The physicians and nurses in the intensive care unit often discuss about withdrawing or withholding life-support therapy of critical ill patients with them or their family members.In this article,we expatiate on the importance,approach,agendas and medical ethical issues of the communication about end-of-life care between clinicians and families.

Post-operative recurrence and metastasis remain the leading causes of death for patients with gastric cancer. The major determinants of recurrence and metastasis are the biological characteristics of cancer cells and the immunological status of the patients. In recent years, due to the target-specificity, biotherapy has yielded efficacious responses in diverse clinical applications for cancer treatment, partially for the treatment of recurrence and metastasis of gastric cancer. However, because of the high diversities in clinical manifestations, patients' condition, and tumor's characteristics, there is no ideal strategy of biotherapy established for the prevention and treatment of recurrence and metastasis in gastric cancer. Therefore, a lot of work need to be done in basic research and clinical trial to make the biotherapy effective in treatment of gastric cancer recurrence.
Biological Therapy ; Humans ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Stomach Neoplasms ; pathology ; therapy ; Treatment Outcome

In pregnant women,positive rate of thyroid peroxidase antibody(TPOAb) is approximately 3%~10%.It is still controversial whether thyroid antibody positive rate is higher in women undergoing artificial assistant reproductive technologies.TAI might have a negative effect on pregnant outcome,which has been proved in different groups of women.Intravenous immunoglobulin,thyroxin replacement therapy and selenium therapy have been used for TAI intervention.More evidence is needed to demonstrate mechanism and evaluate effect for each therapy.

Objective To investigate the etiology and prognostic factors of acute kidney injury (AKI) in pediatric patients . Methods The clinical data of children patients with AKI in this hospital ,including the clinical features ,causes and outcomes ,were retrospectively analyzed .The relationship between the risk factors and prognosis was analyzed .Results Infants were dominated by the prerenal factors and the other age groups were dominated by the renal factors .The univariate analysis revealed that the AKI stage ,etiology ,mechanical ventilation ,sepsis/septic shock ,MODS ,acidosis ,creatinine initial value ,creatinine peak value and serum potassium were the factors affecting prognosis .The Logistic regression analysis showed that mechanical ventilation ,MODS and sep-sis/septic shock were the independent risk factors affecting prognosis .Conclusion The etiology of AKI in children is diverse and its distribution has the age characteristics .Mechanical ventilation ,MODS and sepsis/septic shock are the independent risk factors af-fecting prognosis .The early diagnosis and the active treatment conduces to improve prognosis .

Humans ; Liver Neoplasms ; metabolism ; pathology

Formation of malignant tumor originating from normal healthy cell is a multistep process including genetic and epigenetic lesions. Previous studies of cell line model systems displayed that early important epigenetic events happened in stepwise fashion prior to cell immortalization. Once these epigenetic alterations are integrated into chromatin, they will perform vertical propagation through cell subculture. Hence, status of epigenetics is dramatically important in maintaining of cell identity. Histone modification is another factor of epigenetic alterations during human oncogenesis. Histones, one of main components of chromatin, can be modified post-translationally. Histone tail modifications are regulated by corresponding modification enzymes. This review focuses on the description of relationship between the main sites of histone modification and oncogenesis.

Polymerase chain reaction (PCR) is one of the common techniques in molecular biology, which can amplify nucleic acids through the cycle of denaturation, annealing and extension. Based on the principle of common PCR, rapid PCR is to realize the amplification of nucleic acids in less time without affecting the specificity, sensitivity and fidelity of the reaction. A lot of research work in this field has been going on in recent years. This article will make a review of the development of rapid PCR with emphases on the improvement of DNA polymerase, the choice of additives and the improvement of thermocyclers.

