Pneumonia is the primary cause of death in children under five years of age.About 2 million children younger than 5 years die of pneumonia each year worldwide,accounting for 19％ of the total number of deaths.According to the survey in 2008,7％ ～ 13％ of the children with pneumonia are severe pneumonia.Severe pneumonia is a life-threatening disease which needs for intensive care.Cytokine IL-10 is a anti-inflammatory cytokine,and IL-18 is a proinflammatory cytokine,both of them are released by the inflammatory response,and can be involved in severe pneumonia immune-mediated.They are closely related to the occurrence,development and prognosis of severe pneumonia.

This article makes a contrastive analysis on the first category and second category of traditional Chinese medicine among Chinese Traditional Medicine and Materia Mediea Subject Headings (third edition), the TCMLS Metathesaurus and Chinese Library Classification (fifth edition), and points out the features and defects in these classifications, hoping to give some useful proposals to the construction of traditional Chinese medicine vocabulary.

The puberty and reproduction are regulated by the hypothalamic-pituitary-gonadal axis. The activation of hypothalamic gonadotropin-releasing hormone (GnRH) neurons and an increase in GnRH is critical for the initiation of puberty. The mechanism of GnRH regulation for neurons activity is complicated, because many different factors can affect the secretion of GnRH. Glutamate is the main excitatory neurotransmitter, which can promote the secretion of GnRH through a variety of pathways. In recent years, relevant studies showed that NELL2 may influence the secretion of GnRH by regulating the secretion of glutamate or through other pathways,thereby affecting the onset of puberty. So NELL2 plays an important role in promoting neuronal growth,differentiation, neuronal plasticity maintenance and synapse transportation etc.

Objective The aim of the study was to analyze the psychological problems and psychological needs of the odinopoeia patients with stillbirth or fetal malformation.Methods From May to August 2012,25 patients with stillbirth or fetal malformation were collected and 40 normal patients were selected as control in the targeted hospital,their psychological conditions were compared.The socio-demographics of patients were survey,the Symptom Check List 90(SCL-90) was applied to assess the two groups' psychological conditions,and Impact of Event Scale Revised (IES-R) was applied to assess the post traumatic stress disorder (PTSD),moreover,the associated factors with PTSD was also analyzed.Results The symptom factor scores of the cases were significantly higher in odinopoeia patients than the controls.The age,education levels,having or no offsprings and the support of spouse were greatly associated with PTSD of patients with stillbirth or fetal malformation.The patients with stillbirth or fetal malformation demanded to understand some prenatal care knowledge and the reasons for stillbirth or fetal malformation.Conclusions The patients with stillbirth or fetal malformation had low levels of psychological health,so the medical workers and family members must pay much attention to the psychological conditions of patients with stillbirth or fetal malformation,and provide them the psychological counseling in order to eliminate the patients' suffering from stillbirth or fetal malformation and improve their mental health.

Objective To study the clinical features and the clustering of risk factors in gestational diabetes mellitus (GDM),and analyze the risk factors.Methods Two hundred and three gravida were selected.According to the result of 75 g oral glucose tolerance test,they were divided into 2 groups:GDM group(134 cases) and normal glucose tolerance (NGT) group (69 cases).Blood sugar,blood fat and insulin were measured,and the homeostasis model of assessment for insulin resistance index (HOMA-IR),pancreatic islet beta cell function index (HOMA-β) and insulin sensitivity index (ISI) were calculated.The relation was analyzed between the risk factors and GDM.Results The age,progestation body mass index (BMI),fasting blood glucose,fasting insulin,total cholesterol,triglyeride,low density lipoprotein-eholesterol (LDL-C),HOMA-IR and the positive rate of diabetes mellitus family history in GDM group were significantly higher than those in NGT group [(30.8 ±4.1) years vs.(28.7 ±3.9) years,(24.29 ±3.65) kg/m2 vs.(21.35 ±2.39) kg/m2,(5.22 ±1.26) mmol/L vs.(4.33 ±0.53) mmol/L,(9.27 ±3.55) mU/L vs.(4.75 ±2.73) mU/L,(5.54 ± 1.26) mmol/L vs.(3.74 ± 1.07) mmol/L,(2.63 ± 1.43) mmol/L vs.(1.73 ± 0.76) mmol/L,(3.02 ± 0.97) mmol/L vs.(2.10 ± 0.75) mtmol/L,0.67 ± 0.47 vs.0.43 ± 0.34,40.3％ (54/134) vs.26.1％(18/69)],there were statistical differences (P＜ 0.01 or ＜ 0.05).The HOMA-β and ISI in GDM group were significantly lower than those in NGT group (4.62 ± 0.72 vs.5.57 ± 1.30 and-3.79 ± 0.47 vs.-2.91 ± 0.48),there were statistical differences (P ＜ 0.01).Logistic regression analysis result showed that fasting blood glucose (OR =6.016,95％ CI:1.603-22.585,P =0.008),total cholesterol (OR =2.823,95％ CI:1.568-5.083,P=0.001),diabetes mellitus family history (OR =2.780,95％ CI:1.168-6.617,P=0.021),fasting insulin(OR =1.954,95％ CI:1.371-2.785,P=0.001),progestation BMI(OR =1.787,95％ CI:1.124-2.839,P =0.014),age (OR =1.374,95％ CI:1.087-1.737,P =0.008) and diastolic pressure (OR =1.184,95％ CI:1.045-1.342,P =0.008) were the risk factors of GDM.Conclusions GDM has the clinical features of the clustering of risk factors and genetic susceptibility.The disorder of lipid metabolism and glycometabolism,genetic susceptibility and age are the main risk factors in the development of GDM.

