Analysis on Current Situation and Ethical Problems of Stem Cell Clinical Research in China / 中国医学伦理学

It is worth pondering how to seek advantages and avoid disadvantages in stem cell clinical research and give full play to the advantages of technology for the benefit of mankind. Through the analysis of the status of stem cell clinical research, including technology and related management methods, proposed the main problems existing in stem cell research, such as the risks of technological uncertainty, ambiguity between research and treatment, over-treatment and technological innovation. Then this paper discussed the ethical and legal risks of stem cell clinical research in China, mainly related to the problems that the construction of laws and regulations is lagging behind, the regulatory challenges of administrative departments are large, the ethical awareness of researchers needs to be further improved, the principle of fairness and justice is not taken into account, the research platform construction of medical institutions is not in place and the protection system of subjects is imperfect, and the organization construction and review capacity of the ethics committee is still lacking.

Mechanism of Shugan Huazheng Prescription Against Liver Fibrosis Based on HIF-1α/VEGF/TGF-β1 Pathway / 中国实验方剂学杂志

ObjectiveTo observe the therapeutic effect of Shugan Huazheng prescription on hepatic fibrosis model rats induced by carbon tetrachloride （CCl4） and explore whether it plays its role through hypoxia-induced factor-1α/vascular endothelial growth factor/transforming growth factor-β1 （HIF-1α/VEGF/TGF-β1） pathway. MethodA total of 54 male SPF SD rats were randomly divided into six groups： blank group， model group， colchicine group （0.2 mg·kg-1）， and high-， medium-， and low-dose groups （29.52， 14.76， and 7.38 g·kg-1） of Shugan Huazheng prescription， with nine rats in each group. The molding was conducted three times a week for eight weeks. Administration began the day after the first injection， and the drug intervention was once a day for eight weeks. On the day after the last administration， the rats were deprived of food and water， and they were killed the next day， during which the physiological status of each group of rats was dynamically monitored. The pathological changes in the liver were observed by hematoxylin-eosin （HE） staining， and the content of hydroxyproline （HYP） and angiotensin Ⅱ （AngⅡ） in liver tissue were detected by enzyme-related immunosorbent assay （ELISA）. Real-time fluorescent quantitative PCR （Real-time PCR） was used to determine the mRNA expression levels of HIF-1α， VEGF， and TGF-β1 in liver tissue， and immunohistochemical method （IHC） and Western blot were used to detect the protein expression levels of HIF-1α， VEGF， and TGF-β1 in liver tissue. ResultCompared with the blank group， the overall condition of rats in the model group decreased significantly. The proliferation of connective tissue and the increase in adipose cells between hepatocytes were obvious. The content of HYP and Ang was increased. The mRNA and protein expressions of HIF-1α， VEGF， and TGF-β1 were increased to varying degrees （P<0.05）. Compared with the model group， the proliferation of connective tissue and inflammatory cell infiltration in the liver tissue of colchicine and Shugan Huazheng prescription groups were reduced. The content of HYP and Ang was decreased. The mRNA and protein expression levels of HIF-1α， VEGF， and TGF-β1 were decreased， and the colchicine group and high-dose group of Shugan Huazheng prescription were the most significant （P<0.05）. ConclusionShugan Huazheng prescription has an obvious therapeutic effect on CCl4-induced hepatic fibrosis model rats. Its therapeutic mechanism may be related to the regulation of the HIF-1α/VEGF/TGF-β1 signaling pathway and the improvement of hepatic hypoxia， vascular remodeling， and the syndrome of Qi deficiency and blood stasis in hepatic fibrosis.

Multi-link Linkage Research on Medical Humanistic Education by Integrating Narrative Medical Materials / 中国医学伦理学

Taking the current situation and problems of medical humanities education as the background, the concept of narrative medicine was used to sort out and integrate various course materials of medical humanities, explore the multi-link linkage mode of medical humanities education, and organically integrate medical humanities courses scattered in medical education activities such as medical ethics, health law, doctor-patient communication, and health policy science with teaching stages, teaching resources, and teaching methods, forming vivid narrative medical materials throughout the entire process of medical humanities education, and improving teaching efficiency by sharing and optimizing resources. Through questionnaire analysis, it was found that there are many unsatisfactory aspects of medical humanities education. Further analysis of the issues focuses on the contradiction between learning willingness and time allocation, the lack of synchronization between teaching and social development, the lack of integration between courses, and insufficient innovation in teaching methods. Based on these, countermeasures were put forward to integrate narrative medical materials of medical humanities courses and build a platform for the application and communication of narrative medical materials.

