OBJECTIVE:To explore the effects of enteral nutrition powder in children with phenylketonuria(PKU)under one year. METHODS:120 PKU children under one year were selected and given enteral nutrition powder(20 g/kg,qd)for consecutive 32 weeks. The level of benzene,height,weight,head circumference,IQ level,nutrition indicators and ADR were compared be-fore treatment,8 weeks after treatment,32 weeks after treatment. RESULTS:8 and 32 weeks after treatment,the level of benzene decreased gradually,and height,weight and head circumference increased gradually,with statistical significance(P<0.05). IQ lev-el of children after 8 weeks treatment were better than before,and those of children after 32 weeks treatment were better than after 8 weeks treatment,with statistical significance(P<0.05). 8 and 32 weeks after treatment,nutrition indicators were improved sig-nificantly,compared with before treatment;ALT,Alb and TP levels 32 weeks after treatment were significantly better than 8 weeks after treatment,with statistical significance(P<0.05).There was no statistically significant difference in BUN,TBil and Pa levels between 32 weeks after treatment and 8 weeks after treatment(P>0.05). 66 cases suffered from 181 times of ADR,mainly including 10 times diarrhea and 126 times upper respiratory tract infection,among which one children developed moderate gastroen-teritis. They were all recovered after symptomatic treatment. CONCLUSIONS:For PKU children under one year,enteral nutrition powder can effectively control the phenylalanine levels,prevent the decrease of IQ and improve the nutritional status so as to meet the normal growth and development of children nutritional requirements,with better safety and tolerance.

Objective To study the hope level in patients with high-risk gestational trophoblastic neoplasm and to explore its related factors.Methods 83 cases of patients with high-risk gestational trophoblastic neoplasm were collected and investigated with Herth Hope Scale,Social Support Rating Scale (SSRS) and self-designed questionnaire.The results underwent analysis.Results The hope level of most patients underwent investigation was at the moderate level,among which the positive attitude for future and reality scored (10.80 ± 1.77),adopting positive action scored (10.30 ± 2.36),keeping close relationship with others scored (9.63 ± 2.13),the total scored (30.74 ± 4.82).The hope oevel was positively correlated with rigor personality (r=0.254),but negatively correlated with neuroticism (r=0.237),the difference was statistically significant.Conclusions The hope level of patients with high-risk gestational tropoblastic neoplasm is above the moderate level and is correlated with many factors.Doctors and nurses should evaluate carefully enough and take nursing measures to improve the hope level and life quality.

With acute lymphoblastic leukemia in skeletal muscle symptom,part of these patients may be misdiagnosed as juvenile idiopathic arthritis. How to distinguish these children has significance for the timely and proper treatment and good prognosis. This article from the history and routine laboratory examination and ima-ging examination put forward early in the disease through the analysis of joint symptoms from juvenile joint pain,blood and imaging characteristics and preliminary identification of childhood leukemia from juvenile idio-pathic arthritis in order to decrease the rate of misdiagnosis.

Juvenile idiopathic arthritis is a disease characterized by autoimmune disorders and immune imbalance. In recent years,immune tolerance has become a hot issue in the pathogenesis of juvenile idiopathic ar-thritis. In this article,cytotoxic T lymphocyte associated-antigen 4,programmed death-1,Treg cells and apoptotic cells in the pathogenesis of juvenile idiopathic arthritis are summarized.

Objective To explore the influence of allergic rhinitis (AR) on patients with systemic onset juvenile idiopathic arthritis (SoJIA).Methods The study involved 44 cases with SoJIA from Department of Pediatrics,Renji Hospital affiliated to School of Medicine of Shanghai Jiaotong University from July 2008 to November 2013.The Clinical and laboratory data of all patients were recorded respectively.This was a retrospective cohort study.According to the diagnosis of allergic rhinitis (AR),children were subdivided into AR group (16 cases) and Non-AR group (28 cases).ACR Pediatric criteria (ACR Pedi) 30/ 50/70 and related indicators of SoJIA between the two groups were compared.In the AR group,the correlation between AR scores and DAS28 was analyzed.When SoJIA of the two groups relapsed,the AR group (the treatment group) received anti-rheumatism for arthritis as well as nasal spray and oral antihistamines for AR.The non-AR group (control group) only received the anti-rheumatism for arthritis.The improvement of SoJIA between the two groups was analyzed.The continuous variables were analyzed by Student's t-test or the MannWhitney U-test as appropriate.Categorical data were compared between different groups by the Chi-square test.Correlations were determined by Pearson or Spearman's ranking.Results ① In the retrospective analysis:the physician's and patients'/parents' general assessment on a 10 cm visual-analogue scale (VAS),number of joints with res-triction of movement,number of swollen joints,ESR,serum ferritin(SF) and childhood health assessment questionnaire (CHAQ) score were significantly elevated in the AR group compared with Non-AR group at the disease onset [(6.7±1.0) cm vs (4.8±1.9) cm; (6.5±1.4) cm vs (3.2±1.5) cm; 4.1±2.7 vs 2.7± 1.7; 3.4±2.4 vs 1.4±1.5; (87±35) mm/1 h vs (61±40) mm/1 h; (888±1 043) μg/L vs (311±324) μg/L; 1.6±0.5 vs 0.7±0.3,respectively; all P＜0.05].At the 3 and 6 months follow-up after disease onset,the proportion of patients who reached ACR pedi 50,70 in AR group were lower than the Non-AR group,while the cumulative glucocorticoid dose was higher in the AR group than that of those without AR [at 3 months 38％ vs 71％; 13％ vs 46％; (76±35) mg/kg vs (43±36) mg/kg,respectively; at 6 months 25％ vs 71％; 19％ vs 64％; 127±57 vs 67±58,respectively,all P＜0.05]; In the AR group,at the disease onset,3 and 6 months follow-up after disease onset,the scores of AR was positively correlated with DAS28(r=0.741,0.703,0.680,respectively; all P＜0.05).② In the prospective study:when SoJIA was relapsed,systemic feature score,the physician's and patients' /parents' general assessment on a l0 cm VAS,number of joints with restriction of movement,number of swollen joints,ESR,SF and CHAQ score were significantly elevated in the treatment group compared with the control group [3.8±1.5 vs 2.1±1.1; (5.6±1.5) cm vs (4.5±1.6) cm; (4.6±1.9) cm vs (3.1±1.5)cm; 3.9±1.9 vs 2.5±1.4; 2.4±0.9 vs 1.5±1.2; 92±27 vs 53±37; 565(339,1 192) μg/L vs 171(85,284) μg/L; 13(0.8,1.6) vs 0.7(0.5,1); respectively; P＜0.05].The improvement rate of the physician's and patients'/parents' general assessment on a 10 cm VAS,number of swollen joints,number of joints with restriction of movement,ESR and CHAQ score at the follow-up 3 months were higher in treatment group than the control group [71(55,86)％ vs 46(0,75)％; 67(45,81)％ vs 28(-4,62)％; 92(77,96)％ vs 70(27,88)％; 65(48,81)％ vs 0(-17,67)％; 100(46,100)％ vs 42(0,100)％; 67(49,85)％ vs 37(0,75)％; P＜0.05].At the follow-up 6 months,the improvement rate of ESR,patients'/ parents' general assessment on a 10 cm VAS,number of joints with restriction of movement and CHAQ score were higher than control group [94(85,96)％ vs 73(33,85)％; 89(65,99)％ vs 63(5,85)％; 100(100,100)％ vs 100(0,100)％; 91(69,100)％ vs 72(11,91)％; respectively,P＜0.05].Conclusion AR may exert an adverse influence on SoJIA.SoJIA patients who are treated with combined with AR may have better outcome than those who are only treated for arthritis.