According to the TCM theory, human growth, development and aging are closely related to kidney function and the main cause of human senility is deficiency of “kidney essence”. Recent studies showed that the “kidney” in TOM include the regulatory function of the neuroendocrine and immune systems.
In this paper, the effect of Guzhen Recipe (_??__??__??_), an aging retarding prescription composed of kidney tonifying herbs such as Radix Polygoni Multiflori (_??__??_), Herba Cistanchis (_??__??_) Rubus Chiagii (_??__??__??_) etc. on the hippocampus and HPAT axis in senile rats were observed. The results showed : (1) With age the number of glucocorticoid receptors (GCR) in the hippocampus, the concentrations of NE, DA, 5-HT in the hypothalamus were markedly decreased, while the plasma corticosterone concentration in senile rats was obviously increased. (2) The thymocyte GCR nuclear transition rate was increased significantly ; (3) The contents of cytoplasmic protein, nuclear RNA and DNA, the thymus weight/body weight ratio, the serum thymic factors as well asthe rate of lymphocyte transformation, the activity of IL-2 and NK cells in senile rats were obviously decreased compared to those of young control rats. Guzhen recipe however, was capable of improving these changes in the neuroendocrine-thymic net work in senile rats to varying degrees, suggesting that the kidney with Chinese Medicine might retard the functional degeneration of thymic endocrine partly by improving the feedback regulation of the hippocampal GCR and increasing the concentrations of NE and 5-HT of hypothalamus, thus decreasing the plasma corticosterone ; Simultaneously weakening the nuclear transition rate of thymocyte GCR, which in turn improving the immune function of the senile animal.
We concluded that Guzhen Recipe may retard the functional degeneration of both the hypo-thalamuspituitary-gornadal-thymic and hypothalamus-pituitary-thyroidal-thymic axis. All the above results revealed that retarding the aging effect using TCM in volves multiple-leves, multiple-systems and links. Using holistic regulation, imbalance links in aging process are modulated and the equilibrium of Yin and Yang are maintained. This is an important characteristic of the TCM to retard aging.
This research was supported by funds from National Natural Science Foundation of China No. 38970908.

BACKGROUND: Properties of cancellous bone is significant for metabolic diseases, fracture and joint retrograde diseases.OBJECTIVE: To study the biomechanical properties of cancellous bone.DESIGN: Experimental observation based on femur specimens as the single sample.SETTING: Laboratory of Orthopaedic Biomechanics Ninth Affiliated Hospital Shanghai Second Medical University.PARTICIPANTS: The study was completed in the Laboratory of Orthopaedic Biomechanics, Shanghai Ninth People's Hospital from May to July in 2001,totally 19 male cadaveric femoral heads were selected.METHODS: Totally 19 cadeveric cancellouce bone specimens(about 30years old) from the bearing area of fresh femur head were tested by compression test.MAIN OUTCOME MEASURES: Yield load limiting stress, limiting strain, energy value and elastic modulus of specimens.RESULTS: The compressive data of cancellous bone were measured, the average value of yield load was (410.64 ± 190.29) N , limiting stress was (8.69 ± 3.75) MPa, limiting strain was (10. 84 ±6.58)%, energy value was (2.54 ± 1.89)J, modulus of elasticity was (40.77 ± 32. 12)MPa, At the early time of loading, the cancellous bone showed elastic deformation, then CONCLUSION: The trial indicates that biomechanical properties lighten the pressure of external compression.

Objective To evaluate the targeted antimicrobial prophylaxis in men undergoing trans-rectal ultrasound guided prostate biopsy based on rectal swab culture results.Methods From July 2008 to April 2012 we studied differences in infectious complications in men who received targeted vs standard empirical ciprofloxacin prophylaxis before transrectal ultrasound guided prostate biopsy.All 344 patients were divided into 3 groups according to their hospital records,inculding group A:without antimicrobial prophylaxis(105 eases) ;group B:antimicrobial prophylaxis with fluoroquinolone(117 cases) ;group C:targeted prophylaxis used rectal swab cultures results(122eases).All cases received enema with diluted iodophors before biopsy.We identified men with infectious complications within 7 days after transrectal ultrasound guided prostate biopsy using the electronic medical record,following 3 conditions.Results In group A of 105 case,17 cases of fever were recorded,including prostatic abscess of 3 cases and septicemia of 1 case.Three cases of fever were occurred in group B,including 1 case of bacteremia and 1 case of prostatitis.No infectious complications were recorded in group C.Conclusions Targeted antimicrobial prophylaxis was associated with a notable decrease in the incidence of infections complications after transrectal ultrasound guided prostate biopsy,although fiuoroquinolone can provide good protective effets.