Problems and Proposal of Ethical Review on Clinical Application of Medical Technology / 中国医学伦理学

With the change of medical technology from "access management" to "filing management" in China, it is necessary for medical institutions, as the main responsibility, to pass standardized ethical review and supervision. However, there are many problems at present, such as the absence of regulations and guidelines for ethical review of clinical application of medical technology, the lack law of medical technology ethical review standard operating procedures, the insufficient review capacity, the lack of standardization in the choice of ethical review methods, the elements of informed consent and its examination need to be discussed, the lack of appropriate continuing review mode, as well as the confirmation of technical team members and department qualifications is not clearly defined. In order to safeguard the safety and rights of patients, it is important to take the following measures, including carrying out the whole-process supervision of medical institutions, clarifying the supervision process, improving the multi-departmental communication and cooperation mechanism, establishing a management committee for clinical application of medical technology, standardizing the review system of the medical technology ethics committee, clarifying submit the list of materials for ethical review, implementing classified ethical review and supervision to improve efficiency, exploring the tracking review mode, ensuring the whole-process supervision, and carrying out popular and professional ethics training. In the review of ethics committee, more attention should be paid to the main points of review, such as technical scheme, informed consent, qualifications of technical team members and departments, management system, risk assessment and emergency plan, patient compensation and other materials. While ensuring the safety and rights of patients, it also helps to accelerate the healthy development of medical technology.

Clinical efficacy and complications of surgical resection combined with 131I therapy in elderly patients with differentiated thyroid cancer / 中华地方病学杂志

Objective:To study the clinical efficacy of surgical resection combined with iodine-131 ( 131I) therapy in elderly patients with differentiated thyroid cancer and its influence on complications. Methods:Totally 82 elderly patients with differentiated thyroid cancer who were admitted to Chengde Central Hospital from March 2019 to March 2021 were selected and divided into observation group (41 cases) and control group (41 cases) according to the random number table. The control group underwent total thyroidectomy + neck lymph node dissection, and the observation group was treated with 131I after the operation on the basis of the control group. The indicators in the two groups were evaluated (postoperative observation time cutoff was 3 months), including perioperative indexes, postoperative complications, Karnofsky (KPS) score, serum levels of lymphocyte activating gene-3 (LAG-3) and recombinant human Dick-kopfx related protein-1 (DKK-1) before and after treatment, and the efficacy. Results:There was no significant difference between the two groups in the amount of intraoperative bleeding and operation time ( P > 0.05); the hospitalization time in the observation group [(6.72 ± 1.39) d] was shorter than that in the control group [(8.78 ± 1.43) d, P < 0.001]. The incidence of complications in the observation group (31.71%, 13/41) was lower than that in the control group (53.66%, 22/41, P = 0.045). After treatment, KPS scores in the two groups were higher than those before treatment ( P < 0.001); after treatment, KPS score in the observation group was higher than that in the control group ( P < 0.001). After treatment, the serum LAG-3 levels in the two groups were higher than those before treatment, while DKK-1 levels were lower than those before treatment ( P < 0.001); after treatment, the serum LAG-3 level in the observation group was higher than that in the control group, while the DKK-1 level was lower than that in the control group ( P < 0.001). The total effective rate of the observation group (95.12%, 39/41) was higher than that of the control group (80.49%, 33/41, P = 0.043). Conclusion:The clinical efficacy of surgical resection combined with 131I therapy in elderly patients with differentiated thyroid cancer is good, and it can reduce postoperative complications, up-regulate the expression of LAG-3 and down-regulate the expression of DKK-1.

