The Application of Electronic Informed Consent / 中国医学伦理学

The application of electronic informed consent has the advantages of speeding up the recruitment of subjects, helping the less educated to understand research and recruit groups, facilitating direct communication between subjects and researchers, minimizing human omissions and errors, and effectively improving the efficiency of clinical research. However, there are also some challenges, such as privacy, ethical censorship, hardware costs and so on. On the basis of the above discussion, this paper believed that electronic informed consent, as a new form, would provide a more powerful tool for clinical research in an era full of opportunities and challenges, with research value and potential.

Nonadiabatic Effect in Photodissociation Dynamics of Thiophenol via the 1ππ* State.

Nonadiabatic photodissociation dynamics of thiophenol (PhSH) and deuterated thiophenol (PhSD) via the 1ππ* state was investigated by a reduced three-dimensional (3D) quantum model based on the associated 3D diabatic potential energy surfaces constructed at the explicitly correlated multireference configuration interaction (MRCI-F12) level with the cc-pVTZ-F12 basis. The lifetimes of the low-lying vibronic S1 states for PhSH and PhSD were calculated using a low-storage filter diagonalization method and were in reasonably good agreement with the available experimental results. The nonadiabatic effect was further examined in the photodissociation process by comparing the results in diabatic and adiabatic models. It was found that the adiabatic lifetimes were about 2-4 times shorter than the exact ones in the diabatic model for both PhSH and PhSD. More importantly, the exact ground wave function including the geometric phase (GP) possessed a node along the C-C-S-H/C-C-S-D torsional coordinate, while the node was absent when GP was not included in the adiabatic model. The node structure of the wave function was a hallmark of GP, which sheds light on the nonadiabatic photodissociation dynamics facilitated by the conical intersections.

Investigation and Analysis of Current Situation of Human Research Ethical Management in Beijing Medical and Health Institutions / 中国医学伦理学

Through the questionnaire survey on the current situation of human research ethical management in Beijing medical and health institutions, this paper analyzed the problems existing in ethical management of Beijing medical and health institutions and put forward corresponding countermeasures and suggestions. The results showed that overall status of human research ethical management in Beijing medical and health institutions was satisfying. But the ethical management levels of different types of medical and health institutions were quite different, and medical and health institutions, health family planning administration departments and academic teams should all make corresponding contributions.

Three-Dimensional Diabatic Potential Energy Surfaces for the Photodissociation of Thiophenol.

New reduced three-dimensional (3D) diabatic potential energy surfaces (PESs) involving the 1ππ, 1ππ*, and 1πσ* states for the nonadiabatic photodissociation C6H5SH(S0) + hv → C6H5SH(1ππ*/1πσ*) → H + C6H5S•(A/X) were constructed at a high computational level, namely explicitly correlated multireference configuration interaction (MRCI-F12) method with the cc-pVTZ-F12 basis. The diabatization of the PESs was achieved by a simple, efficient, and reliable "regularized diabatization" method [Köppel, H.; Gronki, J.; Mahapatra, S. J. Chem. Phys. 2001, 115, 2377-2388]. The dissociation energy of the S0 state and the excitation energies of the excited S1 and S2 states were found to be in reasonably good agreement with the experimental values. The vibronic energy levels of the thiophenol (PhSH) and deuterated thiophenol (PhSD) for S0 and S1 states were calculated using a three-dimensional model, and they are in reasonably good agreement with the available experimental results, which validate the high accuracy of the adiabatic PESs and the reasonability of the diabatic couplings.

Monitoring neoadjuvant therapy responses in rectal cancer using multimodal nonlinear optical microscopy.

