Epilepsy is a common disorder of neurological system in children.Inborn errors of metabolism (IEMs) is one of an important etiology of epilepsy.Seizures may be the first and the major presenting feature of IEMs.IEMs are a relatively rare cause of epilepsy,but their recognition and diagnosis is very important because several disorders are treatable.This review will concentrate on diseases where epilepsy is the predominant clinical manifestation and especially where the disease course can be positively influenced by specific metabolic therapies.

?-Thalassemia is an inheritance anaemia disease due to the defect in?- globin gene. Gene therapy is considered to be the only method which could cure this disease. Adeno-associated virus type 2 (AAV2) has benn gaining more attention as a vector in human gene therapy for its non pathogenic character and broad host range. Although, the efficacy of recombinant AAV2 (rAAV2) in transducing human hematopoietic stem cells has been investigated by researchers, the results were varied from different laboratory. The view was proposed recently that it may be resulted from helper virus in their packaging system. Respecting this, the packaging system without helper virus was used to produce rAAV2. Human early fetal liver hematopoietic cells not only possess many superior peculiarity compared to hematopoietic cells of bone marrow or cord blood, but also the inherent?-globin gene in the cells is not expressed. Studies on the AAV2 transduction of human fetal liver hematopoietic cells and mediated expression of ?- globin gene in vivo were performed and the potential role of AAV2 in?-thalassemia gene therapy was analyzed. The rAAV2 containing a normal human?-globin gene (rAAV2-?-globin) without helper virus contamination were produced. The viral titer, purity and the ability of mediating expression of?-globin gene were detected in vitro. Then, human early fetal liver hematopoietic cells were isolated and were further transducted with the rAAV2-?-globin, followed by transplantation into sublethally irradiated BALB/C nude mice to analyze the?-globin gene expression. The results showed that the high titer and purity of rAAV2-?-globin had the ability of mediating ?-globin gene expression in vitro. In 8 recipient BALB/C nude mice, the ?-globin gene expression were detected in the 2 mice marrow by RT-PCR. The results suggested that rAAV2 could transduce human fetal liver hematopoietic cells and mediate the ?-globin gene expression in BALB/C nude mice, meanwhile the expression level of the gene was still rather low. It is necessary to perform further research on AAV2 biology before applying in ?-thalassemia gene therapy.

Objective To discuss the nursing for the different postoperative residual urine of patient with pelvic floor dysfunction.Method To evaluate the nursing for the postoperative residual urine of patient with pelvic floor dysfunction and the time of urinary catheters inserted,We completed a retrospective review of 138 adult patients.Results ①Toally 138 participants were categorized into 3 groups:74 (53.6％) patients carried a residual volume ＜ 100ml,53 (38.4％) patient did 100～300ml,11 (8.0％)did ＞300ml.②About11 patients who were able to void but carried a residual volume ＞300ml required indwelling catheterization.In these cases,100％ carried a residual volume ＜ 100ml after indwelling urinary catheter extraction (IUCE) after 4～5 days.③About 53 patients who were able to void but carried a residual volume between 100ml to 300ml received urine nursing,phychological nursing and bladder function exercise.Two days after IUCE 41 (77.4％) patients' residual volume was ＜100ml;three days after IUCE 11 (20.7％) patients' residul volume was ＜100ml;five days 1 patiens' residul volum was ＜100ml.Conclusion When a postvoid residual＞300ml,the patient should be performed catheterization,When a postvoid residual between 100ml to 300ml,the nurse should give the patient mental easing and teach them to perform pelvic floor muscle exercise.This can reduce the suffering of patients.

