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.

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 .

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.

Humans ; Liver Neoplasms ; metabolism ; pathology

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

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.

Adult ; Decompression, Surgical ; methods ; Endoscopy ; Humans ; Male ; Middle Aged ; Optic Nerve ; surgery ; Optic Nerve Injuries ; surgery ; Young Adult

Objectives To study the relationship of atypical membranous nephropathy (AMN) with idiopathic membranous nephropathy (IMN) and lupus membranous nephropathy (LMN), and to explore the predictive clinical and pathological features for LMN diagnosis. Methods The patients undergone renal biopsy in PUMCH between 2003 and 2006 were selected, and were divided into group AMN (n=28), IMN (n=100) and LMN (n=45). Clinical manifestations and pathological features were compared among three groups retrospectively. The intensity of glomerular IgG subclasses was analyzed by immunohistoehemical staining among three groups semi- quantitatively. The spatial arrangement of IgG and C3 deposits was investigated by immunofluorescenee double staining among three groups by eonfocal laser scanning microscopy. Results (1) The onset age of AMN was (38±17) years and female/male ratio(F/M) was 2.5:1 in group LMN and IMN. The onset age was significantly different among three groups (P<0.01), and F/M ratio was significantly different between AMN and IMN (P=0.017). (2) The incidence of most extra-renal manifestations was less than 20% in AMN except for hematological disorder (21.4%) and serum anti-SSA antibody positivity(40.7%). (3) The incidence of subendothelial electron densedeposits in either LMN or AMN was significantly higher than that in IMN (P<0.01). (4) The percentage of IgG3 predominance in AMN and LMN giomeruli was 78.9% and 73.9%, respectively, while the percentage of IgC,-4 predominance in IMN was 61.1%. The difference was significant(IMN vs AMN and LMN, P<0.01). (5) IMN had an overlapping distribution of IgG and C3 in subepithelial deposition, which was rarely found in AMN or LMN. (6) Among the indexes differentiating LMN and IMN, the high sensitive one was non-IgC,4 predominance in glomeruli (91.3%), while the high specific ones included subendothelial electron dense deposits (100.0%), serum anti-SSA antibody (95.5%), glomendar IgG3 predominance (94.4%). Conclusions AMN with serum ANA positivity is similar to LMN in respect to pathological features and glomerular IgG subclasses, although it has few extra-renal clinical manifestations. It may represent a latent subgroup of lupus nephritis.

Objective To investigate regional systolic function in left ventricle(LV) and postsystolic shortening(PSS) in patients with essential hypertension with different remodeling patterns of LV by strain and strain rate imaging. Methods According to the level of LV mass index and relative wall thickness, forty patients with hypertension were divided into LV normal geometry(LVN) group and LV remodeling(LVR) group, with thirty healthy subjects as control. The strain and strain rate were compared among the basal,middle and apex segments. Results Compared with control, systolic peak strain and strain rate in both groups of LVN and LVR were decreased significantly(P<0.05). Prevalence of PSS in LVR group (55%) was higher than that in LVN group(39%) and control(22%) with significant differences(P<0.01).Conclusions High prevalence of pathologic PSS in patients with hypertension could implied that unbalance of segmental motion in regional myocardial ischemia. However,presence of PSS in healthy subjects might be the result of synchronization and balance of normal myocardium under physical condition.