Most patients with rectal cancer have a better prognosis after receiving neoadjuvant therapy because of its remarkable curative effect. However, no device delivers real-time histopathologic information on treatment response to help clinicians tailor individual therapeutic strategies. We assessed the potential of multimodal nonlinear optical microscopy to monitor therapeutic responses, including tumoral and stromal responses. We found that two-photon excited fluorescence imaging can, without labeling, identify colloid response, inflammatory cell infiltration, vascular proliferation, and tumor regression. It can also directly detect rare residual tumor cells, which may be helpful for distinguishing tumor shrinkage from tumor fragmentation. In addition, second harmonic generation imaging shows the ability to monitor three types of fibrotic responses: mature, intermediate, and immature. We also determined nonlinear spectra, collagen density, and collagen orientation indexes to quantitatively analyze the histopathologic changes induced by neoadjuvant therapy in rectal cancer. Our work demonstrates that nonlinear optical microscopy has the potential to become a label-free, real-time, in vivo medical imaging technique and provides the groundwork for further exploration into the application of nonlinear optical microscopy in a clinical setting.

Correlation analysis of the clinical and sonographic characteristics of papillary thyroid microcarcinomas with its aggressiveness / 中华超声影像学杂志

Objective To compare the clinical and sonographic characteristics of aggressive and nonaggressive papillary thyroid microcarcinomas(PTMC)in order to improve the preoperative predictive value of aggressive PTMC.Methods A total of 309 patients with PTMC from January 2014 to December 2016 were included in this study.Patients with lymphatic metastasis,extrathyroidal invasion,reccurence, distant metastasis and death were classified into aggressive PTMC group,and patients without above characteristics were classified into nonaggressive group.Clinical and sonographic features were reviewed and compared between the two groups.Results Among the 309 patients,76 cases(24.6%)were aggressive PTMC,and 233 cases(75.4%)were nonaggressive.Patients were younger and larger cancerous nodules, microcalcification,capsular inconnection and multifocality were seen more frequently in aggressive PTMC group compared with nonaggressive group.The best cut-off value of age and diameter were 44.5 years and 0.66 cm respectively.Advanced age was the protective factor and larger tumor size and multifocality were independent risk factors for PTMC aggressiveness.The capsular invasion was related with the lateral cervical lymph node metastasis while other features were not.Conclusions Extra attention should be paid to patients with age<44.5 years,tumor size>0.66 cm and multifocal cancerous nodules because their PTMCs are more likely to be aggressive.Thyroid capsule adjacent to the cancerous nodule should be observed carefully.If there is interruption in the capsule,lateral cervical lymph nodes should be carefully examed.

Thoughts on Application of Evaluation Index System on Human Research Ethics Management in Beijing Medical Institutions / 中国医学伦理学

Objective:This thesis aims to construct the evaluation index system ethics management in Beijing medical institutions for application research.Method:The author applied the evaluation system which was agreed and adjusted by expert groups in four medical and health institutions.Result:After three rounds of expert groups have reached the agreement,the Evaluation Index System on Human Research Ethics Management in Beijing Medi-cal Institutions is established,which contains 6 first-class indicators,16 second-class indicators and 39 third-class indicators.The application on four medical and health institutions show that the evaluation index system is practical,operable and is of high degree of distinction.Conclusion:The evaluation index system is scientific,rea-sonable,practical and is of high degree of validity,credibility and distinction.

Multiphoton microscopy for tumor regression grading after neoadjuvant treatment for colorectal carcinoma.

AIM: To evaluate the feasibility of using multiphoton microscopy (MPM) to assess a tumor regression grading (TRG) system. METHODS: Fresh specimens from seven patients with colorectal carcinoma undergoing neoadjuvant radiochemotherapy at the Fujian Medical University Union Hospital were obtained immediately after proctectomy. Specimens were serially sectioned (10 µm thickness) and used for MPM or stained with hematoxylin and eosin for comparison. Sections were imaged by MPM using 810 nm excitation, and images were collected in two wavelength channels corresponding to second-harmonic generation (SHG) and two-photon excited fluorescence (TPEF) signals. The ratio of these signal intensities was used to distinguish fibrosis from normal mucosal and serosal tissues. RESULTS: TRG of specimens assessed by MPM were in complete agreement with histologic grading performed by a consulting pathologist. SHG and TPEF images clearly revealed collagen fibers and fragmented elastic fibers in the muscularis propria specimens following neoadjuvant radiochemotherapy. Additionally, blood vessel hyperplasia was observed as thickening and fibrosis of the intima and media, which was accompanied by minimal inflammatory cell infiltration. Furthermore, the SHG/TPEF ratio in stromal fibrosis (4.15 ± 0.58) was significantly higher than those in the normal submucosal (2.31 ± 0.52) and serosal (1.47 ± 0.10) tissues (P < 0.001 for both). Analysis of emission spectra from cancerous tumor cells revealed two peaks corresponding to nicotinamide adenine dinucleotide hydrogen and flavin adenine dinucleotide signals; the ratio of these values was 1.19 ± 0.02, which is close to a normal metabolic state. CONCLUSION: MPM can be used to perform real-time diagnosis of tumor response after neoadjuvant treatment, and can be applied to evaluate TRG.