Objective:To analyze the status quo and problems of the health human resources of township health center.Methods:296 township health centers in 18 counties of 6 provinces were selected with typical sampling and workers in the centers as target population.Relative administrative officials and directors of township health centers were interviewed.Descriptive analysis and thematic analysis were conducted with quantitative data and qualitative da-ta.Results:The volume and distribution of human resources in township health centers are not balanced and the allo-cation standard of the middle area is low.The null establishment and the employees out of establishment coexist.The allocation of health human resources inside township health centers is not reasonable and the ratio of health profes-sionals is lower than national standard.The rate of senior professionals is low.That health workers are out of stock is a potential problem in some counties.Medical education is not matched with the demand of township health centers.The recruitment policy is inappropriate and the remuneration of health professionals is low.It is difficult for the worker in township health centers to get professional promotion.Recommendations:The structure of workers in township health centers and the recruitment policy should be adjusted.The path of professional promotion should be clear in order to ex-pand the space of career development of workers in township health centers.Improving the remuneration of workers in township health centers should be considered to increase the attractiveness of the post in township health centers.

Objective: To analyze the current status of village health worker practice and their remuneration in six provinces. Methods: After 18 counties (cities/districts) from 6 provinces are selected based on their levels of economic and social development, this paper uses self-designed questionnaires to survey all village clinics under the jurisdiction of these 18 counties. Results: The average numbers of village health workers range from 6. 79 to 19. 05 per 10,000 rural populations and 1. 36 to 3. 24 per village. In some provinces, more than 20% of the village health workers are 60 years old, and the educational level of more than 50% is technical secondary school and they have village health worker prac-ticing certificates only. The coverage ratio of medical malpractice liability insurance among village health workers in two western provinces is less than 11%. Except Jiangsu province, village health workers in the other five provinces have mainly joined the New Rural Pension Scheme ( NRPS) . Jiangsu province ranks the highest in subsidies for the services of public health and essential medicines per village health workers, and Fujian province ranked the lowest. Village health workers who are included in the administrative staffing management of township health centers account for less than 20%. Except Jiangsu province, more than 70% village health workers provide 24-hour service. The number of the outflow personnel is higher than the number of the inflow. Conclusions and Suggestions:The problem of village health worker aging is getting worse. Their education level, practicing quality and remuneration are low. This paper suggests the government not only improve the practicing quality and define the legal status of village health workers, but also in-crease the remuneration, incentives and job satisfaction of village health workers Further studies should be conducted in order to put forward a more practical advice about how to attract more health workers in rural areas.

Objective To explore psychological experience of nurses as the relatives of patients with malignant tumors in order to carry out mental care to malignant tumor patients as well as their family members. Method Nine nurses whose family members were malignant cancer patients were interviewed. Results As the relatives of malignant cancer patients, all the nine nurses presented with anxiety and fear. They were lack of ways to relieve negative emotions, desperate for more information and worried uncertainties about future and medical fees. Conclusion In order to offer better nursing experience, it is necessary for nurses to change ideas and improve recognition in order to establish a psychological supportive system for patients′ relatives in different phases and a social supportive system and fulfill their requirements for knowledge, which can thus help patients and their relatives out of the predicament.

Objective:To Compare the operational status of the New Rural Cooperative Medical Scheme( NCMS) in 14 Counties of 6 provinces. Methods:Two provinces were selected from eastern, central and western areas respec-tively and then two counties were chosen randomly from each province, but each of Jiangsu and Guangxi Provinces pro-vided 3 to reach the sample number of 14 counties. Excel 2007 was used for descriptive and comparative analysis of fund and in-patient service for NCMS. Results:The average funding standard was about 300 and 350 Yuan for 2012 and 2013. Hospitals outside county were frequently used and the ratio was over 40% in county I. Except Jiangsu and An-hui, the rate of enrollees who get compensation for inpatient service was over 10% and the actual compensation rate more than 50%, Fujian being an exception. Average hospitalization costs per time were different among counties and significantly rose in 2013. The ratio of out of pocket inpatient service expenses to the net rural household income was diverse among counties and it declines in some of them in 2013. The rate of fund for hospitals outside county was high and that of G counties was more than50%. The fund surplus rate was negative in that same year and was accumulatively ranging between 1 and 2%. Conclusions:The NCMS financing level was low and the personal financing responsibility was lighter;the enrollees didn’t contribute enough. In-patient service utilization structure was not rational in different level hospitals. The actual compensation rate for inpatient service didn’t increase a lot and the medical expenses burden didn’t alleviate apparently. The funds supervision was weak and it probably leaded to a high risk fund deficit.

