybrid PSO/ACO algorithm is a form of artificial intelligence adapted for hierarchical classification. It is a powerful technique for modeling complex problems involving impacts of causes.

RESULTSThe algorithm was easy to apply, with the accuracy of the results being 69.5%±7.02% at the 95% confidence level.

CONCLUSIONThe proposed method is simple to apply, has acceptable fault tolerance, and greatly enhances the accuracy of calculations.

Algorithms ; Artificial Intelligence ; China ; epidemiology ; Environmental Exposure ; adverse effects ; Humans ; Infant, Newborn ; Models, Biological ; Neural Tube Defects ; epidemiology ; Risk Factors

Objective To analyze the effect of using standardized patient (SP) tutorial in the spe-cialized training of pancreatic surgery with WeChat platform. Methods 48 surgeons participating in resi-dent standardized training in Changhai Hospital (all for postgraduate education) were enrolled as teaching object. 48 surgeons were divided into two groups: SP group (n=24) receiving WeChat combined with SP tutorial which updates learning plan, learning contents, and clinical discussion by Wechat platform and performs practical teaching by SP method, control group (n=24) receiving traditional tutorial by using tradi-tional clinical teaching methods and video teaching followed by practical teaching. The theoretical exami-nation, questionnaires and expert assessment were used to evaluate the effect of the two teaching methods. Statistical analysis was performed using the SPSS 19.0. Continuous data were expressed as median±stan-dard deviation and compared using the Student's t-test. Categorical data were compared using the Pearson's chi-square test. Results The score of theoretical examination of the two groups showed no significant difference [(85.5±7.6) vs. (81.4±14.9), P=0.238]. The results of questionnaires and expert assessment in WeChat&SP group were significantly better than those in the control group (P<0.001) other than theoretical and analytical ability (P>0.05). Conclusion WeChat platform combined with standardized patient tutorial in the specialized training of pancreatic surgery is feasible and more effective than traditional tutorial to improve teaching effectiveness.

Objective To evaluate the theraputic effect of transcatheter arterial chemoembolization (TACE)for hepatocellular carcinoma with tumor thrombosis of portal vein.Methods One hundred and six patients of hepatocellular carcinoma with tumor thrombosis of portal vein under treament of TACE were observed before and after the procedure.Results After TACE tumor size reduced＞50% in 23 patients,＜50% in 25, no significant change in 44.The size of tumor enlarged in 12.The disappearance of portal vein tumor thrombosis accessed in 14,with reduction in 39,and no significant change in 51.Two patients died within one week.Conclusion TACE provides good therapeutic effect on hepatocellular carcinoma with tumor thrombosis of portal vein.

Objective To investigate the rule of the cerebral tissues aquaporin-4(AQP-4) expression in acute and chronic hepatic failure mice.To study the molecular biologic mechanism of the diffusion weighted imaging(DWI).Methods Sixty five male Sprague-Dawley rats were divided into 3 groups randomly,including acute(n=25),chronic hepatic failure(n=25)and control group(n=15). Thioacetamide(TAA)intraperitoneal injection produces the acute and chronic hepatic failure models.All rats in groups were examined with MR DWI.We Observed the distribution of abnormal signal on DWI.The DWI single values of top and lateral cortex of parietal lobe,peripheral region of lateral ventricle in the highest hyperintensity section of brain were measured.Blood ammonia values were examined.The pathologic and immuno-histochemistry and RT-PCR examination for brain specimen were performed.All date were analyzed with statistical methods.Results The mean values of blood ammonia were significantly different (P0.05).Conclusions Increase of the blood ammonia was the main cause for the brain energy metabolic abnormality and AQP-4 mRNA and protein expression.The hyperammonemia was the key factor in the occurrence and development of the hepatic brain edema.The abnormal findings in DWI signal could reflect the range and degree of the brain edema and AQP-4 protein expression.