With the improvement of medical laws,the burden on doctors is getting heavier and heavier.Meanwhile,more and mor attention is being paid to the informed consent right of patients for the purpose of avoiding compensation for malpractive.Through analyzing the jurisprudential base of informed consent right,comparing the difference between informed consent right and“volenti non fit injuria”on law of tort,the article aims at exploring the relationship between informed consent right and doctor’s responsibility.

Objective To observe the effect of enhanced extracorporeal counterpulsation (EECP) on intraocular pressure (IOP). Methods 25 patients were measured their IOP bilaterally with Schoitz tonometer before and after EECP. Results The IOP decreased in both left and right eyes after EECP (P<0.01). Conclusion EECP can reduce intraocular pressure.

Objective To investigate the refraction status of low vision children aged 4~14 years old. Methods 228 children (376 eyes) with low vision aged 4~14 years old were recruited with retinoscopy optometry under ciliary muscles paralysis. Results 53% (72 eyes) of the preschool group had hyperopia, 41.2% (56 eyes) had myopia, and 6.0% (8 eyes) had mix astigmia. 40.0% (96 eyes) of the school-age group had hyperopia, 55.0% (132 eyes) had myopia, and 5.0% (12 eyes) had mix astigmia. The incidence of hyperopia was higher in the preschool group than in the school-age group (P<0.05). The majority of the refraction status in both groups were ranged in high level. After refraction correction and using visual aid device, 27.4% of the low vision children improved, and the number was higher in children who had better naked vision (P<0.01). Conclusion The refraction status of pre-school children with low vision is mainly hyperopia. For school-aged children, the refraction status shows a majority of myopia. The refraction errors of low vision children are mainly ranged in high level and partial low vision children improved after refraction correction

Objective To discuss the clinical effect of different scaffold in pulp vascular regeneration . Methods 22 young permanent teeth with periapical lesions were randomly divided into observation group and control group,11cases in each group .After the disinfection protocol was completed , the apexes of the control group were irritated to initiate bleeding to produce a blood clot to achieve pulp revascularization ,while the observation group used platelet rich plasma as physical scaffold to operate pulp revasculrization .Results In the control group , the two patients showed painful tooth at 1 and 8 months,the three patients showed healed periapical lesions and narrowed apical foramen at 12 and 18 months ,the six patients showed healed periapical lesions and closure of the apical fora -men at 12 and 18 months.In the observation group ,the three patients showed painful tooth at 1,3 and 8 months,the four patients showed healed periapical lesions and narrowed apical foramen at 12 and 18 months,the four patients showed healed periapical lesions and closure of the apical foramen at 12 and 18 months.There was no statistically significant difference between the observation group and control group by Fisher's exact probabilities (P=1.000). Conclusion Platelet rich plasma is potentially an ideal scaffold for pulp revascularization .

[Objective]This study was designed to investigate the genetic evolution of the neuraminidase(NA)gene of seasonal A/H1N1 and 2009 novel A/H1N1 inflilenza virus,and discuss the genetic variation of influenza A virus.[Methods]The virus strains were separately isolated from the clinical samples collected in 2006 and 2009,and then identified as seasonal A/H1N1 and novel A/H1N1.The full length of the NA gene of these strains was amplified by RT-PCR.Then the genetic evolution and mutations of important functional sites were analyzed.[Results]The homology of NA gene between the 2009 novel A/H1N1 isolates and 2006 seasonal A/H1N1 isolates was low(77.9%～78.8%),so was the homology of NA gene between the 2009 novel A/H1N1 isolates and representative strains of different periods and 1979-2001 WHO recommended vaccine strains(78.1%～79.3%).But compared with the WHO recommended vaccine strains of 2009 novel A/H1N1,the homology reached more than 99%.The genetic evolution analysis revealed that NA gene of 2009 novel A/H1N1 had the closest genetic relationship with the swine influenza A virus(A/swine/Belgium/1/1983)from Eurasian Iineage,and some of the antigenic sites and neuraminidase active sites of NA gene of seasonal A/H1N1 were mutated after 2005.[Conclusion]The NA gene of 2009 novel A/H1N1 may originate from Eurasian Iineage of swine influenza virus.The variation of NA gene of seasonal A/H1N1 has occurred in a certain degree.Hence,it is very necessary to continuously monitor the variant of influenza A virus.

To establish the experts consensus on the management of delirium in critically ill patients.A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group.Each statement was assessed based on the GRADE (Grading of Recommendations Assessment,Development,and Evaluation) principle.Then the Delphi method was adopted by 36 experts to reassess all the statements.(1) Delirium is not only a mental change,but also a clinical syndrome with multiple pathophysiological changes.(2) Delirium is a form of disturbance of consciousness and a manifestation of abnormal brain function.(3) Pain is a common cause of delirium in critically ill patients.Analgesia can reduce the occurrence and development of delirium.(4) Anxiety or depression are important factors for delirium in critically ill patients.(5) The correlation between sedative and analgesic drugs and delirium is uncertain.(6) Pay attention to the relationship between delirium and withdrawal reactions.(7) Pay attention to the relationship between delirium and drug dependence/ withdrawal reactions.(8) Sleep disruption can induce delirium.(9) We should be vigilant against potential risk factors for persistent or recurrent delirium.(10) Critically illness related delirium can affect the diagnosis and treatment of primary diseases,and can also be alleviated with the improvement of primary diseases.(11) Acute change of consciousness and attention deficit are necessary for delirium diagnosis.(12) The combined assessment of confusion assessment method for the intensive care unit and intensive care delirium screening checklist can improve the sensitivity of delirium,especially subclinical delirium.(13) Early identification and intervention of subclinical delirium can reduce its risk of clinical delirium.(14) Daily assessment is helpful for early detection of delirium.(15) Hopoactive delirium and mixed delirium are common and should be emphasized.(16) Delirium may be accompanied by changes in electroencephalogram.Bedside electroencephalogram monitoring should be used in the ICU if conditions warrant.(17) Pay attention to differential diagnosis of delirium and dementia/depression.(18) Pay attention to the role of rapid delirium screening method in delirium management.(19) Assessment of the severity of delirium is an essential part of the diagnosis of delirium.(20) The key to the management of delirium is etiological treatment.(21) Improving environmental factors and making patient comfort can help reduce delirium.(22) Early exercise can reduce the incidence of delirium and shorten the duration of delirium.(23) Communication with patients should be emphasized and strengthened.Family members participation can help reduce the incidence of delirium and promote the recovery of delirium.(24) Pay attention to the role of sleep management in the prevention and treatment of delirium.(25) Dexmedetomidine can shorten the duration of hyperactive delirium or prevent delirium.(26) When using antipsychotics to treat delirium,we should be alert to its effect on the heart rhythm.(27) Delirium management should pay attention to brain functional exercise.(28) Compared with non-critically illness related delirium,the relief of critically illness related delirium will not accomplished at one stroke.(29) Multiple management strategies such as ABCDEF,eCASH and ESCAPE are helpful to prevent and treat delirium and improve the prognosis of critically ill patients.(30) Shortening the duration of delirium can reduce the occurrence of long-term cognitive impairment.(31) Multidisciplinary cooperation and continuous quality improvement can improve delirium management.Consensus can promote delirium management in critically ill patients,optimize analgesia and sedation therapy,and even affect prognosis.