The cerebral salt wasting syndrome and syndrome of inappropriate antidiuretic hormone secretion are frequent in hyponatremia in patients with intracranial disorders.There is a major problem about the incidence,diagnosis,and differentiation of cerebral salt wasting syndrome and syndrome of inappropriate secretion of antidiuretic hormone in patients with acute central nervous system disorders.Clinical presentation of cerebral salt wasting syndrome is similar to syndrome of inappropriate antidiuretic hormone secretion,but the therapy is different.So differential diagnosis is essential for appropriate management.This paper differentiate two kinds of diseases from the pathogenesis,diagnosis and treatment.

Fasciolopsis buski speciemens were collected, fixed with neutral formalin fixative solution, stained with alum-carmine staining solution, discolored with 2% kalium alum. The fixed and stained specimen shows clear internal structure with bright color, and can be stored for long time.

A lot of basic and clinical studies have proved that limb remote ischemic preconditioning (RIPre) is a safe and effective means reducing perioperative myocardial reperfusion injury .However ,RIPre possesses specific protec‐tive window .Therefore ,researchers used repeated limb RIPre to prolong the protective window in order to explore a new prevention and rehabilitation measure for cardiovascular diseases .

Objective To investigate the diagnostic value of procalcitonin(PCT) combined with C‐reactive protein (CRP) in the pulmonary infection in elderly patients .Methods 145 cases of inpatients in Affiliated Hospital of Luzhou Medical College from Mar .2013 to Mar .2014 were selected and divided into three groups [non‐infection group (43 cases) ,local infection group (68 ca‐ses) ,severe infection group (34 cases)] according to whether they have pulmonary bacterial infection and the severity of infection . Serum PCT level ,blood CRP level and white blood cell (WBC) counts were detected ,and the receiver operating characteristic curve (ROC curve) were evaluated .The diagnostic values of these inflammatory markers were compared .Results The serum PCT level in the serve infection group was significantly higher than those in the local infection group and non‐infection group (P<0 .05) ,area under the ROC curve (AUC) of PCT was 0 .960 ± 0 .033 ,CRP was 0 .717 ± 0 .084 ,WBC was 0 .582 ± 0 .094 ,respectively .When the threshold of PCT was 0 .2 μg/mL ,the diagnostic sensitivity was 95 .1% ,specificity was 88 .4% ,Youden index was 0 .835 ;when the threshold of CRP was 67 .72 mg/L ,the diagnostic sensitivity was 57 .8% ,specificity was 83 .7% ,Youden index was 0 .415 .The AUC of WBC had no diagnostic value .Conclusion PCT could be an ideal marker in diagnosis of bacterial pneumonia and assessing the severity of infection in elderly patients .PCT combined with CRP ,WBC could provide better auxiliary diagnosis of the pulmonary infection in elderly patients .

Objective To investigate the status of post traumatic growth and role reinforcement in elder patients with cerebral infarction accepting the treatment of rehabilitation, and to explore the effect of role reinforcement on post traumatic growth. Methods Totally 303 patients with cerebral infarction accepting the treatment of rehabilitation were investigated by the Post Traumatic Growth Rating Scale and the Role Reinforcement Scale. Results The post traumatic growth and role reinforcement scores of the patients were (61.50 ± 7.19), (63.51 ± 9.28) points. The scores of each dimension of post traumatic growth were significantly positively correlated with the role reinforcement (r =-0.794--0.123, P < 0.05 or 0.01). Stepwise regression analysis showed that the influence factors on the post traumatic growth of the patients were the cultural level, age and each dimension of role reinforcement (P < 0.05). Conclusions For the patients with cerebral infarction accepting the treatment of rehabilitation, the level of post traumatic growth is in a moderate level, and the role reinforcement is in a strong level, and role reinforcement is the influencing factor of post traumatic growth.