Advantages and Paths of Integrating School History Resources into Medical Ethics Education / 中国医学伦理学

In the new era, innovating medical ethics education and cultivating high-quality medical talents with noble medical ethics, excellent medical skills and both virtues and skills are important topics worthy of study. School history resources are rich in medical ethics ideological nutrients, containing the demonstration effect of medical ethics, strengthening the emotional cultivation of medical ethics, stimulating the establishment of medical ethics beliefs. Therefore, it is suggested that we should continue to tap school history resources, save the source of medical ethics education, organize school history resources and integrate them into the development of medical ethics education platform, and coordinate school history resources to promote the normal development of medical ethics education.

Ethics Struggle of Protection and Sharing in the Construction of Biobank / 中国医学伦理学

At present, the development of biobank in China is still at the initial stage, and there are many problems, such as lack of scientific management and sharing mechanism, insufficient application of transformation and weak sustainable development. Through constructing the ethical challenge of biobank, the author draw out the rights protection claims of biological sample sources, such as the informed consent of samples source and the privacy protection of samples management. In order to achieve the balance between the protection and sharing of biobank construction, we should improve the awareness of privacy protection, take effective means of privacy protection and fully consider and foresee ethical issues after rapid development of technology. Finally, it is pointed out that the principle of public welfare, the principle of fairness in the distribution of results and the predictive principle should be reflected in the transformation of results.

Analysis on the Training Path of Chinese Narrative Medicine / 中国医学伦理学

It has been more than a decade since Charon put forward the definition of narrative medicine.During this period,narrative medicine has developed to a certain extent in other countries and has made some achievements.However,it is still in the stage of conceptual discussion especially in China,and its potential has not been fully excavated.This paper aimed to analyze the current situation of narrative medicine,to compare the differences of domestic and overseas narrative medicine,and thus to explore its training path in China.This paper mainly discussed from the following aspects:enriching the teaching material of narrative medical,digging narrative methods from traditional culture,establishing the training system of narrative medicine,integrating narrative medicine curriculum resources,and so on.It laid a foundation for the construction of Chinese characteristic narrative medical training mode.

Discussion on Chinese Traditional Concepts of Health / 中国医学伦理学

Chinese traditional health concepts are rooted in traditional culture,absorb the essence of various health concepts from Confucianism,Buddhism,Daoism and other schools,and form the unique and rich connotation health concepts.These simple concepts of health are historical origin and precious wealth of modem health concepts.Through analyzing the health outlook in traditional books and quoting some thoughts about physical health,mental health,human and social harmony,and ethical health,this paper excavated the character and limitation of traditional health concepts,and explored the enlightenment to modern health ideas.

The Traditional Chinese Concept of Honesty and the Revelation to Medical Professional Personality Cultivation / 中国医学伦理学

Through the interpretation of traditional Honesty, this article is to understand the semantics of credibility andintegrity in traditional ethical culture, to analyze the relationship between the concept of honesty and medical skills, deriving goodness and endowing novelty, further to reveal the revelation for medical professional personality cultivation. Meanwhile, it points out that we should try our best to overcome the shortcomings of tradi-tional concept of honesty,clarify the connotation of honesty and find out the evidence of honesty culture in tradition-al Chinese ethics. This is the tracing and deepening of the connotation of honesty, as well as the highlighting of honesty as the content of medical professional personality. It is further beneficial to strengthen the pathway con-struction of medical profes.

Effects of Zhengan Xifeng Decoction on Blood Pressure and Gastrointestinal Motility in Spontaneously Hypertensive Rats / 中国中医药信息杂志

Objective To explore the influencing mechanism of Zhengan Xifeng Decoction on blood pressure and gastrointestinal motility in SHR. Methods After 15 WKY and 90 SHR rats were were randomly divided into normal control group, model group, Benner Pury group, amlodipine group, Zhengan Xifeng Decoction high, middle, and low dose groups. The normal control group and model group were fed with distilled water daily. Rats in treatment group were administered with corresponding drugs daily. Blood pressure, gastric residual and intestinal propulsive ratio of rats was detected after eight-week intervention. Results Compared with the blank control group, systolic pressure, diastolic pressure, and mean arterial pressure were significantly higher than WKY rats of same age (P<0.05). Compared with the model group, the systolic pressure, diastolic pressure, and mean arterial pressure of treatment groups were significantly reduced (P<0.05). Compared with the blank control group, gastric residual rate of rats in the model group significantly decreased (P<0.05). Compared with the model group, the gastric residual rate in Zhengan Xifeng high dose group increased significantly, and intestinal propulsive ratio significantly increased (P<0.05), without statistical significance in the other treatment groups. Conclusion Zhengan Xifeng Decoction can reduce blood pressure in SHR, and regulate gastrointestinal motility.

