This article discusses the status quo of mental health,common legal and ethical problems in the diagnosis and treatment of psychological clinical practice,and also puts forward concrete contents and requests for strengthening the self- discipline and right- safeguard in the diagnosis and treatment in psychological clinical practice.

153 TMD patients were randomized to be treated by closed treatment of Kenalog(78 cases)and prednisolone(75 cases)respec-tively.Data were analyzed by SPSS 17.0.4-week-follow-up showed that Kenalog closed treatment was more effective than prednisolone(P<0.05).

Objective To investigate molecular typing and drug resistance patterns of 98 Klebsiella pneumoniae (K.pneumoniae) isolated from type 2 diabetes patients complicated with maxillofacial infection,to research the virulence and resistance mechanisms.Methods The study was a prospective study that adopted the method of continuous sampling from fixed location,from March 2010 to October 2012.The maxillofacial surgery patients diagnosed with type 2 diabetes complicated with maxillofacial infection were chosen in 7 hospitals in Zhengzhou as the research object,and a total of 431 pus sample were collected continuously,in which 98 strains K.pneumoniae were isolated and identified.The Kirby-Bauer disk diffusion test was conducted in 98 strains to determine the resistance to 19 antibacterial agents.K.pneumoniae chromosomal DNA were digested by restriction endonuclease Xba Ⅰ and analyzed by pulsed-field gel electrophoresis (PFGE).PFGE patterns of K.pneumoniae strains were analyzed using Fingerprinting software.The relationship between the molecular types and resistance phenotype was observed.The extended spectrum β-1actamase-producing K.pneumoniae were screened out by the double disc synergy test (DDST)Polymerase chain reaction (PCR) was used to detect resistant genotypes,serotype and virulence genes.The purified PCR products of resistant genes were cloned and sequenced.Hypermucoviscosity phenotype of all strains were determined by string test.Results Much severer drug-resistance for K.pneumoniae was identified and the result of extended-spectrum beta-lactamase producing rate was 57.1 ％.Ninety-eight strains were dispatched into 13 groups by PFGE.No dominant bands and specific extended-spectrum beta-lactamase DNA bands were found.The results of PCR showed that among the 56 strains of extended spectrum β-lactamase-producing K.pneumoniae,40 were positive for blaSHV (accounting for 71.4％),28 positive for blaTEM (accounting for 50.5％),21 positive for blaCTX-M (accounting tor 37.5％).The sequencing results were as follows:TEM-1,CTX-M-3 and a variety of SHV.Serotype K1,K2,K3,K5,K20,K54 and K57 and 3 kinds of virulence genes were detected,but not in strong toxicity-based.Hypermucoviscosity positive rate was 31.6％ (31/98).Conclusion Much severer drug resistance of K.pneumoniae in this study was identified and resistant mechanism was complex,in which strong toxicity serotype and virulence geues exist,which need more attention from clinical.

Objective To study the pathogenesis,diagnosis and treatment of the compression syndrome of the third common plantar digital nerves.Methods Conservative methods were at first used for all the 34 cases of this disease.Treatment methods includes:wearing shoes with soft bottom and metatarsal pad;the administration of Chinese herbs;the application of direct current iontherapy by filtering Chinese herbs and performing local injection therapy with steroid at the tenderness points.15 patients with no effect following conservative methods and other 3 recurrent cases were treated with section of deep transverse metatarsal ligament and relaxing the nerves compression.Of the 18 cases,5 had additional to excision of the neuroma.Results Of the 34 cases treated with conservative methods,19 had effective results,of which 6 cases recurred,and 15 cases had no effect.18 cases treated with operation had no recurrence.Conclusion Toe extending test and forefoot transversely compressing test provide a valuable basis for diagnosis.Conservative treatment are usually effective in earlier phase.If conservative treatment is not effective,the transverse metatarsal ligament should be sectioned,nerves should be relaxed and the neuroma must be excised.The results of operative treatment are satisfactory.

Objective To compare the concentration of 3-nitrotyrosine and tyrosine and the ratio of 3-nitrotyrosine/tyrosine in the cerebrospinal fluid (CSF) of patients with sporadic amyotrophic lateral sclerosis (SALS) and those with healthy nervous system for definiting the role of free radicals oxidative damage in pathogenesis of SALS. Methods Subjects consisted of 15 patients with SALS and 15 patients with norml nervous system who underwent lumbar anesthesia for surgery. Their CSF was analyzed by using high performance liquid chromatography (HPLC). Results The 3-nitrotyrosine concentration was higher in patients with SALS (228.52?124.30 nmol/L) than that in controls (112.86?47.10 nmol/L) (P