Theoretical study of the state-to-state photodissociation dynamics of the vibrationally excited water molecule in the B band.

The state-to-state photodissociation dynamics for the vibrationally excited H2O in its second absorption band has been investigated on the recent three-dimensional potential energy surfaces based on a large number of high-level ab initio points. The photodissociassion dynamics from three fundamental vibrational states of H2O were explored from quantum dynamical calculations including the electronic X̃ and B̃ states on the basis of a Chebyshev real wave packet method. Because of the different shapes of various initial vibrational wave functions, the photoexcited wavepackets access different portions of the upper-state potential energy surface, which yields different absorption spectra, ro-vibrational distributions, and branching ratios. The bending excited vibrational state (0,1,0) generates two lobes with a shallow minimum on the absorption spectrum, a dominant vibrational inverted population OH(X̃, ν = 1) fragment at higher energy, and a nearly single rotational product propensity. The bond-stretching vibrational states (0,0,1) and (1,0,0) show a high OH(Ã)/OH(X̃) ratio at short photon wavelength, which indicates that dissociation proceeds mainly via the adiabatic channel.

The effect of ultrasound in the diagnosis and treatment of rheumatoid arthritis / 重庆医学

Objective To explore the effect of ultrasound in the diagnosis and treatment of rheumatoid arthritis .Methods though early diagnose of RA by ultrasound ,DAS28 and MRI′s result to measure the accuracy of ultrasound test .then though the ul‐trasound index at different time point in the treatment of RA patients ,we knew the changes of the joint ,and provide treatment plan and prognosis .Results ultrasound had high accuracy rate in the diagnoses of RA(P< 0 .05) ,and there were correlation among ul‐trasound diagnoses accuracy and DAS28 and MRI score(r= 0 .859 ,P< 0 .05) ;at the same time ,it provided accurate changes of the joint during the treatment ,and provided basis for treatment .Conclusion Ultrasound has manifest advantageous in diagnose RA .It could be used as a method in early diagnose RA and evaluate the effect on RA′s treatment .

State to state photodissociation dynamics of D2O in the B band.

State-to-state photodissociation dynamics of D2O in the B band has been investigated using the recently developed diabatic potential energy surfaces. Quantum dynamical calculations including the electronic X and B states were carried out using a Chebyshev real wave packet method. The nonadiabatic channel via the DOD conical intersection is facile, direct, and fast, which produces rotationally hot and vibrationally cold OD(X) product. On the other hand, the adiabatic channel on the excited state, leading to the OD(Ã) product, is dominated by long-lived resonances, which depend sensitively on the potential energy surface. The calculated absorption spectra, product state distributions, branching ratios, and angular distributions are in reasonably good agreement with the latest experimental results.

[Effects of laser-assisted cochleostomy on inner hair cell ribbon synapse in rats].

OBJECTIVE: To investigate the effects on ribbon synapse of inner hair cells after superpulsed CO2 laser-assisted cochleostomy in SD rats. METHODS: Eighteen SD rats were randomly divided into laser-assisted surgery groups (2 W group and 5 W group), sham-operated group and control group. Ten of those were performed a cochleostomy using superpulsed CO2 laser with a corresponding power. Auditory brainstem responses (ABR) were measured pre-and postoperatively. The ribbon synapses at apical and middle cochlear turns were observed under laser scanning confocal microscope and then were quantified with 3ds Max software. RESULTS: The postoperative ABR thresholds of the 2 W and 5 W groups were larger than the preoperative case (t = -5.65, P < 0.01; t = -4.97, P < 0.01). The synapse number at the middle turn decreased significantly in 5 W group (F = 17.15, P < 0.01), while no significant changes were noted at the apical turn (P > 0.05). There was no statistical difference in 2 W group (P > 0.05). CONCLUSIONS: The superpulsed CO2 laser-assisted cochleostomy with high-power is accompanied by a synaptic injury, while no obvious effects after the low-power laser surgery, which might be a safe strategy to preform cochleostomy.