Analysis of Simple Bioethics in the Chinese Traditional Culture / 中国医学伦理学

This article started with the different views to death in Confucianism , Taoism, and Buddhism .And then explore the simple bioethics spirit in Chinese traditional culture , such as cherishing life , equal spirit , the spir-it of benevolence .Finally the research significance is summarized .In the bioethics development era background , researching naive ethics thought in the Chinese traditional culture has important significance to tamp multicultural foundation of bioethics , promote the development of bioethics in China , transform the ancient Chinese bioethics wisdom into the common wealth of mankind and perfectly handle ethical confusion in the development of biology and medicine.

CLINICAL OBSERVATION OF ELIMINATING EPILEPTIC DECOCTION COMBINED WITH ACUPUNCTURE TREATMENT OF 35 CHILDREN WITH EPILEPSY / 现代医院

Objective To observe the curative effect of eliminating epileptic decoction combined with acu-puncture treatment of epilepsy in children .Methods In our hospital in 2013 July to 2014 year in March 70 cases of epileptic children with occult , were randomly divided into two groups .Chinese medicine group of 35 cases were trea-ted with eliminating epileptic decoction combined with acupuncture treatment ;According to the epilepsy type , western medicine group of 35 cases were given appropriate antiepileptic drug treatment .The therapeutic effect was evaluated after 2 months.Results The total effective rate was 88.57%in traditional Chinese medicine group , and in western medicine group, the total effective rate was 74.29%(p0.05).In the Chinese medicine group after treatment, the normal rate of 51.43%, significantly higher than the control group (p0.05).The western medicine group arithmetic , understanding, similar score slightly lower but the difference was not significant (p>0.05);the back number rating decreased greatly , compared with those before treatment (p<0.05). Conclusion The elimination of epileptic decoction combined with acupuncture is an effective method for treatment of children with epilepsy , and had no significant effect on intelligence .The curative effect is better than western medi-cine treatment .

SPR-HPV detection of human cervical papillomavirus infection in clinical research / 国际生物医学工程杂志

Objective To study the status of surface plasmon resonance (SPR) detection of cervical human papillomavirus (HPV) infection in clinical practice.Methods 502 cases of cervical HPV in patients with cervical cell's genetic subtypes were diagnosed using SPR.Positive rates of HPV lesions of cervical levels detected by SPR and nucleic acid molecules rapid flow-through hybridization gene chip (HybriMax) technology were compared.Results Twenty-two kinds of subtypes were detected by SPR.106 women were found with single infection of HPV,including 47 women (44.34％) with abnormal cytological results,while 36 women were found with multiple infection of HPV,including 16 women (44.44％) with abnormal cytological results,and the difference was not significant (P＞0.05).Among 106 women with single infection of HPV,93 women were found with high risk HPV infection,including 45 women (48.39％) with abnormal cytological results,while 13 women were found with middle-low risk HPV infection,including 2 women (15.38％) with abnormal cytological results,and the difference was statistically significant (P＜0.005).Comparison of SPR and HybriMax technology showed that the two test results showed no significant difference (P＞0.05).Conclusions SPR for detection of HPV infection is more reliable,it can combine HybriMax as the primary means of clinical detection.

