Research on the Ethical Supervision of Human Gene Editing Technology: Based on the Perspective of Game Theory / 中国医学伦理学

In view of the current norms and demands of human gene editing technology at home and abroad, the paper explained that the regulatory difficulties faced by human gene editing technology were due to the conflict between economic interests and moral bottom line by constructing a game model in a hypothetical way. On this basis, the ideas of the supervision mode of human gene editing technology were put forward: establish unified international standards based on the country as the main body, enact more stringent and effective laws, to jointly deal with the behavior of genetic manipulation of human gametes, zygotes and embryos for the purpose of reproductive, and ensure the normalization and legalization of gene editing technology to avoid technology abuse.

Reflections on "Infant Safety Island" based on the Bioethics of Disabled Newborns and Kant’s "Responsibility" Claim / 中国医学伦理学

"Disabled babies" have been concerned by the state and society. In 2011, China’s first "infant safety island" was officially piloted in Shijiazhuang to receive abandoned babies from all over the country, bringing hope to abandoned disabled babies. As the pilot program has been widely promoted, the survival rate of abandoned babies has been effectively improved, but the infant safety island has been branded as "the cage of connivance with the crime of abandonment". At the same time, there are two controversial issues on disabled newborns, the main subjects of abandoned babies: should disabled newborns be rescued? Should a infant safety island exist under the pressure of reality? From the perspective of the bioethics of newborns with disabilities, this paper analyzed the practical significance of the existence of infant safety island based on Kant’s "responsibility" claim, and made a statement for the practicability of safety island from different perspectives.

Evaluation of tumor heterogeneity in prostate cancer with Gleason score 7 points by MRI texture analysis:a preliminary study / 实用放射学杂志

Objective To explore the feasibility of differential diagnosis of Gleason score (GS)(3+4)and (4+3)in prostate cancer (PCa) based on texture parameters of T2 WI and ADC maps.Methods A total of 77 patients with GS 7 points in PCa confirmed by pathology were enrolled in this retrospective study,including 45 GS(3+4)cases and 32 GS(4+3)cases.ROI was manually drew on the largest section of tumor on the axial T2 WI and ADC maps,and five texture parameters were extracted,namely,angular second moment (ASM),contrast, correlation,inverse difference moment and entropy,and the texture parameters between groups were analyzed statistically,then ROC curve was used to evaluate the diagnostic efficiency of texture parameters with statistical differences.Results There was no significant difference in age and prostate specific antigen (PSA)between GS (3 + 4)and GS (4 + 3)groups (P＞0.05).There were significant differences in ASM and entropy between T2 WI and ADC (P＜0.05),but there was no statistical difference in contrast,correlation and inverse difference moment (P＞0.05).Except for the AUC of T2 WIASM,there were statistical differences among T2 WIentropy ,ADCASM and ADCentropy.The AUC of ADCASM and ADCentropy were larger than that of T2 WIASM and T2 WIentropy.The AUC of ADCentropy had the largest AUC (0.732),the cut off value was 5.71 ,with the sensitivity was 97.6% and specificity was 5 9.5%.Conclusion MRI texture analysis can be used to differentiate GS (3 + 4)from GS (4 + 3)in PCa,and the ADCentropy have the best diagnostic efficacy.

MRI appearances of serous borderline ovarian tumor with pathological correlation / 实用放射学杂志

Objective To investigate the MRI features of serous borderline ovarian tumor(SBOT).Methods The clinical and MRI features of 1 1 patients with SBOT were retrospectively reviewed and compared with surgical and pathologic findings.Results There were 5 bilateral and 6 unilateral cases,and the maximum diameter was 4.4-20.7 cm.According to the MRI appearances,it was divided into surface papillary and cystic papillary subtypes by morphological features and exophytic and endophytic proj ections by growth of papillary architecture.The papillary architecture with internal branching was the characteristic MRI appearance,the papillary architecture showed hypo-intensity on T1WI and hyper-intensity on T2WI with a lobulated contour,the internal branching showed hypo-intensity on T1WI and T2WI.The papillary architecture was obviously enhanced,while the internal branching was slightly enhanced after inj ection of contrast agent.Conclusion The papillary architecture with internal branching is a characteristic MRI appearance of SBOT which provides information for the diagnosis and differential diagnosis;and the types according to the MRI appearances and growth pattern of papillary architecture provides reference for the treatment and prognosis.