ObjectiveTo observe the clinical efficacy of acupuncture-moxibustion in treating tinnitus.MethodNinety-eight patients with tinnitus were divided into a warm-needling group (n=32), an acupuncture group (n=34), and a medication group (n=32), to observe thetherapeuticefficacies.ResultThe total effective rate was 83.3% in the warm-needling group, versus 78.8% in the acupuncture group and 60.0% in the medication group.ConclusionWarm needling and acupuncture plus TDP are both superior to the medication treatment in comparing the therapeutic efficacy.

Medical inorganic chemistry is one of the most important basic courses to bioinformatics specialty,according to the requirements of curriculum;the paper introduces a series of reform and practice in inorganic chemistry teaching content,teaching method and form.These stimulate the students'study interest,enhance educational effect,and let this curriculum serve professional curriculums.

Objective To explore the distribution of Acinetobacter baumannii and its drug resistance to 17 antimicro-bial agents to provide basis for clinical treatment.Methods The data of 689 strains of A.baumannii from Jan.2010 to Dec. 2012 were collected and reviewed for bacterial identification and drug sensitive test and then analyzed using WHONET 5.4. Results 689 strains of A.baumannii isolates were broadly distributed in sputum (75.5%), most primarily isolated from the ICU (36.9%).The antimicrobial susceptibility testing showed that the drug resistance rate of Ab was the highest to Bactrim (36.3%), followed by gentamicin (29.0%), and the lowest to cefperazone-sulbactam (8.0%).The drug resistance rate of Ab to cefperazone-sulbactam was the lowest (8.5%) in 2012.In the three years, the drug resistance rate of Ab to imipenem was the biggest rise (14.5%);while to gatifloxacin and levofloxacin declined.The drug resistance rate of Ab to gatifloxacin dropped by 13.1%, which was bigger than that to levofloxacin (9.5%).The drug resistance rates of Ab to the rest antimi-crobial agents fluctuated insignificantly, but were all in an increasing trend.Conclusion Acinetobacter baummannii mainly distribute in sputum of patients in the ICU and department of respiratory diseases, and its detection rate and drug resistance rate are increasing year by year.

Objective To analyze the prevalence and risk factors of the hyperuricemia ( HUA) in the adult population (aged≥20)in Shandong Province.Methods A cross-sectional survey was conducted among 11 234 subjects(8399 males and 2835 females)selected in a randomized, stratified study between January and December of 2012.The serum samples were collected and some biochemical indicators were assayed including serum uric acid (SUA), glucose, blood lipids, liver function and renal function .The body height , body mass and blood pressure were also measured , and the body mass index (BMI)was calculated.Multiple linear regression was used to clarify the contributions of different variables to SUA .The risk factors of HUA were analyzed using univariate and multivariate logistic regression analysis .Results The overall incidence of HUA was 15.71%,and was 18.89% in men and 6.31% in women, respectively.After age 35,the level of SUA declined with age in males.However,the opposite was true in women .Our results also indicated that drinking , obesity, hyper-triglyceridemia , hypertension , serum creatinine ( SCr ) , blood urea nitrogen ( BUN ) , alanine aminotransferase ( ALT ) , serum gamma-glutamyltransferase ( GGT ) were associated with HUA in men while hypertension , low-density lipoprotein, hyper-triglyceridemia,ALT,SCr and BUN were related to HUA in women .Conclusion HUA is prevalent in Shandong Province .Drinking,obesity,hypertension,abnormal liver and renal functions might increase the risk of HUA while changing lifestyle by decreasing alcohol consumption , adopting a proper diet and controlling hypertension and obesity might decrease the risk of HUA .