Donation after death is the most important ethical principle to carry out organ donation after citizens’ death. The newly-revised Regulations on Human Organ Donation and Transplantation does not define death, and avoids the key question of “whether to recognize brain death”. Certain legal risks or damages to the rights and interests of donors may exist in organ donation. Death is an inevitable part of human life. It is necessary to establish specific criteria, which is also the only approach, to define death in any era. Death criteria are established based on the view of death, and restricted by the development level of productive forces and other social factors. The determination of death criteria hugely varies between China and the West. To standardize organ donation and transplantation and promote high-quality development of organ donation, medical staff must adhere to the principle of pure motivation, take informed consents as the premise, respect the donors' and their close relatives' rights to choose their own death criteria, strictly follow the death judgment procedures and operating norms, and ensure the scientificity, accuracy and fairness of death determination.

Vivid and abundant social practice constantly creates new understanding, which will inevitably lead to the emergence of new disciplines. Organ donation discipline is involved with multiple disciplines, such as ethics, law, medicine, sociology and psychology, etc. After entering a new stage of high-quality development, whether it is necessary to establish the discipline of "organ donation" is worthy of discussion. According to the basic standards for establishing a new discipline, groundbreaking achievements in organ donation could lay a solid foundation for the establishment of "organ donation" discipline. However, current conditions for the establishment of "organ donation" are not fully mature, and the process of discipline establishment will absolutely encounter resistance. In the future, the scope and orientation of organ donation should be further elucidated, and a series of measures should be taken, such as establishing independent academic organizations, offering organ donation courses, carrying out special research and innovation, and strengthening international cooperation and exchanges, aiming to promote the establishment of organ donation discipline. The cooperation between academic community and governments is the key to promote the establishment of the discipline of organ donation. Governments will make final decisions by comprehensively considering the investment of resources, development needs of the discipline and the relationship among existing disciplines.

High-quality development is the primary task of building a socialist modern country in an all-round way. Organ donation and transplantation in China are evolving from high-speed growth to high-quality development, which put forward new requirements for the safe, stable and healthy operation of Organ Procurement Organization (OPO). Safety is the foundation and prerequisite for achieving the goal of high-quality development. As an independent and comprehensive department, internal audit should create new achievements in the new era. The department should include OPO and organ donation into the scope of internal audit, shift the emphasis upon the overall development of organ donation. Besides, it should fully consider the actual situation in different places, conduct all-round, objective and fair evaluation, provide evaluation and consulting services for OPO to properly implement organ donation, and give full play to the supervision and prevention role of internal audit.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
.

Objective:To explore the application and value of metagenomic next-generation sequencing (mNGS) in refractory infection after organ transplantation.Methods:A case report discussed about a patient with lumbar spine infection after kidney transplantation and the relevant literature was reviewed. The recipient was a 63-year-old man with low back pain after kidney transplantation. Lumbar spine magnetic resonance imaging showed lumbar spine infection. Multiple operations plus antibacterial and antituberculosis treatments were ineffective. Before and after treatment, numerous tests of traditional pathogenic microorganisms failed to detect any positive bacteria.Results:The detection of lumbar secretion by mNGS suggested aspergillus infection. The symptoms improved after dosing of voriconazole.Conclusions:The incidence of fungal infection of lumbar spine is low. The imaging manifestations are non-typical so that it is easy to misdiagnose. mNGS helps to timely diagnose and guide treatment. With a review of the literature, mNGS has some application value for some difficult and rare infectious diseases.

