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.

Objective To establish the animal model with stress ulcer(SU) and probe the relationship between the gastric mucosal injury and lasting stress time,the dynamic structural changes of pH of gastric juice.Methods Twenty-four SD young rats were randomly divided into 4 groups:control group,45 min(groupⅠ),90 min(groupⅡ),3 h(groupⅢ)groups under water immersion restraint stress(WRS).The change of gastric mucosal ulcer index(UI),pH of gastric juice were observed.Results Acute gastric mucosal damage was induced by WRS,with the WRS time prolonged,UI increased gradually and pH of gastric juice remarkably decreased in experimental rats.UI was positively rela-ted with stress time(r=0.957 P

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Background Diabetes is one of the risk factors that leads to corneal neuropathy.Silent signal regulatory factor 1 (Sirt1) plays an important role in glucose metabolism,lipid metabolism,regulation of insulin secretion and is closely related to the nervous system disease.The relationship between Sirt1 and diabetic corneal neuropathy is not fully understood.Objective This study was to detect the expression of Sirtl in cornea and trigeminal ganglion with type 1 diabetes model mice and explore the association of Sirt1 expression with diabetic corneal neuropathy.Methods Eight C57BL/6-Ins2Akita/J male mice and eight wild-type C57BL/6 male mice in the same litter were selected as type 1 diabetes model group and control group,respectively.The mice of two groups were sacrificed in overdose anesthesia method at 12-month old.Histological examination of cornea and trigeminal ganglion was performed using hematoxylin and eosin staining.Expression and localization of Sift1 protein in cornea and trigeminal ganglion were detected using immunohistochemistry.Western blot assay and fluorescine quantitative PCR were respectively used to quantitatively analyze the expression of Sirt1 protein and Sirt1 mRNA.Results Trigeminal ganglion cells were uneven in size and shape with the loosened cellular arrangement and disorder neurofibrosis alignment,and the corneal epithelial cells were less in the C57BL/6-Ins2Akita/J mice,but the trigeminal ganglion cells and corneal epithelial cells were normal in wild-type C57BL/6 mice.Immunochemisty exhibited that Sirtl protein was expressed mainly in corneal epithelium and the expression of Sirtl protein was stronger in the C57BL/6 mice than that in C57BL/6-Ins2Akita/J mice.Fluorescine quantitative PCR assay showed that the gray scale value of Sirt1 mRNA in cornea in C57BL/6-Ins2Akita/J mice was lower than that of the wild-type C57BL/6 mice(0.56±0.03 vs.0.98±0.13) with significant difference (t =5.853,P =0.010).Western blot showed that the expression of Sirt1 protein in cornea was lower in C57BL/6-Ins2Akita/J mice than that of the wild-type C57BL/6 mice(0.78±0.017 vs.1.300±0.012) with significant difference(t =33.140,P =0.001).However,no significant differences were seen in the gray scale value of Sirt1 mRNA(2.45±0.18 vs.2.51±0.22) (t=0.587,P=0.599) and protein level(1.100±0.015 vs.1.110±0.017) (t =0.430,P=0.709) in trigeminal ganglion tissues between C57BL/6-Ins2Akita/J mice and wide-type C57BL/6 mice.Conclusions The corneal nerve and structure is abnormal in 12-month-old C57BL/6-Ins2Akita/J mouse.Sirt1 is involved in the pathogenesis of diabetic keratoneuropathy,suggesting that it may be a potential target.

Objective To investigate the factors for retinopathy in premature infants. Methods Ophthalmologic mydri was conducted in premature infants and acording to the international classification of ROP, they were diagnosed as ROP. The risk factors of the incidence of ROP were statistically and respectively analyzed. Results Among total of 47 patients, 11 patients were found retinopathy of prematurity. Conclusion The body weight is lower, the gestation is shorter, incidence of ROP is the higher.

Objective:To provide the basic data for the further revision of mycoplasma test method described in Chinese Pharma-copoeia and some references for the operation standardization of drug mycoplasma test. Methods:Two incubation conditions,namely aerobic conditions and microaerophilic conditions,were compared with respect to the growth status of mycoplasma in liquid and solid media. Results:The growth of mycoplasma was obvious difference between the two incubation conditions,and the microaerophilic con-ditions were better than the aerobic conditions. Conclusion:The microaerophilic conditions can be used in the incubation of mycoplas-ma test,which should be defined and standardized in the future Chinese Pharmacopoeia.

Microbiological data deviations ( MDD) investigation differs from out of the standard ( OOS) investigation in chemical inspection items. Investigating Out-of-Specification( OOS) Test Results for Pharmaceutical Production issued by FDA specifically ex-cludes microbiological and other biological assays. Until recently, there is not a definitive guideline for MDD investigation in the world. Some institutions and experts have explored the practice and theory of MDD investigation. Referred to the existing practical experience and theoretical achievement and based on the provisions of Chinese GMP (2010 revision) and the requirements of Chinese Pharmaco-poeia Ⅱ(2010 edition) Appendix XIX Q, the article discussed the methods for MDD laboratory investigation.

Objective:To investigate the growth-promoting properties and applicability of the mycoplasma test culture media pre-scribed in Chinese pharmacopoeia, and provide reference for the standardization of the drug mycoplasma test method. Methods: Re-spectively using four quantitative detection methods including sensitivity, degree of color change, colony counts and colony diameter, and mycoplasma media widely used in the world as the reference media, the growth-promoting properties of 4 batches of mycoplasma broth and 4 batches of arginine mycoplasma broth from four domestic manufacturers were investigated. Results:The results of sensitivity assay and absorbance detection showed that all the media inoculated with below 100 CFU test microorganisms exhibited visible color change. Furthermore, the results of color change degree and colony diameter showed that there were significant differences among the media products from different manufacturers(P<0. 01). Conclusion:Mycoplasma broth and arginine mycoplasma broth both can sup-port the growth of below 100 CFU test microorganisms. Due to the difference in the growth-promoting properties among the media prod-ucts from different manufacturers, the drug mycoplasma test workers should use more sensitive methods to examine the applicability of the media.

Objective To establish a three- dimensional hindlimb gait data toolkit (THGT) for healthy and spinal cord injured (SCI) non-human primate (rhesus monkey) based on Matlab to realize upload of original data, automatic gait division, calculation and drawing of multiple gait parameters, etc. Methods Vicon system was used to collect three-dimensional hindlimb gait data of healthy and SCI (after 6 weeks) rhesus monkey to obtain the kinematics data of both hindlimbs in continuous strides. It was analyzed with THGT to process the gait division, calculation and drawing of multiple gait parameters. Results THGT read the data, distinguished cycles of gait, calculated 140 kinds of gait parameters and drew graphs of the results. Conclusion THGT extends the universality of the Vicon data, realizes automatically gait division and friendly interactive interface, and puts out the visible results.

ObjectiveTo study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). MethodsThe clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. ResultsThere were 136 female and 37 male patients in this study. The mean age at onset was(26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6％, 41.1％, 28.7％ of patients, respectively. The distribution of arterial involvement were 64.7％in aorta, 9.8％ in pulmonary artery, 19.1％ in innominate artery, 65.9％ in common carotid arteries, 65.3％in the subclavian artery, 36.2％ in the renal artery, 12.1％ in the vertebral artery, and 5.8％ in coeliac axis.Elevated erythrocyte sedimentation rate(ESR) was found in 61.0％ patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients(26.0％). Ten patients(5.8％) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients(94.2％) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. ConclusionCorticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.