MRI qualitative and quantitative anlaysis of wrist and hand changes in patients with rheumatoid arthritis / 中国介入影像与治疗学

Objective To explore the diagnostic value of qualitative and quantitative analysis for wrist and hand changes of rheumatoid arthritis (RA) patients based on 3.0T MR images.Methods A total of 39 RA patients were enrolled and divided into 2 groups according to the course of the diseases,including 20 cases defined as early stage group (≤24 months) and 19 cases defined as middle-late stage group (＞24 months).MRI features such as joint synovitis,bone marrow edema,bone erosion,the tenosynovitis in wrists and hands were observed emphatically.Volumes of synovitis and bone marrow edema for all patients were quantified with the software developed by Kunming University of Science and Technology.Results Among the 78 sides of hands and wrists in 39 patients,the incidence rate of synovitis,bone marrow edema,bone erosion,tenosynovitis was 94.87％ (37/39),64.10％ (25/39),61.54％ (24/39) and 76.92％ (30/39),respectively.The highest incidence rate of synovitis,bone marrow edema and bone erosion was respectively found in the wrist (72/78,92.31 ％),carpus (48/78,61.54 ％) andtriangular bone (50/78,64.1 ％).There was no statistical significance difference of the occurrence of peritendinitis between the flexor tendons (74.36％ [58/78]) and extensor tendons (61.54％ [48/78];x2 =2.94,P=0.09).No statistical difference of the incidence rates of synovitis,bone marrow edema,bone erosion and tenosynovitis was found between the early stage group and middle-late stage group (all P＞0.05).There was no significant difference of synovitis and bone marrow edema volumes between the early stage group and the middle-late stage group (both P＞0.05) with MRI quantitative analysis.Conclusion 3.0T MRI can clearly demonstrate the pathological changes of the wrists and hands in RA patients.The quantitative analysis software can provide more accurate indicators for the assessment of disease severity.

MRI qualitative and quantitative anlaysis of wrist and hand changes in patients with rheumatoid arthritis / 中国介入影像与治疗学

Objective To explore the diagnostic value of qualitative and quantitative analysis for wrist and hand changes of rheumatoid arthritis (RA) patients based on 3.0T MR images.Methods A total of 39 RA patients were enrolled and divided into 2 groups according to the course of the diseases,including 20 cases defined as early stage group (≤24 months) and 19 cases defined as middle-late stage group (＞24 months).MRI features such as joint synovitis,bone marrow edema,bone erosion,the tenosynovitis in wrists and hands were observed emphatically.Volumes of synovitis and bone marrow edema for all patients were quantified with the software developed by Kunming University of Science and Technology.Results Among the 78 sides of hands and wrists in 39 patients,the incidence rate of synovitis,bone marrow edema,bone erosion,tenosynovitis was 94.87％ (37/39),64.10％ (25/39),61.54％ (24/39) and 76.92％ (30/39),respectively.The highest incidence rate of synovitis,bone marrow edema and bone erosion was respectively found in the wrist (72/78,92.31 ％),carpus (48/78,61.54 ％) andtriangular bone (50/78,64.1 ％).There was no statistical significance difference of the occurrence of peritendinitis between the flexor tendons (74.36％ [58/78]) and extensor tendons (61.54％ [48/78];x2 =2.94,P=0.09).No statistical difference of the incidence rates of synovitis,bone marrow edema,bone erosion and tenosynovitis was found between the early stage group and middle-late stage group (all P＞0.05).There was no significant difference of synovitis and bone marrow edema volumes between the early stage group and the middle-late stage group (both P＞0.05) with MRI quantitative analysis.Conclusion 3.0T MRI can clearly demonstrate the pathological changes of the wrists and hands in RA patients.The quantitative analysis software can provide more accurate indicators for the assessment of disease severity.