β-Thalassemia is an inheritance anaemia disease due to the defect in β- globin gene. Gene therapy is considered to be the only method which could cure this disease. Adeno-associated virus type 2 (AAV2) has benn gaining more attention as a vector in human gene therapy for its non pathogenic character and broad host range. Although, the efficacy of recombinant AAV2 (rAAV2) in transducing human hematopoietic stem cells has been investigated by researchers, the results were varied from different laboratory. The view was proposed recently that it may be resulted from helper virus in their packaging system. Respecting this, the packaging system without helper virus was used to produce rAAV2. Human early fetal liver hematopoietic cells not only possess many superior peculiarity compared to hematopoietic cells of bone marrow or cord blood, but also the inherent β-globin gene in the cells is not expressed. Studies on the AAV2 transduction of human fetal liver hematopoietic cells and mediated expression of β- globin gene in vivo were performed and the potential role of AAV2 in β-thalassemia gene therapy was analyzed. The rAAV2 containing a normal human β-globin gene (rAAV2-β-globin) without helper virus contamination were produced. The viral titer, purity and the ability of mediating expression of β-globin gene were detected in vitro. Then, human early fetal liver hematopoietic cells were isolated and were further transducted with the rAAV2-β-globin, followed by transplantation into sublethally irradiated BALB/C nude mice to analyze the β-globin gene expression. The results showed that the high titer and purity of rAAV2-β-globin had the ability of mediating β-globin gene expression in vitro. In 8 recipient BALB/C nude mice, the β-globin gene expression were detected in the 2 mice marrow by RT-PCR. The results suggested that rAAV2 could transduce human fetal liver hematopoietic cells and mediate the β-globin gene expression in BALB/C nude mice, meanwhile the expression level of the gene was still rather low. It is necessary to perform further research on AAV2 biology before applying in β-thalassemia gene therapy.

Objective To systematic review the clinical efficacy and safety of infliximab in treatment of severe alcoholic hepatitis (SAH).Methods The electronic database of PubMed,EMbase,Web of Science,OVID and Cochrane systematic review database,CBM disc and CNKI from building the database until March 2013 were retrieved.With SAH,severe alcoholic hepatitis,infliximab and tumor necrosis factor as key words or free words.Randomized-controlled trials (RCT) on infliximab in treatment of SAH was selected and analyzed by Meta analysis.Results Two RCTs was enrolled,included 56 SAH patients.Infliximab (10 mg/kg) combined with glucocorticoids (40 mg/d) might accelerate death because of the high prevalence of serious infections.Infliximab (5 mg/kg) combined glucocorticoids (40 mg/d) had more tolerability and improved patient's Maddrey scores significantly.Conclusions Existing clinical evidence suggest that it is short of evidence for the clinical efficacy and safety of infliximab.It need guide by large sample of clinically and different doses RCT.

Objectives: The paper aims to analyze the practice and outcome for the rural doctors’ contracted service in Dafeng and Shengzhou counties. Methods:The methods used were typical sampling which played in selec-ting Dafeng and Shengzhou counties and interviews conducted with the director of the bureau of health in Dafeng and Shengzhou counties, the dean of the township health centers ( two for each county) and the rural doctors ( four for each county) . We adopted descriptive statistics to analyze the quantitative data and incentives. Results: The rural clinic and/or township health centers were the main contracted service providers and services were supplied to all in-habitants, especially to the target patients such as those suffering from NCDs. The individual benefit packages were designed to coordinate with local demands and the security and incentive mechanisms were established. Conclusions:Contracted service brought several benefits such as meeting the individual demands of inhabitants, rural doctors were inspired and the basic rural health system consolidated, the basic public health service quality was improved, and the function was intensified for the primary health institutions. The rural doctors’ contracted service is helpful to advance rural health care reforms, and provides more evidence in setting up the local rural health policies. It still needs fur-ther perfections. Suggestions:The rural doctors’ team construction should be strengthened and the incentive mecha-nism, summary and evaluation of their contracted service should be improved timely.