Establishment of an in vitro blood-brain harrier modal by coculturing brain microvascular endothelial cells and pericytes / 国际脑血管病杂志

Objective To establish a stable in vitro model of blood-brain barrier (BBB) simulating in vivo state using the primary-cultured rat brain microvascular endothelial cells (BMVECs) and pericytes.Methods The primary rat BMVECs and pericytes were isolated,purified and cultured.The isolated cells were identified by immunocytochemical staining method.An in vitro model of BBB was constructed using Transwell inserts (pore size 0.4 μm) coculture.Its barrier function was evaluated by the 4-hour leakage test,tight junction protein identification,transendothelial resistance detection,and permeability test.The difference between the cocultured model and simple BMVEC model across the membrane resistance values,and the permeability difference of the small molecule sodium fluorescein (Na-F) were compared.Results Confluent BMVEC monolayers demonstrated a typical cobblestone appearance and the pericytes displayed irregular shape and overlapping growth.Immunodouble labeling technique identification showed that the pericytes positively expressed α-srmooth muscle actin (α-SMA) and neuron-glial antigen 2 (NG2); after the fusion of cocultured model endothelial cells,the surface leakage test became positive; immnocytochemical staining shows that a continuous and dense tight junction formed between the endothelial cells; compared to the BMVEC model,the transendothelial electrical resistance of the cocultured model increased significantly (190.762 ± 10.326 Ω/cm2 vs.96.503 ± 8.012 Ω/cm2; t=- 24.489,P ＜0.01),and the permeability decreased significantly (56.149％ ± 3.572％ of the single endothelial model; t =19.330,P ＜ 0.01 ).Conclusions The primary isolated rat BMVECs and pericytes cocultured the morphology,structure and barrier function of in vitro model have the basic characteristics of BBB,and they have provided a useful tool for the research of BBB.

The effect of psychological intervention on level of hope and quality of life in the breast cancer patients / 中华行为医学与脑科学杂志

Objective To investigate the effect of psychological intervention on level of hope and quality of life in the breast cancer patients.Methods Ninety five breast cancer patients were randomized into intervention group and control group for an eight-week observation.Herth hope index(HHI)and Quality of life core questionnaire for European tumor patients(QLQ-C30)were used to observe the effect of psychological intervention on level of hope and quality of life in the breast cancer patients.Results Hope scores in total and in three subcategories were higher in intervention group((40.43±4.25),(13.28±1.61),(13.62±1.70),(13.53±1.52))than that in control group((37.82±4.49),(12.29±1.89),(12.90±1.67),(12.63±1.51))with statistically significant differences(P＜0.05).Scores for general quality of life,body function and role function were higher in intervention group((82.27±15.11),(75.89±12.24),(72.34±22.86))than that in control group((65.82±14.16),(68.30±16.42),(53.06±27.36))with statistically significant differences(P＜0.05).Scores for fatigue,pain,insomnia and loss of appetite were lower in intervention group((39.48±14.62),(25.18±16.98),(29.79±24.31),(18.44±21.77))than that in control group((49.43±17.58),(36.74±19.54),(46.26±28.72),(40.82±22.84))with statistically significant differences(P＜0.01).Conclusion-Psychological intervention could improve the level of hope and quality of life in the breast cancer patients.

Advances in research on allelopathy of ginseng and American ginseng / 中国中药杂志

Both ginseng and American ginseng can not be replanted on the same soil consecutively. The article reviews the development and progress of studies on the replant failure of ginseng and American ginseng with a special focus on allelopathy in recent years. The allelopathy effect in ginseng and American ginseng is reviewed from following aspects: collecting and extracting allelochemicals, effects of such allelochemicals on seeds germination, seedlings growth, antioxidant enzyme activities in ginseng roots, growth of ginseng pathogens and ginseng callus, and more. It is presumed that inhibitory allelopathy is one of the many possible factors contributing to the replant failure of ginseng and American ginseng. Based on that, the paper points out problems in current researches on the allelopathic effect of ginseng and American ginseng: the allelochemicals are consist of a mixture, which one plays the specific role is not clear; concentrating on a single allelochemical while ignoring the interaction among allelochemicals. It is suggested that further study for this area should be focused on the interactions among allelochemicals and interactions between allelochemicals and environmental impact factors. Another area of needed research is that of the migration and transformation of allelochemicals in soil and microbial involvement in allelopathy on the growth of ginseng and American ginseng.