Comparison of laryngeal mask anesthesia and intubation anesthesia under spontaneous ventilation in uniportal video-assisted thoracoscopic surgery / 实用医学杂志

Objective To assess the feasibility of laryngeal mask anesthesia under spontaneous ventilation in pulmonary resection with uniportal video-assisted thoracoseopic.Methods Forty patients with pulmonary masses were randomized into two groups(n =20 in each group) to undergo pulmonary resection with uniportal videoassisted thoracoscopic,full implementation of thoracoscopic lobectomy and mediastinal lymph node dissection.Patients in two groups were induced by intravenous anesthesia,and the skin of the fifth intercostal space were infiltrated with ropivacaine.Patients in two both groups were maintained by intravenous ancsthesia and sevoflurane anesthesia.Muscle relaxants were administered in endotracheal inmbation group but not in the LMA group.Patients in the LMA group and tracheal intubation group underwent with spontaneous breathing and one-lung ventilation respectively.Results No significant differences were found in surgery time,intraoperative lowest SpO2,preoperative PaCO2,1-h postoperative blood gas analysis between the two groups.The anesthesia induction time,extubation time,and the stay time for the recovery of anesthesia and postoperative hospital stay were significantly shorter than those in the tracheal intubation group.The increments in MAP and HR after intubation operation were smaller than those in the LMA group.The total dosage of sulfentanyl and propofol per kg in the LMA group were significantly less than those in the control group.The PaCO2 after pulmonary resection and the intraoperative maximum level of PETCO2 in the former group were significantly higher than those in the tracheal intubation group,however the incidence of throat discomfort and the hospitalization cast were significantly decreased.Conclusion In view of patient rehabilitation and in hospitalization cast,laryngeal mask anesthesia under spontaneous ventilation in uniportal video-assisted thoracoscopic surgery was better than the procedure performed under intubation anesthesia.

Value of the high-resolution magnetic resonance imaging in diagnosis of extramural vascular invasion of rectal cancer / 实用放射学杂志

Objective To investigate the value of high-resolution magnetic resonance imaging (HRMRI)in diagnosis of extramural vascular invasion (EMVI)of rectal cancer.Methods 33 patients with rectal cancer were reviewed preoperatively.The MRI findings of EMVI of all cases were scored and compared with the postoperative pathological results.Results The MRI EMVI scores were consistent with histopathology findings (k=0.324,P=0.039).The accuracy rate of MRI in diagnosis of EMVI was 66.7% (22/33).The MRI EMVI scores rose up with increased pT stage,meanwhile there was a high correlation between both (r=0.546).The percentage of MRI EMVI positive number was increased with elevated pT stage,and there was also a high correlation between both (r=0.469). ROC curve showed that MRI EMVI scoring was an effective method in diagnosis of rectal cancer EMVI (AUC=0.757).Conclusion HRMRI is a valuable method in diagnosis of EMVI of rectal cancer.

Antimicrobial and disinfectant resistance of pathogens isolated from hospi-tal environmental inanimate surfaces and hands of health care workers / 中国感染控制杂志