Objective To evaluate the diagnostic performance of the histogram analysis of mono-exponential and intravoxel incoherent motion(IVIM) models to the dualistic model of epithelial ovarian cancer(EOC). Methods Forty female patients with histopathologically proven epithelial ovarian cancer underwent preoperative MR examination. Scanning sequences included conventional imaging, diffusion-weighted magnetic resonance imaging with 11 b values (0, 30, 50, 100, 150, 200, 400, 600, 800, 1 000, 1 500 s/mm2) and dynamic contrast enhanced MRI (DCE-MRI). Based on the dualistic model of EOC, all patients were divided into two groups:typeⅠ(low grade, n=16) and typeⅡ(high grade, n=24). ADC, D, D*and f maps and their corresponding histograms were generated by post-processing software. Based on an entire-tumour measurement, the following histogram parameters were recorded, respectively: (a) Mean; (b) the 10th percentile (10th);(c) the mean of the top 10 percent (MeanL);(d) the 90th percentile (90th);(e) the mean of the bottom 10 percent (MeanR). Two types were compared using independent sample t test or Mann-Whitney U test. And areas under ROC curve between two groups were assessed. Results For ADC , D, and f, all indices(Mean,10th,MeanL,90th,MeanR) of the histogram were significantly lower in typeⅡthan in type Ⅰ(P<0.05). All of parameters of D* had no significant different(P>0.05). D demonstrated a comparable accuracy with ADC in differentiating the grade of EOC (area under curve: Mean, 0.898 vs. 0.893; 10th, 0.880 vs. 0.846; MeanL, 0.878 vs. 0.858; 90th, 0.895 vs. 0.839; MeanR, 0.872 vs. 0.814), and both ADC and D have better performance than f. Conclusion It is feasible to stratify the grade of EOC by mono-exponential and IVIM models with histogram metrics,diagnositic efficiency of ADC and D values are higher.

After the characteristics and necessity of medical informatics experimental course were analyzed, the application of three-stage case teaching in medical informatics experimental course was described, and its steps and methods were explained with the teaching contents of hospital system module used in experimental course as an example. This teaching method can strengthen the knowledge the students have learned.

Objective To explore the effect of hot application of carthamus tinctorious for nurses with chronic lumbar strain. Methods By purpose sampling, a total of 60 nurses with chronic lumbar strain had been chosen from February to June 2014 and were randomly and averagely divided into experimental group ( hot application of carthamus tinctorious) and control group ( massage) . Before and after intervention, the Oswestery disability index was used to assess the results of two groups. Results Before intervention, the ODI disability index had no statistical significance between two groups (t=0. 024,P>0. 05), but after the intervention, the results of two groups declined (P<0. 01), which indicated the improvement of symptom. After intervention, there was no statistical significant between the results of ODI disability indexes in two groups ( t=0. 121,P>0. 05), suggested similar curative effect of two methods. Conclusions The hot application of carthmus tinctorius can improve the symptom of chronic lumbar strain as message, and require unnecessary professional person. It also has less expenditure, less restriction, and can popularized in nurses with chronic lumbar strain.

Objective To investigate the effect of hemorrhagic shock on intestinal epithelial tight junction and expression of protein Occludin.Methods Twenty-four SD rats were allocated to sham operation group,hemorrhagic shock 0.5-hour,2-hour,and 4-hour groups according to random number table,with 6 rats per group.A model of hemorrhagic shock in the rat was induced by the improved Wiggers method.Blood samples were drawn from abdominal aorta.Activity of plasma diamine oxidase (DAO) was determined by active colonmetric method; content of plasma D-lactic acid (D-LA) by spectrophotometer method; plasma endotoxin levels by turbidimetry; bacterial translocation by bacterial culture of mesenteric lymph nodes and liver tissues; pathological changes of intestinal mucosa by light microscope; ultrastructure of intestinal epithelial cells by electron microscopy; Occludin mRNA expression in small intestinal mucosa by RT-PCR; Occludin expression by Western blot and imnmnohistochemical method.Results Levels of DAO [(72.68-± 10.24) mg/ml],D-LA [(9.28 ± 0.53) μg/ml] and endotoxin [(41.25 ±3.68) pg/L] in hemorrhagic shock 0.5-hour group increased markedly as compared with those in sham operation group (P ＜0.05).Bacteria were cultivated from the liver tissues and mesenteric lymph nodes in hemorrhagic shock 2-hour group and much more colonies of bacteria were observed in hemorrhagic shock 4-hour group (P ＜ 0.01).Morphology and ultrastructure of the small intestinal epithelium manifested immediate damage in hemorrhagic shock 0.5-hour group and much worse detriment was obsevved with a prolonged bleeding time.Occludin mRNA expression in small intestinal mucosa decreased in hemorrhagic shock 0.5-hour group,followed by a further reduction in hemorrhagic shock 2-hour group (P ＜0.05).Localized expression of Occludin in hemorrhagic shock O.5-hour group was weakly positive.Occludin content in hemorrhagic shock 2-hour group showed significant reduction when compared with that in hemorrhagic shock O.5-hour group (P ＜ 0.01) and its localized express was negative as well.Conclusion Occludin expression in intestinal epithelial cells decreases obviously with a prolonged bleeding time,which is presumed to be an important basis for disruption of cellular tight junction.