Morphology and distribution of EpCAMhigh/CD44+ colorectal cancer stem cells / 中国组织工程研究

BACKGROUND: Cancer stem cells have bean a hot topic in life science research. EpCAMhigh/CD44+ colorectal cancer stem cells are beneficial to observe morphological characteristics and distribution of cancer stem cells.OBJECTIVE: To investigate the quantity, location, distribution and hematoxylin-easin staining morphologic features of colorectal cancer stem cells (Co-CSCs).DESIGN, "rIME AND SETrlNG: The observational study was performed at the Department of Pathology, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA from March to August 2008.MATERIALS: A total of 67 colorectal cancer paraffin embedding samples were collected from 200512007 archive at the Department of Pathology, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA, comprising 27 males and 40 females, aged 29 90 years.METHODS: EpCAM and CD44 was used to label cancer stem cells in paraffin embedding colorectal cancer samples. The locations of EpCAM and CD44 double positive cells were detected by SP(streptavidin HRP) immunohistochemical staining and double immunohistochemical staining. The morphologic features of them were investigated on hematoxylin-easin staining at the same position.MAIN OUTCOME MEASURES: Number, location, distribution of EpCAM and CD44-posltive cells, and morphology following hematoxylin-eosin staining.RESULTS: The number of double-positive cells accounted for 0.1% to 30.0% of all tumor cells, and the cells were scattered or distributed focally along the basement of glandular-like structure. The cells with scarcely cytoplasm were cube or oval, and its nucleus was oval or high cylindrical, deep stained and homogeneous; The quantity of double-positive cells were negatively correlated with the differentiation of colorectal cancer.CONCLUSION: Cancer stem cells are the causes of tumor development, metastasis and recurrence and drug resistance. To observe the number, location, distribution and morphology of Co-CSCs and to analyze the relationship between Co-CSCs and pathological parameters will provide guidance for the diagnosis, staging, prognostic evaluation and clinical prognosis of cotorectal carcinoma.

Research progress in colorectal cancer stem cells / 中国组织工程研究

BACKGROUND: Colorectal cancer is a common malignant tumor in digestive tract. Theory of tumor stem cells (TSCs) offers a new approach to understand the development mechanism of colorectal cancer. OBJECTIVE: To review the progress in the existence, origin and identification of colorectal cancer stem cells (Co-CSCs). RETRIEVAL STRATEGY: Pubmed was undertaken to identify relevant articles published from January 1990 to July 2007 with the of "colorectal cancer,stem cell,tumor stem cells" in English.At the same time, Vip database was undertaken to identify the relevant articles published between January 1990 and July 2007 with the key words of "colorectal cancer, stem cell, tumor stem cells" in Chinese. The data were selected primarily, and then quotations of each article were checked. Inclusive criterion: the articles related to the advances of the existence, origin and identification of Co-CSCs were selected. Exclusive criterion: the articles with repetitive research were excluded. Totally 63 relevant articles were selected and 33 of them met the inclusive criterion. The 30 excluded articles were of old or repetitive content. LITERATURE EVALUATION: Of the 33 inclusive articles, 28 were on the existence and origin of Co-CSCs, 4 were about the isolation and identification of Co-CSCs, and 1 was about the problems and prospect. DATA SYNTHESIS: TSCs is a rare population of cells in tumor tissues with infinitely proliferative and self-renewal potential that drive the formation and growth of tumors. It may become a new target to eradicate malignant tumor. TSCs have been discovered in leukemia and some solid tumors. Intestine stem cells are poorly differentiated. Its phenotype is difficult to identify. There are many reports on the quantity, location, origin, function and relation with intestinal disease. Co-CSCs have been isolated and identified as EpCAMhigh/CD44+ cells recently, which accelerate to understand the mechanism of colorectal cancer. CONCLUSION: The discovery of Co-CSCs is one of the advances in researching of malignant tumor. TSCs may become a new target to eradicate malignant tumor, and brings hope to cure it.

The Combination of Morality Education and Filial Piety Culture——An Ethical Reflection on Medical Students' Filial Piety Practice during Vacations / 中国医学伦理学

Medical students' practice of filial piety during vacations can help to combine the morality education and filial piety culture for medical students,which is of ethical significance.Firstly,the ethical meanings of filial piety are discussed from three aspects,including "filial piety" and "gratitude",ethical choice of filial piety,and the modern value of filial piety culture.Secondly,ethical reflection on medical students' filial piety education is raised and discussed from three aspects including medical students' well-liking growth and development,cultivating medical ethics and expanding new ways of morality education for medical students.