Effects of laser-assisted cochleostomy on inner hair cell ribbon synapse in rats / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effects on ribbon synapse of inner hair cells after superpulsed CO2 laser-assisted cochleostomy in SD rats.</p><p><b>METHODS</b>Eighteen SD rats were randomly divided into laser-assisted surgery groups (2 W group and 5 W group), sham-operated group and control group. Ten of those were performed a cochleostomy using superpulsed CO2 laser with a corresponding power. Auditory brainstem responses (ABR) were measured pre-and postoperatively. The ribbon synapses at apical and middle cochlear turns were observed under laser scanning confocal microscope and then were quantified with 3ds Max software.</p><p><b>RESULTS</b>The postoperative ABR thresholds of the 2 W and 5 W groups were larger than the preoperative case (t = -5.65, P < 0.01; t = -4.97, P < 0.01). The synapse number at the middle turn decreased significantly in 5 W group (F = 17.15, P < 0.01), while no significant changes were noted at the apical turn (P > 0.05). There was no statistical difference in 2 W group (P > 0.05).</p><p><b>CONCLUSIONS</b>The superpulsed CO2 laser-assisted cochleostomy with high-power is accompanied by a synaptic injury, while no obvious effects after the low-power laser surgery, which might be a safe strategy to preform cochleostomy.</p>

[Nonlinear spectral imaging of DNA specimens derived from tumor cells based on second harmonic generation].

Second harmonic generation (SHG) is a second-order nonlinear optical process that has symmetry constraints confining signal to regions lacking a center of symmetry. Using SHG microscopy, a variety of tissue structures have noninvasively been imaged by virtue of intrinsic signal generated by structured proteins such as collagen fibrils in connective tissues or the actomyosin lattice of muscle cells. In biochemistry and structure biology, the high-level structures of DNA and protein macro-molecules are similar in constructing mechanism, although DNAs consist of deoxynucleotides and proteins of amino acid residues. The principal purpose of present work is to detect the SHG signal from different DNA samples by spectral imaging technology based on two-photon excited fluorescence (TPEF) and SHG. These DNA samples include the solution of genomic DNA and extracted nuclei, and cultured living cells. Results show that we can obtain the SHG signal from solution of genomic DNA and extracted nuclei in routine condition, but nothing from cultured cell nuclei. After adding a little of absolute ethanol (less than 5% by volume) in culture medium, the SHG signal is detectable in the interested region of nuclei. The findings suggest that the interaction between ethanol and DNA in living cell gives rise to the shift of molecular conformation, and this shift changes some nonlinear optical properties of DNA molecules.

Impact of "three-in-one" asthma education and management model on asthma control in adult patients / 中华内科杂志

Objective To evaluate the impact of the asthma education and management model developed by Peking University People's Hospital on the level of asthma control. Methods Trained respiratory physicians from 6 large teaching hospitals in the urban districts of Beijing conducted a successive questionnaire survey in the form of face-to-face interviews with adult asthma patients attending their respective clinics. The results were used to compare the levels of asthma control between patients who were administered "three-in-one" asthma education and management (education group) and those who were not(control group). Results Among the 100 patients in the education group, 85% showed asthma control test(ACT) values ≥20 points. This was significantly higher than that in the 427 control group patients (37%,χ2 =74.345 ,P <0.01 ). During the past 1 year, the rate of hospitalization due to exacerbation of asthma,number of emergency treatments, and missed working days were significantly lower in the education group than in the control group ( 4%, 18%, 20% vs 23%, 32%, 55%, respectively; χ2 = 19.431,7.515 and 17.853 respectively; and P < 0.01 for all). Conclusion The " three-in-one" asthma education and management model can significantly improve asthma control.