Objective To investigate the operative technique and efficacy of PPH for severe hemorrhoids. Methods The clinical data of 153 cases of severe hemorrhoids treated by PPH, individualized according to size and nature of the piles, concomitant morbidities and conditions at the dentate line, and analysis of the relevance between operative technique and clinical efficacy as well as postoperative complications, were revieuled retropectively. Results All of the prolapsed tissue retracted immediately. Bleeding at the anastomotic site occurred in 49 cases, pulsatile bleeding in 12 cases, all of which were sutured under direct vision with cessation of bleeding. The width of excised-tissue was 2.1~4.6cm(average 3.5cm). The main symptoms of patients on the 1st post-operation day were abdominal distention caused by dysuria, pain, and tenesmus and burning sensation. At followup of 1-40 months, there was no stenosis of stoma, anal incontinence or recurrence of prolapse. After operation, a very satistactory result was achieved in 87 cases, satisfactory in 63 cases and mostly satisfactory in 3 cases. Conclusions In order to achieve ideal results with good retraction of tissues, avoidance of complications and improve patient satisfactory rate, the use of PPH for severe hemorrhords must be individualized and technical skill during operation are important.

Objective To study the comprehensive hospital patients with psychological health department liaison consultation characteristics of the factors to cause delirium.Methods General hospital in 102 patients of psychological health department liaison consultation,this paper analyzed the factors which cause delirium.Results 102 cases(63 males and 39 females),the sex ratio was 1 :0.62;Men's and women's average age had no statistical difference(t =1.866,P =0.087 ).Age or age:70 ~ 79years,80 ~ 89 years of age to delirium patients were 39.26%,30.39% respectively.Delirium distribution respectively the main cause of the central nervous system disease,acute vascular disease,infection,disorder of digestion and absorption,anemia,endocrine metabolic disorders, acute metabolic disorders,trauma,surgery,spirit of active substances and non addictive drugs,etc.;Cause delirium in first place of the central nervous system disease,the etiology of acute vascular disease and infection of 29 cases respec-tively(28.43%),11 cases(10.78%),16 cases(15.69%).Additional surgery,spirit of active substances and non addictive drugs were 11 cases(10.78%),13 cases(12.75%),2 cases(1.96%).Many kinds of disease:102 patients with each with 1 ~7 kinds of diseases,the average (4.09 ±1.56)kinds.Share of drug species:102 patients in each oral 0 ~8 kinds of drugs,to average (5.86 ±1.52)kinds.Conclusion Comprehensive hospital patients with age or age group,the main factors to cause delirium etiology,patients with various diseases and share related species of drugs,disease complex,such as strengthening contact consultation for clinical sense.

[Summary] A total of 1 510 subjects undergoing physical examination in the Central Hospital of Xuzhou were included in this study. According to the level of TSH, the subjects were divided into low TSH group(0. 30-0. 99 mIU/L,n=351), moderate TSH group(1. 00-1. 89 mIU/L, n=703), and high TSH group(1. 90-4. 80 mIU/L, n=456). Analysis of variance and linear regression were used for data analysis. The results showed that systolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , triglyceride ( TG) , and high-density lipoprotein cholesterol( HDL-C) revealed significant differences among 3 group(P<0. 05 or P<0. 01). In the univariate linear regression model, serumTSHwithinthereferencerangewasnegativelyassociatedwithSBPandDBP(P<0.05orP<0.01),and positively associated with TG and HDL-C (P<0. 05 or P<0. 01). However, the correlations disappeared after adjustment for gender, age, body mass index, fasting plasma glucose ( FPG ) , and TG. In the multiple linear regression model, a significant negative correlation of TSH with SBP and FPG was found in males(P<0. 05).

Objective To investigate the effect of compound catechu anti-diarrhea ointment on the expression of aquaporin3 (AQP3) in the colonic tissues of diarrhea rat model, and the mechanism thereof. Methods Forty SD rats were randomly divided into four groups:blank control group, model control group, positive control group and compound catechu anti-diarrhea ointment group. Rats were given 6 g blank matrix cream in model control group, 2 mL suspension of berberine in positive control group and compound catechu anti-diarrhea ointment in compound catechu anti-diarrhea ointment group, two times/d for 7 d. The rat model of diarrhea was established by using senna intragastric administration. The water content of feces was measured. The expression of AQP3 in colonic tissues was detected by immunohistochemistry assay. Results The water contents of feces were significantly higher in model control group (64.09±0.41)%than those of other three groups (F=53.879,P＜0.05). There was no significant difference in the water content of feces between compound catechu anti-diar-rhea ointment group (48.83 ± 1.08)%and positive control group (46.87 ± 2.19)%. The AQP3-positive cells were mainly ex-pressed in the intestinal mucosa. The dyeing index was significantly lower in model control group (0.85±0.18) than that of other three groups (F=14.971,P＜0.05). There was no significant difference in the dyeing index between compound catechu anti-diarrhea ointment group (1.30±0.18) and positive control group (1.37±0.14). Conclusion Compound catechu anti-di-arrhea ointment can significantly reduce the water contents of feces, which may be related to the increased AQP 3 expression in colonic tissues.