Objective To investigate the types,antimicrobial resistance,and disinfectant resistance of pathogens isolated from hospital environmental inanimate surfaces and hands of health care workers (HCWs).Methods Pathogens isolated from hospital environmental inanimate surfaces and hands of HCWs in intensive care units and general wards in 16 hospitals in Beijing were performed bacterial identification,antimicrobial susceptibility testing,and disinfectant re-sistance testing. The carriage of antimicrobial resistance genes and disinfectant genes in pathogens were also detec-ted.Results A total of 979 specimens were collected from inanimate surfaces and hands of HCWs in 16 hospitals,75 (7.66% )pathogenic strains were isolated,78.67% of which were gram-negative bacilli. The top 3 pathogens were Pseud-omonasaeruginosa (P.aeruginosa,n= 24),Enterobactercloacae (E. cloacae,n= 14),and Klebsiella pneumoniae (K. pneumoniae,n= 4 ). One P. aeruginosa strain was resistant to aztreonam,gentamycin,tobramycin,ciprofloxacin,and levofloxacin;One E. cloacae strain was resistant to piperacillin,7 strains were resistant to nitrofurantoin;4 K. pneumoni-ae strains were all resistant to piperacillin,2 were resistant to cephalosporins,and 1 was resistant meropenem. P. aerugi-nosahad7drug-resistantgenes,positiverateofmirwas100.00% ;E.cloacaehad4drug-resistantgenes,positiveratesof tem 1and shv were both 100.00% ;K. pneumoniae had 5 drug-resistant genes,positive rates of shv and mir were both 100.00% . The resistant rates of P. aeruginosa and E. cloacae to chlorhexidine gluconate were 4.17% and 57.14% re-spectively,to trichloroisocyanuric acid were both 50.00% ,positive rates of drug-resistant genes (qacE△1-sul 1)were 79. 17% and 57.14% respectively;K. pneumoniae had no resistance to two kinds of disinfectant,dug-resistance gene was not found.Conclusion Multiple common pathogens which can cause healthcare-associated infection exist in hospital environ-mental inanimate surfaces and hands of HCWs,which are dominated by gram-negative bacilli,pathogens had resistance to antimicrobial agents and disinfectant in different degrees.

The strategy of diagnosis and treatment of endovascular graft exclusion in treating thoracic aortic dissection / 重庆医学

Objective To analyse the preoperative diagnose and treatment experience of applying endovascular graft exclusion (EVGE)curing thoracic aortic dissection(AD) ,thus provide experience of diagnose and treatment for cure AD in clinical .Methods Review the clinical data ,therapeutic measures and follow‐up results of 226 AD patients .All patients were treated by EVGE ,coun‐terchecked by DSA post‐operation and reviewed .Results CTA and MRA in the diagnosis of crevasse position coincidence rate was 96 .8% and 95 .2% respectively .One case failed ,the remaining 225 cases were successfully placed graft ,success rate was 99 .6% .It showed that 93 .8% (211/225) complete disappearance of the false lumen or remarkable decrease of the endoleak was noted on the angiograms after stent implantation .No severe procedure‐related complications and death was observed .Conclusion CTA and MRA are important for us to choose appropriate routes ,can be the first choice of pre‐operation examination .EVGE is small trauma , short recovery time and effective in curing AD .

MRI findings of chromophobe renal cell carcinoma and literature review / 实用放射学杂志

Objective To evaluate the diagnostic value and limitation of MRI for chromophobe renal cell carcinoma.Methods MRI features of 5 cases with pathology proved chromophobe renal cell carcinoma were analyzed retrospectively.Results All tumors showed homogenous isoin-tensity or slightly hypointensity on T1 weighted images and isointensity or slightly hyperintensity on T2 weighted images.Slightly hyperintensity were showed on DWI images,the mean ADC value of tumors was 1.42×10-3 mm2/s.On the contrast enhanced images,all the mass showed slight to moderate enhancement ,1 case had spoke-wheel-like enhancement,1 case showed flowed out blood vessels in the tumor.Conclusion The preoperative diagnosis is difficult for chromophobe renal cell carcinoma,MRI is a valuable method which could provide useful information for qualitative diagnosis.

Disinfection Situation in Medical Cosmetic Institutions:A Detection Survey / 中华医院感染学杂志

OBJECTIVE To provide evidence to establish properly protocol for medical cosmetic institutions.METHODS Through investigation to analyze the current situation and problems of disinfection and isolation in the medical cosmetic institutions.RESULTS There were 86.7% medical cosmetic institutions located in commercial buildings.And there were 33.3% institutions with improper layout of therapeutic room,sterilizing room and dressing room resulting from insufficient space or less rooms.The illumination intensity of the ultraviolet lamp and the disinfection effect of air were not coincident with standards.CONCLUSIONS There are many problems of disinfection and isolation in the medical cosmetic institutions,the disinfection is insufficient,the ultraviolet light is in wild-using,people only focus on using,but ignore irradiation dose and distance.It is very important for strictly observing Hospital Infection Management Methods,Disinfection Technology Standards and Disinfection Management Methods,and strengthening the management of disinfection and isolation in the medical cosmetic institutions.